Being a Nursing Aide; Student Manual.

ERIC Educational Resources Information Center

American Hospital Association, Chicago, IL.

Developed for students receiving on-the-job training as nursing aides, this illustrated manual contains these chapters: (1) Orientation, (2) Introduction to the Patient, (3) Your Working Environment, (4) The Patient's Unit: Making the Unoccupied Bed, (5) Lifting, Moving, and Transporting Patients: Making the Occupied Bed, (6) Personal Care of the…

Effect of a national 4C antibiotic stewardship intervention on the clinical and molecular epidemiology of Clostridium difficile infections in a region of Scotland: a non-linear time-series analysis.

PubMed

Lawes, Timothy; Lopez-Lozano, José-María; Nebot, Cesar A; Macartney, Gillian; Subbarao-Sharma, Rashmi; Wares, Karen D; Sinclair, Carolyn; Gould, Ian M

2017-02-01

Whereas many antibiotics increase risk of Clostridium difficile infection through dysbiosis, epidemic C difficile ribotypes characterised by multidrug resistance might depend on antibiotic selection pressures arising from population use of specific drugs. We examined the effect of a national antibiotic stewardship intervention limiting the use of 4C antibiotics (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) and other infection prevention and control strategies on the clinical and molecular epidemiology of C difficile infections in northeast Scotland. We did a non-linear time-series analysis and quasi-experimental study to explore ecological determinants of clinical burdens from C difficile infections and ribotype distributions in a health board serving 11% of the Scottish population. Study populations were adults (aged ≥16 years) registered with primary carer providers in the community (mean 455 508 inhabitants) or admitted to tertiary level, district general, or geriatric hospitals (mean 33 049 total admissions per month). A mixed persuasive-restrictive 4C antibiotic stewardship intervention was initiated in all populations on May 1, 2009. Other population-specific interventions considered included limiting indications for macrolide prescriptions, introduction of alcohol-based hand sanitiser, a national hand-hygiene campaign, national auditing and inspections of hospital environment cleanliness, and reminders to reduce inappropriate use of proton-pump inhibitors. The total effect of interventions was defined as the difference between observations and projected scenarios without intervention. Primary outcomes were prevalence density of C difficile infection per 1000 occupied bed-days in hospitals or per 100 000 inhabitant-days in the community. Between Jan 1, 1997, and Dec 31, 2012, we identified 4885 cases of hospital-onset C difficile infection among 1 289 929 admissions to study hospitals, and a further 1625 cases of community-onset C difficile infection among 455 508 adults registered in primary care. Use of 4C antibiotics was reduced by 50% in both hospitals (mean reduction 193 defined daily doses per 1000 occupied bed-days, 95% CI 45-328, p=0·008) and the community (1·85 defined daily doses per 1000 inhabitant-days, 95% CI 0·23-3·48, p=0·025) during antibiotic stewardship. Falling 4C use predicted rapid declines in multidrug-resistant ribotypes R001 and R027. Hospital-onset C difficile infection prevalence densities were associated with fluoroquinolone, third-generation cephalosporin, macrolides, and carbapenem use, exceeding hospital population specific total use thresholds. Community-onset C difficile infection prevalence density was predicted by recent hospital C difficile infection rates, introduction of mandatory surveillance in individuals older than 65 years, and primary-case use of fluoroquinolones and clindamycin exceeding total use thresholds. Compared with predictions without intervention, C difficile infection prevalence density fell by 68% (mean reduction 1·01 per 1000 occupied bed-days, 0·27-1·76, p=0·008) in hospitals and 45% (0·083, 0·045-0·121 cases per 100 000 inhabitant-days, p<0·0001) in the community, during antibiotic stewardship. We identified no significant effects from other interventions. Limiting population use of 4C antibiotics reduced selective pressures favouring multidrug-resistant epidemic ribotypes and was associated with substantial declines in total C difficile infections in northeast Scotland. Efforts to control C difficile through antibiotic stewardship should account for ribotype distributions and non-linear effects. NHS Grampian Microbiology Endowment Fund. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hospital output forecasts and the cost of empty hospital beds.

PubMed Central

Pauly, M V; Wilson, P

1986-01-01

This article investigates the cost incurred when hospitals have different levels of beds to treat a given number of patients. The cost of hospital care is affected by both the forecasted level of admissions and the actual number of admissions. When the relationship between forecasted and actual admissions is held constant, it is found that an empty hospital bed at a typical hospital in Michigan has a relatively low cost, about 13 percent or less of the cost of an occupied bed. However, empty beds in large hospitals do add significantly to cost. If hospital beds are closed, whether by closing beds at hospitals which remain in business or by closing entire hospitals, cost savings are estimated to be small. PMID:3759473

Health-systems efficiency in the Russian Federation: tuberculosis control.

PubMed Central

Floyd, Katherine; Hutubessy, Raymond; Samyshkin, Yevgeniy; Korobitsyn, Alexei; Fedorin, Ivan; Volchenkov, Gregory; Kazeonny, Boris; Coker, Richard; Drobniewski, Francis; Jakubowiak, Wieslaw; Shilova, Margarita; Atun, Rifat A.

2006-01-01

OBJECTIVE: To conduct a comprehensive assessment of the case-mix of patients admitted to tuberculosis hospitals and the reasons for their admission in four Russian regions: Ivanovo, Orel, Samara and Vladimir. We also sought to quantify the extent to which efficiency could be improved by reducing hospitalization rates and re-profiling hospital beds available in the tuberculosis-control system. METHODS: We used a standard questionnaire to determine how beds were being used and who was using the beds in tuberculosis facilities in four Russian regions. Data were collected to determine how 4306 tuberculosis beds were utilized as well as on the socioeconomic and demographic indicators, clinical parameters and reasons for hospitalization for 3352 patients. FINDINGS: Of the 3352 patients surveyed about 70% were male; the average age was 40; and rates of unemployment, disability and alcohol misuse were high. About one-third of beds were occupied by smear-positive or culture-positive tuberculosis patients; 20% were occupied by tuberculosis patients who were smear-negative and/or culture-negative; 20% were occupied by patients who no longer had tuberculosis; and 20% were unoccupied. If clinical and public health admission criteria were applied then < 50% of admissions would be justified and < 50% of the current number of beds would be required. Up to 85% of admissions and beds were deemed to be necessary when social problems and poor access to outpatient care were considered along with clinical and public health admission criteria. CONCLUSION: Much of the Russian Federation's large tuberculosis hospital infrastructure is unnecessary when clinical and public health criteria are used, but the large hospital infrastructure within the tuberculosis-control system has an important social support function. Improving the efficiency of the system will require the reform of health-system norms and regulations as they relate to resource allocation and clinical care and implementation of lower-cost approaches to case management for patients with social problems. Additionally, closer attention will need to be paid to the management of staff numbers in the tuberculosis system. PMID:16501714

Effects of Various Interventions, Including Mass Trapping with Passive Pitfall Traps, on Low-Level Bed Bug Populations in Apartments.

PubMed

Cooper, Richard; Wang, Changlu; Singh, Narinderpal

2016-04-01

Two experiments were conducted to evaluate the effects of various interventions on low-level bed bug, Cimex lectularius L., populations in occupied apartments. The first experiment was conducted in occupied apartments under three intervention conditions: never treated (Group I), recently treated with no further treatment (Group II), and recently treated with continued treatment (Group III). Each apartment was monitored with pitfall-style traps (interceptors) installed at beds and upholstered furniture (sleeping and resting areas) along with ∼18 additional interceptors throughout the apartment. The traps were inspected every 2 wk. After 22 wk, bed bugs had been eliminated (zero trap catch for eight consecutive weeks and none detected in visual inspections) in 96, 87, and 100% of the apartments in Groups I, II, and III, respectively. The second experiment investigated the impact of interceptors as a control measure in apartments with low-level infestations. In the treatment group, interceptors were continuously installed at and away from sleeping and resting areas and were inspected every 2 wk for 16 wk. In the control group, interceptors were placed in a similar fashion as the treatment group but were only placed during 6–8 and 14–16 wk to obtain bed bug counts. Bed bug counts were significantly lower at 8 wk in the treatment group than in the control group. At 16 wk, bed bugs were eliminated in 50% of the apartments in the treatment group. The implications of our results in the development of bed bug management strategies and monitoring protocols are discussed.

Changes in mortality for extremely low birth weight infants in the 1990s: implications for treatment decisions and resource use.

PubMed

Meadow, William; Lee, Grace; Lin, Kathy; Lantos, John

2004-05-01

Much has changed in neonatal intensive care unit (NICU) care over the past decade. High-frequency oscillation, inhaled nitric oxide, and antenatal corticosteroids are now widely available. We wondered how these medical advances had affected both the epidemiology and ethics of life and death for extremely low birth weight (ELBW) infants in the NICU. We identified 1142 ELBW infants (birth weight [BW] < 1000 g) consecutively admitted to our NICU between 1991 and 2001. We abstracted BW, gestational age, survival or death, and length of stay in the NICU. Statistical analyses were performed by using linear regression and 2-way analysis of variance. Both increasing BW and later year were significantly associated with improved survival. However, for larger ELBW infants, survival was approximately 90% for the entire decade, and large-scale improvement was hardly possible. For smaller infants, greater improvements were both possible and observed, at least early in the decade. From 1991 to 1997, overall ELBW survival increased steadily (approximately 4% per year). However, from 1997 to 2001, there was no significant improvement in survival for ELBW infants. There was no change in the distribution of deaths accounted for by BW subgroups within the ELBW population from 1991 to 2001. Median length of stay for infants who eventually expired before discharge rose from 2 days in 1991 to 10 days in 2001. As a consequence, during the past decade, the percentage of infants whose outcome was "undeclared" by day of life 4 rose from 10% to 20% for ELBW infants overall and to 33% for infants with BWs of 450 to 700 g. The percentage of ELBW NICU bed-days occupied by nonsurvivors remained very low (approximately 7%) from 1991 to 2001. 1) Fewer infants in all ELBW subgroups are dying, compared with a decade ago, and the improvement has been most prominent for BWs of 450 to 700 g, at which mortality was and remains to be greatest. 2) This progress seems to have slowed, or even stopped, by the end of the decade. 3) Although most NICU nonsurvivors still expire early, doomed infants are lingering longer. 4) Nonsurvivors continue to occupy a constant (and extremely small) fraction of NICU bed-days.

Behavioural responses of females of two anopheline mosquito species to human-occupied, insecticide-treated and untreated bed nets

PubMed Central

2014-01-01

Background Insecticide-treated bed nets (ITNs), used extensively to reduce human exposure to malaria, work through physical and chemical means to block or deter host-seeking mosquitoes. Despite the importance of ITNs, very little is known about how host-seeking mosquitoes behave around occupied bed nets. As a result, evidence-based evaluations of the effects of physical damage on bed net effectiveness are not possible and there is a dearth of knowledge on which to base ITN design. Methods The dispersion of colony-raised female Anopheles gambiae and Anopheles albimanus was observed in 2-hr laboratory experiments in which up to 200 mosquitoes were released inside a mosquito-proof 3 m × 3 m tent housing a bed net arrayed with 18 30 cm × 30 cm sticky screen squares on the sides, ends and roof. Numbers of mosquitoes caught on the sticky squares were interpreted as the ‘mosquito pressure’ on that part of the net. Results Presence of a human subject in the bed net significantly increased total mosquito pressure on the net for both species and significantly re-oriented An. gambiae to the roof of the net. Anopheles albimanus pressure was greatest on the bed net roof in both host-present and no-host conditions. The effects of different human subjects in the bed net, of different ambient conditions (dry, cool conditions vs warm, humid conditions) and of bed net treatment (deltamethrin-treated or no insecticide) on mosquito pressure patterns were tested for both species. Species-specific pressure patterns did not vary greatly as a result of any of these factors though some differences were noted that may be due the size of the different human subjects. Conclusions As a result of the interaction between host-seeking responses and the convective plume from the net occupant, species-specific mosquito pressure patterns manifest more or less predictably on the bed net. This has implications for bed net design and suggests that current methods of assessing damaged bed nets, which do not take damage location into account, should be modified. PMID:25080389

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation

PubMed Central

2012-01-01

Purpose A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a “real-lifeâ application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. Key messages (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. Conclusion (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care. PMID:22506504

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.

PubMed

Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar

2012-01-01

A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.

Acute medical bed usage by nursing home residents.

PubMed

Beringer, T R; Flanagan, P

1999-05-01

An increasing number of elderly patients in nursing home care appears to be presenting to hospital for acute medical admission. A survey of acute hospital care was undertaken to establish accurately the number and character of such admissions. A total of 1300 acute medical beds was surveyed in Northern Ireland in June 1996 and January 1997 on a single day using a standardised proforma. Demographic details, diagnosis and length of admission were recorded. A total of 84 patients over the age of 65 (mean 79.5 years) admitted from nursing home care was identified in June 1996 and a total of 125 (mean 83.3 years) in January 1997. A total of 88 (70%) of admissions in 1997 were accompanied by a general practitioner's letter. The assessing doctor judged that 12 (9.6%) of admissions in 1997 could have had investigations and or treatment reasonably instituted in a nursing home. The proportion of acute medical beds occupied by nursing home residents was 6% in June 1996 rising to 10% in January 1997. The study accurately identifies the significant contribution of nursing home patients to acute medical admissions and the low proportion in whom admission was unnecessary. Closure of long stay hospital facilities should be accompanied by investment in community medical services and also reinvestment in acute hospital care for elderly people.

Creation of inpatient capacity during a major hospital relocation: lessons for disaster planning.

PubMed

Jen, Howard C; Shew, Stephen B; Atkinson, James B; Rosenthal, J Thomas; Hiatt, Jonathan R

2009-09-01

To identify tools to aid the creation of disaster surge capacity using a model of planned inpatient census reduction prior to relocation of a university hospital. Prospective analysis of hospital operations for 1-week periods beginning 2 weeks (baseline) and 1 week (transition) prior to move day; analysis of regional hospital and emergency department capacity. Large metropolitan university teaching hospital. Hospital census figures and patient outcomes. Census was reduced by 36% from 537 at baseline to 345 on move day, a rate of 18 patients/d (P < .005). Census reduction was greater for surgical services than nonsurgical services (46% vs 30%; P = .02). Daily volume of elective operations also decreased significantly, while the number of emergency operations was unchanged. Hospital admissions were decreased by 42%, and the adjusted discharges per occupied bed were increased by 8% (both P < .05). Inpatient mortality was not affected. Regional capacity to absorb new patients was limited. During a period in which southern California population grew by 8.5%, acute care beds fell by 3.3%, while Los Angeles County emergency departments experienced a 13% diversion rate due to overcrowding. Local or regional disasters of any size can overwhelm the system's ability to respond. Our strategy produced a surge capacity of 36% without interruption of emergency department and trauma services but required 3 to 4 days for implementation, making it applicable to disasters and mass casualty events with longer lead times. These principles may aid in disaster preparedness and planning.

What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed.

PubMed

Wiggermann, Neal; Smith, Kathryn; Kumpar, Dee

A bed that is too small to allow patients to turn from supine to side lying increases the difficulty of mobilizing patients, which can increase risk of musculoskeletal injury to caregivers, increase risk of pressure injuries to patients, and reduce patient comfort. Currently, no guidance is available for what patient sizes are accommodated by the standard 91cm (36 in.)-wide hospital bed, and no studies have evaluated the relationship between anthropometric attributes and space required to turn in bed. The purpose of this research was to determine how much space individuals occupy when turning from supine to side lying as predicted by their anthropometry (i.e., body dimensions) to establish guidance on selecting the appropriate bed size. Forty-seven adult participants (24 female) with body mass index (BMI) from 20 to 76 kg/m participated in a laboratory study. Body dimensions were measured, and the envelope of space required to turn was determined using motion capture. Linear regressions estimated the relationship between anthropometric attributes and space occupied when turning. BMI was strongly correlated (R = .88) with the space required to turn. Based on the linear regressions, individuals with BMI up to 35 kg/m could turn left and right within 91 cm and individuals with BMI up to 45 kg/m could turn one direction within 91 cm. BMI is a good predictor of the space required to turn from supine to lateral. Nurses should consider placing patients that are unable to laterally reposition themselves on a wider bed when BMI is greater than 35 kg/m and should consider placing all patients greater than 45 kg/m on a wider bed regardless of mobility. Hospital administrators can use historical demographic information about the BMI of their patient populations to plan facility-level equipment procurement for equipment that accommodates their patients.

Tiny is mighty: seagrass beds have a large role in the export of organic material in the tropical coastal zone.

PubMed

Gillis, Lucy G; Ziegler, Alan D; van Oevelen, Dick; Cathalot, Cecile; Herman, Peter M J; Wolters, Jan W; Bouma, Tjeerd J

2014-01-01

Ecosystems in the tropical coastal zone exchange particulate organic matter (POM) with adjacent systems, but differences in this function among ecosystems remain poorly quantified. Seagrass beds are often a relatively small section of this coastal zone, but have a potentially much larger ecological influence than suggested by their surface area. Using stable isotopes as tracers of oceanic, terrestrial, mangrove and seagrass sources, we investigated the origin of particulate organic matter in nine mangrove bays around the island of Phuket (Thailand). We used a linear mixing model based on bulk organic carbon, total nitrogen and δ13C and δ15N and found that oceanic sources dominated suspended particulate organic matter samples along the mangrove-seagrass-ocean gradient. Sediment trap samples showed contributions from four sources oceanic, mangrove forest/terrestrial and seagrass beds where oceanic had the strongest contribution and seagrass beds the smallest. Based on ecosystem area, however, the contribution of suspended particulate organic matter derived from seagrass beds was disproportionally high, relative to the entire area occupied by mangrove forests, the catchment area (terrestrial) and seagrass beds. The contribution from mangrove forests was approximately equal to their surface area, whereas terrestrial contributions to suspended organic matter under contributed compared to their relative catchment area. Interestingly, mangrove forest contribution at 0 m on the transects showed a positive relationship with the exposed frontal width of the mangrove, indicating that mangrove forest exposure to hydrodynamic energy may be a controlling factor in mangrove outwelling. However we found no relationship between seagrass bed contribution and any physical factors, which we measured. Our results indicate that although seagrass beds occupy a relatively small area of the coastal zone, their role in the export of organic matter is disproportional and should be considered in coastal management especially with respect to their importance as a nutrient source for other ecosystems and organisms.

What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed

PubMed Central

Wiggermann, Neal; Smith, Kathryn; Kumpar, Dee

2017-01-01

Background A bed that is too small to allow patients to turn from supine to side lying increases the difficulty of mobilizing patients, which can increase risk of musculoskeletal injury to caregivers, increase risk of pressure injuries to patients, and reduce patient comfort. Currently, no guidance is available for what patient sizes are accommodated by the standard 91cm (36 in.)-wide hospital bed, and no studies have evaluated the relationship between anthropometric attributes and space required to turn in bed. Objective The purpose of this research was to determine how much space individuals occupy when turning from supine to side lying as predicted by their anthropometry (i.e., body dimensions) to establish guidance on selecting the appropriate bed size. Methods Forty-seven adult participants (24 female) with body mass index (BMI) from 20 to 76 kg/m2 participated in a laboratory study. Body dimensions were measured, and the envelope of space required to turn was determined using motion capture. Linear regressions estimated the relationship between anthropometric attributes and space occupied when turning. Results BMI was strongly correlated (R2 = .88) with the space required to turn. Based on the linear regressions, individuals with BMI up to 35 kg/m2 could turn left and right within 91 cm and individuals with BMI up to 45 kg/m2 could turn one direction within 91 cm. Discussion BMI is a good predictor of the space required to turn from supine to lateral. Nurses should consider placing patients that are unable to laterally reposition themselves on a wider bed when BMI is greater than 35 kg/m2 and should consider placing all patients greater than 45 kg/m2 on a wider bed regardless of mobility. Hospital administrators can use historical demographic information about the BMI of their patient populations to plan facility-level equipment procurement for equipment that accommodates their patients. PMID:28968285

Stranded: causes and effects of discharge delays involving non-acute in-patients requiring maintenance care in a tertiary hospital general medicine service.

PubMed

Salonga-Reyes, Armi; Scott, Ian A

2017-03-01

Objectives The aims of the present study were to identify causes of prolonged discharge delays among non-acute in-patients admitted to a tertiary general medicine service, quantify occupied bed days (OBDs) and propose strategies for eliminating avoidable delays. Methods A retrospective study was performed of patients admitted between 1 January 2012 and 31 May 2015 and discharged as non-acute cases requiring maintenance care and who incurred a total non-acute length of stay (LOS) >7 days and total hospital LOS >14 days. Long-stay patients with non-acute LOS ≥28 days were subject to chart review in ascertaining serial causes of discharge delay and their attributable OBDs. Literature reviews and staff feedback identified potential strategies for minimising delays. Results Of the 406 patients included in the present study, 131 incurred long-stays; for these 131 patients, delays were identified that accounted for 5420 of 6033 (90%) non-acute OBDs. Lack of available residential care beds was most frequent, accounting for 44% of OBDs. Waits for outcomes of guardianship applications accounted for 13%, whereas guardian appointments, Public Trustee applications and funding decisions for equipment or care packages each consumed between 4% and 5% of OBDs. Family and/or carer refusal of care accounted for 7%. Waits for aged care assessment team (ACAT) assessments, social worker reports, geriatrician or psychiatrist reviews and confirmation of enduring power of attorney each accounted for between 1% and 3% of OBDs. Of 30 proposed remedial strategies, those rated as high priority were: greater access to interim care or respite care beds or supported accommodation, especially for patients with special needs; dedicated agency officers for hospital guardianship applications and greater interagency collaboration and harmonisation of assessment and decision processes; and formal requests from hospital administrators to patients and family to accept care options and attend mediation meetings. Conclusions Delayed discharge of non-acute maintenance care patients results principally from impaired access to residential care, administrative delays involving external agencies and patient or family refusal of care. Proposed remedial actions require concerted interjurisdictional advocacy. What is known about this topic? Delays in discharge of non-acute patients requiring maintenance care can occur for many reasons and incur inordinately long hospital stays. What does this paper add? The present detailed chart review of 131 long-stay non-acute patients identified causes of serial discharge delays and quantified their prevalence and attributable bed days. Waits for residential care accounted for less than half the bed days, administrative delays involving decisions by agencies external to the hospital accounted for one-quarter and patient or family refusal of care options accounted for one-tenth. Strategies are proposed that may minimise these delays. What are the implications for practitioners? Delayed discharge of non-acute patients requiring maintenance care threatens to consume an ever-increasing proportion of acute hospital bed days. Remedial action is required from stakeholders both within and outside hospitals to reverse this trend.

Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview.

PubMed

Pandey, Anita; Ahuja, Sanjiv; Madan, Molly; Asthana, Ajay Kumar

2016-11-01

Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by 'Synergy' waste management Pvt. Ltd. The practice of BMW Management was lacking in 30-35% HCP which may lead to mixing of the 15% infectious waste with the remaining non-infectious. Therefore, training courses and awareness programs about BMW management will be carried out every month targeting smaller groups.

Use of benchmarking techniques to justify the evolution of antibiotic management programs in healthcare systems.

PubMed

Schentag, J J; Paladino, J A; Birmingham, M C; Zimmer, G; Carr, J R; Hanson, S C

1995-01-01

To apply basic benchmarking techniques to hospital antibiotic expenditures and clinical pharmacy personnel and their duties, to identify cost savings strategies for clinical pharmacy services. Prospective survey of 18 hospitals ranging in size from 201 to 942 beds. Each was asked to provide antibiotic expenditures, an overview of their clinical pharmacy services, and to describe the duties of clinical pharmacists involved in antibiotic management activities. Specific information was sought on the use of pharmacokinetic dosing services, antibiotic streamlining, and oral switch in each of the hospitals. Most smaller hospitals (< 300 beds) did not employ clinical pharmacists with the specific duties of antibiotic management or streamlining. At these institutions, antibiotic management services consisted of formulary enforcement and aminoglycoside and/or vancomycin dosing services. The larger hospitals we surveyed employed clinical pharmacists designated as antibiotic management specialists, but their usual activities were aminoglycoside and/or vancomycin dosing services and formulary enforcement. In virtually all hospitals, the yearly expenses for antibiotics exceeded those of Millard Fillmore Hospitals by $2,000-3,000 per occupied bed. In a 500-bed hospital, this difference in expenditures would exceed $1.5 million yearly. Millard Fillmore Health System has similar types of patients, but employs clinical pharmacists to perform streamlining and/or switch functions at days 2-4, when cultures come back from the laboratory. The antibiotic streamlining and oral switch duties of clinical pharmacy specialists are associated with the majority of cost savings in hospital antibiotic management programs. The savings are considerable to the extent that most hospitals with 200-300 beds could readily cost-justify a full-time clinical pharmacist to perform these activities on a daily basis. Expenses of the program would be offset entirely by the reduction in the actual pharmacy expenditures on antibiotics.

Differences in sleep complaints in adults with varying levels of bed days residing in extended care facilities for chronic disease management.

PubMed

Fox, Mary T; Sidani, Souraya; Brooks, Dina

2010-05-01

This cohort study examined differences in perceived insomnia and daytime sleepiness in 67 adults residing in extended care facilities for chronic disease management who had varying levels of bed days. One bed day was defined as spending 24 hours in bed. Planned pairwise comparisons, using Bonferroni adjustment, were made between participants who spent 0 (n = 21), 2 to 4 (n = 23), and 5 to 7 (n = 23) days in bed during 1 week of monitoring. Participants who spent 5 to 7 days in bed had significantly greater insomnia than those who spent 2 to 4 days in bed. No group differences were found in daytime sleepiness. Based on the findings, nurses may assess subjective insomnia and explore sleep hygiene strategies, such as increasing time out of bed with patients who have high levels of 5 to 7 bed days.

Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle.

PubMed

Kawai, Yu; Weatherhead, Jeffrey R; Traube, Chani; Owens, Tonie A; Shaw, Brenda E; Fraser, Erin J; Scott, Annette M; Wojczynski, Melody R; Slaman, Kristen L; Cassidy, Patty M; Baker, Laura A; Shellhaas, Renee A; Dahmer, Mary K; Shever, Leah L; Malas, Nasuh M; Niedner, Matthew F

2017-01-01

Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends <45 decibels (dB) in hospital environments. The objectives are to assess the degree of PICU noise pollution, to develop a delirium bundle targeted at reducing noise, and to assess the effect of the bundle on nocturnal noise pollution. This is a QI initiative at an academic PICU. Thirty-five sound sensors were installed in patient bed spaces, hallways, and common areas. The pediatric delirium bundle was implemented in 8 pilot patients (40 patient ICU days) while 108 non-pilot patients received usual care over a 28-day period. A total of 20,609 hourly dB readings were collected. Hourly minimum, average, and maximum dB of all occupied bed spaces demonstrated medians [interquartile range] of 48.0 [39.0-53.0], 52.8 [48.1-56.2] and 67.0 [63.5-70.5] dB, respectively. Bed spaces were louder during the day (10AM to 4PM) than at night (11PM to 5AM) (53.5 [49.0-56.8] vs. 51.3 [46.0-55.3] dB, P < 0.01). Pilot patient rooms were significantly quieter than non-pilot patient rooms at night (n=210, 45.3 [39.7-55.9]) vs. n=1841, 51.2 [46.9-54.8] dB, P < 0.01). The pilot rooms compliant with the bundle had the lowest hourly nighttime average dB (44.1 [38.5-55.5]). Substantial noise pollution exists in our PICU, and utilizing the pediatric delirium bundle led to a significant noise reduction that can be perceived as half the loudness with hourly nighttime average dB meeting the EPA standards when compliant with the bundle.

Improving ED efficiency to capture additional revenue.

PubMed

Mandavia, Sujal; Samaniego, Loretta

2016-06-01

An increase in the number of patients visiting emergency departments (EDs) presents an opportunity for additional revenue if hospitals take four steps to optimize resources: Streamline the patient pathway and reduce the amount of time each patient occupies a bed in the ED. Schedule staff according to the busy and light times for patient arrivals. Perform registration and triage bedside, reducing initial wait times. Create an area for patients to wait for test results so beds can be freed up for new arrivals.

Early processing variations in selective attention to the color and direction of moving stimuli during 30 days head-down bed rest

NASA Astrophysics Data System (ADS)

Wang, Lin-Jie; He, Si-Yang; Niu, Dong-Bin; Guo, Jian-Ping; Xu, Yun-Long; Wang, De-Sheng; Cao, Yi; Zhao, Qi; Tan, Cheng; Li, Zhi-Li; Tang, Guo-Hua; Li, Yin-Hui; Bai, Yan-Qiang

2013-11-01

Dynamic variations in early selective attention to the color and direction of moving stimuli were explored during a 30 days period of head-down bed rest. Event-related potentials (ERPs) were recorded at F5, F6, P5, P6 scalp locations in seven male subjects who attended to pairs of bicolored light emitting diodes that flashed sequentially to produce a perception of movement. Subjects were required to attend selectively to a critical feature of the moving target, e.g., color or direction. The tasks included: a no response task, a color selective response task, a moving direction selective response task, and a combined color-direction selective response task. Subjects were asked to perform these four tasks on: the 3rd day before bed rest; the 3rd, 15th and 30th day during the bed rest; and the 5th day after bed rest. Subjects responded quickly to the color than moving direction and combined color-direction response. And they had a longer reaction time during bed rest on the 15th and 30th day during bed rest after a relatively quicker response on the 3rd day. Using brain event-related potentials technique, we found that in the color selective response task, the mean amplitudes of P1 and N1 for target ERPs decreased in the 3rd day during bed rest and 5th day after bed rest in comparison with pre-bed rest, 15th day and 30th day during bed rest. In the combined color-direction selective response task, the P1 latencies for target ERPs on the 3rd and 30th day during bed rest were longer than on the 15th day during bed rest. As 3rd day during bed rest was in the acute adaptation period and 30th day during bed rest was in the relatively adaptation stage of head-down bed rest, the results help to clarify the effects of bed rest on different task loads and patterns of attention. It was suggested that subjects expended more time to give correct decision in the head-down tilt bed rest state. A difficulty in the recruitment of brain resources was found in feature selection task, but no variations were detected in the no response and direction selective response tasks. It is suggested that the negative shift in color selective response task on the 3rd day of bed rest are a result of fluid redistribution. And feature selection was more affected than motion selection in the head down bed rest. The variations in cognitive processing speed observed for the combined color-direction selective response task are suggested to reflect the interaction between top-down mechanisms and hierarchical physiological characteristics during 30 days head-down bed rest.

Pediatric care as part of the US Army medical mission in the global war on terrorism in Afghanistan and Iraq, December 2001 to December 2004.

PubMed

Burnett, Mark W; Spinella, Philip C; Azarow, Kenneth S; Callahan, Charles W

2008-02-01

Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan. The Patient Administration Systems and Biostatistics Activity database was queried for all local national patients <18 years of age who were admitted to deployed Army hospitals in Afghanistan and Iraq between December 2001 and December 2004. Pediatric admissions during the study period were 1012 (4.2%) of 24,227 admissions, occupying 10% of all bed-days. The median length of stay was 4 days (interquartile range: 1-8 days). The largest proportion of children were 11 to 17 years of age (332 of 757 children; 44%), although 45 (6%) of 757 children hospitalized were <1 year of age. The majority (63%) of pediatric patients admitted required either general surgical or orthopedic procedures. The in-hospital mortality rate for all pediatric patients was 59 (5.8%) of 1012 patients, compared with 274 (4.5%) of 6077 patients for all adult non-US coalition patients. Pediatric patients with injuries threatening life, limb, or eyesight are part of the primary responsibility of military medical facilities during combat and have accounted for a significant number of admissions and hospital bed-days in deployed Army hospitals in Afghanistan and Iraq. Military medical planners must continue to improve pediatric medical support, including personnel, equipment, and medications that are necessary to treat children injured during combat operations, as well as those for whom the existing host nation medical infrastructure is unable to provide care.

Measles in a South African paediatric intensive care unit: again!

PubMed

Coetzee, Saskia; Morrow, Brenda M; Argent, Andrew C

2014-05-01

The aim of this study is to evaluate the outcomes of children with measles-related disease (MRD) admitted to a paediatric intensive care unit (PICU) and the effect on PICU resources and elective surgery of a recent measles epidemic. This was a retrospective observational study of all patients admitted to the PICU of Red Cross War Memorial Children's Hospital, Cape Town, South Africa, with MRD from January to December 2010. Patient admission characteristics, duration of PICU admission and mortality were recorded. Costs were calculated using bed days utilised and estimated daily PICU admission cost. A total of 1274 children were admitted over the study period, 58 (4.6%) with MRD (median (interquartile range) age 7 (5-9) months). Pneumonia was the most common reason for admission (81%) and the main cause of mortality. Non-MRD mortality was 8.8% compared with MRD mortality of 31% (P < 0.0001). Standardised mortality for non-MRD was 0.7 versus 1.7 in MRD (P = 0.002). HIV comorbidity and being underweight for age were associated with increased mortality. Patients with MRD occupied 379 bed days with a median (interquartile range) duration of stay of 5.5 (3.0-9.0) days at an estimated overall cost of R4,813,300 (approximately $543,900). During the study period, 67 children booked for elective surgery, and 87 other referrals were refused PICU admission. MRD was associated with significant morbidity and mortality, and substantial strain on scarce PICU resources. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Alternative Level of Care: Canada's Hospital Beds, the Evidence and Options

PubMed Central

Sutherland, Jason M.; Crump, R. Trafford

2013-01-01

Patients designated as alternative level of care (ALC) are an ongoing concern for healthcare policy makers across Canada. These patients occupy valuable hospital beds and limit access to acute care services. The objective of this paper is to present policy alternatives to address underlying factors associated with ALC bed use. Three alternatives, and their respective limitations and structural challenges, are discussed. Potential solutions may require a mix of policy options proposed here. Inadequate policy jeopardizes new acute care activity-based funding schemes in British Columbia and Ontario. Failure to address this issue could exacerbate pressures on the existing bottlenecks in the community care system in these and other provinces. PMID:23968671

Flight prototype CO2 and humidity control system

NASA Technical Reports Server (NTRS)

Rudy, K. M.

1977-01-01

A regenerable CO2 and humidity control system is presently being developed for potential use on the space shuttle as an alternative to the baseline lithium hydroxide system. The system utilizes a sorbent material (designated HS-C) to adsorb CO2 and water vapor from the cabin atmosphere and desorb the CO2 and water vapor overboard when exposed to a space vacuum. Continuous operation is achieved by utilizing two beds which are alternately cycled between adsorption and desorption. A shuttle vehicle integration study showed that the HS-C system offers substantial weight advantages compared to the baseline shuttle orbiter expendable lithium hydroxide CO2 removal system for extended missions beyond the nominal design of four men for seven days. This study defined a system packaging envelope in the area presently occupied by the LiOH cartridges.

Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview

PubMed Central

Ahuja, Sanjiv; Madan, Molly; Asthana, Ajay Kumar

2016-01-01

Introduction Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. Aim To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. Materials and Methods The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Results Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by ‘Synergy’ waste management Pvt. Ltd. Conclusion The practice of BMW Management was lacking in 30-35% HCP which may lead to mixing of the 15% infectious waste with the remaining non-infectious. Therefore, training courses and awareness programs about BMW management will be carried out every month targeting smaller groups. PMID:28050362

Effects of health insurance on non-working married women’s medical care use and bed days at home

PubMed Central

2013-01-01

Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313

Effects of health insurance on non-working married women's medical care use and bed days at home.

PubMed

Lee, Changwoo; Shin, Euichul

2013-07-01

This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual's health insurance status. This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. In contrast to previous studies' findings indicating that absences from work and medical care use among working males may be complements, this study's results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements.

Effect of 14 days of bed rest on urine metabolite excretion and plasma enzyme levels

NASA Technical Reports Server (NTRS)

Pace, N.; Grunbaum, B. W.; Kodama, A. M.; Rahlmann, D. F.; Newsom, B. D.

1974-01-01

After 1 week of ambulatory base-line measurement, a group of 8 men 19-26 years of age remained continuously recumbent for 14 days. Studies were continued for 1 week following the prolonged recumbency. Urine excretion rates for a number of constituents were determined 2 days before bed rest, on day 14 of bed rest, and day 6 after bed rest. Blood plasma samples were also obtained at these times, and analyzed for several enzymes. On day 14 of bed rest significant increases were observed in urine excretion of total osmotically-active substances, magnesium, calcium, phosphate, creatinine, hydroxyproline, and 17-OH corticosteroids. A decrease occurred in urinary glucose excretion. Plasma levels of alkaline phosphatase and LDH-3 were depressed, while plasma GPT was elevated. Many of these changes persisted on day 6 after bed rest, and are interpreted as concomitants of the disuse atrophy of the musculoskeletal system that characterizes prolonged bed rest and weightlessness.

Habitat persistence for sedentary organisms in managed rivers: the case for the federally endangered dwarf wedgemussel (Alasmidonta heterodon) in the Delaware River

USGS Publications Warehouse

Maloney, Kelly O.; Lellis, William A.; Bennett, Randy M.; Waddle, Terry J.

2012-01-01

1. To manage the environmental flow requirements of sedentary taxa, such as mussels and aquatic insects with fixed retreats, we need a measure of habitat availability over a variety of flows (i.e. a measure of persistent habitat). Habitat suitability measures in current environmental flow assessments are measured on a ‘flow by flow’ basis and thus are not appropriate for these taxa. Here, we present a novel measure of persistent habitat suitability for the dwarf wedgemussel (Alasmidonta heterodon), listed as federally endangered in the U.S.A., in three reaches of the Delaware River. 2. We used a two-dimensional hydrodynamic model to quantify suitable habitat over a range of flows based on modelled depth, velocity, Froude number, shear velocity and shear stress at three scales (individual mussel, mussel bed and reach). Baseline potentially persistent habitat was quantified as the sum of pixels that met all thresholds identified for these variables for flows ≥40 m3 s−1, and we calculated the loss of persistently suitable habitat by sequentially summing suitable habitat estimates at lower flows. We estimated the proportion of mussel beds exposed at each flow and the amount of change in the size of the mussel bed for one reach. 3. For two reaches, mussel beds occupied areas with lower velocity, shear velocity, shear stress and Froude number than the reach average at all flows. In the third reach, this was true only at higher flows. Together, these results indicate that beds were possible refuge areas from the effects of these hydrological parameters. Two reaches showed an increase in the amount of exposed mussel beds with decreasing flow. 4. Baseline potentially persistent habitat was less than half the areal extent of potentially suitable habitat, and it decreased with decreasing flow. Actually identified beds and modelled persistent habitat showed good spatial overlap, but identified beds occupied only a portion of the total modelled persistent habitat, indicating either that additional suitable habitat is available or the need to improve habitat criteria. At one site, persistent beds (beds where mussels were routinely collected) were located at sites with stable substratum, whereas marginal beds (beds where mussels were infrequently collected or that were lost following a large flood event) were located in scoured areas. 5. Taken together, these model results support a multifaceted approach, which incorporates the effects of low and high flow stressors, to quantify habitat suitability for mussels and other sedentary taxa. Models of persistent habitat can provide a more holistic environmental flow assessment of rivers.

Plasma vasopressin and renin activity in women exposed to bed rest and +G/z/ acceleration

NASA Technical Reports Server (NTRS)

Keil, L. C.; Ellis, S.

1976-01-01

To study the effect of prolonged recumbency on plasma vasopressin and renin activity, eight women were subjected to 17 days of absolute bed rest. The tolerance to +3G vertical acceleration of the subjects was tested before and after 14 days of bed rest. From day 2 and through day 17 of bed rest, plasma arginine vasopressin (AVP) levels were reduced 33%. Plasma renin activity (PRA) increased 91% above ambulatory control values from days 10 through 15 of bed rest. When compared to precentrifuge values, exposure to vertical acceleration prior to bed rest provoked a 20-fold rise in mean plasma AVP but resulted in only a slight increase in PRA. After bed rest, acceleration increased plasma AVP 7-fold; however, the magnitude of this increase was less than the post +3G acceleration value obtained prior to bed rest. After bed rest, no significant rise was noted in PRA following +3G acceleration. This study demonstrates that prolonged bed rest leads to a significant rise in the PRA of female subjects, while exposure to positive vertical acceleration provokes a marked rise in plasma AVP.

What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.

PubMed

Page, Katie; Barnett, Adrain G; Graves, Nicholas

2017-02-14

Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is the better value for making resource decisions, and we describe our valuation method and estimations for costing this important resource. We performed a contingent valuation using 37 Australian Chief Executive Officers' (CEOs) willingness to pay (WTP) to release bed days in their hospitals, both generally and using specific cases. We provide a succinct thematic analysis from qualitative interviews post survey completion, which provide insight into the decision making process. On average CEOs are willing to pay a marginal rate of $216 for a ward bed day and $436 for an Intensive Care Unit (ICU) bed day, with estimates of uncertainty being greater for ICU beds. These estimates are significantly lower (four times for ward beds and seven times for ICU beds) than the traditional accounting costs often used. Key themes to emerge from the interviews include the importance of national funding and targets, and their associated incentive structures, as well as the aversion to discuss bed days as an economic resource. This study highlights the importance for valuing bed days as an economic resource to inform cost effectiveness models and thus improve hospital decision making and resource allocation. Significantly under or over valuing the resource is very likely to result in sub-optimal decision making. We discuss the importance of recognising the opportunity costs of this resource and highlight areas for future research.

Effects of head-down bed rest on complex heart rate variability: Response to LBNP testing

NASA Technical Reports Server (NTRS)

Goldberger, Ary L.; Mietus, Joseph E.; Rigney, David R.; Wood, Margie L.; Fortney, Suzanne M.

1994-01-01

Head-down bed rest is used to model physiological changes during spaceflight. We postulated that bed rest would decrease the degree of complex physiological heart rate variability. We analyzed continuous heart rate data from digitized Holter recordings in eight healthy female volunteers (age 28-34 yr) who underwent a 13-day 6 deg head-down bed rest study with serial lower body negative pressure (LBNP) trials. Heart rate variability was measured on a 4-min data sets using conventional time and frequency domain measures as well as with a new measure of signal 'complexity' (approximate entropy). Data were obtained pre-bed rest (control), during bed rest (day 4 and day 9 or 11), and 2 days post-bed rest (recovery). Tolerance to LBNP was significantly reduced on both bed rest days vs. pre-bed rest. Heart rate variability was assessed at peak LBNP. Heart rate approximate entropy was significantly decreased at day 4 and day 9 or 11, returning toward normal during recovery. Heart rate standard deviation and the ratio of high- to low-power frequency did not change significantly. We conclude that short-term bed rest is associated with a decrease in the complex variability of heart rate during LBNP testing in healthy young adult women. Measurement of heart rate complexity, using a method derived from nonlinear dynamics ('chaos theory'), may provide a sensitive marker of this loss of physiological variability, complementing conventional time and frequency domain statistical measures.

Numerical study of rice husk and coal co-combustion characteristics in a circulating fluidized bed

NASA Astrophysics Data System (ADS)

Wang, Zuomin; Li, Jiuru

2018-02-01

This paper discussed the rationality of coal and rice husk co-combustion. Using ICEM software, a two-dimensional model of the riser has been established for circulating fluidized bed experimental table. Using Fluent software, numerical simulation has been made for the combustion reaction of different proportions of rice husk mixed with coal. The results show that, with the increase of rice husk ratio, both the combustion temperature and the amount of nitrogen oxides decrease and the effect is gradually reduced. In this simulation, the rice husks occupying about 30% is a reasonable proportion.

Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children.

PubMed

Van den Bulck, Jan

2004-02-01

To investigate the relationship between the presence of a television set, a gaming computer, and/or an Internet connection in the room of adolescents and television viewing, computer game playing, and Internet use on the one hand, and time to bed, time up, time spent in bed, and overall tiredness in first- and fourth-year secondary-school children on the other hand. A random sample of students from 15 schools in Flanders, Belgium, yielded 2546 children who completed a questionnaire with questions about media presence in bedrooms; volume of television viewing, computer game playing, and Internet use; time to bed and time up on average weekdays and average weekend days; and questions regarding the level of tiredness in the morning, at school, after a day at school, and after the weekend. Children with a television set in their rooms went to bed significantly later on weekdays and weekend days and got up significantly later on weekend days. Overall, they spent less time in bed on weekdays. Children with a gaming computer in their rooms went to bed significantly later on weekdays. On weekdays, they spent significantly less time in bed. Children who watched more television went to bed later on weekdays and weekend days and got up later on weekend days. They spent less time in bed on weekdays. They reported higher overall levels of being tired. Children who spent more time playing computer games went to bed later on weekdays and weekend days and got up later on weekend days. On weekdays, they actually got up significantly earlier. They spent less time in bed on weekdays and reported higher levels of tiredness. Children who spent more time using the Internet went to bed significantly later during the week and during the weekend. They got up later on weekend days. They spent less time in bed during the week and reported higher levels of tiredness. Going out was also significantly related to sleeping later and less. Concerns about media use should not be limited to television. Computer game playing and Internet use are related to sleep behavior as well. Leisure activities that are unstructured seem to be negatively related to good sleep patterns. Imposing more structure (eg, end times) might reduce impact.

Vehicle-related injuries in and around a medium sized Swedish City - bicyclist injuries caused the heaviest burden on the medical sector.

PubMed

Björnstig, Johanna; Bylund, Per-Olof; Björnstig, Ulf

2017-12-01

A data acquisition from the medical sector may give one important view of the burden on the society caused by vehicle related injuries. The official police-reported statistics may only reflect a part of all vehicle-related injured seeking medical attention. The aim is to provide a comprehensive picture of the burden of vehicle related injuries on the medical sector (2013), and to compare with official police-reported statistics and the development year 2000-2013. The data set includes 1085 injured from the Injury Data Base at Umeå University Hospital's catchment area with 148,500 inhabitants in 2013. Bicyclists were the most frequently injured (54%). One-third had non-minor (MAIS2+) injuries, and bicyclists accounted for 58% of the 1071 hospital bed days for all vehicle-related injuries. Car occupants represented 23% of all injured, and only 9% had MAIS2+ injuries. They accounted for 17% of the hospital bed days. Motorized two wheel vehicle riders represented 11% of the injured and 39% had MAIS2+ injuries and they occupied 11% of the hospital bed days. Of the 1085 medically treated persons, 767 were injured in public traffic areas, and, therefore, should be included in the official police statistics; however, only a third (232) of them were reported by the police. The annual injury rate had not changed during 2000-2013 for bicyclists, motor-cycle riders, pedestrians or snowmobile riders. However, for passenger car occupants a decrease was observed after 2008, and for mopedists the injury rate was halved after 2009 when a licensing regulation was introduced. The Swedish traffic injury reducing strategy Vision Zero, may have contributed to the reduction of injured car occupants and moped riders. The official police-reported statistics was a biased data source for vehicle related injuries and the total number medically treated was in total five times higher. Bicyclists caused the heaviest burden on the medical sector; consequently, they need to be prioritized in future safety work, as recently declared in the Government plan Vision Zero 2.0.

Assaultive Behavior in State Psychiatric Hospitals: Differences Between Forensic and Nonforensic Patients

ERIC Educational Resources Information Center

Linhorst, Donald M.; Scott, Lisa Parker

2004-01-01

Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two…

Disposal Site Selection Technical Appendix. Phase 2. (North and South Puget Sound)

DTIC Science & Technology

1989-09-01

target species were sampled at each site. This reflects in part variation in the habitat preferences of the selected target species. The ichthyofauna ...Region. Mar. Geol., 64:291-312. Carr, W.E.S. and C.A. Adams. 1973. Food Habits of Juvenile Marine Fishes Occupying Seagrass Beds in the Estuarine Zone

Effects of Bed-Rest on Urea and Creatinine: Correlation with Changes in Fat-Free Mass

PubMed Central

Bilancio, Giancarlo; Lombardi, Cinzia; Pisot, Rado; De Santo, Natale G.; Cavallo, Pierpaolo; Cirillo, Massimo

2014-01-01

Background Bed-rest experiments are designed for investigation on catabolic effects of hypokinetic conditions and/or for microgravity simulation in on-ground aerospace research. Bed-rest effects include a reduction in fat-free mass and muscle mass. Urea and creatinine are catabolites of endogenous protein and of muscular energetic metabolism which are excreted mainly by the kidney. The study investigated on urea, creatinine, and kidney function during bed-rest. Methods Twenty healthy young men underwent a 7-day adaptation period (day-6 to day-0) and a 35-day bed-rest experiment (day1 to day35) during normocaloric diet. Urine were collected from day-3 to day0 (baseline) and from day1 to day35. Blood samples and anthropometrical data were collected at day0 (baseline) and bed-rest days 7, 14, 21, 28, and 35. Results Bed-rest reduced plasma volume, weight, fat-free mass, and muscle mass (P<0.001). During bed-rest there was a transient increase in plasma and urinary urea, a decrease in plasma creatinine, and no change in urinary creatinine. The overall integral of changes from day0 to day35 was on average +101.7 mg/dL for plasma urea (95%CI = +43.4/+159.9), +82.2 g/24 h for urinary urea (95%CI = +55.8/+108.7), −2.5 mg/dL for plasma creatinine (95%CI = −3.1/−1.9). Bed-rest reduced plasma cistatyn C also, which was used as mass-independent marker of glomerular filtration rate (−13.1%, P<0.05). Correlations with final reduction in fat-free mass and muscle mass were significant for the overall integral of changes in urinary urea from day0 to day35 (R = 0.706, P<0.001) and for early changes in urinary urea and plasma urea from day0 to day7 (R = 0.566, P = 0.009 and R = 0.715, P<0.001, respectively). Conclusions Study results shows that urea is a marker of catabolic conditions secondary to hypokinetic conditions. PMID:25265226

Effects of bed-rest on urea and creatinine: correlation with changes in fat-free mass.

PubMed

Bilancio, Giancarlo; Lombardi, Cinzia; Pisot, Rado; De Santo, Natale G; Cavallo, Pierpaolo; Cirillo, Massimo

2014-01-01

Bed-rest experiments are designed for investigation on catabolic effects of hypokinetic conditions and/or for microgravity simulation in on-ground aerospace research. Bed-rest effects include a reduction in fat-free mass and muscle mass. Urea and creatinine are catabolites of endogenous protein and of muscular energetic metabolism which are excreted mainly by the kidney. The study investigated on urea, creatinine, and kidney function during bed-rest. Twenty healthy young men underwent a 7-day adaptation period (day-6 to day-0) and a 35-day bed-rest experiment (day1 to day35) during normocaloric diet. Urine were collected from day-3 to day0 (baseline) and from day1 to day35. Blood samples and anthropometrical data were collected at day0 (baseline) and bed-rest days 7, 14, 21, 28, and 35. Bed-rest reduced plasma volume, weight, fat-free mass, and muscle mass (P<0.001). During bed-rest there was a transient increase in plasma and urinary urea, a decrease in plasma creatinine, and no change in urinary creatinine. The overall integral of changes from day0 to day35 was on average +101.7 mg/dL for plasma urea (95%CI = +43.4/+159.9), +82.2 g/24 h for urinary urea (95%CI = +55.8/+108.7), -2.5 mg/dL for plasma creatinine (95%CI = -3.1/-1.9). Bed-rest reduced plasma cistatyn C also, which was used as mass-independent marker of glomerular filtration rate (-13.1%, P<0.05). Correlations with final reduction in fat-free mass and muscle mass were significant for the overall integral of changes in urinary urea from day0 to day35 (R = 0.706, P<0.001) and for early changes in urinary urea and plasma urea from day0 to day7 (R = 0.566, P = 0.009 and R = 0.715, P<0.001, respectively). Study results shows that urea is a marker of catabolic conditions secondary to hypokinetic conditions.

Retention and mitigation of metals in sediment, soil, water, and plant of a newly constructed root-channel wetland (China) from slightly polluted source water.

PubMed

Wang, Baoling; Wang, Yu; Wang, Weidong

2014-01-01

Constructed root-channel wetland (CRCW) is a term for pre-pond/wetland/post-pond complexes, where the wetland includes plant-bed/ditch landscape and root-channel structure. Source water out of pre-ponds flows through alternate small ditches and plant beds with root-channels via a big ditch under hydraulic regulation. Then source water flows into post-ponds to finish final polishing. This article aims to explore the potential of components of a pilot CRCW in China on mitigating metals in micro-polluted source water during its initial operation stage. We investigated six heavy metals (Cd, Cr, Cu, Ni, Zn, and Pb) in surface sediment, plant-bed subsurface soil, water, and aquatic plants during 2012-2013. Monitoring results showed that pond/ditch sediments and plant-bed soil retained a significant amount of Cr, Ni, and Zn with 93.1%, 72.4%, and 57.5% samples showing contamination factor above limit 1 respectively. Remarkably the high values of metal enrichment factor (EF) occurred in root-channel zones. Water monitoring results indicated that Ni, Zn, and Pb were removed by 78.5% (66.7%), 57.6% (59.6%), and 26.0% (7.5%) in east (west) wetland respectively. Mass balance estimation revealed that heavy metal mass in the pond/ditch sediments accounted for 63.30% and that in plant-bed soil 36.67%, while plant uptake occupied only 0.03%. The heavy metal accretion flux in sediments was 0.41 - 211.08 μg · cm(-2) · a(-1), less than that in plant-bed soil (0.73 - 543.94 μg · cm(-2) · a(-1)). The 1.83 ha wetland has retained about 86.18 kg total heavy metals within 494 days after operation. This pilot case study proves that constructed root-channel wetland can reduce the potential ecological risk of purified raw water and provide a new and effective method for the removal of heavy metals from drinking water sources.

Cardiovascular Adaptations to Long Duration Head-Down Tilt Bed Rest

NASA Technical Reports Server (NTRS)

Platts, Steven H.; Martin, David S.; Perez, Sondar A.; Ribeiro, Christine; Stenger, Michael B.; Summers, Richard; Meck, Janice V.

2008-01-01

INTRODUCTION: Orthostatic hypotension is a serious risk for crewmembers returning from spaceflight. Numerous cardiovascular mechanisms have been proposed to account for this problem, including vascular and cardiac dysfunction, which we studied during bed rest. METHODS: Thirteen subjects were studied before and during bed rest. Statistical analysis was limited to the first 49-60 days of bed rest, and compared to pre-bed rest data. Ultrasound data were collected on vascular and cardiac structure and function. Tilt testing was conducted for 30 minutes or until presyncopal symptoms intervened. RESULTS: Plasma volume was significantly reduced by day 7 of bed rest. Flow-mediated dilation in the leg was significantly increased at bed rest day 49. Arterial responses to nitroglycerin differed in the arm and leg, but did not change as a result of bed rest. Intimal-medial thickness markedly decreased at bed rest days 21, 35 and 49. Several cardiac functional parameters including isovolumic relaxation time, ejection time and myocardial performance index were significantly increased (indicating a decrease in cardiac function) during bed rest. There was a trend for decreased orthostatic tolerance following 60 days of bed rest. DISCUSSION: These data suggest that 6 head-down tilt bed rest alters cardiovascular structure and function in a pattern similar to short duration spaceflight. Additionally, the vascular alterations are primarily seen in the lower body, while vessels of the upper body are unaffected. KEY WORDS: spaceflight, orthostatic intolerance, hypotension, fluid-shift, plasma volume

The association between number of doctors per bed and readmission of elderly patients with pneumonia in South Korea.

PubMed

Lee, Joo Eun; Kim, Tae Hyun; Cho, Kyoung Hee; Han, Kyu-Tae; Park, Eun-Cheol

2017-06-08

There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013. Pneumonia admissions to acute care hospitals among 7446 inpatients older than 65 were examined. We conducted a multivariate Cox proportional hazard model to analyze the association between the number of doctors per bed and 30-day readmission, as well as that of pneumonia-specific 30-day readmission with the combined effects of number of doctors per bed and number of beds. Overall, 1421 (19.1%) patients were readmitted within 30 days and 756 (11.2%) patients were readmitted for pneumonia within 30 days. Patients with pneumonia treated by very low or low number of doctors per bed showed higher readmission (pneumonia-specific readmission: hazard ratio [HR] = 1. 406, 95% confidence interval [CI] = 1.072-1.843 for low number of doctors per bed; all-cause readmissions: HR = 1.276, 95% CI = 1.026-1.587 for very low number of doctors per bed, and HR = 1.280, 95% CI = 1.064-1.540 for low number of doctors per bed). This empirical study showed that patients with pneumonia cared for in hospitals with more doctors were less likely to be readmitted. Pneumonia-specific 30-day readmission was also significantly associated with the combined effect of the number of doctors and the number of hospital beds.

The effect of hydraulic bed movement on the quality of chest compressions.

PubMed

Park, Maeng Real; Lee, Dae Sup; In Kim, Yong; Ryu, Ji Ho; Cho, Young Mo; Kim, Hyung Bin; Yeom, Seok Ran; Min, Mun Ki

2017-08-01

The hydraulic height control systems of hospital beds provide convenience and shock absorption. However, movements in a hydraulic bed may reduce the effectiveness of chest compressions. This study investigated the effects of hydraulic bed movement on chest compressions. Twenty-eight participants were recruited for this study. All participants performed chest compressions for 2min on a manikin and three surfaces: the floor (Day 1), a firm plywood bed (Day 2), and a hydraulic bed (Day 3). We considered 28 participants of Day 1 as control and each 28 participants of Day 2 and Day 3 as study subjects. The compression rates, depths, and good compression ratios (>5-cm compressions/all compressions) were compared between the three surfaces. When we compared the three surfaces, we did not detect a significant difference in the speed of chest compressions (p=0.582). However, significantly lower values were observed on the hydraulic bed in terms of compression depth (p=0.001) and the good compression ratio (p=0.003) compared to floor compressions. When we compared the plywood and hydraulic beds, we did not detect significant differences in compression depth (p=0.351) and the good compression ratio (p=0.391). These results indicate that the movements in our hydraulic bed were associated with a non-statistically significant trend towards lower-quality chest compressions. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of 2 Bedding Materials on Ammonia Levels in Individually Ventilated Cages

PubMed Central

Koontz, Jason M; Kumsher, David M; III, Richard Kelly; Stallings, Jonathan D

2016-01-01

This study sought to identify an optimal rodent bedding and cage-change interval to establish standard procedures for the IVC in our rodent vivarium. Disposable cages were prefilled with either corncob or α-cellulose bedding and were used to house 2 adult Sprague–Dawley rats (experimental condition) or contained no animals (control). Rats were observed and intracage ammonia levels measured daily for 21 d. Intracage ammonia accumulation became significant by day 8 in experimental cages containing α-cellulose bedding, whereas experimental cages containing corncob bedding did not reach detectable levels of ammonia until day 14. In all 3 experimental cages containing α-cellulose, ammonia exceeded 100 ppm (our maximum acceptable limit) by day 11. Two experimental corncob cages required changing at days 16 and 17, whereas the remaining cage containing corncob bedding lasted the entire 21 d without reaching the 100-ppm ammonia threshold. These data suggests that corncob bedding provides nearly twice the service life of α-cellulose bedding in the IVC system. PMID:26817976

Effect of 2 Bedding Materials on Ammonia Levels in Individually Ventilated Cages.

PubMed

Koontz, Jason M; Kumsher, David M; Kelly, Richard; Stallings, Jonathan D

2016-01-01

This study sought to identify an optimal rodent bedding and cage-change interval to establish standard procedures for the IVC in our rodent vivarium. Disposable cages were prefilled with either corncob or α-cellulose bedding and were used to house 2 adult Sprague-Dawley rats (experimental condition) or contained no animals (control). Rats were observed and intracage ammonia levels measured daily for 21 d. Intracage ammonia accumulation became significant by day 8 in experimental cages containing α-cellulose bedding, whereas experimental cages containing corncob bedding did not reach detectable levels of ammonia until day 14. In all 3 experimental cages containing α-cellulose, ammonia exceeded 100 ppm (our maximum acceptable limit) by day 11. Two experimental corncob cages required changing at days 16 and 17, whereas the remaining cage containing corncob bedding lasted the entire 21 d without reaching the 100-ppm ammonia threshold. These data suggests that corncob bedding provides nearly twice the service life of α-cellulose bedding in the IVC system.

Bed rest suppresses bioassayable growth hormone release in response to muscle activity

NASA Technical Reports Server (NTRS)

McCall, G. E.; Goulet, C.; Grindeland, R. E.; Hodgson, J. A.; Bigbee, A. J.; Edgerton, V. R.

1997-01-01

Hormonal responses to muscle activity were studied in eight men before (-13 or -12 and -8 or -7 days), during (2 or 3, 8 or 9, and 13 or 14 days) and after (+2 or +3 and +10 or +11 days) 17 days of bed rest. Muscle activity consisted of a series of unilateral isometric plantar flexions, including 4 maximal voluntary contractions (MVCs), 48 contractions at 30% MVC, and 12 contractions at 80% MVC, all performed at a 4:1-s work-to-rest ratio. Blood was collected before and immediately after muscle activity to measure plasma growth hormone by radioimmunoassay (IGH) and by bioassay (BGH) of tibia epiphyseal cartilage growth in hypophysectomized rats. Plasma IGH was unchanged by muscle activity before, during, or after bed rest. Before bed rest, muscle activity increased (P < 0.05) BGH by 66% at -13 or -12 days (2,146 +/- 192 to 3,565 +/- 197 microg/l) and by 92% at -8 or -7 days (2,162 +/- 159 to 4,161 +/- 204 microg/l). After 2 or 3 days of bed rest, there was no response of BGH to the muscle activity, a pattern that persisted through 8 or 9 days of bed rest. However, after 13 or 14 days of bed rest, plasma concentration of BGH was significantly lower after than before muscle activity (2,594 +/- 211 to 2,085 +/- 109 microg/l). After completion of bed rest, muscle activity increased BGH by 31% at 2 or 3 days (1,807 +/- 117 to 2,379 +/- 473 microg/l; P < 0.05), and by 10 or 11 days the BGH response was similar to that before bed rest (1,881 +/- 75 to 4,160 +/- 315 microg/l; P < 0.05). These data demonstrate that the ambulatory state of an individual can have a major impact on the release of BGH, but not IGH, in response to a single bout of muscle activity.

Comparison of Three Bed Bug Management Strategies in a Low-Income Apartment Building.

PubMed

Wang, Changlu; Saltzmann, Kurt; Bennett, Gary; Gibb, Timothy

2012-04-02

Bed bug (Cimex lectularius L.) infestations are currently controlled by a variety of non-chemical and chemical methods. There have been few studies on the comparative effectiveness of these control techniques. We evaluated three bed bug management strategies in an apartment building: (1) non-chemical methods only (n = 9); (2) insecticides only (n = 6); and (3) integrated pest management including both non-chemical methods and insecticides (n = 9). The apartments were one-bedroom units occupied by seniors or people with disabilities. Bed bug numbers in each apartment were determined by visual inspection and/or installing intercepting devices under bed and sofa legs. The median (min, max) bed bug counts in the non-chemical methods only, insecticides only, and integrated pest management (IPM) treatment were: 4 (1, 57), 19 (1, 250), and 14 (1, 219), respectively prior to the treatments. The apartments were retreated if found necessary during biweekly to monthly inspections. After 10 weeks, bed bugs were found to be eliminated from 67, 33, and 44% of the apartments in the three treatment groups, respectively. The final (after 10 weeks) median (min, max) bed bug counts in the non-chemical methods only, insecticides only, and IPM treatment were: 0 (0, 134), 11.5 (0, 58), and 1 (0, 38), respectively. There were no significant differences in the speed of bed bug count reduction or the final bed bug counts. Lack of resident cooperation partially contributed to the failure in eliminating bed bugs from some of the apartments. Results of this study suggest that non-chemical methods can effectively eliminate bed bugs in lightly infested apartments.

Direct and indirect effects of channel catfish (Ictalurus punctatus) on native crayfishes (Cambaridae) in experimental tanks

Treesearch

Susan B. Adams

2006-01-01

For The incised, sand-bed streams of northcentral Mississippi, USA, fish predation is one plausible mechanism to explain both relatively low crayfish densities and differences in stream size occupied by various native crayfishes. I conducted two mesocosm experiments to test effects of a fish predator (channel catfish, Ictalurus punctahls) on the...

Static Histomorphometry of the iliac crest after 360 days of antiorthostatic bed rest with and without countermeasures

NASA Astrophysics Data System (ADS)

Thomsen, J. S.; Morukov, B. V.; Vico, L.; Saparin, P. I.; Gowin, W.

The loss of bone during immobilization is well-known and investigated, whereas the structural changes human cancellous bone undergoes during disuse is less well examined. The aim of the study was to examine the influence of hypokinesia on the static histomorphometric measures of the iliac crest using a 360-day-long bed rest experiment, simulating exposure to microgravity. Eight healthy males underwent 360 days of 5° head-down tilt bed rest. Three subjects were treated with the bisphosphonate Xidifon (900 mg/day) combined with a treadmill and ergonometer exercise regimen (1--2 hours/day) for the entire study period. Five subjects underwent 120 days of bed rest without countermeasures followed by 240 days of bed rest with the treadmill and ergonometer exercise regimen. Transiliac bone biopsies were obtained either at day 0 and 360 or at day 0, 120, and 360 at alternating sides of the ileum. The biopsies were embedded in methylmethacrylate, cut in 7-μm-thick sections, stained with Goldner trichrome, and static histomorphometry was performed. 120 days of bed rest without countermeasures resulted in decreased trabecular bone volume (-6.3%, p = 0.046) and trabecular number (-10.2%, p = 0.080) and increased trabecular separation (14.7%, p = 0.020), whereas 240 days of subsequent bed rest with exercise treatment prevented further significant deterioration of the histomorphometric measures. 360 days of bed rest with bisphosphonate and exercise treatment did not induce any significant changes in any of the histomorphometric measures. The study showed that 120 days of antiorthostatic bed rest without countermeasures induced significant deterioration of iliac crest trabecular bone histomorphometric properties. There are indications that the immobilization induced changes involve a loss of trabeculae rather than a general thinning of the trabeculae. On average, the countermeasures consisting of either bisphosphonate and exercise or exercise alone were able to either prevent or stop immobilization induced changes of the iliac trabecular bone structure. Limitation: due to the inhomogeneous distribution of the trabecular bone structure of the iliac crest, it should be carefully considered whether paired sets of iliac crest bone biopsies are well-suited for studies of microgravity induced changes of trabecular bone structure.

Changes in markers of bone formation and resorption in a bed rest model of weightlessness

NASA Technical Reports Server (NTRS)

Lueken, S. A.; Arnaud, S. B.; Taylor, A. K.; Baylink, D. J.

1993-01-01

To study the mechanism of bone loss in physical unloading, we examined indices of bone formation and bone resorption in the serum and urine of eight healthy men during a 7 day -6 degrees head-down tilt bed rest. Prompt increases in markers of resorption--pyridinoline (PD), deoxypyridinoline (DPD), and hydroxyproline (Hyp)/g creatinine--during the first few days of inactivity were paralleled by tartrate-resistant acid phosphatase (TRAP) with significant increases in all these markers by day 4 of bed rest. An index of formation, skeletal alkaline phosphatase (SALP), did not change during bed rest and showed a moderate 15% increase 1 week after reambulation. In contrast to SALP, serum osteocalcin (OC) began increasing the day preceding the increase in Hyp, remained elevated for the duration of the bed rest, and returned to pre-bed rest values within 5 days of reambulation. Similarly, DPD increased significantly at the onset of bed rest, remained elevated for the duration of bed rest, and returned to pre-bed rest levels upon reambulation. On the other hand, the other three indices of resorption, Hyp, PD, and TRAP, remained elevated for 2 weeks after reambulation. The most sensitive indices of the levels of physical activity proved to be the noncollagenous protein, OC, and the collagen crosslinker, DPD. The bed rest values of both these markers were significantly elevated compared to both the pre-bed rest values and the post-bed rest values. The sequence of changes in the circulating markers of bone metabolism indicated that increases in serum OC are the earliest responses of bone to head-down tilt bed rest.

Paediatric burn unit in Portugal: Beds needed using a bed-day approach.

PubMed

Santos, João V; Viana, João; Amarante, José; Freitas, Alberto

2017-03-01

Despite the high burden of children with burns, there is not a paediatric burn unit (PBU) in Portugal. We aimed to estimate the Portuguese health care providing needs on paediatric burns. We performed a nation-wide retrospective study, between 2009 and 2013, among less than 16 years-old inpatients with burns that met the transfer criteria to a burn unit in Portugal. A bed-day approach was used, targeting an occupancy rate of 70-75%, and possible locations were studied. The primary outcome was the number of beds needed, and secondary outcomes were the overload and revenue for each possible number of beds in a PBU. A total of 1155 children met the transfer criteria to a burn unit, representing a total of 17,371 bed-days. Occupancy rates of 11-bed, 12-bed, 13-bed and 14-bed PBU were, respectively, 79.7%, 75.3%, 71.0% and 66.8%. The 13-bed PBU scenario would represent an overload of 523 bed-days, revenue of more than 5 million Euros and a ratio of 1 PBU bed per 123,409 children. Using a groundbreaking approach, the optimal number of PBU beds needed in Portugal is 13. However, as half of the patients who met burn transfer criteria are not transferred, this bed number might be overestimated if this pattern maintains, despite the underestimation with our method approach. If a PBU is to be created the preferable location is Porto. Cost-effectiveness studies should be performed. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Exercise Within LBNP to Produce Artificial Gravity

NASA Technical Reports Server (NTRS)

Hargens, Alan R.

1996-01-01

Integrated physiologic countermeasures are needed to maintain orthostatic tolerance after spaceflight or bed rest. We hypothesized that supine exercise during LBNP would prevent bed rest-induced loss of orthostatic tolerance by preventing hemoconcentration. In a study conducted jointly with NASA Johnson Space Center and the University of Texas Medical Branch, Galveston, TX, fifteen male subjects underwent 5 days of 6 deg head-down bed rest: 5 control subjects did not exercise, and 10 performed 30 min/day of supine interval treadmill exercise at intensities up to 90% VO(sub 2peak). We will undertake two 14 day bed-rest studies (6 deg head-down tilt bed rest, HDT) to investigate the mechanism of action and efficacy of our partial vacuum exerciser concept. These 14 day bed rest studies were chosen to simulate current microgravity exposures for Space Shuttle crew members.

Pharmacologic counter measures minimizing post-space flight orthostatic intolerance. [bed rest, drug disposition, and physiological function

NASA Technical Reports Server (NTRS)

Harrison, D. C.; Kates, R.

1982-01-01

The effect of bed rest on drug disposition and physiological function was investigated as part of a project to determine the cardiovascular effects of space flight. One group of subjects was given doses of lidocane, penicillin-G, and ICG during a control period and following seven days of bed rest. Cardiac function was evaluated by echo-cardiography. Renal function was evaluated in a second group before and after several days of bed rest. Inulin, para-aminohippurate, and dextran clearances were studied. In the first group, the post-bed rest parameters were not statistically different from the pre-bed rest valves. In the second study, renal function did not change significantly after seven days of bed rest. Plans for future research are reviewed.

[Incidence of multi-resistant bacteria in Intensive Care Units of Chilean hospitals].

PubMed

Acuña, M Paz; Cifuentes, Marcela; Silva, Francisco; Rojas, Álvaro; Cerda, Jaime; Labarca, Jaime

2017-12-01

Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals. To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile. Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested. With these data incidence was calculated per 1,000 patient days for each unit. Information from 20 adults and 9 pediatric ICUs was reviewed. In adult ICUs the bacteria with the highest incidence were K. pneumoniae ESBL [4.72 × 1,000 patient day (1.21-13.89)] and oxacillin -resistant S. aureus [3.85 (0.71-12.66)]. In the pediatric units the incidence was lower, highlighting K. pneumoniae ESBL [2.71 (0-7.11)] and carbapenem -resistant P. aeruginosa [1.61 (0.31-9.25)]. Important differences between hospitals in the incidence of these bacteria were observed. Incidence of multi-resistant bacteria in adult ICU was significantly higher than in pediatric ICU for most of the studied bacterias.

Bone metabolism and nutritional status during 30-day head-down-tilt bed rest

PubMed Central

Morgan, Jennifer L. L.; Zwart, Sara R.; Heer, Martina; Ploutz-Snyder, Robert; Ericson, Karen

2012-01-01

Bed rest studies provide an important tool for modeling physiological changes that occur during spaceflight. Markers of bone metabolism and nutritional status were evaluated in 12 subjects (8 men, 4 women; ages 25–49 yr) who participated in a 30-day −6° head-down-tilt diet-controlled bed rest study. Blood and urine samples were collected twice before, once a week during, and twice after bed rest. Data were analyzed using a mixed-effects linear regression with a priori contrasts comparing all days to the second week of the pre-bed rest acclimation period. During bed rest, all urinary markers of bone resorption increased ∼20% (P < 0.001), and serum parathyroid hormone decreased ∼25% (P < 0.001). Unlike longer (>60 days) bed rest studies, neither markers of oxidative damage nor iron status indexes changed over the 30 days of bed rest. Urinary oxalate excretion decreased ∼20% during bed rest (P < 0.001) and correlated inversely with urinary calcium (R = −0.18, P < 0.02). These data provide a broad overview of the biochemistry associated with short-duration bed rest studies and provide an impetus for using shorter studies to save time and costs wherever possible. For some effects related to bone biochemistry, short-duration bed rest will fulfill the scientific requirements to simulate spaceflight, but other effects (antioxidants/oxidative damage, iron status) do not manifest until subjects are in bed longer, in which case longer studies or other analogs may be needed. Regardless, maximizing research funding and opportunities will be critical to enable the next steps in space exploration. PMID:22995395

Comparison of Three Bed Bug Management Strategies in a Low-Income Apartment Building

PubMed Central

Wang, Changlu; Saltzmann, Kurt; Bennett, Gary; Gibb, Timothy

2012-01-01

Bed bug (Cimex lectularius L.) infestations are currently controlled by a variety of non-chemical and chemical methods. There have been few studies on the comparative effectiveness of these control techniques. We evaluated three bed bug management strategies in an apartment building: (1) non-chemical methods only (n = 9); (2) insecticides only (n = 6); and (3) integrated pest management including both non-chemical methods and insecticides (n = 9). The apartments were one-bedroom units occupied by seniors or people with disabilities. Bed bug numbers in each apartment were determined by visual inspection and/or installing intercepting devices under bed and sofa legs. The median (min, max) bed bug counts in the non-chemical methods only, insecticides only, and integrated pest management (IPM) treatment were: 4 (1, 57), 19 (1, 250), and 14 (1, 219), respectively prior to the treatments. The apartments were retreated if found necessary during biweekly to monthly inspections. After 10 weeks, bed bugs were found to be eliminated from 67, 33, and 44% of the apartments in the three treatment groups, respectively. The final (after 10 weeks) median (min, max) bed bug counts in the non-chemical methods only, insecticides only, and IPM treatment were: 0 (0, 134), 11.5 (0, 58), and 1 (0, 38), respectively. There were no significant differences in the speed of bed bug count reduction or the final bed bug counts. Lack of resident cooperation partially contributed to the failure in eliminating bed bugs from some of the apartments. Results of this study suggest that non-chemical methods can effectively eliminate bed bugs in lightly infested apartments. PMID:26466533

Benthic Resources Assessment Technique Evaluation of Potential Dredged Material Disposal Sites in Puget Sound. Phase 2 Sites

DTIC Science & Technology

1987-12-01

the habitat preferences of the selected target species. The ichthyofauna inhabiting the southern versus the northern Puget Sound study areas were not...studies. Trans. Amer. Fish. Soc. 92(4):434-435. Carr, W.E.S. and C.A. Adams. 1973. Food habits of juvenile marine fishes occupying seagrass beds in the

Malaspina Glacier: a modern analog to the Laurentide Glacier in New England

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gustavson, T.C.; Boothroyd, J.C.

1985-01-01

The land-based temperate Malaspina Glacier is a partial analog to the late Wisconsinan Laurentide Ice Sheet that occupied New England and adjacent areas. The Malaspina occupies a bedrock basin similar to basins occupied by the margin of the Laurentide Ice Sheet. Ice lobes of the Malaspina are similar in size to end moraine lobes in southern New England and Long Island,New York. Estimated ice temperature, ablation rates, surface slopes and meltwater discharge per unit of surface area for the Laurentide Ice Sheet are similar to those for the Malaspina Glacier. In a simple hydrologic-fluvial model for the Malaspina Glacier meltwatermore » moves towards the glacier bed and down-glacier along intercrystalline pathways, crevasses and moulins, and a series of tunnels. Regolith and bedrock at the glacier floor, which are eroded and transported by subglacial and englacial streams, are the sources of essentially all fluvio-lacustrine sediment on the Malaspina Foreland. Supraglacial eskers containing coarse gravels occur as much as 100 m above the glacier bed and are evidence that bedload can be lifted hydraulically. Subordinant amounts of sediment are contributed to outwash by small surface streams draining the ice margin. By analogy a similar hydrologic-fluvial system existed along the southeastern margin of the Laurentide Ice Sheet. Subglacial regolith and bedrock eroded from beneath the Laurentide Ice Sheet by meltwater was also the source of most glaciofluvial and glaciolacustrine deposits in southern New England, not sediment carried to the surface of the ice sheet along shear planes and washed off the glacier by meltwater.« less

Field Study of the Comparative Efficacy of Three Pyrethroid/Neonicotinoid Mixture Products for the Control of the Common Bed Bug, Cimex lectularius.

PubMed

Wang, Changlu; Singh, Narinderpal; Cooper, Richard

2015-03-18

Three insecticide mixtures that contain two classes of insecticides (pyrethroid and neonicotinoid) were recently developed to control bed bugs. We evaluated three integrated bed bug management strategies in apartments, each using the same non-chemical control methods and one of the three insecticide mixture products: Tandem (lambda-cyhalothrin + thiamethoxam), Temprid SC (beta-cyfluthrin + imidacloprid), and Transport Mikron (bifenthrin + acetamiprid). No insecticides were applied in the Control apartments. In all apartments, we installed vinyl mattress encasements (if not already present) and applied steam to beds and other infested upholstered furniture. Insecticide sprays were applied in the three treatments. Each treatment and the Control included 8-10 occupied apartments. Re-treatment was conducted during biweekly inspections if necessary. After eight weeks, the mean (± SEM) bed bug count reduction in the Tandem, Temprid SC, Transport Mikron, and Control was 89 ± 9, 87 ± 6, 98 ± 1, and 23 ± 54%, respectively. Only Tandem and Transport Mikron treatments resulted in significantly higher population reduction than the Control at eight weeks. There were no significant differences in mean percent reduction among the three treatments (Tandem, Temprid SC, Transport Mikron) at eight weeks. Tandem spray caused significantly faster bed bug reduction than Temprid SC spray and Transport Mikron spray.

Field Study of the Comparative Efficacy of Three Pyrethroid/Neonicotinoid Mixture Products for the Control of the Common Bed Bug, Cimex lectularius

PubMed Central

Wang, Changlu; Singh, Narinderpal; Cooper, Richard

2015-01-01

Three insecticide mixtures that contain two classes of insecticides (pyrethroid and neonicotinoid) were recently developed to control bed bugs. We evaluated three integrated bed bug management strategies in apartments, each using the same non-chemical control methods and one of the three insecticide mixture products: Tandem (lambda-cyhalothrin + thiamethoxam), Temprid SC (beta-cyfluthrin + imidacloprid), and Transport Mikron (bifenthrin + acetamiprid). No insecticides were applied in the Control apartments. In all apartments, we installed vinyl mattress encasements (if not already present) and applied steam to beds and other infested upholstered furniture. Insecticide sprays were applied in the three treatments. Each treatment and the Control included 8–10 occupied apartments. Re-treatment was conducted during biweekly inspections if necessary. After eight weeks, the mean (± SEM) bed bug count reduction in the Tandem, Temprid SC, Transport Mikron, and Control was 89 ± 9, 87 ± 6, 98 ± 1, and 23 ± 54%, respectively. Only Tandem and Transport Mikron treatments resulted in significantly higher population reduction than the Control at eight weeks. There were no significant differences in mean percent reduction among the three treatments (Tandem, Temprid SC, Transport Mikron) at eight weeks. Tandem spray caused significantly faster bed bug reduction than Temprid SC spray and Transport Mikron spray. PMID:26463075

Using simulation to determine the need for ICU beds for surgery patients.

PubMed

Troy, Philip Marc; Rosenberg, Lawrence

2009-10-01

As the need for surgical ICU beds at the hospital increases, the mismatch between demand and supply for those beds has led to the need to understand the drivers of ICU performance. A Monte Carlo simulation study of ICU performance was performed using a discrete event model that captured the events, timing, and logic of ICU patient arrivals and bed stays. The study found that functional ICU capacity, ie, the number of occupied ICU beds at which operative procedures were canceled if they were known to require an ICU stay, was the main determinant of the wait, the number performed, and the number of cancellations of operative procedures known to require an ICU stay. The study also found that actual and functional ICU capacity jointly explained ICU utilization and the mean number of patients that should have been in the ICU that were parked elsewhere. The study demonstrated the necessity of considering actual and functional ICU capacity when analyzing surgical ICU bed requirements, and suggested the need for additional research on synchronizing demand with supply. The study also reinforced the authors' sense that simulation facilitates the evaluation of trade-offs between surgical management alternatives proposed by experts and the identification of unexpected drawbacks or opportunities of those proposals.

WISE-2005 Protective Effect of Exercise within LBNP Countermeasure Detected by Heart Rate Response to Low Levels of LBNP

NASA Technical Reports Server (NTRS)

Hughson, R. L.; Shoemaker, J. K.; Hargens, A. R.; Mattar, L.; Edgell, H.; Kerbeci, P.; Arbeille, Ph.

2006-01-01

Sixteen women were studied before, during and after a 60 day, continu ous 6" head-down bed-rest (HDBR). Subjects were randomly assigned to two groups: Control (no countermeasures) and Exercise+LBNP (supine ru nning within an LBNP chamber for 40-min followed by 10-min passive L BNP for 3-4 days/week, plus flywheel resistive training of the legs e very third day). Cardiovascular responses were observed before bed re st, on day 50 of HDBR and R+8 after bed rest. Subjects were supine in the LBNP device with suction applied at 0, -10, -20 and -30 mmHg LBN P for 2-min per stage. In the pre-bed rest testing, there was no diff erence in HR between the groups at rest or at -30 mmHg. On HDBR day 50, HR was elevated at supine rest for the Con not the Ex group, whil e at -30 mmHg HR was elevated above pre-HDBR for both groups, but the magnitude of increase from Pre- to HDBR day 50 was less for the Ex g roup than for the Con group. The change in HR on HDBR day 50 is an im portant indicator as it was less than 24-hours after the Exercise+LBN P countermeasure on day 49. After bed rest, no specific countermeasu res were provided in the first week, so HR responses on day R+8 refle cted the effects of bed rest with or without countermeasure plus any recovery from simply returning to the upright posture. Relative to th e Pre-bed rest responses, HR on day R+8 had recovered in the Ex group but was still elevated in the Con group. These results indicate that the cardiovascular response to LBNP is preserved to a greater degre e during bed rest by the countermeasures, and further that the cardio vascular response returned to pre-bed rest much more rapidly in the E xercise+LBNP group than hi the group that received no cardiovascular countermeasures.

The Effects of Long Duration Bed Rest on Functional Mobility and Balance: Relationship to Resting State Motor Cortex Connectivity

NASA Technical Reports Server (NTRS)

Erdeniz, B.; Koppelmans, V.; Bloomberg, J. J.; Kofman, I. S.; DeDios, Y. E.; Riascos-Castaneda, R. F.; Wood, S. J.; Mulavara, A. P.; Seidler, R. D.

2014-01-01

NASA offers researchers from a variety of backgrounds the opportunity to study bed rest as an experimental analog for space flight. Extended exposure to a head-down tilt position during long duration bed rest can resemble many of the effects of a low-gravity environment such as reduced sensory inputs, body unloading and increased cephalic fluid distribution. The aim of our study is to a) identify changes in brain function that occur with prolonged bed rest and characterize their recovery time course; b) assess whether and how these changes impact behavioral and neurocognitive performance. Thus far, we completed data collection from six participants that include task based and resting state fMRI. The data have been acquired through the bed rest facility located at the University of Texas Medical Branch (Galveston, TX). Subjects remained in bed with their heads tilted down 6 degrees below their feet for 70 consecutive days. Behavioral measures and neuroimaging assessments were obtained at seven time points: a) 7 and 12 days before bed rest; b) 7, 30, and 65 days during bed rest; and c) 7 and 12 days after bed rest. Functional connectivity magnetic resonance imaging (FcMRI) analysis was performed to assess the connectivity of motor cortex in and out of bed rest. We found a decrease in motor cortex connectivity with vestibular cortex and the cerebellum from pre bed rest to in bed rest. We also used a battery of behavioral measures including the functional mobility test and computerized dynamic posturography collected before and after bed rest. We will report the preliminary results of analyses relating brain and behavior changes. Furthermore, we will also report the preliminary results of a spatial working memory task and vestibular stimulation during in and out of bed rest.

Efficient Software Systems for Cardio Surgical Departments

NASA Astrophysics Data System (ADS)

Fountoukis, S. G.; Diomidous, M. J.

2009-08-01

Herein, the design implementation and deployment of an object oriented software system, suitable for the monitoring of cardio surgical departments, is investigated. Distributed design architectures are applied and the implemented software system can be deployed on distributed infrastructures. The software is flexible and adaptable to any cardio surgical environment regardless of the department resources used. The system exploits the relations and the interdependency of the successive bed positions that the patients occupy at the different health care units during their stay in a cardio surgical department, to determine bed availabilities and to perform patient scheduling and instant rescheduling whenever necessary. It also aims to successful monitoring of the workings of the cardio surgical departments in an efficient manner.

Variability of Bed Load Transport During Six Summers of Continuous Measurements in Two Austrian Mountain Streams (Fischbach and Ruetz)

NASA Astrophysics Data System (ADS)

Rickenmann, Dieter

2018-01-01

Previous measurements of bed load transport in gravel bed streams revealed a large temporal and spatial variability of bed load transport rates. Using an impact plate geophone system, continuous bed load transport measurements were made during 6 years in two mountain streams in Austria. The two streams have a snow-melt and glacier-melt dominated hydrologic regime resulting in frequent transport activity during the summer half year. Periods of days to weeks were identified which are associated with approximately constant Shields values that indicate quasi-stable bed conditions. Between these stable periods, the position of the bed load transport function varied while its steepness remained approximately constant. For integration time scales of several hours to 1 day, the fluctuations in bed load transport decreased and the correlation between bed load transport and water discharge increased. For integration times of about 70-100 days, bed load transport is determined by discharge or shear stress to within a factor of about 2, relative to the 6 year mean level. Bed load texture increased with increasing mean flow strength and mean transport intensity. Weak and predominantly clockwise daily hysteresis of bed load transport was found for the first half of the summer period.

The difference between activity when in bed and out of bed. II. Subjects on 27-hour "days".

PubMed

Minors, D; Folkard, S; MacDonald, I; Owens, D; Sytnik, N; Tucker, P; Waterhouse, J

1996-08-01

Nine healthy subjects have been studied while exposed to the normal alternation of light and dark, but with their sleep and activity pattern adjusted to a 27-h "day" for 17 imposed "days." Rectal temperature showed clearly the competing influences of 27-h and 24-h components, and these were separated by the method of "purification." The method indicated that the endogenous component had a constant amplitude throughout the experiment and remained entrained to solar (24-h) time; by contrast, the exogenous component followed the imposed 27-h "day" and increased rectal temperature in proportion to the amount of subjects' activity. Wrist movement was used to assess activity while in bed (attempting sleep) and out of bed (when naps were forbidden). While these results confirmed adherence of the subjects to the imposed 27-h "days," they also showed that the dichotomy between "out of bed" activity and "in bed" inactivity depended on the phase relationship between endogenous (24h) and exogenous (27h) components. Thus, the dichotomy was highest and was equal to that during control days (with a conventional 24-h life-style) when the two components were in phase and lowest when the solar and imposed day were in antiphase. This was due to changes in activity, both during time spent in bed and out of bed. We confirm that this protocol can produce valuable information about the properties of the circadian system in humans and the value of the process of purification of temperature data. We have established also that the very simple and noninvasive measurement of wrist movement, coupled with its use to calculate dichotomy indices, provides valuable information that both confirms and extends the results obtained from the more conventional (but also more invasive) measurement of rectal temperature.

Cardiovascular Adaptations to Long Duration Head Down Tilt Bed Rest

NASA Technical Reports Server (NTRS)

Platts, Steven H.; Meck, Janice V.; Martin, David S.; Freeman-Perez, Sondra A.; Riberio, Christine; Garcia, Kathleen M.; Waters, Wendy W.

2007-01-01

Orthostatic hypotension is a recognized risk for crewmembers returning from space. Numerous cardiovascular mechanisms have been proposed to account for this problem including vascular and cardiac dysfunction. We studied arterial and cardiac function in 6-degree head-down tilt bed rest, which is the most widely accepted ground-based analog of spaceflight. Eleven subjects are included in this study (8 men and 3 women). Data analysis was limited to the first 49 days, and compared to pre-bed rest baseline data. Using ultrasound, data was collected on arterial diameters and flows at baseline and during reactive hyperemia and following administration of nitroglycerin. Echocardiography was used to acquire information regarding systolic and diastolic function as well as ventricular mass and diameter. Plasma volumes were significantly decreased by 7 days of bed rest and stayed down through 49 days. There were no differences in reactive hyperemic response in the arm at any time point. However, the hyperemic response in the leg was significantly increased at day 49. Arterial responses to nitroglycerin did not change over the duration of bed rest (day effect) in either the arm or leg, but there was a significant difference between the arm and the leg responses. There was a marked decrease in anterior tibial intimal-medial thickness at days 21, 35 and 49. Several cardiac functional parameters including IVRT, Mitral e-wave, ejection time, velocity of circumferential shortening and myocardial performance index were significantly changed following 49 days of bed rest. These data show that some cardiovascular measures change during bed rest, while others do not. Further study is needed to determine if these measures can provide any insight into the effects of bed rest, or spaceflight, on human cardiovascular performance.

The Effects of Long Duration Bed Rest as a Spaceflight Analogue on Resting State Sensorimotor Network Functional Connectivity and Neurocognitive Performance

NASA Technical Reports Server (NTRS)

Cassady, K.; Koppelmans, V.; Yuan, P.; Cooke, K.; De Dios, Y.; Stepanyan, V.; Szecsy, D.; Gadd, N.; Wood, S.; Reuter-Lorenz, P.;

The Southwest Atlantic intertidal burrowing crab Neohelice granulata modifies nutrient loads of phreatic waters entering coastal area

NASA Astrophysics Data System (ADS)

Fanjul, Eugenia; Grela, María A.; Canepuccia, Alejandro; Iribarne, Oscar

2008-08-01

Along the coastal areas of the Southwest Atlantic estuaries and embayments, phreatic water often circulates through very extended areas (up to several hundred meters perpendicular to the coast), dominated by dense assemblages of deep burrows of the crab Neohelice granulata (formerly Chasmagnathus granulatus). This crab inhabits the intertidal area, from mudflats to marshes vegetated by species of Spartina, Sarcocornia and Juncus, generating extensive burrowing beds where burrow density may reach up to 60 burrows m -2. Since the lower limit of the crab burrows is usually the water table, we investigated through field experiments the effect of N. granulata and their burrows on the chemical characteristics of this phreatic water. Water analysis from experimental (1) occupied burrows (with crabs), (2) unoccupied burrows (where crabs were excluded), and (3) sediment pore water show remarkable differences. Water oxygenation, and nitrate, ammonium and sulphate concentrations inside occupied burrows were higher than in the water inside unoccupied burrows or pore waters. Moreover, directed sampling of phreatic water entering and leaving the crab bed, shows that dissolved inorganic nitrogen concentration is enhanced as the water crosses the crab bed. These results may be ascribed to the fact that in the salt marsh the crabs spend most of their time within burrows, where presumably they store food (plants) and defecate. These activities generate an area of accumulation of excrements and nutrients in different decomposition states. The present work shows a novel way by which bioturbating organisms can affect nutrients exportation from salt marshes to the open waters.

The effect of supplemental oral phosphate on the bone mineral changes during prolonged bed rest

PubMed Central

Hulley, Stephen B.; Vogel, John M.; Donaldson, Charles L.; Bayers, Jon H.; Friedman, Ronald J.; Rosen, Sheldon N.

1971-01-01

Five healthy young men were studied during 24-30 wk of continuous bed rest. During the first 12 wk of bed rest, untreated subjects increased calcium excretion in the urine by 109 mg/day and in the feces by 147 mg/day. The rate of total body calcium loss was 0.5-0.7% per month. Losses of central calcaneus mineral, assessed by gamma ray transmission scanning, occurred at a tenfold higher rate, whereas the mineral content of the radius did not change. Changes in phosphorus balance resembled the calcium pattern, and increased excretion of nitrogen and hydroxyproline also occurred during bed rest. Upon reambulation, the subjects' calcium balance became positive in 1 month and recovery of their calcaneus mineral was complete within 10-20 wk. Treatment with potassium phosphate supplements (1327 mg P/day) entirely prevented the hypercalciuria of bed rest, but fecal calcium tended to increase. During the first 12 wk, calcium balance was slightly less negative (mean - 193 mg/day) than during bed rest without added phosphate (mean - 267 mg/day). This effect was not seen during the second 12 wk of bed rest. The patterns of magnesium excretion were similar to those of calcium. Fecal and urinary phosphorus excretions were doubled, and phosphorus balance became positive (+ 113 mg/day). Mineral loss from the central calcaneus was similar to that of untreated subjects. It is concluded that this form of phosphate supplementation reduces urinary calcium excretion but does not prevent bone loss during bed rest. PMID:5129304

Branched-chain amino acid supplementation during bed rest: effect on recovery

NASA Technical Reports Server (NTRS)

Stein, T. P.; Donaldson, M. R.; Leskiw, M. J.; Schluter, M. D.; Baggett, D. W.; Boden, G.

2003-01-01

Bed rest is associated with a loss of protein from the weight-bearing muscle. The objectives of this study are to determine whether increasing dietary branched-chain amino acids (BCAAs) during bed rest improves the anabolic response after bed rest. The study consisted of a 1-day ambulatory period, 14 days of bed rest, and a 4-day recovery period. During bed rest, dietary intake was supplemented with either 30 mmol/day each of glycine, serine, and alanine (group 1) or with 30 mmol/day each of the three BCAAs (group 2). Whole body protein synthesis was determined with U-(15)N-labeled amino acids, muscle, and selected plasma protein synthesis with l-[(2)H(5)]phenylalanine. Total glucose production and gluconeogenesis from alanine were determined with l-[U-(13)C(3)]alanine and [6,6-(2)H(2)]glucose. During bed rest, nitrogen (N) retention was greater with BCAA feeding (56 +/- 6 vs. 26 +/- 12 mg N. kg(-1). day(-1), P < 0.05). There was no effect of BCAA supplementation on either whole body, muscle, or plasma protein synthesis or the rate of 3-MeH excretion. Muscle tissue free amino acid concentrations were increased during bed rest with BCAA (0.214 +/- 0.066 vs. 0.088 +/- 0.12 nmol/mg protein, P < 0.05). Total glucose production and gluconeogenesis from alanine were unchanged with bed rest but were significantly reduced (P < 0.05) with the BCAA group in the recovery phase. In conclusion, the improved N retention during bed rest is due, at least in part, to accretion of amino acids in the tissue free amino acid pools. The amount accreted is not enough to impact protein kinetics in the recovery phase but does improve N retention by providing additional essential amino acids in the early recovery phase.

Healthy Life-Years Lost and Excess Bed-Days Due to 6 Patient Safety Incidents: Empirical Evidence From English Hospitals.

PubMed

Hauck, Katharina D; Wang, Shaolin; Vincent, Charles; Smith, Peter C

2017-02-01

There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years. To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days. The study used cross-sectional analysis of the medical records of all inpatients treated in 273 English hospitals. Patients with 6 types of preventable incidents were identified. Total attributable loss of HLYs was estimated through propensity score matching by considering the hypothetical remaining length and quality of life had the incident not occurred. The 6 incidents resulted in an annual loss of 68 HLYs and 934 excess bed-days per 100,000 population. Preventable pressure ulcers caused the loss of 26 HLYs and 555 excess bed-days annually. Deaths in low-mortality procedures resulted in 25 lost life-years and 42 bed-days. Deep-vein thrombosis/pulmonary embolisms cost 12 HLYs, and 240 bed-days. Postoperative sepsis, hip fractures, and central-line infections cost <6 HLYs and 100 bed-days each. The burden caused by the 6 incidents is roughly comparable with the UK burden of Multiple Sclerosis (80 DALYs per 100,000), HIV/AIDS and Tuberculosis (63 DALYs), and Cervical Cancer (58 DALYs). There were marked differences in the harm caused by the incidents, despite the public attention all of them receive. Decision makers can use the results to prioritize resources into further research and effective interventions.

Circadian rhythm asynchrony in man during hypokinesis.

NASA Technical Reports Server (NTRS)

Winget, C. M.; Vernikos-Danellis, J.; Cronin, S. E.; Leach, C. S.; Rambaut, P. C.; Mack, P. B.

1972-01-01

Posture and exercise were investigated as synchronizers of certain physiologic rhythms in eight healthy male subjects in a defined environment. Four subjects exercised during bed rest. Body temperature (BT), heart rate, plasma thyroid hormone, and plasma steroid data were obtained from the subjects for a 6-day ambulatory equilibration period before bed rest, 56 days of bed rest, and a 10-day recovery period after bed rest. The results indicate that the mechanism regulating the circadian rhythmicity of the cardiovascular system is rigorously controlled and independent of the endocrine system, while the BT rhythm is more closely aligned to the endocrine system.

Feasibility Study of a Lunar Analog Bed Rest Model

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.; Platts, Steven H.; Yarbough, Patrice; Buccello-Stout, Regina

2010-01-01

The purpose of this study was to determine the feasibility of using a 9.5deg head-up tilt bed rest model to simulate the effects of the 1/6 g load to the human body that exists on the lunar surface. The lunar analog bed rest model utilized a modified hospital bed. The modifications included mounting the mattress on a sled that rolled on bearings to provide freedom of movement. The weight of the sled was off-loaded using a counterweight system to insure that 1/6 body weight was applied along the long axis (z-axis) of the body. Force was verified through use of a force plate mounted at the foot of the bed. A seating assembly was added to the bed to permit periods of sitting. Subjects alternated between standing and sitting positions throughout the day. A total of 35% of the day was spent in the standing position and 65% was spent sitting. In an effort to achieve physiologic fluid shifts expected for a 1/6 G environment, subjects wore compression stockings and performed unloaded foot and ankle exercises. Eight subjects (3 females and 5 males) participated in this study. Subjects spent 13 days in the pre-bed rest phase, 6 days in bed rest and 3 days post bed rest. Subjects consumed a standardized diet throughout the study. To determine feasibility, measures of subject comfort, force and plasma volume were collected. Subject comfort was assessed using a Likert scale. Subjects were asked to assess level of comfort (0-100) for 11 body regions and provide an overall rating. Results indicated minimal to no discomfort as most subjects reported scores of zero. Force measures were performed for each standing position and were validated against subject s calculated 1/6 body weight (r(sup 2) = 0.993). The carbon monoxide rebreathing technique was used to assess plasma volume during pre-bed rest and on the last day of bed rest. Plasma volume results indicated a significant decrease (p = 0.001) from pre to post bed rest values. Subjects lost on average 8.3% (sd = 6.1%) during the bed rest phase. Findings from this feasibility study indicated that 1) the lunar analog bed rest model was well tolerated by subjects; 2) a 1/6 load was accurately applied to the z-axis of the body; and 3) plasma volume losses could be achieved in a head-up tilt bed rest model. Future work to refine this model should include extending the duration of bed rest to mimic longer mission durations and a comprehensive assessment of the physiological responses to this bed rest analog.

Pandemic influenza-implications for critical care resources in Australia and New Zealand.

PubMed

Anderson, Therese A; Hart, Graeme K; Kainer, Marion A

2003-09-01

To quantify resource requirements (additional beds and ventilator capacity), for critical care services in the event of pandemic influenza. Cross-sectional survey about existing and potential critical care resources. Participants comprised 156 of the 176 Australasian (Australia and New Zealand) critical care units on the database of the Australian and New Zealand Intensive Care Society (ANZICS) Research Centre for Critical Care Resources. The Meltzer, Cox and Fukuda model was adapted to map a range of influenza attack rate estimates for hospitalisation and episodes likely to require intensive care and to predict critical care admission rates and bed day requirements. Estimations of ventilation rates were based on those for community-acquired pneumonia. The estimated extra number of persons requiring hospitalisation ranged from 8,455 (10% attack rate) to 150,087 (45% attack rate). The estimated number of additional admissions to critical care units ranged from 423 (5% admission rate, 10% attack rate) to 37,522 (25% admission rate, 45% attack rate). The potential number of required intensive care bed days ranged from 846 bed days (2 day length of stay, 10% attack rate) to 375,220 bed days (10 day length of stay, 45% attack rate). The number of persons likely to require mechanical ventilation ranged from 106 (25% of projected critical care admissions, 10% attack rate) to 28,142 (75% of projected critical care admissions, 45% attack rate). An additional 1,195 emergency ventilator beds were identified in public sector and 248 in private sector hospitals. Cancellation of elective surgery could release a potential 76,402 intensive care bed days (per annum), but in the event of pandemic influenza, 31,150 bed days could be required over an 8- to 12-week period. Australasian critical care services would be overwhelmed in the event of pandemic influenza. More work is required in relation to modelling, contingency plans, and resource allocation.

Effectiveness of bed bug monitors for detecting and trapping bed bugs in apartments.

PubMed

Wang, Changlu; Tsai, Wan-Tien; Cooper, Richard; White, Jeffrey

2011-02-01

Bed bugs, Cimex lectularius L., are now considered a serious urban pest in the United States. Because they are small and difficult to find, there has been strong interest in developing and using monitoring tools to detect bed bugs and evaluate the results of bed bug control efforts. Several bed bug monitoring devices were developed recently, but their effectiveness is unknown. We comparatively evaluated three active monitors that contain attractants: CDC3000, NightWatch, and a home-made dry ice trap. The Climbup Insect Interceptor, a passive monitor (without attractants), was used for estimating the bed bug numbers before and after placing active monitors. The results of the Interceptors also were compared with the results of the active monitors. In occupied apartments, the relative effectiveness of the active monitors was: dry ice trap > CDC3000 > NightWatch. In lightly infested apartments, the Interceptor (operated for 7 d) trapped similar number of bed bugs as the dry ice trap (operated for 1 d) and trapped more bed bugs than CDC3000 and NightWatch (operated for 1 d). The Interceptor was also more effective than visual inspections in detecting the presence of small numbers of bed bugs. CDC3000 and the dry ice trap operated for 1 d were equally as effective as the visual inspections for detecting very low level of infestations, whereas 1-d deployment of NightWatch detected significantly lower number of infestations compared with visual inspections. NightWatch was designed to be able to operate for several consecutive nights. When operated for four nights, NightWatch trapped similar number of bed bugs as the Interceptors operated for 10 d after deployment of NightWatch. We conclude these monitors are effective tools in detecting early bed bug infestations and evaluating the results of bed bug control programs.

The Effects of Long Duration Bed Rest on Brain Functional Connectivity and Sensorimotor Functioning

NASA Technical Reports Server (NTRS)

Cassady, K.; Koppelmans, V.; De Dios, Y.; Stepanyan, V.; Szecsy, D.; Gadd, N.; Wood, S.; Reuter-Lorenz, P.; Castenada, R. Riascos; Kofman, I.;

Effect of Sand and Sawdust Bedding Materials on the Fecal Prevalence of Escherichia coli O157:H7 in Dairy Cows

PubMed Central

LeJeune, Jeffrey T.; Kauffman, Michael D.

2005-01-01

Farm management practices that reduce the prevalence of food-borne pathogens in live animals are predicted to enhance food safety. To ascertain the potential role of livestock bedding in the ecology and epidemiology of Escherichia coli O157:H7 on farms, the survival of this pathogen in used-sand and used-sawdust dairy cow bedding was determined. Additionally, a longitudinal study of mature dairy cattle housed on 20 commercial dairy farms was conducted to compare the prevalence of E. coli O157:H7 in cattle bedded on sand to that in cattle bedded on sawdust. E. coli O157:H7 persisted at higher concentrations in used-sawdust bedding than in used-sand bedding. The overall average herd level prevalence (3.1 versus 1.4%) and the number of sample days yielding any tests of feces positive for E. coli O157:H7 (22 of 60 days versus 13 of 60 days) were higher in sawdust-bedded herds. The choice of bedding material used to house mature dairy cows may impact the prevalence of E. coli O157:H7 on dairy farms. PMID:15640205

Human skeletal muscle protein breakdown during spaceflight

NASA Technical Reports Server (NTRS)

Stein, T. P.; Schluter, M. D.

1997-01-01

Human spaceflight is associated with a loss of body protein. Excretion of 3-methylhistidine (3-MH) in the urine is a useful measurement of myofibrillar protein breakdown. Bed rest, particularly with 6 degrees head-down tilt, is an accepted ground-based model for human spaceflight. The objectives of this report were to compare 3-MH excretion from two Life Sciences shuttle missions (duration 9.5 and 15 days, n = 9) and from 17 days of bed rest (n = 7) with 6 degrees head-down tilt. The bed rest study was designed to mimic an actual Life Sciences spaceflight and so incorporated an extensive battery of physiological tests focused on the musculoskeletal system. Results showed that nitrogen retention, based on excretion of nitrogen in the urine, was reduced during both bed rest [from 22 +/- 1 to 1 +/- 5 mg N x kg(-1) x day(-1) (n = 7; P < 0.05)] and spaceflight [from 57 +/- 9 to 19 +/- 3 mg N x kg(-1) x day(-1) (n = 9; P < 0.05)]. 3-MH excretion was unchanged with either bed rest [pre-bed rest 5.30 +/- 0.29 vs. bed rest 5.71 +/- 0.30 micromol 3-MH x kg(-1) x day(-1), n = 7; P = not significant (NS)] or spaceflight [preflight 4.98 +/- 0.37 vs. 4.59 +/- 0.39 micromol 3-MH x kg(-1) x day(-1) in-flight, n = 9; P = NS]. We conclude that 1) 3-MH excretion was unaffected by spaceflight on the shuttle or with bed rest plus exercise, and 2) because protein breakdown (elevated 3-MH) was increased on Skylab but not on the shuttle, it follows that muscle protein breakdown is not an inevitable consequence of spaceflight.

Limited effect of fly-wheel and spinal mobilization exercise countermeasures on lumbar spine deconditioning during 90 d bed-rest in the Toulouse LTBR study

NASA Astrophysics Data System (ADS)

Belavý, Daniel L.; Ohshima, Hiroshi; Bareille, Marie-Pierre; Rittweger, Jörn; Felsenberg, Dieter

2011-09-01

We examined the effect of high-load fly-wheel (targeting the lower-limb musculature and concurrent loading of the spine via shoulder restraints) and spinal movement countermeasures against lumbar spine muscle atrophy, disc and spinal morphology changes and trunk isokinetic torque loss during prolonged bed-rest. Twenty-four male subjects underwent 90 d head-down tilt bed-rest and performed either fly-wheel (FW) exercises every three days, spinal movement exercises in lying five times daily (SpMob), or no exercise (Ctrl). There was no significant impact of countermeasures on losses of isokinetic trunk flexion/extension ( p≥0.65). Muscle volume change by day-89 of bed-rest in the psoas, iliacus, lumbar erector spinae, lumbar multifidus and quadratus lumborum, as measured via magnetic resonance imaging (MRI), was statistically similar in all three groups ( p≥0.33). No significant effect on MRI-measures of lumbar intervertebral disc volume, spinal length and lordosis ( p≥0.09) were seen either, but there was some impact ( p≤0.048) on axial plane disc dimensions (greater reduction than in Ctrl) and disc height (greater increases than in Ctrl). MRI-data from subjects measured 13 and 90-days after bed-rest showed partial recovery of the spinal extensor musculature by day-13 after bed-rest with this process complete by day-90. Some changes in lumbar spine and disc morphology parameters were still persistent 90-days after bed-rest. The present results indicate that the countermeasures tested were not optimal to maintain integrity of the spine and trunk musculature during bed rest.

Flume Experiments on the Influence of Salmon Spawning Density on Grain Stability and Bedload Transport in Gravel-bed Streams

NASA Astrophysics Data System (ADS)

Buxton, T. H.

2015-12-01

Salmon spawning in streams involves the female salmon digging a pit in the bed where she deposits eggs for fertilization before covering them with gravel excavated from the next pit upstream. Sequences of pit excavation and filling winnow fines, loosen sediment, and move bed material into a tailspill mound resembling the shape of a dune. Research suggests salmonid nests (redds) destabilize streambeds by reducing friction between loosened grains and converging flow that elevates shear stress on redd topography. However, bed stability may be enhanced by form drag from redds in clusters that lower shear stress on the granular bed, but this effect will vary with the proportion of the bed surface that is occupied by redds (P). I used simulated redds and water-worked ("unspawned") beds in a laboratory flume to evaluate these competing influences on grain stability and bedload transport rates with P=0.12, 0.34, and 0.41. Results indicate that competence (largest-grain) and reference transport rate estimates of critical conditions for particle entrainment inversely relate to P. Bedload transport increased as exponential functions of P and excess boundary shear stress. Therefore, redd form drag did not overcome the destabilizing effects of spawning. Instead, grain mobility and bedload transport increased with P because larger areas of the bed were composed of relatively loose, unstable grains and redd topography that experienced elevated shear stress. Consequently, the presence of redds in fish-bearing streams likely reduces the effects of sedimentation from landscape disturbance on stream habitats that salmon use for reproduction.

[The prevalence of nosocomial infection in Intensive Care Units in the State of Rio Grande do Sul].

PubMed

Lisboa, Thiago; Faria, Mario; Hoher, Jorge A; Borges, Luis A A; Gómez, Jussara; Schifelbain, Luciele; Dias, Fernando S; Lisboa, João; Friedman, Gilberto

2007-12-01

To determine the prevalence of intensive care unit (ICU)-acquired infections and the risk factors for these infections, identify the predominant infecting organisms, and evaluate the relationship between ICU-acquired infection and mortality. A 1-day point prevalence study. Sixteen ICU of the State of Rio Grande do Sul-Brazil, excluding coronary care and pediatric units. All patients < 12 yrs occupying an ICU bed over a 24-hour period. The 16 ICU provided 174 case reports. rates of ICU-acquired infection, resistance patterns of microbiological isolates, and potential risks factors for ICU-acquired infection and death. A total of 122 patients (71%) was infected and 51 (29%) had ICU-acquired infection. Pneumonia (58.2%), lower tract respiratory infection (22.9%), urinary tract infection (18%) were the most frequents types of ICU infection. Most frequently microorganisms reported were staphylococcus aureus (42% [64% resistant to oxacilin]) and pseudomonas aeruginosa (31%). Six risk factors for ICU acquired infection were identified: urinary catheterization, central vascular line, tracheal intubation for prolonged time (> 4 days), chronic disease and increased length of ICU stay (> 30 days). The risks factors associated with death were age, APACHE II, organ dysfunction, and tracheal intubation with or without mechanical ventilation. ICU-acquired infection is common and often associated with microbiological isolates of resistant organisms. This study may serve as an epidemiological reference to help the discussion of regional infection control policies.

Physician organization care management capabilities associated with effective inpatient utilization management: a fuzzy set qualitative comparative analysis.

PubMed

Sheehy, Thomas J; Thygeson, N Marcus

2014-12-03

We studied the relationship between physician organization (PO) care management capabilities and inpatient utilization in order to identify PO characteristics or capabilities associated with low inpatient bed-days per thousand. We used fuzzy-set qualitative comparative analysis (fsQCA) to conduct an exploratory comparative case series study. Data about PO capabilities were collected using structured interviews with medical directors at fourteen California POs that are delegated to provide inpatient utilization management (UM) for HMO members of a California health plan. Health plan acute hospital claims from 2011 were extracted from a reporting data warehouse and used to calculate inpatient utilization statistics. Supplementary analyses were conducted using Fisher's Exact Test and Student's T-test. POs with low inpatient bed-days per thousand minimized length of stay and surgical admissions by actively engaging in concurrent review, discharge planning, and surgical prior authorization, and by contracting directly with hospitalists to provide UM-related services. Disease and case management were associated with lower medical admissions and readmissions, respectively, but not lower bed-days per thousand. Care management methods focused on managing length of stay and elective surgical admissions are associated with low bed-days per thousand in high-risk California POs delegated for inpatient UM. Reducing medical admissions alone is insufficient to achieve low bed-days per thousand. California POs with high bed-days per thousand are not applying care management best practices.

Effects of 45-day -6° head-down bed rest on the time-based prospective memory

NASA Astrophysics Data System (ADS)

Chen, SiYi; Zhou, RenLai; Xiu, LiChao; Chen, ShanGuang; Chen, XiaoPing; Tan, Cheng

2013-03-01

The research explored the effects of 45-day -6° head-down bed rest (HDBR) simulation of microgravity on the time-based prospective memory (PM) with 16 males. The time-based prospective memory task was performed on the 2nd day before HDBR, on the 11th, 20th, 32nd, and 40th days during HDBR, and on the 8th day after HDBR, and subjects' anxiety and depression feelings were recorded simultaneously using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The results demonstrated that it showed decreased accuracy of PM responses and frequency of clock checks during and after bed rest; long term bed rest did not induce significant emotional changes. The deficit of prospective memory performance induced by long term HDBR may result from a lack of aerobic physical activity or changes in the prefrontal cortex, but it remains to be determined.

[Environmental impact of a public hospital in the city of Lima, Peru].

PubMed

Bambarén-Alatrista, Celso; Alatrista-Gutiérrez de Bambarén, María del Socorro

2014-01-01

The operation of hospitals produces negative effects on the environment which contributes to air pollution and climate change. The institution in this study is a category III health care facility located in the city of Lima. It generates 4.89 kg/bed/day of solid waste, and consumes 1.36 m3/bed/day of water; 25.22 kWh/bed/day of electricity, and 2.76 liters/bed/day of fuel. The level of PM10 and measured parameters of disposal to the public network are within legal limits, while mobile source noise exceeds the maximum allowable limit. The institution releases into the atmosphere 2,291 tons of CO2 equivalents per year. In conclusion, the institution studied generates a negative impact on the environment.

Assessment of Appalachian basin oil and gas resources: Carboniferous Coal-bed Gas Total Petroleum System: Chapter G.1 in Coal and petroleum resources in the Appalachian basin: distribution, geologic framework, and geochemical character

USGS Publications Warehouse

Milici, Robert C.; Ruppert, Leslie F.; Ryder, Robert T.

2014-01-01

Trap formation began with the deposition of the peat deposits during the Mississippian and continued into the Late Pennsylvanian and Permian, when strata of the Appalachian Plateaus were deformed during the Alleghanian orogeny. The seals are the connate waters that occupy fractures and larger pore spaces within the coal beds, as well as the fine-grained, siliciclastic sedimentary strata that are intercalated with the coal. The critical moment for the petroleum system occurred during the Alleghanian orogeny, when deformation resulted in the geologic structures in the eastern part of the Appalachian basin that enhanced fracture porosity within the coal beds. In places, burial by thrust sheets (thrust loading) in the Valley and Ridge physiographic province may have resulted in the additional generation of thermogenic coalbed methane in the Pennsylvania Anthracite region and in the semianthracite deposits of Virginia and West Virginia, although other explanations have been offered.

Bed Capacity Planning Using Stochastic Simulation Approach in Cardiac-surgery Department of Teaching Hospitals, Tehran, Iran

PubMed Central

TORABIPOUR, Amin; ZERAATI, Hojjat; ARAB, Mohammad; RASHIDIAN, Arash; AKBARI SARI, Ali; SARZAIEM, Mahmuod Reza

2016-01-01

Background: To determine the hospital required beds using stochastic simulation approach in cardiac surgery departments. Methods: This study was performed from Mar 2011 to Jul 2012 in three phases: First, collection data from 649 patients in cardiac surgery departments of two large teaching hospitals (in Tehran, Iran). Second, statistical analysis and formulate a multivariate linier regression model to determine factors that affect patient's length of stay. Third, develop a stochastic simulation system (from admission to discharge) based on key parameters to estimate required bed capacity. Results: Current cardiac surgery department with 33 beds can only admit patients in 90.7% of days. (4535 d) and will be required to over the 33 beds only in 9.3% of days (efficient cut off point). According to simulation method, studied cardiac surgery department will requires 41–52 beds for admission of all patients in the 12 next years. Finally, one-day reduction of length of stay lead to decrease need for two hospital beds annually. Conclusion: Variation of length of stay and its affecting factors can affect required beds. Statistic and stochastic simulation model are applied and useful methods to estimate and manage hospital beds based on key hospital parameters. PMID:27957466

Effects of three day bed-rest on circulatory, metabolic and hormonal responses to oral glucose load in endurance trained athletes and untrained subjects

NASA Technical Reports Server (NTRS)

Smorawinski, J.; Kubala, P.; Kaciuba-Uociako, H.; Nazar, K.; Titow-Stupnicka, E.; Greenleaf, J. E.

1996-01-01

Endurance trained long distance runners and untrained individuals underwent three days of bed rest and oral glucose loading. Before and after bed rest, individuals were given glucose tolerance tests, and their heart rates, blood pressure, blood glucose levels, insulin levels, and catecholamine interactions were measured. Results indicated that glucose tolerance is more affected by bed rest-induced deconditioning in untrained individuals than in trained individuals.

Ammonia, Total Reduced Sulfides, and Greenhouse Gases of Pine Chip and Corn Stover Bedding Packs.

PubMed

Spiehs, Mindy J; Brown-Brandl, Tami M; Parker, David B; Miller, Daniel N; Berry, Elaine D; Wells, James E

2016-03-01

Bedding materials may affect air quality in livestock facilities. Our objective in this study was to compare headspace concentrations of ammonia (NH), total reduced sulfides (TRS), carbon dioxide (CO), methane (CH), and nitrous oxide (NO) when pine wood chips ( spp.) and corn stover ( L.) were mixed in various ratios (0, 10, 20, 30, 40, 60, 80, and 100% pine chips) and used as bedding with manure. Air samples were collected from the headspace of laboratory-scaled bedded manure packs weekly for 42 d. Ammonia concentrations were highest for bedded packs containing 0, 10, and 20% pine chips (equivalent to 501.7, 502.3, and 502.3 mg m, respectively) in the bedding mixture and were lowest when at least 80% pine chips were used as bedding (447.3 and 431.0 mg m, respectively for 80 and 100% pine chip bedding). The highest NH concentrations were observed at Day 28. The highest concentration of TRS was observed when 100% pine chips were used as bedding (11.4 µg m), with high concentrations occurring between Days 7 and 14, and again at Day 35. Greenhouse gases were largely unaffected by bedding material but CH and CO concentrations increased as the bedded packs aged and NO concentrations were highly variable throughout the incubation. We conclude that a mixture of bedding material that contains 30 to 40% pine chips may be the ideal combination to reduce both NH and TRS emissions. All gas concentrations increased as the bedded packs aged, suggesting that frequent cleaning of facilities would improve air quality in the barn, regardless of bedding materials used. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Effects of acute exercise on attenuated vagal baroreflex function during bed rest

NASA Technical Reports Server (NTRS)

Convertino, Victor A.; Doerr, Donald F.; Guell, Antonio; Marini, J.-F.

1992-01-01

We measured carotid baroreceptor-cardiac reflex responses in six healthy men, 24 h before and 24 h after a bout of leg exercise during 6 deg head-down bed rest to determine if depressed vagal baroreflex function associated with exposure to microgravity environments could be reversed by a single exposure to acute intense exercise. Baroreflex responses were measured before bed rest and on day 7 of bed rest. An exercise bout consisting of dynamic and isometric actions of the quadriceps at graded speeds and resistances was performed on day 8 of bed rest and measurements of baroreflex response were repeated 24 h later. Vagally-mediated cardiac responses were provoked with ramped neck pressure-suction sequences comprising pressure elevations to +40 mm Hg, followed by serial, R-wave triggered 15 mm Hg reductions, to -65 mm Hg. Baroreceptor stimulus-cardiac response relationships were derived by plotting each R-R interval as a function of systolic pressure less the neck chamber pressure applied during the interval. Compared with pre-bed rest baseline measurements, 7 d of bed rest decreased the gain (maximum slope) of the baroreflex stimulus-response relationship by 16.8 +/- 3.4 percent (p less than 0.05). On day 9 of bed rest, 24 h after exercise, the maximum slope of the baroreflex stimulus-response relationship was increased (p less than 0.05) by 10.7 +/- 3.7 percent above pre-bed rest levels and 34.3 +/- 7.9 percent above bed rest day 7. Our data verify that vagally-mediated baroreflex function is depressed by exposure to simulated microgravity and demonstrate that this effect can be acutely reversed by exposure to a single bout of intense exercise.

Effect of bed rest and exercise on body balance

NASA Technical Reports Server (NTRS)

Haines, R. F.

1974-01-01

A battery of 11 body balance tests was administered to 7 men before and after 14 days of bedrest. Seven men who had not undergone bed rest served as controls. During bed rest, each subject underwent daily either isotonic, isometric, or no leg exercise. The results showed that, for the bed-rested no exercise, isotonic exercise, and isometric exercise groups, 2 weeks of bed rest produces significant body balance decrements on 3, 4, and 5 of the 11 tests, respectively. Daily leg exercise did not prevent the debilitating effects of bed rest on body balance. After bed rest, balance skill was relearned rapidly so that in most tests, performance had reached prebed-rest levels by the third recovery day. These data suggest that balance impairment is not due to loss of muscular strength in the legs but, perhaps, to a bed-rest-related change in the neurally coded information to postural control centers.

Thyroid and adrenal cortical rhythmicity during bed rest.

NASA Technical Reports Server (NTRS)

Vernikos-Danellis, J.; Leach, C. S.; Winget, C. M.; Rambaut, P. C.; Mack, P. B.

1972-01-01

The effects of prolonged bed rest on adrenocortical and thyroid function were assessed in eight healthy males, aged 20-40 years, who were submitted to bed rest for 56 days on a 14L:10D regimen (lights-on, 9:00 AM). Four of these subjects exercised three times daily throughout the experiment. Circulating cortisol, triiodothyronine, and thyroxine, concentrations were determined in blood samples drawn at four hourly intervals for 48-hr periods before, 10, 20, 30, 42, and 54 days during, and 10 days post-bed rest. Significant fluctuations in the circulating levels of all three hormones occurred with peaks at 7:30 AM. The suggestion is advanced that thyroid rhythms may be posture dependent.

Pressure ulcer incidence and progression in critically ill subjects: influence of low air loss mattress versus a powered air pressure redistribution mattress.

PubMed

Black, Joyce; Berke, Christine; Urzendowski, Gail

2012-01-01

The primary objective of this study was to compare facility-acquired pressure ulcer incidence and progression of pressure ulcers present on admission in critically ill patients, using 2 different support surfaces. We completed a comparison cohort study in a surgical intensive care unit (ICU). The study setting was a 12-bed cardiovascular ICU in a university-based hospital in the Midwestern United States. The sample comprised 52 critically ill patients; 31 were placed on low air loss weight-based pressure redistribution-microclimate management system beds and 21 were placed on integrated powered air pressure redistribution beds. Prior to the start of the study, 5 low airloss beds were placed in open rooms in the cardiovascular surgical ICU. Inclusion criteria were anticipated ICU stay of 3 days, and patients did not receive a speciality bed for pulmonary or wound issues. Initial assessment of the patients included risk assessment and prior events that would increase risk for pressure ulcer development such as extended time in operating room, along with skin assessment for existing pressure ulcers. Subjects in both groups had ongoing skin assessment every 3 to 4 days and a subjective evaluation of heel elevation and turning or repositioning by the researcher. Data were collected until the subjects were dismissed from the ICU. Patients admitted to the unit were assigned to open rooms following the usual protocols. The mean length of stay was 7.0 days, with an 8.1-day length of stay for subjects on "low air loss with microclimate management" beds (LAL-MCM) and 6.6 days on the integrated power pressure air redistribution (IP-AR) beds (P = NS). The incidence of pressure ulcers on the buttocks, sacrum, or coccyx was 0% (0/31) on the low air loss bed and 18% (4/21) on the IP-AR bed (P = .046). Five subjects had 6 pressure ulcers on admission. Two pressure ulcers on 2 patients worsened on the integrated power air redistribution beds, which required specialty bed rental costing the facility $4116. No subjects on the low air loss beds experienced worsening of existing pressure ulcer. One patient with a deep tissue injury present on admission improved on the LAL-MCM bed. The IP-AR beds were approximately 7 years old, and the LAL-MCM beds were new. Critically ill subjects placed on low air loss beds with microclimate management in surgical ICUs had a lower pressure ulcer incidence than those placed on integrated powered air pressure redistribution beds. The clinical performance of the IP-AR surfaces may have been influenced by their age.

Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults.

PubMed

Deutz, Nicolaas E P; Pereira, Suzette L; Hays, Nicholas P; Oliver, Jeffery S; Edens, Neile K; Evans, Chris M; Wolfe, Robert R

2013-10-01

Loss of muscle mass due to prolonged bed rest decreases functional capacity and increases hospital morbidity and mortality in older adults. To determine if HMB, a leucine metabolite, is capable of attenuating muscle decline in healthy older adults during complete bed rest. A randomized, controlled, double-blinded, parallel-group design study was carried out in 24 healthy (SPPB ≥ 9) older adult subjects (20 women, 4 men), confined to complete bed rest for ten days, followed by resistance training rehabilitation for eight weeks. Subjects in the experimental group were treated with HMB (calcium salt, 1.5 g twice daily - total 3 g/day). Control subjects were treated with an inactive placebo powder. Treatments were provided starting 5 days prior to bed rest till the end rehabilitation phase. DXA was used to measure body composition. Nineteen eligible older adults (BMI: 21-33; age: 60-76 year) were evaluable at the end of the bed rest period (Control n = 8; Ca-HMB n = 11). Bed rest caused a significant decrease in total lean body mass (LBM) (2.05 ± 0.66 kg; p = 0.02, paired t-test) in the Control group. With the exclusion of one subject, treatment with HMB prevented the decline in LBM over bed rest -0.17 ± 0.19 kg; p = 0.23, paired t-test). There was a statistically significant difference between treatment groups for change in LBM over bed rest (p = 0.02, ANOVA). Sub-analysis on female subjects (Control = 7, HMB = 8) also revealed a significant difference in change in LBM over bed rest between treatment groups (p = 0.04, ANOVA). However, differences in function parameters could not be observed, probably due to the sample size of the study. In healthy older adults, HMB supplementation preserves muscle mass during 10 days of bed rest. These results need to be confirmed in a larger trial. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Early and late lithification of aragonitic bivalve beds in the Purbeck Formation (upper jurassic-lower cretaceous) of Southern England

NASA Astrophysics Data System (ADS)

El-Shahat, Adam; West, Ian

1983-05-01

Beds of euryhaline bivalves alternating with shales constitute much of the middle Purbeck Formation. They originated on "tidal" flats at the western margin of an extensive brackish lagoon. When these shell beds are thin and enclosed in shale they are often still preserved as aragonite and are associated with "beef", fibrous calcite formed during compaction. In most cases, however, the shell debris has been converted by diagenesis into calcitic biosparrudite limestones. A compacted type has been lithified at a late stage, after deep burial. In this, pyrite is abundant and most of the shell aragonite has been replaced neomorphically by ferroan pseudopleochroic calcite. A contrasting uncompacted type of biosparrudite is characterised by bivalve fragments with micrite envelopes. Shells and former pores are occupied by non-ferroan sparry calcite cement, and there is little pyrite. These limestones frequently contain dinosaur footprints and originated in "supratidal" environments where they were cemented early, mainly in meteoric water. Once lithified they were unaffected by compaction. This uncompacted type indicates phases of mild uplift or halts in subsidence. These shell-bed lithologies, and also intermediate types described here, will probably be recognised in other lagoonal formations.

Pooled Open Blocks Shorten Wait Times for Nonelective Surgical Cases.

PubMed

Zenteno, Ana C; Carnes, Tim; Levi, Retsef; Daily, Bethany J; Price, Devon; Moss, Susan C; Dunn, Peter F

2015-07-01

Assess the impact of the implementation of a data-driven scheduling strategy that aimed to improve the access to care of nonelective surgical patients at Massachusetts General Hospital (MGH). Between July 2009 and June 2010, MGH experienced increasing throughput challenges in its perioperative environment: approximately 30% of the nonelective patients were waiting more than the prescribed amount of time to get to surgery, hampering access to care and aggravating the lack of inpatient beds. This work describes the design and implementation of an "open block" strategy: operating room (OR) blocks were reserved for nonelective patients during regular working hours (prime time) and their management centralized. Discrete event simulation showed that 5 rooms would decrease the percentage of delayed patients from 30% to 2%, assuming that OR availability was the only reason for preoperative delay. Implementation began in January 2012. We compare metrics for June through December of 2012 against the same months of 2011. The average preoperative wait time of all nonelective surgical patients decreased by 25.5% (P < 0.001), even with a volume increase of 9%. The number of bed-days occupied by nonurgent patients before surgery declined by 13.3% whereas the volume increased by 4.5%. The large-scale application of an open-block strategy significantly improved the flow of nonelective patients at MGH when OR availability was a major reason for delay. Rigorous metrics were developed to evaluate its performance. Strong managerial leadership was crucial to enact the new practices and turn them into organizational change.

A single day of bed rest, irrespective of energy balance, does not affect skeletal muscle gene expression or insulin sensitivity.

PubMed

Dirks, Marlou L; Stephens, Francis B; Jackman, Sarah R; Galera Gordo, Jesús; Machin, David J; Pulsford, Richard M; van Loon, Luc J C; Wall, Benjamin T

2018-06-01

What is the central question of this study? What are the initial metabolic and molecular events that underpin bed rest-induced skeletal muscle deconditioning, and what is the contribution of energy balance? What is the main finding and its importance? A single day of bed rest, irrespective of energy balance, did not lead to overt changes in skeletal muscle gene expression or insulin sensitivity. More than 1 day of physical inactivity is required to observe the insulin resistance and robust skeletal muscle transcriptional responses associated with bed rest and consequent alterations in energy balance. The initial metabolic and molecular events that underpin disuse-induced skeletal muscle deconditioning, and the contribution of energy balance, remain to be investigated. Ten young, healthy men (age 25 ± 1 years; body mass index 25.3 ± 0.8 kg·m -2 ) underwent three 24 h laboratory-based experimental periods in a randomized, crossover manner: (i) controlled habitual physical activity with an energy-balanced diet (CON); (ii) strict bed rest with a diet to maintain energy balance (BR-B); and (iii) strict bed rest with a diet identical to CON, consequently resulting in positive energy balance. Continuous glucose monitoring was performed throughout each visit, with vastus lateralis muscle biopsies and an oral glucose tolerance test performed before and after. In parallel with muscle samples collected from a previous 7 day bed rest study, biopsies were used to examine the expression of genes associated with the regulation of muscle mass and insulin sensitivity. A single day of bed rest, irrespective of energy balance, did not lead to overt changes in whole-body substrate oxidation, indices of insulin sensitivity [i.e. homeostatic model assessment of insulin resistance, BR-B from 2.7 ± 1.7 to 3.1 ± 1.5 (P > 0.05) and Matsuda index, BR-B from 5.9 ± 3.3 to 5.2 ± 2.9 (P > 0.05)] or 24 h glycaemic control/variability compared with CON. Seven days of bed rest led to ∼30-55% lower expression of genes involved in insulin signalling, lipid storage/oxidation and muscle protein breakdown, whereas no such changes were observed after 1 day of bed rest. In conclusion, more than a single day of physical inactivity is required to observe the insulin resistance and robust skeletal muscle transcriptional responses associated with bed rest and consequent alterations in energy balance. © 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.

Hypoxia Worsens Affective Responses and Feeling of Fatigue During Prolonged Bed Rest

PubMed Central

Stavrou, Nektarios A. M.; Debevec, Tadej; Eiken, Ola; Mekjavic, Igor B.

2018-01-01

Previous research, although limited, suggests that both hypoxia and bed rest influence psychological responses by exaggerating negative psychological responses and attenuating positive emotions. The present study investigated the effect of a 21-day prolonged exposure to normobaric hypoxia and bed rest on affective responses and fatigue. Eleven healthy participants underwent three 21-day interventions using a cross-over design: (1) normobaric hypoxic ambulatory confinement (HAMB), (2) normobaric hypoxic bed rest (HBR) and (3) normoxic bed rest (NBR). Affective and fatigue responses were investigated using the Activation Deactivation Adjective Check List, and the Multidimensional Fatigue Inventory, which were completed before (Pre), during (Day 7, Day 14, and Day 21) and after (Post) the interventions. The most negative psychological profile appeared during the HBR intervention. Specifically, tiredness, tension, general and physical fatigue significantly increased on days 7, 14, and 21, as well as at Post. After the HBR intervention, general and physical fatigue remained higher compared to Pre values. Additionally, a deterioration of psychological responses was also noted following HAMB and NBR. In particular, both hypoxia and BR per se induced subjective fatigue and negative affective responses. BR seems to exert a moderate negative effect on the sensation of fatigue, whereas exercise attenuates the negative effects of hypoxia as noted during the HAMB condition. In conclusion, our data suggest that the addition of hypoxia to bed rest-induced inactivity significantly worsens affective responses and feeling of fatigue. PMID:29628903

Analog and numerical experiments investigating force chain influences on bed conditions in granular flows

NASA Astrophysics Data System (ADS)

Estep, J.; Dufek, J.

2013-12-01

Granular flows are fundamental processes in several terrestrial and planetary natural events; including surficial flows on volcanic edifices, debris flows, landslides, dune formation, rock falls, sector collapses, and avalanches. Often granular flows can be two-phase, whereby interstitial fluids occupy void space within the particulates. The mobility of granular flows has received significant attention, however the physics that govern their internal behavior remain poorly understood. Here we extend upon previous research showing that force chains can transmit extreme localized forces to the substrates of free surface granular flows, and we combine experimental and computational approaches to further investigate the forces at the bed of simplified granular flows. Analog experiments resolve discrete bed forces via a photoelastic technique, while numerical experiments validate laboratory tests using discrete element model (DEM) simulations. The current work investigates (1) the role of distributed grain sizes on force transmission via force chains, and (2) how the inclusion of interstitial fluids effects force chain development. We also include 3D numerical simulations to apply observed 2D characteristics into real world perspective, and ascertain if the added dimension alters force chain behavior. Previous research showed that bed forces generated by force chain structures can transiently greatly exceed (by several 100%) the bed forces predicted from continuum approaches, and that natural materials are more prone to excessive bed forces than photoelastic materials due to their larger contact stiffnesses. This work suggests that force chain activity may play an important role in the bed physics of dense granular flows by influencing substrate entrainment. Photoelastic experiment image showing force chains in gravity driven granular flow.

WISE 2005-2006: 60-days of Head-Down Bed Rest Increases the Incidence of Menstrual Cycle Disruption

NASA Astrophysics Data System (ADS)

Wade, Charles

Objective: It has been suggested that acute bed rest of short duration (11 days) disrupts the menstrual cycle of healthy subjects. Furthermore, use of countermeasures such as heavy exercise or dietary manipulations may adversely effect the menstrual cycle. We hypothesized that bed rest of 60 days and the use of countermeasures would increase the incidence of disruption of the menstrual cycle (MC). Methods: Twenty-four healthy subjects with a mean age of 32±0.8 yr, body mass of 59±0.8 kg and MC lengths of 25-32 days were enrolled. Three months prior to the study subjects did not use hormonal birth control methods. Subjects were assigned to one of three groups (n=8 per group): control, exercise countermeasures, and dietary countermeasures. MC lengthening was defined as an increase in duration of 10 or more days. Analysis was performed accounting for the effects of bedrest as well as treatment group. Results: Effects of countermeasures were not significant in the present analysis. After the conclusion of the study, subjects were classified as either normal (N; n=16) or oligomenorrhea (O; n=8) as determined by MC length during the pre-bed rest (PB) and bed rest (BR) periods. During the control period prior to bed rest one subject (4%) had an increase MC length. During the control period the average MC length was 31±0.8 days with a leutinizing hormone (LH) surge 12±0.8 days prior to menses. The duration of menses was 4±0.4 days. During BR there was an increase to 33% (p¡0.05) in the number of subjects having MC lengthening. In these subjects the mean length was increased from 31±0.9 to 62±8.2 days (p¡0.05). There was no change in the period from the LH surge prior to the next menses, 11±0.8 days, or duration of menses, 4±0.2 days. Plasma LH, follicle stimulating hormone (FSH), prolacin (PRL), progesterone (PRG), estradiol (E2), dehydroepiandrosterone sulfate (DHEA-S), aldosterone (Aldo), testosterone (T) and cortisol (C) were measured during PB, BR, early post bed rest (day 0-day 60;EPBR) and late post bed rest (day 60-day 367;LPBR). Plasma PRG was significantly higher (p¡0.02) in the N group before BR and continued throughout the BR period. A significant difference in E2 was observed in the N group between PB and BR, BR and EPBR, and EPBR and LPBR (p¡0.01). E2 was significantly different between N and O during BR (p¡0.02). No differences were observed in the other plasma measurements. Daily urine samples demonstrated no changes in C or Aldo over the course of the study. At 6 and 12 months following completion of the study all subjects reported normal MC. Conclusion: The lengthening of menstrual cycle during bed rest is a result of a delay in ovulation due to the absence of a LH surge (ovulation) associated with lower PRG and E2 levels. In females, changes in menstrual cycles may be a contributing factor to the adverse responses to bed rest such as loss of bone mass, reductions in blood volume and decreased work performance.

Earth Observations taken by the Expedition 18 Crew

NASA Image and Video Library

2009-01-06

ISS018-E-018110 (6 Jan. 2009) --- Kerguelen Kelp Beds in the Southern Indian Ocean are featured in this image photographed by an Expedition 18 crewmember on the International Space Station. MacMurdo and Howe Islands are two of the 300 islands of the Kerguelen Archipelago, a remote place located in the Southern Indian Ocean that belongs to the French Southern and Antarctic Lands. The Kerguelen Archipelago is also known as the "Desolation Islands". The coastal regions of the islands support low vegetation (mainly genus Acaena), while elevations above 50 meters are rocky. There are no permanent inhabitants of the islands, but there is a permanent settlement (Port aux Francais) that hosts scientists mainly interested in biology, oceanography and earth sciences ? in addition, the settlement maintains a weather station and satellite/rocket tracking station. Latitudinal weather conditions are typical from the ?roaring forties? through the ?furious fifties? - on the day this image was taken, the mean daily temperature was 4.5 degrees Celsius with mean westerly winds of 9 meters per second. A substantial proportion of the coastlines of sub-Antarctic islands, like the Kerguelen Islands, are occupied by highly productive giant kelp beds (Macrocystis pyrifera). One of the largest marine macroalgaes, the species can grow up to 50 meters in length, forming undersea forests in hard-bottom subtidal areas. Fronds can spread out to form a canopy which can totally cover the water surface ? we interpret that the black patches surrounding coastal areas in this astronaut photograph are the offshore kelp beds. These forests serve as a habitat for marine fauna, and due to their large biomass and relatively long turnover act as an efficient sink for atmospheric carbon dioxide. The surface wave pattern traveling southeastward along the gray-blue ocean surface, and through the kelp beds, are visible due to the sunglint from the water surface. This also improves the identification of the kelp beds by creating a different water texture (and therefore a contrast) between the dark vegetation and the ocean surface. Kerguelen Archipelago hosts thousands of marine birds (penguins, albatrosses, and petrels among others) and seals (elephant and Antarctic fur species). Whales (humpback) and dolphins (killer whales and Commerson's dolphin) are very common in the area. Fishing boats also frequent the Archipelago ? including unlicensed, so-called ?pirate? fishing vessels.

Effects of long-term head-down-tilt bed rest and different training regimes on the coagulation system of healthy men

PubMed Central

Haider, Thomas; Gunga, Hanns-Christian; Matteucci-Gothe, Raffaella; Sottara, Elke; Griesmacher, Andrea; Belavý, Daniel L; Felsenberg, Dieter; Werner, Andreas; Schobersberger, Wolfgang

2013-01-01

Immobility plus preexisting chronic disease or acute trauma can activate the coagulation system, thus increasing the risk for thromboembolic events. The effects of long-term bed-rest immobility and microgravity on the coagulation system of healthy persons (e.g., during crewed Mars missions) have not yet been studied. The main objective of the second Berlin BedRest Study (BBR2-2) “Coagulation Part” was to investigate adaptations of the hemostatic system during long-term bed rest (60 days) under simulated microgravity (6° head-down-tilt [6°HDT]) and after mobilization in three different volunteer groups (randomly assigned to CTR= inactive control group; RE= resistive exercise only group; and RVE= resistive exercise with whole-body vibration group). In 24 males (aged 21–45 years), before, during, and after long-term bed rest, key parameters of coagulation were measured from venous blood samples: D-dimer (DD), thrombin–antithrombin III complex (TAT), and prothrombin fragment F1 + 2 (PT-F1 + 2). Additionally, modified rotational thrombelastometry (ROTEM®) analysis was performed. Times of exploratory analyses were as follows: baseline data collection 2 days before bed rest (BDC-2); eight different days of 6°HDT bed rest (HDT1–HDT60), and two different days after reambulation (R + 3 and R + 6). We found significant changes in DD, TAT, and PT-F1 + 2 over the total time course, but no consistent effect of physical interventions (RE, RVE) on these parameters. Notably, no parameter reached levels indicative of intravascular thrombin formation. All ROTEM® parameters remained within the normal range and no pathological traces were found. Sixty days of 6°HDT bed rest are not associated with pronounced activation of the coagulation system indicative of intravascular thrombus formation in healthy volunteers independent of the training type during the bed rest. PMID:24400137

The effect of 8 days of strict bed rest on the incretin effect in healthy volunteers.

PubMed

Nielsen, Signe Tellerup; Harder-Lauridsen, Nina Majlund; Benatti, Fabiana Braga; Wedell-Neergaard, Anne-Sophie; Lyngbæk, Mark Preben; Møller, Kirsten; Pedersen, Bente Klarlund; Krogh-Madsen, Rikke

2016-03-15

Bed rest and physical inactivity are the consequences of hospital admission for many patients. Physical inactivity induces changes in glucose metabolism, but its effect on the incretin effect, which is reduced in, e.g., Type 2 diabetes, is unknown. To investigate how 8 days of strict bed rest affects the incretin effect, 10 healthy nonobese male volunteers underwent 8 days of strict bed rest. Before and after the intervention, all volunteers underwent an oral glucose tolerance test (OGTT) followed by an intravenous glucose infusion (IVGI) on the following day to mimic the blood glucose profile from the OGTT. Blood glucose, serum insulin, serum C-peptide, plasma incretin hormones [glucagon-like peptide (GLP-1) and glucose-dependent insulinotropic peptide (GIP)], and serum glucagon were measured serially during both the OGTT and the IVGI. The incretin effect is calculated as the relative difference between the area under the curve for the insulin response during the OGTT and that of the corresponding IVGI, respectively. Concentrations of glucose, insulin, C-peptide, and GIP measured during the OGTT were higher after the bed rest intervention (all P < 0.05), whereas there was no difference in the levels of GLP-1 and Glucagon. Bed rest led to a mean loss of 2.4 kg of fat-free mass, and induced insulin resistance evaluated by the Matsuda index, but did not affect the incretin effect (P = 0.6). In conclusion, 8 days of bed rest induces insulin resistance, but we did not see evidence of an associated change in the incretin effect. Copyright © 2016 the American Physiological Society.

Bedform Dimensions and Suspended Sediment Observations in a Mixed Sand-Mud Intertidal Environment

NASA Astrophysics Data System (ADS)

Lichtman, I. D.; Amoudry, L.; Peter, T.; Jaco, B.

2016-02-01

Small-scale bedforms, such as ripples, can profoundly modify near-bed hydrodynamics, near-bed sediment transport and resuspension, and benthic-pelagic fluxes. Knowledge of their dimensions is important for a number of applications. Fundamentally different processes can occur depending on the dimensions of ripples: for low and long ripples, the bed remains dynamically flat and diffusive processes dominate sediment entrainment; for steep ripples, flow separation occurs above the ripples creating vortices, which are far more efficient at entraining sediment into the water column. Recent laboratory experiments for mixtures of sand and mud have shown that bedform dimensions decrease with increasing sediment mud content. However, these same experiments also showed that mud is selectively taken into suspension when bedforms are created and migrate on the bed, leaving sandy bedforms. This entrainment process, selectively suspending fine sediment, is referred to as winnowing. To improve our understanding of bedform and entrainment dynamics of mixed sediments, in situ observations were made on intertidal flats in the Dee Estuary, United Kingdom. A suite of instruments were deployed collecting co-located measurements of the near-bed hydrodynamics, waves, small-scale bed morphology and suspended sediment. Three sites were occupied consecutively, over a Spring-Neap cycle, collecting data for different bed compositions, tide levels and wind conditions. Bed samples were taken when the flats became exposed at low water and a sediment trap collected suspended load when inundated. This study will combine these measurements to investigate the interactions between small-scale bed morphology, near-bed hydrodynamics and sediment entrainment. We will examine bedform development in the complex hydrodynamic and wave climate of tidal flats, in relation to standard ripple predictors. We will also relate the variability in small-scale bedforms to variation in hydrodynamic and wave conditions, and to suspension and entrainment processes for mixed sediments.

Impact of 9 Days of Bed Rest on Hepatic and Peripheral Insulin Action, Insulin Secretion, and Whole-Body Lipolysis in Healthy Young Male Offspring of Patients With Type 2 Diabetes

PubMed Central

Alibegovic, Amra C.; Højbjerre, Lise; Sonne, Mette P.; van Hall, Gerrit; Stallknecht, Bente; Dela, Flemming; Vaag, Allan

2009-01-01

OBJECTIVE The aim of this study was to investigate the impact of 9 days of bed rest on insulin secretion, insulin action, and whole-body glucose and fat metabolism in first-degree relative (FDR) and matched control (CON) subjects. RESEARCH DESIGN AND METHODS A total of 13 FDR and 20 CON subjects participated in the study. All were studied before and after 9 days of bed rest using the clamp technique combined with indirect calorimetry preceded by an intravenous glucose tolerance test. Glucose and glycerol turnover rates were studied using stable isotope kinetics. RESULTS Bed rest caused a significant decrease in whole-body insulin sensitivity in both groups. Hepatic insulin resistance was elevated in FDR subjects prior to bed rest and was significantly augmented by bed rest in FDR (P < 0.01) but not in CON (P = NS) subjects. The rate of whole-body lipolysis decreased during bed rest in both FDR and CON subjects, with no significant differences between the groups. Insulin resistance induced by bed rest was fully accounted for by the impairment of nonoxidative glucose metabolism in both groups (overall P < 0.001). CONCLUSIONS Whole-body insulin action in both insulin-resistant FDR and healthy CON subjects deteriorates with 9 days of bed rest, converging toward similar degrees of whole-body insulin resistance. FDR subjects exhibit hepatic insulin resistance (HIR), which, in contrast to CON subjects, deteriorates in response to physical inactivity. FDR subjects exhibit reduced insulin secretion when seen in relation to their degree of HIR but not peripheral insulin resistance. PMID:19720789

Amino acid supplementation alters bone metabolism during simulated weightlessness

NASA Technical Reports Server (NTRS)

Zwart, S. R.; Davis-Street, J. E.; Paddon-Jones, D.; Ferrando, A. A.; Wolfe, R. R.; Smith, S. M.

2005-01-01

High-protein and acidogenic diets induce hypercalciuria. Foods or supplements with excess sulfur-containing amino acids increase endogenous sulfuric acid production and therefore have the potential to increase calcium excretion and alter bone metabolism. In this study, effects of an amino acid/carbohydrate supplement on bone resorption were examined during bed rest. Thirteen subjects were divided at random into two groups: a control group (Con, n = 6) and an amino acid-supplemented group (AA, n = 7) who consumed an extra 49.5 g essential amino acids and 90 g carbohydrate per day for 28 days. Urine was collected for n-telopeptide (NTX), deoxypyridinoline (DPD), calcium, and pH determinations. Bone mineral content was determined and potential renal acid load was calculated. Bone-specific alkaline phosphatase was measured in serum samples collected on day 1 (immediately before bed rest) and on day 28. Potential renal acid load was higher in the AA group than in the Con group during bed rest (P < 0.05). For all subjects, during bed rest urinary NTX and DPD concentrations were greater than pre-bed rest levels (P < 0.05). Urinary NTX and DPD tended to be higher in the AA group (P = 0.073 and P = 0.056, respectively). During bed rest, urinary calcium was greater than baseline levels (P < 0.05) in the AA group but not the Con group. Total bone mineral content was lower after bed rest than before bed rest in the AA group but not the Con group (P < 0.05). During bed rest, urinary pH decreased (P < 0.05), and it was lower in the AA group than the Con group. These data suggest that bone resorption increased, without changes in bone formation, in the AA group.

Treadmill Exercise Within LBNP as an Integrated Coutermeasure to Microgravity

NASA Technical Reports Server (NTRS)

Lee, Stuart; Hargens, A. R.; Schneider, S. M.; Watenpaugh, D. E.

2010-01-01

An integrated exercise countermeasure for microgravity is needed to protect multiple physiologic systems and save crew time. Such a countermeasure should protect orthostatic tolerance, upright ambulatory capability (including sprinting), aerobic capacity, muscle strength/endurance, and other physiologic parameters relevant to human performance. We developed a novel physiologic countermeasure, treadmill exercise within LBNP, for preventing cardiovascular and musculoskeletal deconditioning associated with prolonged bed rest and spaceflight. We evaluated 40 min of daily LBNP treadmill exercise by a battery of physiologic parameters relevant to maintaining exercise performance and health of both women and men during bed-rest (simulated microgravity) studies lasting from 5 to 60 days. For 30 day studies, we employed identical twins with one twin as the control and the other twin as the exerciser to improve comparative power. During the WISE 60-day HDT study, the treadmill exercise within LBNP was performed 3-4 days each week and resistive exercise was performed 2-3 days each week. Our treadmill within LBNP protocol maintained plasma volume and sprint speed (30 day HDT bed-rest studies of identical twins), orthostatic tolerance to a degree, upright exercise capacity, muscle strength and endurance, and some bone parameters during 30 day (twin studies) and 60 day (WISE-2005) bed-rest simulations of microgravity. When combining treadmill exercise within LBNP and resistive exercise (WISE), cardiac mass increased significantly in the exercise (EX) group during bed rest relative to controls (CON). Upright peak VO2, and knee extensor strength and endurance decreased significantly in CON subjects; but these parameters were preserved in the EX group. In the 60 day WISE study, each LBNP exercise session was followed immediately by 10 minutes of static LBNP, and the last such session occurred three days before the end of bed rest. Still, orthostatic tolerance was better maintained in the EX group than in the CON group. Therefore, these collective peer-reviewed results document that our treadmill exercise within LBNP countermeasure safely and efficiently protects multiple physiologic systems in women and men during bed-rest studies of up to 60 days. Supported by NASA grants NNJ04HF71G and NAG 9-1425, NIH grant GCRC M01 RR00827 and by WISE support from ESA, NASA, CSA, and CNES.

Body Lice

MedlinePlus

... lice live in your clothing and bedding and travel to your skin several times a day to feed on blood. The most ... typically live in your clothes and bedding. They travel to your skin several times a day to feed on blood. The seams ...

Conditions for Adopting an Irregular Defense Strategy

DTIC Science & Technology

2014-06-01

in Indochina or in Algeria, when insurgents burned a farm , other farms and village requested protection.66 Since occupying 64 Von der Heydte, Modern...troop withdrawal from Lebanese lands in 2000. It also made a fresh demand for Israeli-occupied farms on the Golan Heights. That did not really help a...days to water a hundred sheep and goats in small groups, and the wells had to be dug by day and by night to yield water.”100 Additionally, to this

Great Issues in American History: A Compilation of Primary Sources Related to Issues That Have Occupied the Attention of the American People from Colonial Days to the Present. Oregon ASCD Curriculum Bulletin, Vol. 30, No. 333.

ERIC Educational Resources Information Center

Nance, Elizabeth

This publication is a compilation of primary source materials related to issues that have occupied the attention of the American people from colonial days to the present. It is intended for use at the secondary level. A prologue contains creation stories and poems on the origins of the world and man. Documentation of the primary sources is…

The prevalence of leisure time sedentary behaviour and physical activity in adolescent boys: an ecological momentary assessment approach.

PubMed

Gorely, Trish; Biddle, Stuart J H; Marshall, Simon J; Cameron, Noel

2009-01-01

To use ecological momentary assessment to describe how adolescent boys in the United Kingdom spend their leisure time. Design. Cross-sectional, stratified, random sample from secondary schools in 15 regions within the United Kingdom. The data are from a larger study of adolescent lifestyles (Project STIL). A total of 561 boys with a mean age of 14.6 years (range 12.7-16.7 years). The majority were white-European (86.5%). Television viewing occupied the most leisure time on both weekdays (131 minutes) and weekend (202.5 minutes) days. On weekdays the five most time consuming sedentary activities (television viewing, homework, motorised travel, playing computer/video games and shopping/hanging out) occupied on average 272.2 minutes. On weekend days, the five most time consuming sedentary activities (television viewing, shopping/hanging out, motorised travel, sitting and talking and playing computer/video games) occupied 405.5 minutes. In total, 54 minutes were occupied by active transport or sports and exercise per weekday and 81 minutes per weekend day. Only a minority watched more than 4 hours of TV per day (8.9% on weekdays and 33.8% on weekend days). Differences were noted in the means and prevalence between weekend and weekdays, reflecting the greater discretionary time available at the weekend. Adolescent boys engage in a variety of sedentary and active free time behaviours. It appears prudent to encourage adolescents to adopt overall healthy lifestyles by considering the combination of both active and sedentary pursuits an individual engages in and by moving beyond a focus on any one single behaviour.

The Metabolic Cost of a High Intensity Exercise Program During Bed Rest

NASA Technical Reports Server (NTRS)

Hackney, Kyle; Everett, Meghan; Guined, Jamie; Cunningham, Daid

2012-01-01

Background: Given that disuse-related skeletal muscle atrophy may be exacerbated by an imbalance between energy intake and output, the amount of energy required to complete exercise countermeasures is an important consideration in the well being of subject health during bed rest and spaceflight. Objective: To evaluate the energy cost of a high intensity exercise program performed during short duration bed rest. Methods: 9 subjects (8 male and 1 female; 34.5 +/- 8.2 years) underwent 14 days of bed rest and exercise countermeasures. Exercise energy expenditure and excess post exercise oxygen consumption (EPOC) were collected once in each of 5 different exercise protocols (30 second, 2 minute and 4 minute intervals, continuous aerobic and a variety of resistance exercises) during bed rest. Body mass, basal metabolic rate (BMR), upper and lower leg muscle, subcutaneous, and intramuscular adipose tissue (IMAT) volumes were assessed before and at the end of bed rest. Results: There were no significant differences in body mass (pre: 75.1 +/- 10.5 kg; post: 75.2 +/- 10.1 kg), BMR (pre: 1649 +/- 216 kcal; post: 1657 +/- 177 kcal), muscle subcutaneous, or IMAT volumes (Table 2) after 14 days of bed rest and exercise. Body mass was maintained with an average daily intake of 2710 +/- 262 kcal (36.2 +/- 2.1 kcal/kg/day), while average daily energy expenditure was 2579 +/-311 kcal (34.5 +/- 3.6 kcal/kg/day). Exercise energy expenditure was significantly greater as a result of continuous aerobic exercise than all other exercise protocols.

Circadian Rhythms and Second Language Performance

ERIC Educational Resources Information Center

de Bot, Kees; Fang, Fang

2017-01-01

Human behavior is not constant over the hours of the day, and there are considerable individual differences. Some people raise early and go to bed early and have their peek performance early in the day ("larks") while others tend to go to bed late and get up late and have their best performance later in the day ("owls"). In…

Estimating the opportunity costs of bed-days.

PubMed

Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

2018-03-01

Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.

Prospective data, experience, and lessons learned at a surgically augmented brigade medical company (Level II+) during the 2007 Iraq surge.

PubMed

Lesho, Emil

2011-07-01

Provide data and experience at a surgically augmented brigade medical support company during the Iraq surge for future deployments. Data were prospectively aggregated. Eight thousand and eighty-three patients consisting of 52% coalition military, 19% U.S. military, and 29% U.S. or local civilians were evaluated. Ninety-four percent had disease nonbattle injuries and 4% had battle injuries. Ninety-five percent returned to duty, 2.5% admitted, 2% evacuated, and < 1% died of wounds. Total occupied bed days were 416. Predominate trauma and surgical conditions included burns, explosive injury, extremity trauma, and predominate medical conditions included infections, musculoskeletal injuries, and mental health issues. One hundred and fifty-eight air evacuations were required (80% trauma and 20% medical). Challenges included lack of mental health providers, cardiac and chronic medications, and exercise electrocardiogram capability. Without physical therapists, experienced nurses, and ancillary medical care, approximately 1500 more air evacuations would have been required, and return-to-duty would have been significantly delayed for approximately 300 patients.

Digital analytical data from mineral resource assessments of national forest lands in Washington

USGS Publications Warehouse

Boleneus, D.E.; Chase, D.W.

1999-01-01

Extensive reconnaissance assessments of the mineral resource potential of the Colville and Okanogan National Forests in northeastern Washington were conducted during 1979-1982 by a private consultant A.R. Grant, under contract with the U.S. Department of Agriculture, Forest Service. These forests occupy large parts of Pend Oreille, Stevens, Ferry, and Okanogan counties, and smaller parts of Whatcom, Skagit, and Chelan counties adjoining Okanogan County in the Cascades. Sampled terrain also included the Kaniksu National Forest in Pend Oreille County and one stream bed of the Kaniksu in adjacent Bonner County, Idaho. Two unpublished reports resulting from the assessments (Grant, 1982a,b) list a total of 3,927 analyses of gold, silver, copper, lead, zinc, molybdenum, tungsten, and uranium content of stream sediment and bedrock samples collected at widely dispersed sites in the three National Forests. This report makes this important body of work available in digital form on diskettes, to enhance manipulations with computer spreadsheets, geographic information systems (GIS), and digital spatial analyses. This will allow for utilization of data by modern day explorationists and by the general geodata user community.

Field studies of estuarine turbidity under different freshwater flow conditions, Kaipara River, New Zealand

NASA Astrophysics Data System (ADS)

Mitchell, Steven B.; Green, Malcolm O.; MacDonald, Iain T.; Pritchard, Mark

2017-11-01

We present a first interpretation of three days of measurements made in 2013 from the tidal reaches of the Kaipara River (New Zealand) under both low and high freshwater inputs and a neap tidal cycle. During the first day, we occupied two stations that were approximately 6 km apart in a tidal reach that runs for 25 km from the river mouth to the upstream limit of tidal influence. During the second day, longitudinal surveys were conducted over a distance of 6 km centred on the upstream station. The data reveal a turbidity maximum in the form of a high-concentration 'plug' of suspended mud that was advected downstream on the ebbing tide past the upper (HB) measurement station and which exchanged sediment with the seabed by settling at low slack water and by resuspension in the early flooding tide. The data suggest that fine sediment is transported landwards and trapped in the upper part of the tidal reach under these low-flow conditions. On the third day of measurements we repeated the experiments of the first day but later in the year, for a much higher freshwater flow. This interpretation of our data set highlights the potential contribution of a range of processes to the generation of the observed suspended-sediment signals, including resuspension of local bed sediment, advection by the tidal current, settling of suspended sediment over a long timescale compared to the advection timescale, advection of longitudinal gradients in suspended sediment, and suppression of vertical mixing by density stratification of the water column. The level of temporal and spatial detail afforded by these measurements allows a much clearer understanding of the timing and importance of vertical stratification on the transport of suspended particulate matter than is generally possible using fixed-point sensors.

Prolonged head-down tilt exposure reduces maximal cutaneous vasodilator and sweating capacity in humans

NASA Technical Reports Server (NTRS)

Crandall, C. G.; Shibasaki, M.; Wilson, T. E.; Cui, J.; Levine, B. D.

2003-01-01

Cutaneous vasodilation and sweat rate are reduced during a thermal challenge after simulated and actual microgravity exposure. The effects of microgravity exposure on cutaneous vasodilator capacity and on sweat gland function are unknown. The purpose of this study was to test the hypothesis that simulated microgravity exposure, using the 6 degrees head-down tilt (HDT) bed rest model, reduces maximal forearm cutaneous vascular conductance (FVC) and sweat gland function and that exercise during HDT preserves these responses. To test these hypotheses, 20 subjects were exposed to 14 days of strict HDT bed rest. Twelve of those subjects exercised (supine cycle ergometry) at 75% of pre-bed rest heart rate maximum for 90 min/day throughout HDT bed rest. Before and after HDT bed rest, maximal FVC was measured, via plethysmography, by heating the entire forearm to 42 degrees C for 45 min. Sweat gland function was assessed by administering 1 x 10(-6) to 2 M acetylcholine (9 doses) via intradermal microdialysis while simultaneously monitoring sweat rate over the microdialysis membranes. In the nonexercise group, maximal FVC and maximal stimulated sweat rate were significantly reduced after HDT bed rest. In contrast, these responses were unchanged in the exercise group. These data suggest that 14 days of simulated microgravity exposure, using the HDT bed rest model, reduces cutaneous vasodilator and sweating capacity, whereas aerobic exercise training during HDT bed rest preserves these responses.

Circulating microRNAs Correlated with Bone Loss Induced by 45 Days of Bed Rest

PubMed Central

Ling, Shukuan; Zhong, Guohui; Sun, Weijia; Liang, Fengji; Wu, Feng; Li, Hongxing; Li, Yuheng; Zhao, Dingsheng; Song, Jinping; Jin, Xiaoyan; Wu, Xiaorui; Song, Hailin; Li, Qi; Li, Yinghui; Chen, Shanguang; Xiong, Jianghui; Li, Yingxian

2017-01-01

The purpose of this study was to find the circulating microRNAs (miRNAs) co-related with bone loss induced by bed rest, and testify whether the selected miRNAs could reflect the bone mineral status of human after bed-rest. We analyzed plasma miRNA levels of 16 subjects after 45 days of −6° head-down tilt bed rest, which is a reliable model for the simulation of microgravity. We characterize the circulating miRNA profile in individuals after bed rest and identify circulating miRNAs which can best reflect the level of bone loss induced by bed rest. Expression profiling of circulating miRNA revealed significant downregulation of 37 miRNAs and upregulation of 2 miRNAs, while only 11 of the downregulated miRNAs were further validated in a larger volunteer cohort using qPCR. We found that 10 of these 11 miRNAs (miR-103, 130a, 1234, 1290, 151-5p, 151-3p, 199a-3p, 20a, 363, and 451a) had ROC curve that distinguished the status after bed rest. Importantly, significant positive correlations were identified between bone loss parameters and several miRNAs, eventually miR-1234 showed clinical significance in detecting the bone loss of individuals after 45 days of bed rest. PMID:28261104

6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial

PubMed Central

Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

2016-01-01

Objective To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Design Cluster randomised controlled trial. Setting Six Australian hospitals. Participants All patients admitted to 24 acute wards during the trial period. Interventions Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: “falls alert” sign, supervision of patients in the bathroom, ensuring patients’ walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. Main outcome measures The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. Results During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients’ characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards. Conclusions Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000332921. PMID:26813674

Exercise and Transversus Abdominis Muscle Atrophy after 60-d Bed Rest.

PubMed

Belavý, Daniel Ludovic; Gast, Ulf; Felsenberg, Dieter

2017-02-01

This study aimed to investigate atrophy in the deep abdominal muscles, spinal extensors, and the effect of high-load resistive exercise with and without whole-body vibration after 60 d of strict bed rest. Twenty-four subjects underwent 60 d of head-down tilt bed rest and performed either resistive vibration exercise (RVE), resistive exercise only (RE), or no exercise control (2nd Berlin BedRest Study). The thickness of the transversus abdominis, internal oblique, and erector spinae muscles and the area of the multifidus muscle were measured bilaterally via real-time ultrasound. Intention-to-treat analysis was implemented, and P values were adjusted by the false discovery rate method. At the end of the bed rest, transversus abdominis thickness was reduced by 18.3% in the inactive group (P = 0.00011) with no significant change in the RVE (-4.0%; P = 0.014 vs control) or RE (-5.0%; P = 0.10 vs control) groups. In the inactive subjects, internal oblique thickness reduced by 10.6% (P = 0.0025) and by 7% (P > 0.05) in each of the training groups. The lengthening of the lumbar spine was greatest on day 1 (+7.4%, P = 0.004) and day 2 (+6.3%, P = 0.004; day 54: +4.1%, P = 0.023). A 4.7% reduction of multifidus area was observed on day 1 of bed rest (P = 0.0049) and a 4.2% reduction of erector spinae thickness was observed on day 2 (P = 0.0011). Extensor atrophy and spinal lengthening was not affected by exercise. No significant difference was seen between RVE and RE. Bed rest leads to atrophy of the transversus abdominis and internal oblique muscles. The exercise program, which implemented lower-limb and back extension exercises against shoulder restraints, was able to reduce atrophy seen in transversus abdominis in bed rest.

Focal Gray Matter Plasticity as a Function of Long Duration Bedrest: Preliminary Results

NASA Technical Reports Server (NTRS)

Koppelmans, V.; Erdeniz, B.; De Dios, Y. E.; Wood, S. J.; Reuter-Lorenz, P. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.; Seidler, R. D.

2014-01-01

Long duration spaceflight (i.e., 22 days or longer) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. It is unknown whether and how spaceflight impacts sensorimotor brain structure and function, and whether such changes may potentially underlie behavioral effects. Long duration head down tilt bed rest has been used repeatedly as an exclusionary analog to study microgravity effects on the sensorimotor system [1]. Bed rest mimics microgravity in body unloading and bodily fluid shifts. We are currently testing sensorimotor function, brain structure, and brain function pre and post a 70-day bed rest period. We will acquire the same measures on NASA crewmembers starting in 2014. Here we present the results of the first eight bed rest subjects. Subjects were assessed at 12 and 7 days before-, at 7, 30, and 70 days in-, and at 8 and 12 days post 70 days of bed rest at the NASA bed rest facility, UTMB, Galveston, TX, USA. At each time point structural MRI scans (i.e., high resolution T1-weighted imaging and Diffusion Tensor Imaging (DTI)) were obtained using a 3T Siemens scanner. Focal changes over time in gray matter density were assessed using the voxel based morphometry 8 (VBM8) toolbox under SPM. Focal changes in white matter microstructural integrity were assessed using tract based spatial statistics (TBSS) as part of the FMRIB software library (FSL). TBSS registers all DTI scans to standard space. It subsequently creates a study specific white matter skeleton of the major white matter tracts. Non-parametric permutation based t-tests and ANOVA's were used for voxel-wise comparison of the skeletons. For both VBM and TBSS, comparison of the two pre bed rest measurements did not show significant differences. VBM analysis revealed decreased gray matter density in bilateral areas including the frontal medial cortex, the insular cortex and the caudate nucleus from pre to in bed rest. Over the same time period, there was an increase in gray matter density in the cerebellum, occipital, and parietal cortices. The majority of these changes did not recover from during to post bed rest. TBSS analyses will also be presented. Extended bed rest, which is an analog for microgravity, can result in gray matter changes and potentially in microstructural white matter changes in areas that are important for neuromotor behavior and cognition. These changes did not recover at two weeks post bed rest. These results have significant public health implications, and will also aid in interpretation of our future data obtained pre and post spaceflight. Whether the effects of bed rest wear off at longer times post bed rest, and if they are associated with behavior are important questions that warrant further research.

Determination of mean recency period for estimation of HIV type 1 Incidence with the BED-capture EIA in persons infected with diverse subtypes.

PubMed

Parekh, Bharat S; Hanson, Debra L; Hargrove, John; Branson, Bernard; Green, Timothy; Dobbs, Trudy; Constantine, Niel; Overbaugh, Julie; McDougal, J Steven

2011-03-01

The IgG capture BED enzyme immunoassay (BED-CEIA) was developed to detect recent HIV-1 infection for the estimation of HIV-1 incidence from cross-sectional specimens. The mean time interval between seroconversion and reaching a specified assay cutoff value [referred to here as the mean recency period (ω)], an important parameter for incidence estimation, is determined for some HIV-1 subtypes, but testing in more cohorts and new statistical methods suggest the need for a revised estimation of ω in different subtypes. A total of 2927 longitudinal specimens from 756 persons with incident HIV infections who had been enrolled in 17 cohort studies was tested by the BED-CEIA. The ω was determined using two statistical approaches: (1) linear mixed effects regression (ω(1)) and (2) a nonparametric survival method (ω(2)). Recency periods varied among individuals and by population. At an OD-n cutoff of 0.8, ω(1) was 176 days (95% CL 164-188 days) whereas ω(2) was 162 days (95% CL 152-172 days) when using a comparable subset of specimens (13 cohorts). When method 2 was applied to all available data (17 cohorts), ω(2) ranged from 127 days (Thai AE) to 236 days (subtypes AG, AD) with an overall ω(2) of 197 days (95% CL 173-220). About 70% of individuals reached a threshold OD-n of 0.8 by 197 days (mean ω) and 95% of people reached 0.8 OD-n by 480 days. The determination of ω with more data and new methodology suggests that ω of the BED-CEIA varies between different subtypes and/or populations. These estimates for ω may affect incidence estimates in various studies.

[Consumption of hand-hygiene products in health establishments in the west of France].

PubMed

Branger, B; Senechal, H; Bataillon, S; Ertzscheid, M A; Baron, R; Borgey, F; Thibon, P; Van Der Mee, N; Girard, N; Wiesel, M; Avril, C; Coulomb, F; Chaperon, J; Lejeune, B

2005-06-01

The study had for aim to investigate hand hygiene product use in French hospitals between 2000 and 2003. A questionnaire was sent in 2002 and 2 more in 2003 and 2004 (for 2000 to 2003) requiring data on type of hospital, number of beds, staff members, admissions and patient-day, litres of mild soap, antiseptic soap and alcohol-based rub used and price per litre. Indices were calculated accordingly. 574 hospitals answered over the 4 year period (average 143 per year) representing an average of 50 000 beds/year, 80 000 full-time staff positions, 1.2 million admissions and 16 millions patient-days. The median consumption of mild soap was 3.8 l per bed, 2.7 l per staff member, 2.4 l per 100 admissions, and 10.6 ml per patient-day. The median consumption of antiseptic soap was 1 l per bed, 0.8 l per staff member, 4.8 l per 100 admissions, and 3.2 ml per patient-day. The median consumption of alcohol-based rub (HAS) was 0.3 l per bed, 0.3 l per staff-member, 1.5 l per admission, and 0.9 l per patient-day. Between 2000 and 2003, HAS use significantly increased from 69 to 88% (a relative increase of 31%) and the median consumption increased from 0.5 ml to 1.5 ml per patient-day. 370 fully completed grids gave a number of 7 opportunities per patient-day with less than 1 for HAS. The best indicator for an infection control practitioners is the quantity of alcohol-based solution in ml/patient-day and HAS per patient-day is the reference.

High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study)

PubMed Central

Commons, Robert J.; Robinson, Claire H.; Gawler, David; Davis, Joshua S.; Price, Ric N.

2015-01-01

Introduction The risk of diabetes mellitus is increasing worldwide, and is particularly high in Indigenous Australians. Complicated foot infection is one of the most common sequelae of diabetes. We describe the incidence and associations of Indigenous and non-Indigenous inpatients with diabetic foot infections at Royal Darwin Hospital. Methods All adult Royal Darwin Hospital inpatients with diabetic foot infections were enrolled prospectively from September 2012 to November 2013. Incidence, demographics, microbiology, management and clinical outcomes were analysed by Indigenous status, and association with methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa. Results There were 245 separate hospital admissions in 177 patients with an incidence of 79 admissions per 100,000 person years. Patients occupied a mean of 19.4 hospital beds each day. Compared to the non-Indigenous population, Indigenous patients had a greater incidence of admission (Rate Ratio (RR) = 5.1, [95%CI = 3.8, 7.0]), were younger (mean difference of 11.1 years; p < 0.001), and more likely to undergo major and minor amputations (RR = 4.1 [95%CI = 1.6, 10.7], and 6.2 [95%CI = 3.5, 11.1] respectively). Non-multiresistant methicillin resistant S. aureus was present in 44.7% of wounds from Indigenous patients versus 20.6% of non-Indigenous patients (Odds Ratio (OR) = 3.1, [95%CI = 1.5, 6.4]), whereas P. aeruginosa presence was significantly lower (15.8% versus 46.0%; OR = 0.22; [95%CI = 0.11, 0.45]). Methicillin resistant S. aureus or P. aeruginosa infections were associated with longer antibiotic courses and durations of stay. Conclusions This study highlights a rising burden of diabetic foot infections in the Top End of Australia, with a four-fold increase in bed days since 2002 and an overrepresentation in the Indigenous population. PMID:26453263

A modified method for measuring antibiotic use in healthcare settings: implications for antibiotic stewardship and benchmarking.

PubMed

Aldeyab, Mamoon A; McElnay, James C; Scott, Michael G; Lattyak, William J; Darwish Elhajji, Feras W; Aldiab, Motasem A; Magee, Fidelma A; Conlon, Geraldine; Kearney, Mary P

2014-04-01

To determine whether adjusting the denominator of the common hospital antibiotic use measurement unit (defined daily doses/100 bed-days) by including age-adjusted comorbidity score (100 bed-days/age-adjusted comorbidity score) would result in more accurate and meaningful assessment of hospital antibiotic use. The association between the monthly sum of age-adjusted comorbidity and monthly antibiotic use was measured using time-series analysis (January 2008 to June 2012). For the purposes of conducting internal benchmarking, two antibiotic usage datasets were constructed, i.e. 2004-07 (first study period) and 2008-11 (second study period). Monthly antibiotic use was normalized per 100 bed-days and per 100 bed-days/age-adjusted comorbidity score. Results showed that antibiotic use had significant positive relationships with the sum of age-adjusted comorbidity score (P = 0.0004). The results also showed that there was a negative relationship between antibiotic use and (i) alcohol-based hand rub use (P = 0.0370) and (ii) clinical pharmacist activity (P = 0.0031). Normalizing antibiotic use per 100 bed-days contributed to a comparative usage rate of 1.31, i.e. the average antibiotic use during the second period was 31% higher than during the first period. However, normalizing antibiotic use per 100 bed-days per age-adjusted comorbidity score resulted in a comparative usage rate of 0.98, i.e. the average antibiotic use was 2% lower in the second study period. Importantly, the latter comparative usage rate is independent of differences in patient density and case mix characteristics between the two studied populations. The proposed modified antibiotic measure provides an innovative approach to compare variations in antibiotic prescribing while taking account of patient case mix effects.

Effect of enforced physical inactivity induced by 60-day of bed rest on hepatic markers of NAFLD in healthy normal-weight women.

PubMed

Rudwill, Floriane; Bergouignan, Audrey; Gastebois, Caroline; Gauquelin-Koch, Guillemette; Lefai, Etienne; Blanc, Stéphane; Simon, Chantal

2015-06-01

Physical inactivity leads to a cluster of metabolic disorders that have been associated with non-alcoholic fatty liver diseases. We tested whether physical inactivity increases hepatic biomarkers of NAFLDs. Sixteen normal-weight healthy women (body mass index = 21.2 ± 0.5 kg/m(2) ) were studied under controlled energy balance conditions during a previous 60-day bed rest with (n = 8) or without (n = 8) a combined aerobic/resistive exercise protocol. Stored samples were retrospectively used to measure plasma hepatic markers, i.e. steatosis-related alanine and aspartate transaminases, cytokeratin 18 and angiopoietin-like 3, at baseline, after 30 and 60 days of bed rest. Fasting insulin and triglycerides were measured at baseline and after 30 days of bed rest. Two indexes were calculated, one combining alanine and aspartate transaminase and cytokeratin 18 and another cytokeratin 18, homeostasis model assessment of insulin resistance and aspartate aminotransferase. Sixty days of bed rest increased all hepatic markers (P < 0.05 for all) and the two indexes (P < 0.01 for both). Exercise significantly reduced the elevation in aspartate transaminase, cytokeratin 18 and both indexes (P < 0.02 for all) but not the increase in alanine transaminase and angiopoietin-like 3. Changes between baseline and 30 days of bed rest in triglycerides were positively associated with changes in aspartate transaminase (R(2) = 0.28, P = 0.04) suggesting a role of hypertriglyceridaemia in the alteration of liver metabolism under inactive conditions. Physical inactivity increases, independent of fat mass, hepatic markers of steatosis and steatohepatitis. Regular exercise can limit these physical inactivity-induced metabolic alterations. Future studies need to elucidate the underlying mechanisms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Retrospective Study of Serum Sclerostin Measurements in Bed Rest Subjects

NASA Technical Reports Server (NTRS)

Spatz, J. M.; Fields, E. E.; Yu, E. W.; Divieti, Pajevic P.; Bouxsein, M. L.; Sibonga, M. L.; Zwart, S. R.; Smith, S. M.

2011-01-01

Animal models and human studies suggest that osteocytes regulate the skeleton s response to mechanical unloading at the cellular level in part by an increase in sclerostin, an inhibitor of the anabolic Wnt pathway. However, few studies have reported changes in serum sclerostin in humans exposed to reduced mechanical loading. Thus, we determined changes in serum sclerostin and bone turnover markers in healthy adult men who participated in a controlled bed rest study. Seven healthy adult men (31 +/- 3 yrs old) underwent 90-day six-degree head down tilt bed rest at the University of Texas Medical Branch in Galveston's Institute for Translational Sciences - Clinical Research Center (ITS-CRC). Serum sclerostin, PTH, serum markers of bone turnover (bone specific alkaline phosphatase, RANKL/OPG, and osteocalcin), urinary calcium and phosphorus excretion, and 24 hour pooled urinary markers of bone resorption (NTX, DPD, PYD) were evaluated pre-bed rest (BL), bed rest day 28 (BR-28), bed rest day 60 (BR-60), and bed rest day 90 (BR-90). In addition, bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA) at BL, BR-60, and post bed rest day 5 (BR+5). Data are reported as mean +/- standard deviation. We used repeated measures ANOVA to compare baseline values to BR-28, BR-60, and BR-90. RESULTS Consistent with prior reports, BMD declined significantly (1-2% per month) at weight-bearing skeletal sites (spine, hip, femur neck, and calcaneus). Serum sclerostin levels were elevated above BL at BR-28 (+29% +/- 20%, p = 0.003), BR-60 (+42% +/- 31%, p < 0.001), and BR-90 (22% +/- 21%, p = 0.07). Serum PTH levels were reduced at BR-28 (-17% +/- 16%, p = 0.02), BR-60 (-24% +/- 14%, p = 0.03), and returned to baseline at BR-90 (-21% +/- 21%, p = 0.14). Serum bone turnover markers did not change, however urinary bone resorption markers and calcium were significantly elevated following bed rest (p < 0.01). CONCLUSION We observed an increase of serum sclerostin associated with decreased serum PTH and elevated bone resorption markers in otherwise healthy men subjected to long-term immobilization.

Direct measurements of lift and drag on shallowly submerged cobbles in steep streams: Implications for flow resistance and sediment transport

NASA Astrophysics Data System (ADS)

Lamb, Michael P.; Brun, Fanny; Fuller, Brian M.

2017-09-01

Steep mountain streams have higher resistance to flow and lower sediment transport rates than expected by comparison with low gradient rivers, and often these differences are attributed to reduced near-bed flow velocities and stresses associated with form drag on channel forms and immobile boulders. However, few studies have directly measured drag and lift forces acting on bed sediment for shallow flows over coarse sediment, which ultimately control sediment transport rates and grain-scale flow resistance. Here we report on particle lift and drag force measurements in flume experiments using a planar, fixed cobble bed over a wide range of channel slopes (0.004 < S < 0.3) and water discharges. Drag coefficients are similar to previous findings for submerged particles (CD ˜ 0.7) but increase significantly for partially submerged particles. In contrast, lift coefficients decrease from near unity to zero as the flow shallows and are strongly negative for partially submerged particles, indicating a downward force that pulls particles toward the bed. Fluctuating forces in lift and drag decrease with increasing relative roughness, and they scale with the depth-averaged velocity squared rather than the bed shear stress. We find that, even in the absence of complex bed topography, shallow flows over coarse sediment are characterized by high flow resistance because of grain drag within a roughness layer that occupies a significant fraction of the total flow depth, and by heightened critical Shields numbers and reduced sediment fluxes because of reduced lift forces and reduced turbulent fluctuations.

A Theoretical Model of Drumlin Formation Based on Observations at Múlajökull, Iceland

NASA Astrophysics Data System (ADS)

Iverson, N. R.; McCracken, R. G.; Zoet, L. K.; Benediktsson, Í. Ö.; Schomacker, A.; Johnson, M. D.; Woodard, J.

2017-12-01

The drumlin field at the surge-type glacier, Múlajökull, provides an unusual opportunity to build a model of drumlin formation based on field observations in a modern drumlin-forming environment. These observations indicate that surges deposit till layers that drape the glacier forefield, conform to drumlin surfaces, and are deposited in shear. Observations also indicate that erosion helps create drumlin relief, effective stresses in subglacial till are highest between drumlins, and during quiescent flow, crevasses on the glacier surface overlie drumlins while subglacial channels occupy intervening swales. In the model, we consider gentle undulations on the bed bounded by subglacial channels at low water pressure. During quiescent flow, slip of temperate ice across these undulations and basal water flow toward bounding channels create an effective stress distribution that maximizes till entrainment in ice on the heads and flanks of drumlins. Crevasses amplify this effect but are not necessary for it. During surges, effective stresses are uniformly low, and the bed shears pervasively. Vigorous basal melting during surges releases debris from ice and deposits it on the bed, with deposition augmented by transport in the deforming bed. As surge cycles progress, drumlins migrate downglacier and grow at increasing rates, due to positive feedbacks that depend on drumlin height. Drumlin growth can be accompanied by either net aggradation or erosion of the bed, and drumlin heights and stratigraphy generally correspond with observations. This model highlights that drumlin growth can reflect instabilities other than those of bed shear instability models, which require heuristic till transport assumptions.

Par Pond vegetation status 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mackey, H.E. Jr.; Riley, R.S.

1996-12-01

The water level of Par Pond was lowered approximately 20 feet in mid-1991 in order to protect downstream residents from possible dam failure suggested by subsidence on the downstream slope of the dam and to repair the dam. This lowering exposed both emergent and nonemergent macrophyte beds to drying conditions resulting in extensive losses. A survey of the newly emergent, shoreline aquatic plant communities of Par Pond began in June 1995, three months after the refilling of Par Pond to approximately 200 feet above mean sea level. These surveys continued in July, September, and late October, 1995, and into themore » early spring and late summer of 1996. Communities similar to the pre-drawdown, Par Pond aquatic plant communities continue to become re-established. Emergent beds of maidencane, lotus, waterlily, watershield, and Pontederia are extensive and well developed. Measures of percent cover, width of beds, and estimates of area of coverage with satellite data indicate regrowth within two years of from 40 to 60% of levels prior to the draw down. Cattail occurrence continued to increase during the summer of 1996, especially in the former warm arm of Par Pond, but large beds common to Par Pond prior to the draw down still have not formed. Lotus has invaded and occupies many of the areas formerly dominated by cattail beds. To track the continued development of macrophytes in Par Pond, future surveys through the summer and early fall of 1997, along with the evaluation of satellite data to map the extent of the macrophyte beds of Par Pond, are planned.« less

Impact of huge tsunami in March 2011 on seaweed bed distributions in Shizugawa Bay, Sanriku Coast, revealed by remote sensing

NASA Astrophysics Data System (ADS)

Sakamoto, Shingo X.; Sasa, Shuji; Sawayama, Shuhei; Tsujimoto, Ryo; Terauchi, Genki; Yagi, Hiroshi; Komatsu, Teruhisa

2012-10-01

Seaweed beds are very important for abalones and sea urchins as a habitat. In Sanriku Coast, these animals are target species of coastal fisheries. The huge tsunami hit Sanriku Coast facing Pacific Ocean on 11 March 2011. It is needed for fishermen to know present situation of seaweed beds and understand damages of the huge tsunami on natural environments to recover coastal fisheries. We selected Shizugawa Bay as a study site because abalone catch of Shizugawa Bay occupied the first position in Sanriku Coast. To evaluate impact of tsunami on seaweed beds, we compared high spatial resolution satellite image of Shizugawa Bay before the tsunami with that after the tsunami by remote sensing with ground surveys to know impact of the tsunami on seaweed beds. We used two multi-band imageries of commercial high-resolution satellite, Geoeye-1, which were taken on 4 November 2009 before the tsunami and on 22 February 2012 after the tsunami. Although divers observed the tsunami damaged a very small part of Eisenia bicyclis distributions on rock substrates at the bay head, it was not observed clearly by satellite image analysis. On the other hand, we found increase in seaweed beds after the tsunami from the image analysis. The tsunami broke concrete breakwaters, entrained a large amount of rocks and pebble from land to the sea, and disseminated them in the bay. Thus, hard substrates suitable for attachment of seaweeds were increased. Ground surveys revealed that seaweeds consisting of E. bicyclis, Sargassum and Laminaria species grew on these hard substrates on the sandy bottom.

Collagen cross-link excretion during space flight and bed rest

NASA Technical Reports Server (NTRS)

Smith, S. M.; Nillen, J. L.; Leblanc, A.; Lipton, A.; Demers, L. M.; Lane, H. W.; Leach, C. S.; LeBlanc, A. (Principal Investigator)

1998-01-01

Extended exposure to weightlessness results in bone loss. However, little information exists as to the precise nature or time course of this bone loss. Bone resorption results in the release of collagen breakdown products, including N-telopeptide and the pyridinium (PYD) cross-links, pyridinoline and deoxypyridinoline. Urinary pyridinoline and deoxypyridinoline are known to increase during bed rest. We assessed excretion of PYD cross-links and N-telopeptide before, during, and after long (28-day, 59-day, and 84-day) Skylab missions, as well as during short (14-day) and long (119-day) bed-rest studies. During space flight, the urinary cross-link excretion level was twice those observed before flight. Urinary excretion levels of the collagen breakdown products were also 40-50% higher, during short and long bed rest, than before. These results clearly show that the changes in bone metabolism associated with space flight involve increased resorption. The rate of response (i.e. within days to weeks) suggests that alterations in bone metabolism are an early effect of weightlessness. These studies are important for a better understanding of bone metabolism in space crews and in those who are bedridden.

Focal Gray Matter Plasticity as a Function of Long Duration Head-down Tilt Bed Rest

NASA Technical Reports Server (NTRS)

Koppelmans, V.; DeDios, Y. E.; Wood, S. J.; Reuter-Lorenz, P. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.; Koppelmans, V.

2014-01-01

Long duration spaceflight (i.e., > or = 22 days) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes. Whether these sensorimotor changes may be related to structural and functional brain changes is yet unknown. However, experimental studies revealed changes in the gray matter (GM) of the brain after simulated microgravity. Thus, it is possible that spaceflight may affect brain structure and thereby cognitive functioning and motor behavior. Long duration head-down tilt bed rest has been suggested as an exclusionary analog to study microgravity effects on the sensorimotor system. Bed rest mimics microgravity in body unloading and bodily fluid shifts. In consideration of the health and performance of crewmembers both in- and post-flight, we are conducting a prospective longitudinal 70-day bed rest study as an analog to investigate the effects of microgravity on the brain. VBM analysis revealed a progressive decrease from pre- to in- bed rest in GM volume in bilateral areas including the frontal medial cortex, the insular cortex and the caudate. Over the same time period, there was a progressive increase in GM volume in the cerebellum, occipital-, and parietal cortex, including the precuneus. The majority of these changes did not fully recover during the post-bed rest period. Analysis of lobular GM volumes obtained with BRAINS showed significantly increased volume from pre-bed rest to in-bed rest in GM of the parietal lobe and the third ventricle. Temporal GM volume at 70 days in bed rest was smaller than that at the first pre-bed rest measurement. Trend analysis showed significant positive linear and negative quadratic relationships between parietal GM and time, a positive linear relationship between third ventricle volume and time, and a negative linear relationship between cerebellar GM volume and time. FM performance improved from pre-bed rest session 1 to session 2. From the second pre-bed rest measure to the last-day-in-bed rest, there was a significant decrease in performance that only partially recovered post-bed rest. No significant association was observed between changes in brain volume and changes in functional mobility. Extended bed rest, which is an analog for microgravity, can result in local volumetric GM increase and decrease and adversely affect functional mobility. These changes in brain structure and performance were not related in this sample. Whether the effects of bed rest dissipate at longer times post-bed rest, and if they are associated with behavior are important questions that warrant further research including more subjects and longer follow-up times.

Changes in mood status and neurotic levels during a 20-day bed rest

NASA Astrophysics Data System (ADS)

Ishizaki, Yuko; Ishizaki, Tatsuro; Fukuoka, Hideoki; Kim, Chang-Sun; Fujita, Masayo; Maegawa, Yuko; Fujioka, Hiroshi; Katsura, Taisaku; Suzuki, Yoji; Gunji, Atsuaki

2002-04-01

This study evaluated changes of mood status and depressive and neurotic levels in nine young male subjects during a 20-day 6° head-down tilting bed rest and examined whether exercise training modified these changes. Participants were asked to complete psychometrical inventories on before, during, and after the bed rest experiment. Depressive and neurotic levels were enhanced during bed rest period according to the Japanese version of Zung's Self-rating Depression Scale and the Japanese version of the General Health Questionnaire. Mood state "vigor" was impaired and "confusion" was increased during bed rest and recumbent control periods compared to pre-bed rest and ambulatory control periods according to the Japanese version of Profiles of Mood State, whereas the mood "tension-anxiety", "depression-dejection", "anger-hostility" and "fatigue" were relatively stable during experiment. Isometric exercise training did not modify these results. Microgravity, along with confinement to bed and isolation from familiar environments, induced impairment of mental status.

Bed rest and immunity

NASA Astrophysics Data System (ADS)

Sonnenfeld, Gerald; Aviles, Hernan; Butel, Janet S.; Shearer, William T.; Niesel, David; Pandya, Utpal; Allen, Christopher; Ochs, Hans D.; Blancher, Antoine; Abbal, Michel

2007-02-01

Space flight has been shown to result in altered immune responses. The current study was designed to investigate this possibility by using the bed rest model of some space flight conditions. A large number of women are included as subjects in the study. The hypothesis being tested is: 60 days head-down tilt bed rest of humans will affect the immune system and resistance to infection. Blood, urine and saliva samples will be obtained from bed rest subjects prior to, at intervals during, and after completion of 60 days of head-down tilt bed rest. Leukocyte blastogenesis, cytokine production and virus reactivation will be assessed. The ability of the subjects to respond appropriately to immunization with the neoantigen bacteriophage φX-174 will also be determined. Bed rest is being carried out at MEDES, Toulouse France, and the University of Texas Medical Branch, Galveston, TX. The studies to be carried out in France will also allow assessment of the effects of muscle/bone exercise and nutritional countermeasures on the immune system in addition to the effects of bed rest.

Executive function on the 16-day of bed rest in young healthy men

NASA Astrophysics Data System (ADS)

Ishizaki, Yuko; Fukuoka, Hideoki; Tanaka, Hidetaka; Ishizaki, Tatsuro; Fujii, Yuri; Hattori-Uchida, Yuko; Nakamura, Minako; Ohkawa, Kaoru; Kobayashi, Hodaka; Taniuchi, Shoichiro; Kaneko, Kazunari

2009-05-01

Microgravity due to prolonged bed rest may cause changes in cerebral circulation, which is related to brain function. We evaluate the effect of simulated microgravity due to a 6° head-down tilt bed rest experiment on executive function among 12 healthy young men. Four kinds of psychoneurological tests—the table tapping test, the trail making test, the pointing test and losing at rock-paper-scissors—were performed on the baseline and on day 16 of the experiment. There was no significant difference in the results between the baseline and day 16 on all tests, which indicated that executive function was not impaired by the 16-day 6° head-down tilting bed rest. However, we cannot conclude that microgravity did not affect executive function because of the possible contribution of the following factors: (1) the timing of tests, (2) the learning effect, or (3) changes in psychophysiology that were too small to affect higher brain function.

Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

NASA Technical Reports Server (NTRS)

Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Taibbi, G.; Vizzeri, G.

2011-01-01

Reports of astronauts visual changes raised concern about ocular health during long-duration spaceflight. Some of these findings included hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, hypotheses speculate that hypertension in the brain caused by cephalad fluid shifts during spaceflight is a possible mechanism for these ocular changes. Head-down tilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. In addition, previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP). For these reasons, vision monitoring of HDT bed rest subjects was implemented for NASA bed rest studies. Subjects selected for these studies were healthy adults (14 males and 5 females). Average age was 37.5 plus or minus 9.1 years, weight was 77.4 plus or minus 11.3 Kg, and height was 173.4 plus or minus 7.2 14 cm. Controlled conditions followed for all NASA bed rest studies were implemented. These conditions included factors such as eating a standardized diet, maintaining a strict sleep wake cycle, and remaining in bed for 24 hours each day. In one study, subjects maintained a horizontal (0 degree) position while in bed and were exercised six days per week with an integrated resistance and aerobic training (iRAT) program. In the other study, subjects were placed at 6 degrees HDT while in bed and did not engage in exercise. All subjects underwent pre- and post bed rest vision testing. While the battery of vision tests for each study was not identical, measures common to both studies will be presented. These measures included IOP and measures that provided an indication of optic disc swelling as derived from optical coherence tomography (OCT) testing: average retinal nerve fiber layer (RNFL) thickness (millimeters), disc area (square millimeters), rim area (square millimters), and average cup to disc (C/D) ratio. For all measures, there was no significant difference between subject groups for pre-bed rest testing. Post bed rest values also remained similar between groups. Comparison of pre- to post bed rest testing within each group did not demonstrate any statistical differences. These preliminary results from 14-day bed rest studies suggest that the combination of exercise and horizontal bed rest as compared to 6 degrees HDT bed rest did not produce differences in the ocular response with regard to IOP and optic disc parameters. The ocular measures reported here only included pre- and post bed rest time points. Further investigation is needed to examine both the acute response and long term adaptation of structural and functional ocular parameters in the bed rest platform and determine its usefulness for studying spaceflight phenomena. From a clinical perspective, the ability to study ocular responses in the controlled environment of the bed rest platform can provide valuable information for the care of patients restricted to bed rest.

Effects of a spaceflight analog environment on brain connectivity and behavior.

PubMed

Cassady, Kaitlin; Koppelmans, Vincent; Reuter-Lorenz, Patricia; De Dios, Yiri; Gadd, Nichole; Wood, Scott; Castenada, Roy Riascos; Kofman, Igor; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael

2016-11-01

Sensorimotor functioning is adaptively altered following long-duration spaceflight. The question of whether microgravity affects other central nervous system functions such as brain network organization and its relationship with behavior is largely unknown, but of importance to the health and performance of astronauts both during and post-flight. In the present study, we investigate the effects of prolonged exposure to an established spaceflight analog on resting state brain functional connectivity and its association with behavioral changes in 17 male participants. These bed rest participants remained in bed with their heads tilted down six degrees below their feet for 70 consecutive days. Resting state functional magnetic resonance imaging (rs-fMRI) and behavioral data were obtained at seven time points averaging around: 12 and 8days prior to bed rest; 7, 50, and 70days during bed rest; and 8 and 12days after bed rest. To assess potential confounding effects due to scanning interval or task practice, we also acquired rs-fMRI and behavioral measurements from 14 control participants at four time points. 70days of head-down tilt (HDT) bed rest resulted in significant changes in the functional connectivity of motor, somatosensory, and vestibular areas of the brain. Moreover, several of these network alterations were significantly associated with changes in sensorimotor and spatial working memory performance, which suggests that neuroplasticity mechanisms may facilitate adaptation to the microgravity analog environment. The findings from this study provide novel insights into the underlying neural mechanisms and operational risks of spaceflight analog-related changes in sensorimotor performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Implications of bed reduction in an acute psychiatric service.

PubMed

Bastiampillai, Tarun J; Bidargaddi, Niranjan P; Dhillon, Rohan S; Schrader, Geoffrey D; Strobel, Jörg E; Galley, Philip J

2010-10-04

To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating data-driven practices, in a mental health service. Retrospective comparison of the changes in services within three consecutive financial years: baseline period - before bed reduction (2006-07); observation period - after bed reduction (2007-08); and intervention period - second year after bed reduction (2008-09). The study was conducted at Cramond Clinic, Queen Elizabeth Hospital, Adelaide. Length of stay, 28-day readmission rates, discharges, bed occupancy rates, emergency department (ED) presentations, ED waiting time, seclusions, locality of treatment, and follow-up in the community within 7days. Reduced bed numbers were associated with reduced length of stay, fewer referrals from the community and subsequently shorter waiting times in the ED, without significant change in readmission rates. A higher proportion of patients was treated in the local catchment area, with improved community follow-up and a significant reduction in inpatient seclusions. Our findings should reassure clinicians concerned about psychiatric bed numbers that service redesign with planned bed reductions will not necessarily affect clinical care, provided data literacy and team training programs are in place to ensure smooth transition of patients across ED, inpatient and community services.

A dismantling study of assertive outreach services: comparing activity and outcomes following replacement with the FACT model.

PubMed

Firn, Mike; Hindhaugh, Keelyjo; Hubbeling, Dieneke; Davies, Gwyn; Jones, Ben; White, Sarah Jane

2013-06-01

Financial constraints and some disappointing research evaluations have seen English assertive outreach (AO) teams subject to remodelling, decommissioning and integration into standard care. We tested a specific alternative model of integrating the AO function from two AO teams into six standard community mental health teams (CMHT). The Flexible Assertive Community Treatment model (FACT) was adopted from the Netherlands (Van Veldhuizen, Commun Mental Health J 43(4):421-433, 2007; Bond and Drake, Commun Mental Health J 43(4):435-438, 2007). We aimed to demonstrate non-inferiority in clinical effectiveness and thereby show cost efficiencies associated with FACT. Outcomes were compared in a mirror-image study of the 12 months periods pre- and post-service change with eligible individuals from the AO teams' caseloads (n = 112) acting as their own controls. We also conducted a cost-consequence analysis of the changes. Outcome data regarding admissions, use of crisis and home treatment, frequency of contact and DNA rate were extracted from the electronic patient record. The results show AO patients (n = 112) transferred to standard CMHTs with FACT had significantly fewer admissions and a halving of bed use (21 fewer admission and 2,394 fewer occupied bed days) whilst being in receipt of a less intensive service (2,979 fewer contacts). This was offset by significantly poorer engagement but not by increased use of crisis and home treatment services. Enhancing multi-disciplinary CMHTs with FACT provides a clinically effective alternative to AO teams. FACT offers a cost-effective model compared to AO.

Sensitivity of whole body protein synthesis to amino acid administration during short-term bed rest.

PubMed

Biolo, Gianni; Ciocchi, Beniamino; Lebenstedt, Marion; Heer, Martina; Guarnieri, Gianfranco

2002-07-01

We tested the hypothesis that a reduced stimulation of whole-body protein synthesis by amino acid administration represents a major mechanism for the bed rest-induced loss of lean body mass. Healthy young subjects and matched controls were studied on the last day of a 14-day bed rest or ambulatory period, as part of the overall protocol "Short-term Bed Rest - Integrated Physiology" set up by the German Aerospace Centre (DLR) in co-operation with the European Space Agency. A balanced mixture of essential and non-essential amino acids was intravenously infused in the postabsorptive state for 3 hours at the rate of 0.1 g/kg/hour. The oxidative and non-oxidative (i.e., to protein synthesis) disposal of the infused leucine was determined by stable isotope and mass spectrometry techniques. The clearance of total infused amino acids tended to be greater (P=0.07) in the ambulatory group than in the bed rest group. When leucine clearance was partitioned between its oxidative and non-oxidative (i.e., to protein synthesis) components, the results indicated that the oxidative disposal was not statistically different in the bed rest and in the ambulatory groups. In contrast, the non-oxidative leucine disposal (i.e., to protein synthesis) was about 20% greater (P<0.01) in the ambulatory group than in the bed rest group. In conclusion, these preliminary data suggest that 14-day bed rest impairs the ability to utilise exogenous amino acids for protein synthesis.

Association Between Cardiovascular and Intraocular Pressure Changes in a 14-Day 6 deg Head Down Tilt (HDT) Bed Rest Study: Possible Implications in Retinal Anatomy

NASA Technical Reports Server (NTRS)

Cromwell, Ronita; Zanello, Susana; Yarbough, Patrice; Ploutz-Snyder, Robert; Taibbi, Giovanni; Vizzeri, Gianmarco

2013-01-01

Visual symptoms and intracranial pressure increase reported in astronauts returning from long duration missions in low Earth-orbit are thought to be related to fluid shifts within the body due to microgravity exposure. Because of this possible relation to fluid shifts, studies conducted in head-down tilt (HDT) bed rest are being monitored for potential changes in ocular health. These measures will also serve to determine whether HDT is a suitable ground-based analog to model subclinical cardiovascular and ocular changes that could shed light on the etiology of the VIIP syndrome observed in spaceflight. Sixteen healthy normotensive (12M, 4F, age range 29-54 years), non-smoker and normal weight subjects, volunteered to participate in a 14 day 6 deg head HDT study conducted at the NASA Flight Analogs Research Unit (FARU). This facility provides standard bed rest conditions (diet, wake/sleep time, time allowed in sunlight) during the time that the subjects stay at the FARU. Cardiovascular parameters were obtained in supine posture at BR-5, BR+0, and BR+3 and ocular monitoring was performed weekly. Intraocular pressure (IOP) increased from pre-bed rest BR-3) to the third day into bed rest (BR+3). Values reached a plateau towards the end of the bed rest phase (BR10) and decreased within the first three days of recovery (BR+2) returning to levels comparable to baseline at BR-3. As expected, most cardiovascular parameters were affected by 14 days of HDT bed rest. Plasma volume decreased as a result of bed rest but recovered to baseline levels by BR+3. Indications of cardiovascular deconditioning included increase in both systolic and diastolic blood pressure and heart rate, and a decrease in stroke volume and cardiac output between BR-5 and BR+3. Due to the experimental design of this study, we were not able to test the hypothesis that fluid shifts might be involved in the IOP increase during the bed rest phase, since cardiovascular measures were not available for those time points. There was no correlation between the largest change in IOP (BR-3 versus BR3) and cardiovascular measure changes between baseline (BR-5) and post bed rest (BR+2). While no clinically relevant visual changes were observed during the study, measurement of various retinal parameters was performed with optical coherence tomography (OCT). A decrease in central subfield retinal thickness was observed between BR+2 and baseline at BR-10, but no association was observed with IOP changes. This work investigates the time course of changes in IOP during 14-day HDT bed rest in an attempt to characterize HDT bed rest as a model of the VIIP syndrome and delve into its etiology.

Northern Cascadia Subduction Zone Earthquake Records from Onshore and Offshore Core Data

NASA Astrophysics Data System (ADS)

Hausmann, R. B.; Goldfinger, C.; Black, B.; Romsos, C. G.; Galer, S.; Collins, T.

2016-12-01

We are investigating the paleoseismic record at Bull Run Lake, at the latitude of Portland, Oregon, central Cascadia margin. Bull Run is a landslide dammed lake in a cirque basin on the western flanks of Mt. Hood, 65 km east of Portland, and is the City of Portland's primary water supply. We collected full coverage high-resolution multibeam and backscatter data, high resolution CHIRP sub-bottom profiles, and seven sediment cores which contain a correlative turbidite sequence of post Mazama beds. The continuity of the turbidite record shows little or no relationship to the minor stream inlets, suggesting the disturbance beds are not likely to be storm related. CT and physical property data were used to separate major visible beds and background sedimentation, which also contain thin laminae. The XRF element Compton scattering may show grading due to mineralogical variation and a change in wave profile, commonly found at bed boundaries. We have identified 27 post -Mazama event beds and 5 ashes in the lake, and constructed an OxCal age model anchored by radiocarbon ages, the Mazama ash, and the twin Timberline ash beds. The radiocarbon ages, age model results, as well as electron microprobe (EMP) data clearly identify the Mazama ash at the base of our cores. Two closely-spaced ash beds in our cores likely correlate to the Timberline eruptive period at 1.5ka. The number, timing and sequence of the event beds, and physical property log correlation, as well as key bed characteristics, closely matches offshore turbidite sequences off northern Oregon. For example, key regional bed T11, observed as a thick two-pulse bed in all offshore cores, also anchors the Bull Run sequence. One difference is that the twin Timberline ash occupies the stratigraphic position of regional offshore paleoseismic bed T4, which is also a two pulse event at this latitude. The cores also contain many faint laminae that may contain a storm record, however, the identification of small beds is complicated by the low sedimentation rate and low resolution of the Bull Run cores. The watershed and lake may also contain evidence of crustal faulting, though the event sequence appears to be primarily that of the Cascadia subduction zone earthquake sequence. See also Goldfinger et al. for investigation of slope stability and ground motions at Bull Run and other Cascadia lakes.

Outdoor air 1,3-butadiene monitoring: Comparison of performance of Radiello® passive samplers and active multi-sorbent bed tubes

NASA Astrophysics Data System (ADS)

Gallego, Eva; Teixidor, Pilar; Roca, Francisco Javier; Perales, José Francisco; Gadea, Enrique

2018-06-01

A comparison was made between the relative performance of active and passive sampling methods for the analysis of 1,3-butadiene in outdoor air. Active and passive sampling was conducted using multi-sorbent bed tubes (Carbotrap, Carbopack X, Carboxen 569) and RAD141 Radiello® diffusive samplers (filled with Carbopack X), respectively. Daily duplicate samples of multi-sorbent bed tubes were taken over a period of 14 days (9 + 5 days) at El Morell (Tarragona, Spain), near the petrochemical area. As 1,3-butadiene is a reactive pollutant and can be rapidly oxidized, half of the samplers were equipped with ozone scrubbers. Samples consisted in two tubes connected in series (front and back) to allow the determination of breakthrough. Quadruplicate samples of Radiello® tubes were taken over a period of 14 days (9 days and 5 days), too. During those days, ozone concentration was measured using RAD172 Radiello® samplers. In addition to this, daily duplicate samples of multi-sorbent bed tubes were taken in the city of Barcelona over a period of 8 days. Simultaneously, 4 samples of Radiello® tubes were exposed to outdoor air. Sampling was done throughout June and July 2017. Analysis was performed by thermal desorption coupled with gas chromatography/mass spectrometry. Analytical performance of the two sampling methods was evaluated by describing several quality assurance parameters, with results showing that performances are quite similar. They display low detection limits, good precision, linearity and desorption efficiency, low levels of blank values, and low breakthrough for multi-sorbent bed tubes. However, Radiello® samplers were not able to uptake episodic 1,3-butadiene high concentrations, leading to underestimation of real values. Hence, we can conclude that Radiello® samplers can be used for baseline 1,3-butadiene levels whereas multi-sorbent bed tubes would be advisable when relevant episodes are expected.

Increased Brain Activation for Foot Movement During 70-Day 6 Deg Head-Down Bed Rest (HDBR): Evidence from Functional Magnetic Resonance Imaging (fMRI)

NASA Technical Reports Server (NTRS)

Yuan, P.; Koppelmans, V.; Cassady, K.; Cooke, K.; De Dios, Y. E.; Stepanyan, V.; Szecsy, D.; Gadd, N.; Wood, S. J.; Reuter-Lorenz, P. A.;

Module Measurements | Photovoltaic Research | NREL

Science.gov Websites

prototype concentrator evaluation test bed, and the Daystar DS-10/125 portable I-V curve tracer. Standard Evaluation Test Bed. We developed this test bed to be able to evaluate I-V characteristics throughout the day a function of time, temperature, and light level. This test bed data set is also used to evaluate

Bed management team with Kanban web-based application.

PubMed

Rocha, Hermano Alexandre Lima; Santos, Ana Kelly Lima da Cruz; Alcântara, Antônia Celia de Castro; Lima, Carmen Sulinete Suliano da Costa; Rocha, Sabrina Gabriele Maia Oliveira; Cardoso, Roberto Melo; Cremonin, Jair Rodrigues

2018-05-15

To measure the effectiveness of the bed management process that uses a web-based application with Kanban methodology to reduce hospitalization time of hospitalized patients. Before-after study was performed. The study was conducted between July 2013 and July 2017, at the Unimed Regional Hospital of Fortaleza, which has 300 beds, of which 60 are in the intensive care unit (ICU). It is accredited by International Society for Quality in Healthcare. Patients hospitalized in the referred period. Bed management with an application that uses color logic to signal at which stage of high flow the patients meet, in which each patient is interpreted as a card of the classical Kanban theory. It has an automatic user signaling system for process movement, and a system for monitoring and analyzing discharge forecasts. Length of hospital stay, number of customer complaints related to bed availability. After the intervention, the hospital's overall hospital stay time was reduced from 5.6 days to 4.9 days (P = 0.001). The units with the greatest reduction were the ICUs, with reduction from 6.0 days to 2.0 (P = 0.001). The relative percentage of complaints regarding bed availability in the hospital fell from 27% to 0%. We conclude that the use of an electronic tool based on Kanban methodology and accessed via the web by a bed management team is effective in reducing patients' hospital stay time.

Health-service Use in Women with Binge Eating Disorders

PubMed Central

Dickerson, John; DeBar, Lynn; Perrin, Nancy A.; Lynch, Frances; Wilson, G. Terence; Rosselli, Francine; Kraemer, Helena C.; Striegel-Moore, Ruth H.

2014-01-01

Objective To compare health-care utilization between participants who met DSM-IV criteria for Binge Eating Disorder (BED) and those engaged in Recurrent Binge Eating (RBE) and to evaluate whether objective binge eating (OBE) days, a key measurement for diagnosing BED, predicted health-care costs. Method We obtained utilization and cost data from electronic medical records to augment patient reported data for 100 adult female members of a large health maintenance organization (HMO) who were enrolled in a randomized clinical trial to treat binge eating. Results Total costs did not differ between the BED and RBE groups (β=−0.117, z=−0.48, p=0.629), nor did the number of OBE days predictor total costs (β= −0.017, z=−1.01, p=0.313). Conclusions Findings suggest that the medical impairment, as assessed through health care costs, caused by BED may not be greater than impairment caused by RBE. The current threshold number of two OBE days/week as a criterion for BED may need to be reconsidered PMID:21823138

Philadelphia gas works medium-Btu coal gasification project: environmental assessment. [GKT supplied by Krupp-Koppers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1981-12-01

The coal gasification plant will occupy a 43-acre site, known as the Riverside Site, located along the Delaware River next to Port Richmond between the Betsy Ross and Benjamin Franklin Bridges. The cleared site was previously used for industrial purposes and has a G-2 industrial zoning. Adverse impacts during the construction phase of the project are not expected to be significantly different than those occurring during any major industrial construction project. During operation of the coal gasification facility, specific mitigative measures have been designed into the facility to avoid adverse environmental impacts wherever possible. In addition to these extensive engineeringmore » safeguards, elaborate monitoring and control instrumentation shall be used. The GKT entrained bed, oxygen-blown gasification process provided by Krupp/Koppers was selected because it is a commercially proven system and because of its positive environmental characteristics such as its ability to gasify many coal types and the fact that it does not produce tars, phenols, or ammonia. During gasification of the coal, pollutants such as heavy metals in the coal are concentrated into the slag and ash. None of these pollutants are found in the product gas. The facility will produce 250 tpd of non-hazardous slag and fly ash. The combined slag and fly ash will occupy 347 cubic yards per day of landfill volume. Available haulers and landfills have been identified.A sophisticated health and safety program will include appropriate monitoring instruments for CO, H/sub 2/, H/sub 2/S, polynuclear aromatic hydrocarbons, organic compounds, and coal dust. Air emissions from operation of the coal gasification plant are not considered significant. Dust control systems have been designed into the facility to minimize fugitive dust emissions.« less

The probability of readmission within 30 days of hospital discharge is positively associated with inpatient bed occupancy at discharge--a retrospective cohort study.

PubMed

Blom, Mathias C; Erwander, Karin; Gustafsson, Lars; Landin-Olsson, Mona; Jonsson, Fredrik; Ivarsson, Kjell

2015-12-14

Previous work has suggested that given a hospital's need to admit more patients from the emergency department (ED), high inpatient bed occupancy may encourage premature hospital discharges that favor the hospital's need for beds over patients' medical interests. We argue that the effects of such action would be measurable as a greater proportion of unplanned hospital readmissions among patients discharged when the hospital was full than when not. In response, the present study tested this hypothesis by investigating the association between inpatient bed occupancy at the time of hospital discharge and the 30-day readmission rate. The sample included all inpatient admissions from the ED at a 420-bed emergency hospital in southern Sweden during 2011-2012 that resulted in discharge before 1 December 2012. The share of unplanned readmissions within 30 days was computed for levels of inpatient bed occupancy of <95%, 95-100%, 100-105% and >105% at the hour of discharge. A binary logistic regression model was constructed to adjust for age, time of discharge, and other factors that could affect the outcome. In all, 32,811 visits were included in the study, 9.9% of which resulted in an unplanned readmission within 30 days of discharge. The proportion of readmissions was 9.0% for occupancy levels of <95% at the patient's discharge, 10.2% for 95-100% occupancy, 10.8% for 100-105% occupancy, and 10.5% for >105% occupancy (p = 0.0001). Results from the multivariate models show that the OR (95% CI) of readmission was 1.11 (1.01-1.22) for patients discharged at 95-100% occupancy, 1.17 (1.06-1.29) at 100-105% occupancy, and 1.15 (0.99-1.34) at >105% occupancy. Results indicate that patients discharged from inpatient wards at times of high inpatient bed occupancy experience an increased risk of unplanned readmission within 30 days of discharge.

Biochemical and hemodynamic changes in normal subjects during acute and rigorous bed rest and ambulation

NASA Astrophysics Data System (ADS)

Zorbas, Yan G.; Kakurin, Vassily J.; Afonin, Victor B.; Yarullin, Vladimir L.

2002-06-01

Rigorous bed rest (RBR) induces significant biochemical and circulatory changes. However, little is known about acute rigorous bed rest (ARBR). Measuring biochemical and circulatory variables during ARBR and RBR the aim of this study was to establish the significance of ARBR effect. Studies were done during 3 days of a pre-bed rest (BR) period and during 7 days of ARBR and RBR period. Thirty normal male individuals aged, 24.1±6.3 years were chosen as subjects. They were divided equally into three groups: 10 subjects placed under active control conditions served as unrestricted ambulatory control subjects (UACS), 10 subjects submitted to an acute rigorous bed rest served as acute rigorous bed rested subjects (ARBRS) and 10 subjects submitted to a rigorous bed rest served as rigorous bed rested subjects (RBRS). The UACS were maintained under an average running distance of 9.7 km day -1. For the ARBR effect simulation, ARBRS were submitted abruptly to BR for 7 days. They did not have any prior knowledge of the exact date and time when they would be asked to confine to RBR. For the RBR effect simulation, RBRS were subjected to BR for 7 days on a predetermined date and time known to them right away from the start of the study. Plasma renin activity (PRA), plasma cortisol (PC), plasma aldosterone (PA), plasma and urinary sodium (Na) and potassium (K) levels, heart rate (HR), cardiac output (CO), and arterial blood pressure (ABP) increased significantly, and urinary aldosterone (UA), stroke volume (SV) and plasma volume (PV) decreased significantly ( p<0.05) in ARBRS and RBRS as compared with their pre-BR values and the values in UACS. Electrolyte, hormonal and hemodynamic responses were significantly ( p<0.05) greater and occurred significantly faster ( p<0.05) during ARBR than RBR. Parameters change insignificantly ( p>0.05) in UACS compared with pre-BR control values. It was concluded that, the more abruptly muscular activity is restricted in experimental subjects while they are very active, the greater hemodynamic and biochemical change there is and probably in individuals whose muscular activity is abruptly terminated after an accident or sudden illness.

Artificial Gravity as a Multi-System Countermeasure to Bed Rest Deconditioning: Preliminary Results

NASA Technical Reports Server (NTRS)

Warren, L. E.; Paloski, William H.; Young, L. R.

2006-01-01

Artificial gravity paradigms may offer effective, efficient, multi-system protection from the untoward effects of adaptation to the microgravity of space or the hypogravity of planetary surfaces. Intermittent artificial gravity (AG) produced by a horizontal short-radius centrifuge (SRC) has recently been utilized on human test subjects deconditioned by bed rest. This presentation will review preliminary results of a 41 day study conducted at the University of Texas Medical Branch, Galveston, TX bed rest facility. During the first eleven days of the protocol, subjects were ambulatory, but confined to the facility. They began a carefully controlled diet, and participated in multiple baseline tests of bone, muscle, cardiovascular, sensory-motor, immunological, and psychological function. On the twelfth day, subjects entered the bed rest phase of the study, during which they were confined to strict 6deg head down tilt bed rest for 21 days. Beginning 24 hrs into this period, treatment subjects received one hour daily exposures to artificial gravity which was produced by spinning the subjects on a 3.0 m radius SRC. They were oriented radially in the supine position so that the centrifugal force was aligned with their long body axis, and while spinning, they "stood" on a force plate, supporting the centrifugal loading (2.5 g at the feet, 1.0 g at the heart). The subject station allowed free translation over approximately 10 cm to ensure full loading of the lower extremities and to allow for anti-orthostatic muscle contractions. Control subjects were positioned on the centrifuge but did not spin. Following the bed rest phase, subjects were allowed to ambulate again, but remained within the facility for an additional 9 days and participated in multiple follow-up tests of physiological function.

Day/Night Variability in Blood Pressure: Influence of Posture and Physical Activity

PubMed Central

2013-01-01

BACKGROUND Blood pressure (BP) is highest during the day and lowest at night. Absence of this rhythm is a predictor of cardiovascular morbidity and mortality. Contributions of changes in posture and physical activity to the 24-hour day/night rhythm in BP are not well understood. We hypothesized that postural changes and physical activity contribute substantially to the day/night rhythm in BP. METHODS Fourteen healthy, sedentary, nonobese, normotensive men (aged 19–50 years) each completed an ambulatory and a bed rest condition during which BP was measured every 30–60 minutes for 24 hours. When ambulatory, subjects followed their usual routines without restrictions to capture the “normal” condition. During bed rest, subjects were constantly confined to bed in a 6-degree head-down position; therefore posture was constant, and physical activity was minimized. Two subjects were excluded from analysis because of irregular sleep timing. RESULTS The systolic and diastolic BP reduction during the sleep period was similar in ambulatory (−11±2mmHg/−8±1mmHg) and bed rest conditions (−8±3mmHg/−4±2mmHg; P = 0.38/P = 0.12). The morning surge in diastolic BP was attenuated during bed rest (P = 0.001), and there was a statistical trend for the same effect in systolic BP (P = 0.06). CONCLUSIONS A substantial proportion of the 24-hour BP rhythm remained during bed rest, indicating that typical daily changes in posture and/or physical activity do not entirely explain 24-hour BP variation under normal ambulatory conditions. However, the morning BP increase was attenuated during bed rest, suggesting that the adoption of an upright posture and/or physical activity in the morning contributes to the morning BP surge. PMID:23535155

Changes in intervertebral disc cross-sectional area with bed rest and space flight

NASA Technical Reports Server (NTRS)

LeBlanc, A. D.; Evans, H. J.; Schneider, V. S.; Wendt, R. E. 3rd; Hedrick, T. D.

1994-01-01

STUDY DESIGN. We measured the cross-sectional area of the intervertebral discs of normal volunteers after an overnight rest; before, during, and after 5 or 17 weeks of bed rest; and before and after 8 days of weightlessness. OBJECTIVES. This study sought to determine the degree of expansion of the lumbar discs resulting from bed rest and space flight. SUMMARY OF BACKGROUND DATA. Weightlessness and bed rest, an analog for weightlessness, reduce the mechanical loading on the musculoskeletal system. When unloaded, intervertebral discs will expand, increasing the nutritional diffusion distance and altering the mechanical properties of the spine. METHODS. Magnetic resonance imaging was used to measure the cross-sectional area and transverse relaxation time (T2) of the intervertebral discs. RESULTS. Overnight or longer bed rest causes expansion of the disc area, which reaches an equilibrium value of about 22% (range 10-40%) above baseline within 4 days. Increases in disc area were associated with modest increases in disc T2. During bed rest, disc height increased approximately 1 mm, about one-half of previous estimates based on body height measurements. After 5 weeks of bed rest, disc area returned to baseline within a few days of ambulation, whereas after 17 weeks, disc area remained above baseline 6 weeks after reambulation. After 8 days of weightlessness, T2, disc area, and lumbar length were not significantly different from baseline values 24 hours after landing. CONCLUSIONS. Significant adaptive changes in the intervertebral discs can be expected during weightlessness. These changes, which are rapidly reversible after short-duration flights, may be an important factor during and after long-duration missions.

Characteristics of fast voluntary and electrically evoked isometric knee extensions during 56 days of bed rest with and without exercise countermeasure

PubMed Central

Gerrits, K. H. L.; Rittweger, J.; Felsenberg, D.; Stegeman, D. F.; de Haan, A.

2008-01-01

The contractile characteristics of fast voluntary and electrically evoked unilateral isometric knee extensions were followed in 16 healthy men during 56 days of horizontal bed rest and assessed at bed rest days 4, 7, 10, 17, 24, 38 and 56. Subjects were randomized to either an inactive control group (Ctrl, n = 8) or a resistive vibration exercise countermeasure group (RVE, n = 8). No changes were observed in neural activation, indicated by the amplitude of the surface electromyogram, or the initial rate of voluntary torque development in either group during bed rest. In contrast, for Ctrl, the force oscillation amplitude at 10 Hz stimulation increased by 48% (P < 0.01), the time to reach peak torque at 300 Hz stimulation decreased by 7% (P < 0.01), and the half relaxation time at 150 Hz stimulation tended to be slightly reduced by 3% (P = 0.056) after 56 days of bed rest. No changes were observed for RVE. Torque production at 10 Hz stimulation relative to maximal (150 Hz) stimulation was increased after bed rest for both Ctrl (15%; P < 0.05) and RVE (41%; P < 0.05). In conclusion, bed rest without exercise countermeasure resulted in intrinsic speed properties of a faster knee extensor group, which may have partly contributed to the preserved ability to perform fast voluntary contractions. The changes in intrinsic contractile properties were prevented by resistive vibration exercise, and voluntary motor performance remained unaltered for RVE subjects as well. PMID:18386049

Sequential healing of open extraction sockets. An experimental study in monkeys.

PubMed

Scala, Alessandro; Lang, Niklaus P; Schweikert, Michael T; de Oliveira, José Américo; Rangel-Garcia, Idelmo; Botticelli, Daniele

2014-03-01

To describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made. The third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180 days was morphometrically studied. After 4 days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10 days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20 days, the amount of woven bone was sensibly increasing. At 30 days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180 days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4 days to 7.6% at 180 days, of the whole length of the inner alveolar surface. Modeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

SU-E-T-296: Single Field Per Day Vs. Multiple Fields Per Day and the Impact On BED in Proton Therapy Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grantham, K; Wooten, H; Zhao, T

2014-06-01

Purpose: A common practice, in proton therapy, is to deliver a rotating subset of fields from the treatment plan for the daily fractions. This study compares the impact this practice has on the biological effective dose (BED) versus delivering all planned fields daily. Methods: For two scenarios (a phantom with a geometry approximating the anatomy of a prostate treatment with opposing lateral beams, and a clinical 3-field brain treatment), treatment plans were produced in Eclipse (Varian) to simulate delivery of one, two, and three fields per fraction. The RT-Dose file, structure set, and α/β ratios were processed using in-house MATLABmore » code to return a new RT-Dose file containing the BED (including a proton RBE of 1.1) which was imported back into Eclipse for analysis. Results: For targets and regions of field overlap in the treatment plan, BED is not affected by delivery regimen. In the phantom, BED in the femoral heads showed increased by 20% when a single field was used rather than two fields. In the brain treatment, the minimum BED to the left optic nerve and the pituitary gland increased by 13% and 10% respectively, for a one-field regime compared to three-fields per fraction. Comparing the two-field and threefield regimes, the optic nerve BED was not significantly affected and the minimum pituitary BED was 4% higher for two fields per day. Conclusion: Hypo-fractionation effects, in regions of non-overlap of fields, significantly increase the BED to the involved tissues by as much as 20%. Care should be taken to avoid inadvertently sacrificing plan effectiveness in the interest of reduced treatment time.« less

Occupy Wall Street: Examining a Current Event as It Happens

ERIC Educational Resources Information Center

Bellows, Elizabeth; Bauml, Michele; Field, Sherry; Ledbetter, Mary

2012-01-01

On September 17, 2011 (Constitution Day), Occupy Wall Street began as a protest movement when approximately 2,000 supporters assembled in lower Manhattan's Zuccotti Park. The group's concerns focused on the corporate role in the current financial crisis and economic inequality. Rhetoric both in support of and against the protest began to flood the…

Energy expenditure and balance during spaceflight on the space shuttle

NASA Technical Reports Server (NTRS)

Stein, T. P.; Leskiw, M. J.; Schluter, M. D.; Hoyt, R. W.; Lane, H. W.; Gretebeck, R. E.; LeBlanc, A. D.

1999-01-01

The objectives of this study were as follows: 1) to measure human energy expenditure (EE) during spaceflight on a shuttle mission by using the doubly labeled water (DLW) method; 2) to determine whether the astronauts were in negative energy balance during spaceflight; 3) to use the comparison of change in body fat as measured by the intake DLW EE, 18O dilution, and dual energy X-ray absorptiometry (DEXA) to validate the DLW method for spaceflight; and 4) to compare EE during spaceflight against that found with bed rest. Two experiments were conducted: a flight experiment (n = 4) on the 16-day 1996 life and microgravity sciences shuttle mission and a 6 degrees head-down tilt bed rest study with controlled dietary intake (n = 8). The bed rest study was designed to simulate the flight experiment and included exercise. Two EE determinations were done before flight (bed rest), during flight (bed rest), and after flight (recovery). Energy intake and N balance were monitored for the entire period. Results were that body weight, water, fat, and energy balance were unchanged with bed rest. For the flight experiment, decreases in weight (2.6 +/- 0.4 kg, P < 0.05) and N retention (-2. 37 +/- 0.45 g N/day, P < 0.05) were found. Dietary intake for the four astronauts was reduced in flight (3,025 +/- 180 vs. 1,943 +/- 179 kcal/day, P < 0.05). EE in flight was 3,320 +/- 155 kcal/day, resulting in a negative energy balance of 1,355 +/- 80 kcal/day (-15. 7 +/- 1.0 kcal. kg-1. day-1, P < 0.05). This corresponded to a loss of 2.1 +/- 0.4 kg body fat, which was within experimental error of the fat loss determined by 18O dilution (-1.4 +/- 0.5 kg) and DEXA (-2.4 +/- 0.4 kg). All three methods showed no change in body fat with bed rest. In conclusion, 1) the DLW method for measuring EE during spaceflight is valid, 2) the astronauts were in severe negative energy balance and oxidized body fat, and 3) in-flight energy (E) requirements can be predicted from the equation: E = 1.40 x resting metabolic rate + exercise.

Joint US/USSR study: Comparison of effects of horizontal and head-down bed rest

NASA Technical Reports Server (NTRS)

Sandler, Harold; Grigoriev, Anatoli I.

1990-01-01

An account is given of the results of the first joint U.S./U.S.S.R. bed rest study. The study was accomplished in two parts: A soviet part (May to June 1979) and an American part (July to August 1979). Both studies were conducted under identical conditions and provided a basis for comparison of physiologic reactions and standardizing procedures and methods. Each experiment consisted of three periods: 14 days of pre-bed rest control, 7 days of bed rest, and a 10 to 14 day recovery period. Ten males participated in each study, with five subjects experiencing horizontal bed rest and five subjects a -6 deg head-down body position. Biochemical and hormonal measurements were made of blood and urine, with particular attention to electrolyte metabolism and kidney function; cardio-pulmonary changes at rest and exercise; influence of Lower Body Negative Pressure (LBNP); and incremental exercise using a bicyle ergometer while supine and sitting. Expected moderate changes were noted to occur for various physiologic parameters. Clinical evidence pointed to the fact that head-down bed rest when compared to horizontal conditions more closely matched the conditions seen after manned spaceflight. For the most part, statistically significant differences between the two body positions were not observed.

Fuel utilization during exercise after 7 days of bed rest

NASA Technical Reports Server (NTRS)

Barrows, Linda H.; Harris, Bernard A.; Moore, Alan D.; Siconolfi, Steven F.

1992-01-01

Energy yield from carbohydrate, fat, and protein during physical activity is partially dependent on an individual's fitness level. Prolonged exposure to microgravity causes musculoskeletal and cardiovascular deconditioning; these adaptations may alter fuel utilization during space flight. Carbohydrate and fat metabolism during exercise were analyzed before and after 7 days of horizontal bed rest.

[Measurement of antimicrobial consumption using DDD per 100 bed-days versus DDD per 100 discharges after the implementation of an antimicrobial stewardship program].

PubMed

Collado, Roberto; Losa, Juan Emilio; Álvaro, Elena Alba; Toro, Piedad; Moreno, Leonor; Pérez, Montserrat

2015-12-01

Monitoring antimicrobial consumption in hospitals is a necessary measure. The indicators commonly employed do not clearly reflect the antibiotic selection pressure. The objective of this study is to evaluate two different methods that analyze antimicrobial consumption based on DDD, per stay and per discharge, before and after the implementation an antimicrobial stewardship program. Comparative pre-post study of antimicrobial consumption with the implementation of an antimicrobial stewardship program using DDD per 100 bed-days and DDD per 100 discharges as indicators. Hospital bed days remained stable and discharges increased slightly along the period of study Antibiotic consumption in DDD per 100 bed-days decreased by 2.5% versus 3.8% when expressed as DDD per 100 discharges. Antifungal consumption decreased by more than 50%. When average hospital stay decreases, reductions in the consumption of antimicrobials with an antimicrobial stewardship program system occur at the expense of reducing the number of patients receiving treatment, while increases occur due to longer durations of treatment.

Gradient Compression Stockings may Prevent Recovery after Bed Rest Deconditioning

NASA Technical Reports Server (NTRS)

Stenger, Michael B.; Lee, Stuart M.; Westby, Christian M.; Willig, Michael C.; Platts, Steven H.

2011-01-01

Introduction: Astronauts continue to wear a compression garment during and immediately after landing to prevent orthostatic intolerance (OI). We recently developed a custom-fitted, 3-piece garment that consists of thigh-high stockings with biker-style shorts that provides continuous, gradient compression: 55 mmHg at the ankle that decreases to approximately 20 mmHg at the top of the leg and 15 mmHg over the abdomen. This garment has been shown to be effective in preventing symptoms of OI during a short stand test after Space Shuttle missions, but symptoms may persist for several days after a long-duration mission in some astronauts. The purpose of this study was to confirm the effectiveness of wearing these elastic, gradient compression garments during orthostatic testing after 2 weeks of 6 degree head-down tilt bed rest as a model of spaceflight and to determine whether they would impact recovery after bed rest. Methods: Eight (5 treatment, 3 control) of 16 subjects have completed this study to-date. All subjects wore the 3-piece garment from waking until tilt testing (3 h) as a simulation of the timeline for astronauts on landing day (BR+0). Control subjects removed the garment after the tilt test. Treatment subjects wore the garment for the remainder of the day and wore lower compression thigh-high only garments on the day after bed rest (BR+1). Blood pressure, heart rate, and stroke volume responses to a 15-min 80 degree head-up tilt test were determined before 2 weeks of 6 degree head-down tilt, and on BR+0 and BR+1. Plasma volume (PV) was measured before each of these test sessions. Data are mean SE. Results: Compression garments prevented signs of OI on BR+0; all subjects in both groups completed the full 15-min test. Heart rate responses to tilt were lower on BR+0 than all other test days. Control subjects demonstrated a marginal PV decrease after bed rest, but showed typical recovery the day after bed rest (BR+0: 2.32 plus or minus 0.15 L to BR+1: 2.79 plus or minus 0.15 L). Treatment subjects did not recover PV the day after bed rest (BR+0: 2.61 plus or minus 0.23 L to BR+1: 2.61 plus or minus 0.23 L). Conclusion: Abdomen-high compression garments, which are effective in preventing post-bed rest orthostatic intolerance, may slow recovery of PV. Modified garments with reduced compression may be necessary to prevent prolonging recovery.

Calcium kinetics during bed rest with artificial gravity and exercise countermeasures

PubMed Central

Smith, S. M.; Castaneda-Sceppa, C.; O’Brien, K. O.; Abrams, S. A.; Gillman, P.; Brooks, N. E.; Cloutier, G. J.; Heer, M.; Zwart, S. R.; Wastney, M. E.

2015-01-01

Summary We assessed the potential for countermeasures to lessen the loss of bone calcium during bed rest. Subjects ingested less calcium during bed rest, and with artificial gravity, they also absorbed less calcium. With exercise, they excreted less calcium. To retain bone during bed rest, calcium intake needs to be maintained. Introduction This study aims to assess the potential for artificial gravity (AG) and exercise (EX) to mitigate loss of bone calcium during space flight. Methods We performed two studies: (1) a 21-day bed rest (BR) study with subjects receiving 1 h/day AG (n=8) or no AG (n=7) and (2) a 28-day BR study with 1 h/day resistance EX (n=10) or no EX (n=3). In both studies, stable isotopes of Ca were administered orally and intravenously, at baseline and after 10 days of BR, and blood, urine, and feces were sampled for up to 14 days post dosing. Tracers were measured using thermal ionization mass spectrometry. Data were analyzed by compartmental modeling. Results Less Ca was absorbed during BR, resulting in lower Ca balance in BR+AG (−6.04±3.38 mmol/day, P=0.023). However, Ca balance did not change with BR+EX, even though absorbed Ca decreased and urinary Ca excretion increased, because endogenous excretion decreased, and there was a trend for increased bone deposition (P=0.06). Urinary N-telopeptide excretion increased in controls during BR, but not in the EX group. Markers of bone formation were not different between treatment groups for either study. Ca intake decreased during BR (by 5.4 mmol/day in the AG study and 2.8 mmol/day in the EX study), resulting in lower absorbed Ca. Conclusions During BR (or space flight), Ca intake needs to be maintained or even increased with countermeasures such as exercise, to enable maintenance of bone Ca. PMID:24861908

Effect of three day bed-rest on circulatory and hormonal responses to active orthostatic test in endurance trained athletes and untrained subjects

NASA Technical Reports Server (NTRS)

Kubala, P.; Smorawinski, J.; Kaciuba-Uscilko, H.; Nazar, K.; Bicz, B.; Greenleaf, J. E.

1996-01-01

Circulatory and hormonal parameters were measured in endurance-trained athletes and control subjects during orthostatic tolerance tests conducted prior to and after three days of bed rest. Heart rate and blood pressure changes due to bed rest appeared to be the same in both groups. Hormonal changes, however, were different between the two groups, with the athletes having decreased sympathoadrenal activity and increased plasma renin activity. Untrained subjects had changes in cortisol secretion only.

Effects of Bed Rest on Conduction Velocity of the Triceps Surae Stretch Reflex and Postural Control

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Wood, S. J.; Cerisano, J. M.; Kofman, I. S.; Fisher, E. A.; Esteves, J. T.; Taylor, L. C.; DeDios, Y. E.; Harm, D. L.

2011-01-01

Despite rigorous exercise and nutritional management during space missions, astronauts returning from microgravity exhibit neuromuscular deficits and a significant loss in muscle mass in the postural muscles of the lower leg. Similar changes in the postural muscles occur in subjects participating in long-duration bed rest studies. These adaptive muscle changes manifest as a reduction in reflex conduction velocity during head-down bed rest. Because the stretch reflex encompasses both the peripheral (muscle spindle and nerve axon) and central (spinal synapse) components involved in adaptation to calf muscle unloading, it may be used to provide feedback on the general condition of neuromuscular function, and might be used to evaluate the effectiveness of countermeasures aimed at preserving muscle mass and function during periods of unloading. Stretch reflexes were measured on 18 control subjects who spent 60 to 90 days in continuous 6 deg head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 degrees at a peak velocity of about 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender. Computerized posturography was also conducted on these same subjects before and after bed rest as part of the standard measures. Peak-to-peak sway was measured during Sensory Organization Tests (SOTs) to evaluate changes in the ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Although no gender differences were found, a significant increase in reflex latency and a significant decrease in CV were observed during the bed rest period, with a return to baseline 3 to 5 days after bed rest, depending on the duration of bed rest. In addition, a relationship between CV and loss of muscle strength in the lower leg was observed post bed rest for most subjects. Immediately post-bed rest, most subjects showed decreased performance on SOTs, with the greater decrements on sway-referenced support and head movement conditions. Post-bed rest decrements were less than typically observed following spaceflight. Decrements in postural control and the stretch reflex can be primarily attributed to the unloading mechanisms this ground-based analog provides. The stretch reflex is a concise test measurement that can be obtained during the head-down phase of bed rest, as it does not interfere with the bed rest paradigm. This makes it an ideal tool that can detect, early on, whether a countermeasure is successful in preserving muscle function.

Regenerative Life Support Systems Test Bed performance - Lettuce crop characterization

NASA Technical Reports Server (NTRS)

Barta, Daniel J.; Edeen, Marybeth A.; Eckhardt, Bradley D.

1992-01-01

System performance in terms of human life support requirements was evaluated for two crops of lettuce (Lactuca sative cv. Waldmann's Green) grown in the Regenerative Life Support Systems Test Bed. Each crop, grown in separate pots under identical environmental and cultural conditions, was irrigated with half-strength Hoagland's nutrient solution, with the frequency of irrigation being increased as the crop aged over the 30-day crop tests. Averaging over both crop tests, the test bed met the requirements of 2.1 person-days of oxygen production, 2.4 person-days of CO2 removal, and 129 person-days of potential potable water production. Gains in the mass of water and O2 produced and CO2 removed could be achieved by optimizing environmental conditions to increase plant growth rate and by optimizing cultural management methods.

Effects of 21 days of bed rest, with or without artificial gravity, on nutritional status of humans

PubMed Central

Zwart, S. R.; Crawford, G. E.; Gillman, P. L.; Kala, G.; Rodgers, A. S.; Rogers, A.; Inniss, A. M.; Rice, B. L.; Ericson, K.; Coburn, S.; Bourbeau, Y.; Hudson, E.; Mathew, G.; DeKerlegand, D. E.; Sams, C. F.; Heer, M. A.; Paloski, W. H.; Smith, S. M.

2009-01-01

Spaceflight and bed rest models of microgravity have profound effects on physiological systems, including the cardiovascular, musculoskeletal, and immune systems. These effects can be exacerbated by suboptimal nutrient status, and therefore it is critical to monitor nutritional status when evaluating countermeasures to mitigate negative effects of spaceflight. As part of a larger study to investigate the usefulness of artificial gravity as a countermeasure for musculoskeletal and cardiovascular deficits during bed rest, we tested the hypothesis that artificial gravity would have an effect on some aspects of nutritional status. Dietary intake was recorded daily before, during, and after 21 days of bed rest with artificial gravity (n = 8) or bed rest alone (n = 7). We examined body composition, hematology, general blood chemistry, markers of oxidative damage, and blood levels of selected vitamins and minerals before, during, and after the bed rest period. Several indicators of vitamin status changed in response to diet changes: serum α- and γ-tocopherol and urinary 4-pyridoxic acid decreased (P < 0.001) and plasma β-carotene increased (P < 0.001) in both groups during bed rest compared with before bed rest. A decrease in hematocrit (P < 0.001) after bed rest was accompanied by a decrease in transferrin (P < 0.001), but transferrin receptors were not changed. These data provide evidence that artificial gravity itself does not negatively affect nutritional status during bed rest. Likewise, artificial gravity has no protective effect on nutritional status during bed rest. PMID:19074571

Incident angle of saltating particles in wind-blown sand.

PubMed

Fu, Lin-Tao; Bo, Tian-Li; Gu, Hai-Hua; Zheng, Xiao-Jing

2013-01-01

Incident angle of saltating particles plays a very important role in aeolian events. In this paper, the incident angles of sand particles near the sand bed were measured in wind tunnel. It reveals that the incident angles range widely from 0° to 180° and thereby the means of angles are larger than published data. Surprisingly, it is found the proportion that angles of 5°-15° occupy is far below previous reports. The measuring height is probably the most important reason for the measurement differences between this study and previous investigations.

Infrared video tracking of Anopheles gambiae at insecticide-treated bed nets reveals rapid decisive impact after brief localised net contact

PubMed Central

Parker, Josephine E.A.; Angarita-Jaimes, Natalia; Abe, Mayumi; Towers, Catherine E.; Towers, David; McCall, Philip J.

2015-01-01

Long-lasting insecticidal bed nets (LLINs) protect humans from malaria transmission and are fundamental to malaria control worldwide, but little is known of how mosquitoes interact with nets. Elucidating LLIN mode of action is essential to maintain or improve efficacy, an urgent need as emerging insecticide resistance threatens their future. Tracking multiple free-flying Anopheles gambiae responding to human-occupied bed nets in a novel large-scale system, we characterised key behaviours and events. Four behavioural modes with different levels of net contact were defined: swooping, visiting, bouncing and resting. Approximately 75% of all activity occurred at the bed net roof where multiple brief contacts were focussed above the occupant’s torso. Total flight and net contact times were lower at LLINs than untreated nets but the essential character of the response was unaltered. LLINs did not repel mosquitoes but impacted rapidly: LLIN contact of less than 1 minute per mosquito during the first ten minutes reduced subsequent activity; after thirty minutes, activity at LLINs was negligible. Velocity measurements showed that mosquitoes detected nets, including unbaited untreated nets, prior to contact. This is the most complete characterisation of mosquito-LLIN interactions to date, and reveals many aspects of LLIN mode of action, important for developing the next generation of LLINs. PMID:26323965

Coal resources of the Fruitland Formation in part of the Ute Mountain Ute Indian Reservation, San Juan County, New Mexico

USGS Publications Warehouse

Roberts, Laura N. Robinson

1991-01-01

The coal-bearing Upper Cretaceous Fruitland Formation occupies an area of about 14 square miles in the extreme southeast corner of the Ute Mountain Ute Indian Reservation in San Juan County, New Mexico. In this area, the Fruitland Formation contains an estimated 252 million short tons of coal in beds that range from 1.2 to 14 feet thick. About 100 million short tons of coal occur under less than 500 feet of overburden in the Ute Canyon, Upper Main, and Main coal beds. These three coal beds reach a cumulative coal thickness of about 18 feet in a stratigraphic interval that averages about 120 feet thick in the prospecting permit area, which is located in the extreme southwestern part of the study area. The southwestern part of the study area is probably best suited for surface mining, although steep dips may reduce minability locally. A major haul road that was recently constructed across the eastern half of the study area greatly improves the potential for surface mining. Core sample analyses indicate that the apparent rank of the Ute Canyon, Upper Main, and Main coal beds is high-volatile C bituminous. Average heat-of-combustion on an as-received basis is 10,250 British thermal units per pound, average ash content is 15.5 percent, and average sulfur content is 1.0 percent.

Questing activity in bed bug populations: male and female responses to host signals.

PubMed

Aak, Anders; Rukke, Bjørn A; Soleng, Arnulf; Rosnes, Marte K

2014-09-01

A large-arena bioassay is used to examine sex differences in spatiotemporal patterns of bed bug Cimex lectularius L. behavioural responses to either a human host or CO 2 gas. After release in the centre of the arena, 90% of newly-fed bed bugs move to hiding places in the corners within 24 h. They require 3 days to settle down completely in the arena, with generally low activity levels and the absence of responses to human stimuli for 5 days. After 8-9 days, persistent responses can be recorded. Sex differences are observed, in which females are more active during establishment, respond faster after feeding, expose themselves more than males during the daytime, and respond more strongly to the host signal. The number of bed bugs that rest in harbourages is found to vary significantly according to light setting and sex. Both sexes stay inside harbourages more in daylight compared with night, and males hide more than females during the daytime but not during the night. The spatial distribution of the bed bugs is also found to change with the presence of CO 2 , and peak aggregation around the odour source is observed after 24 min. Both male and female bed bugs move from hiding places or the border of the arena toward the centre where CO 2 is released. Peak responses are always highest during the night. Bed bug behaviour and behaviour-regulating features are discussed in the context of control methods.

Questing activity in bed bug populations: male and female responses to host signals

PubMed Central

Aak, Anders; Rukke, Bjørn A; Soleng, Arnulf; Rosnes, Marte K

2014-01-01

A large-arena bioassay is used to examine sex differences in spatiotemporal patterns of bed bug Cimex lectularius L. behavioural responses to either a human host or CO2 gas. After release in the centre of the arena, 90% of newly-fed bed bugs move to hiding places in the corners within 24 h. They require 3 days to settle down completely in the arena, with generally low activity levels and the absence of responses to human stimuli for 5 days. After 8–9 days, persistent responses can be recorded. Sex differences are observed, in which females are more active during establishment, respond faster after feeding, expose themselves more than males during the daytime, and respond more strongly to the host signal. The number of bed bugs that rest in harbourages is found to vary significantly according to light setting and sex. Both sexes stay inside harbourages more in daylight compared with night, and males hide more than females during the daytime but not during the night. The spatial distribution of the bed bugs is also found to change with the presence of CO2, and peak aggregation around the odour source is observed after 24 min. Both male and female bed bugs move from hiding places or the border of the arena toward the centre where CO2 is released. Peak responses are always highest during the night. Bed bug behaviour and behaviour-regulating features are discussed in the context of control methods. PMID:26166936

Hindered erosion: The biological mediation of noncohesive sediment behavior

NASA Astrophysics Data System (ADS)

Chen, X. D.; Zhang, C. K.; Paterson, D. M.; Thompson, C. E. L.; Townend, I. H.; Gong, Z.; Zhou, Z.; Feng, Q.

2017-06-01

Extracellular polymeric substances (EPS) are ubiquitous on tidal flats but their impact on sediment erosion has not been fully understood. Laboratory-controlled sediment beds were incubated with Bacillus subtilis for 5, 10, 16, and 22 days before the erosion experiments, to study the temporal and spatial variations in sediment stability caused by the bacterial secreted EPS. We found the biosedimentary systems showed different erosional behavior related to biofilm maturity and EPS distribution. In the first stage (5 days), the biosedimentary bed was more easily eroded than the clean sediment. With increasing growth period, bound EPS became more widely distributed over the vertical profile resulting in bed stabilization. After 22 days, the bound EPS was highly concentrated within a surface biofilm, but a relatively high content also extended to a depth of 5 mm and then decayed sharply with depth. The biofilm increased the critical shear stress of the bed and furthermore, it enabled the bed to withstand threshold conditions for an increased period of time as the biofilm degraded before eroding. After the loss of biofilm protection, the high EPS content in the sublayers continued to stabilize the sediment (hindered erosion) by binding individual grains, as visualized by electron microscopy. Consequently, the bed strength did not immediately revert to the abiotic condition but progressively adjusted, reflecting the depth profile of the EPS. Our experiments highlight the need to treat the EPS-sediment conditioning as a bed-age associated and depth-dependent variable that should be included in the next generation of sediment transport models.

Plasma lactic dehydrogenase activities in men during bed rest with exercise training

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Juhos, L. T.; Young, H. L.

1985-01-01

Peak oxygen uptake and the activity of lactic dehydrogenase (LDH-T) and its five isoenzymes were measured by spectrophotometer in seven men before, during, and after bed rest and exercise training. Exercise training consisted of isometric leg exercises of 250 kcal/hr for a period of one hour per day. It is found that LDH-T was reduced by 0.05 percent in all three regimens by day 10 of bed rest, and that the decrease occurred at different rates. The earliest reduction in LDH-T activity in the no-exercise regimen was associated with a decrease in peak oxygen uptake of 12.3 percent. It is concluded that isometric (aerobic) muscular strength training appear to maintain skeletal muscle integrity better during bed rest than isotonic exercise training. Reduced hydrostatic pressure during bed rest, however, ultimately counteracts the effects of both moderate isometric and isotonic exercise training, and may result in decreased LDH-T activity.

Photovoltaic dryer with dual packed beds for drying medical herb

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abdel-Rehim, Z.S.; Fahmy, F.H.

1998-03-01

This work presents design and optimization of a cylindrical photovoltaic dryer with dual packed beds thermal energy storage for drying medical herb. The dryer is provided with electrical heater where the electrical energy is generated by using photovoltaic system. The electrical heater is designed and sized to realize continuous drying (day and night) to minimize the drying time. Two packed beds are used to fix the drying temperature in dryer during day and night. The main packed bed thermal energy storage is charged during the sunlight hours directly, to realize continued drying after sunset. An efficient PV dryer is devisedmore » to work under forced air created by air blower and heated by the electrical coils.« less

Stretch Reflex as a Simple Measure to Evaluate the Efficacy of Potential Flight Countermeasures Using the Bed Rest Environment

NASA Technical Reports Server (NTRS)

Cerisano, J. M.; Reschke, M. F.; Kofman, I. S.; Fisher, E. A.; Harm, D. L.

2010-01-01

INTRODUCTION: Spaceflight is acknowledged to have significant effects on the major postural muscles. However, it has been difficult to separate the effects of ascending somatosensory changes caused by the unloading of these muscles during flight from changes in sensorimotor function caused by a descending vestibulo-cerebellar response to microgravity. It is hypothesized that bed rest is an adequate model to investigate postural muscle unloading given that spaceflight and bed rest may produce similar results in both nerve axon and muscle tissue. METHODS: To investigate this hypothesis, stretch reflexes were measured on 18 subjects who spent 60 to 90 days in continuous 6 head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 deg at a peak velocity of approximately 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender and compared with spaceflight data. RESULTS: Although no gender differences were found, bed rest induced changes in reflex latency and CV similar to the ones observed during spaceflight. Also, a relationship between CV and loss of muscle strength in the lower leg was observed for most bed rest subjects. CONCLUSION: Even though bed rest (limb unloading) alone may not mimic all of the synaptic and muscle tissue loss that is observed as a result of spaceflight, it can serve as a working analog of flight for the evaluation of potential countermeasures that may be beneficial in mitigating unwanted changes in the major postural muscles that are observed post flight.

Competence of Cimex lectularius Bed Bugs for the Transmission of Bartonella quintana, the Agent of Trench Fever

PubMed Central

Leulmi, Hamza; Bitam, Idir; Berenger, Jean Michel; Lepidi, Hubert; Rolain, Jean Marc; Almeras, Lionel; Raoult, Didier; Parola, Philippe

2015-01-01

Background Bartonella quintana, the etiologic agent of trench fever and other human diseases, is transmitted by the feces of body lice. Recently, this bacterium has been detected in other arthropod families such as bed bugs, which begs the question of their involvement in B. quintana transmission. Although several infectious pathogens have been reported and are suggested to be transmitted by bed bugs, the evidence regarding their competence as vectors is unclear. Methodology/Principal Findings Bed bugs at the adult and instar developmental stages were fed three successive human blood meals inoculated with B. quintana bacterium from day one (D1) to D5; subsequently they were fed with pathogen-free human blood until the end of the experiment. Bed bugs and feces were collected in time series, to evaluate their capacities to acquire, multiply and expel viable B. quintana using molecular biology, immunohistochemistry and cultures assays. B. quintana was detected molecularly in 100% of randomly selected experimentally infected bed bug specimens (D3). The monitoring of B. quintana in bed bug feces showed that the bacterium was detectable starting on the 3rd day post-infection (pi) and persisted until day 18±1 pi. Although immunohistochemistry assays localized the bacteria to the gastrointestinal bed bug gut, the detection of B. quintana in the first and second instar larva stages suggested a vertical non-transovarial transmission of the bacterium. Conclusion The present work demonstrated for the first time that bed bugs can acquire, maintain for more than 2 weeks and release viable B. quintana organisms following a stercorarial shedding. We also observed the vertical transmission of the bacterium to their progeny. Although the biological role of bed bugs in the transmission of B. quintana under natural conditions has yet to be confirmed, the present work highlights the need to reconsider monitoring of these arthropods for the transmission of human pathogens. PMID:26000974

Forces on a segregating particle

NASA Astrophysics Data System (ADS)

Lueptow, Richard M.; Shankar, Adithya; Fry, Alexander M.; Ottino, Julio M.; Umbanhowar, Paul B.

2017-11-01

Size segregation in flowing granular materials is not well understood at the particle level. In this study, we perform a series of 3D Discrete Element Method (DEM) simulations to measure the segregation force on a single spherical test particle tethered to a spring in the vertical direction in a shearing bed of particles with gravity acting perpendicular to the shear. The test particle is the same size or larger than the bed particles. At equilibrium, the downward spring force and test particle weight are offset by the upward buoyancy-like force and a size ratio dependent force. We find that the buoyancy-like force depends on the bed particle density and the Voronoi volume occupied by the test particle. By changing the density of the test particle with the particle size ratio such that the buoyancy force matches the test particle weight, we show that the upward size segregation force is a quadratic function of the particle size ratio. Based on this, we report an expression for the net force on a single particle as the sum of a size ratio dependent force, a buoyancy-like force, and the weight of the particle. Supported by NSF Grant CBET-1511450 and the Procter and Gamble Company.

Plant pigment types, distributions, and influences on shallow water submerged aquatic vegetation mapping

NASA Astrophysics Data System (ADS)

Hall, Carlton R.; Bostater, Charles R., Jr.; Virnstein, Robert

2004-11-01

Development of robust protocols for use in mapping shallow water habitats using hyperspectral imagery requires knowledge of absorbing and scattering features present in the environment. These include, but are not limited to, water quality parameters, phytoplankton concentrations and species, submerged aquatic vegetation (SAV) species and densities, epiphytic growth on SAV, benthic microalgae and substrate reflectance characteristics. In the Indian River Lagoon, Fl. USA we conceptualize the system as having three possible basic layers, water column and SAV bed above the bottom. Each layer is occupied by plants with their associated light absorbing pigments that occur in varying proportions and concentrations. Phytoplankton communities are composed primarily of diatoms, dinoflagellates, and picoplanktonic cyanobacteria. SAV beds, including flowering plants and green, red, and brown macro-algae exist along density gradients ranging in coverage from 0-100%. SAV beds may be monotypic, or more typically, mixtures of the several species that may or may not be covered in epiphytes. Shallow water benthic substrates are colonized by periphyton communities that include diatoms, dinoflagellates, chlorophytes and cyanobacteria. Inflection spectra created form ASIA hyperspectral data display a combination of features related to water and select plant pigment absorption peaks.

Essential oils as fumigants for bed bugs (Hemiptera: Cimicidae)

USDA-ARS?s Scientific Manuscript database

In Petri dish assays, fumigation of a pyrethroid-susceptible strain of bed bugs Cimex lectularius L. (Hemiptera: Cimicidae) with various essential oils resulted in mortality that approached or equaled 100%, after 5 days. However, when bed bugs were exposed to the same essential oils in sealed, comme...

In Vivo measurement of human body composition. [during continuous bed rest

NASA Technical Reports Server (NTRS)

Pace, N.; Grunbaum, B. W.; Kodama, A. M.; Price, D. C.

1975-01-01

Physiological changes in human beings were studied during a 21 day bed rest regime. Results of blood analyses indicated clearly that major metabolic adjustments occurred during prolonged bed rest. However, urinary metabolic analyses showed variances attributed to specimen collection inaccuracies and the small number of test subjects.

High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

PubMed

Kramer, Andreas; Kümmel, Jakob; Mulder, Edwin; Gollhofer, Albert; Frings-Meuthen, Petra; Gruber, Markus

2017-01-01

Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance. 23 male participants (29±6 years, 181±6 cm, 77±7 kg) were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT), and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12) or the control group (CTRL, n = 11). A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week. Peak force for the reactive hops (3.6±0.4 kN) as well as jump height (35±4 cm) and peak power (3.1±0.2 kW) for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03). Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect p<0.001). Participants tolerated the near-daily high-intensity jump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

Porcine wound healing in full-thickness skin defects using Integra™ with and without fibrin glue with keratinocytes

PubMed Central

Melendez, Mark M; Martinez, Rodrigo R; Dagum, Alexander B; McClain, Steve A; Simon, Marcia; Sobanko, Joseph; Zimmerman, Thomas; Wetterau, Meredith; Muller, Douglas; Xu, Xiaoti; Singer, Adam J; Arora, Balvantray

2008-01-01

BACKGROUND: An artificial dermal matrix such as Integra (Integra Life Sciences Corporation, USA) provides a wound bed template for vascular and fibrocyte ingrowth as well as collagen remodelling. Dermal repair leads to epidermal and basement membrane regeneration. Burn wounds in particular have been shown to benefit from Integra by enhanced wound healing. OBJECTIVE: To evaluate the effect of fibrin glue to modify the integration of Integra in large excised cutaneous wounds. It was hypothesized that applying fibrin glue on a wound bed would reduce the time needed for matrix vascularization and incorporation of Integra and take of the cultured keratinocytes. METHODS: Four separate full-thickness wounds were created on the dorsum of two swine. Wound beds were randomly assigned to either application of fibrin glue or no application of fibrin glue before application of Integra. Full-thickness biopsies were performed at days 7, 14, 21, 29 and 35. On day 21, keratinocytes were applied either as sheets or aerosolized fibrin glue suspension. RESULTS: Histological analysis revealed a wave of inflammatory cells and early granulation tissue ingrowth into the Integra from the fascia below on day 7. Only this initial phase was augmented by application of fibrin glue to the wound bed. By day 14, most and by day 21, all of the Integra thickness was incorporated. Accelerated dermal repair proceeded from the base with new collagen deposition in Integra spaces. There was no evidence of keratinocyte engraftment, although re-epithelialization occurred at wound edges extending onto the incorporated Integra. CONCLUSIONS: It appears there is an acceleration of early phase (day 7 to day 21) dermal incorporation with fibrin glue application to the wound bed, perhaps secondary to increased cellular migration. Day 21 appears to be too early to apply cultured keratinocytes either as sheets or aerosolized suspension. PMID:19721792

Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study.

PubMed

Lee, Joo Eun; Park, Eun Cheol; Jang, Suk Yong; Lee, Sang Ah; Choy, Yoon Soo; Kim, Tae Hyun

2018-03-01

Readmission and mortality rates of patients with heart failure are good indicators of care quality. To determine whether hospital resources are associated with care quality for cardiac patients, we analyzed the effect of number of physicians and the combined effects of number of physicians and beds on 30-day readmission and 1-year mortality. We used national cohort sample data of the National Health Insurance Service (NHIS) claims in 2002-2013. Subjects comprised 2345 inpatients (age: >65 years) admitted to acute-care hospitals for heart failure. A multivariate Cox regression was used. Of the 2345 patients hospitalized with heart failure, 812 inpatients (34.6%) were readmitted within 30 days and 190 (8.1%) had died within a year. Heart-failure patients treated at hospitals with low physician volumes had higher readmission and mortality rates than high physician volumes [30-day readmission: hazard ratio (HR)=1.291, 95% confidence interval (CI)=1.020-1.633; 1-year mortality: HR=2.168, 95% CI=1.415-3.321]. Patients admitted to hospitals with low or middle bed and physician volume had higher 30-day readmission and 1-year mortality rates than those admitted to hospitals with high volume (30-day readmission: HR=2.812, 95% CI=1.561-5.066 for middle-volume beds & low-volume physicians, 1-year mortality: HR=8.638, 95% CI=2.072-36.02 for middle-volume beds & low-volume physicians). Physician volume is related to lower readmission and mortality for heart failure. Of interest, 30-day readmission and 1-year mortality were significantly associated with the combined effects of physician and institution bed volume. © Copyright: Yonsei University College of Medicine 2018

Body Unloading Associated with Space Flight and Bed-rest Impacts Functional Performance

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Ballard, K. L.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

Paleocene-eocene lignite beds of southwest Alabama: Parasequence beds in highstand systems tracts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mancini, E.A.; Tew, B.H.; Carroll, R.E.

1993-09-01

In southwest Alabama, lignite beds are present in at least four stratigraphic intervals that span approximately 8 m.y. of geologic time. Lignite is found in the Paleocene Oak Hill Member and Coal Bluff Member of the Naheola Formation of the Midway Group and the Paleocene Tuscahoma Sand and the Eocene Hatchetigbee Formation of the Wilcox Group. Lignite beds range in thickness from 0.5 to 11 ft and consist of 32-53% moisture, 13-39% volatile matter, 4-36% fixed carbon, and 5-51% ash. These Paleocene and Eocene lignite beds occur as parasequence deposits in highstand systems tracts of four distinct third-order depositional sequences.more » The lignite beds are interpreted as strata within highstand systems tract parasequences that occur in mud-dominated regressive intervals. Lignite beds were deposited in coastal marsh and low-lying swamp environments as part of deltaic systems that prograded into southwestern Alabama from the west. As sediment was progressively delivered into the basin from these deltas, the effects of relative sea level rise during an individual cycle were overwhelmed, producing a net loss of accommodation and concomitant overall basinward progradation of the shoreline (regression). Small-scale fluctuations in water depth resulting from the interaction of eustasy, sediment yield, and subsidence led to cyclical flooding of the low-lying coastal marshes and swamps followed by periods of progradational and regression. Highstand systems tract deposition within a particular depositional sequence culminated with a relative sea level fall that resulted in a lowering of base level and an abrupt basinward shift in coastal onlap. Following sea level fall and the subsequent accumulation of the lowstand deposits, significant relative sea level rise resulted in the marine inundation of the area previously occupied by coastal marshes and swamps and deposition of the transgressive systems tract of the overlying sequence.« less

Medicaid Bed-Hold Policy and Medicare Skilled Nursing Facility Rehospitalizations

PubMed Central

Grabowski, David C; Feng, Zhanlian; Intrator, Orna; Mor, Vincent

2010-01-01

Objective To analyze the effect of states' Medicaid bed-hold policies on the 30-day rehospitalization of Medicare postacute skilled nursing facility (SNF) residents. Data Sources Minimum data set assessments were merged with Medicare claims and eligibility files for all first-time SNF admissions (N = 3,322,088) over the period 2000 through 2005; states' Medicaid bed-hold policies were obtained via survey. Study Design Regression specification incorporating facility fixed effects to examine changes in Medicaid bed-hold policies on the likelihood of a 30-day SNF rehospitalization. Principal Findings Using a continuous measure of bed-hold generosity, state Medicaid bed-hold was positively related to Medicare SNF rehospitalization. Specifically, the introduction of a bed-hold policy with average generosity increases Medicare rehospitalizations by 1.8 percent, representing roughly 12,000 SNF rehospitalizations at a cost to Medicare of approximately U.S.$100 million over our study period. Conclusions Although facilities do not receive a Medicaid bed-hold payment for Medicare SNF stays, we found that the adoption of more generous policies led to greater SNF rehospitalizations. This type of spillover is largely ignored in current discussions of Medicare payment reforms such as bundled payment. Neither Medicare nor Medicaid has an incentive to internalize the risks and benefits of its actions as they affect the other. PMID:20403059

[Prediction model of health workforce and beds in county hospitals of Hunan by multiple linear regression].

PubMed

Ling, Ru; Liu, Jiawang

2011-12-01

To construct prediction model for health workforce and hospital beds in county hospitals of Hunan by multiple linear regression. We surveyed 16 counties in Hunan with stratified random sampling according to uniform questionnaires,and multiple linear regression analysis with 20 quotas selected by literature view was done. Independent variables in the multiple linear regression model on medical personnels in county hospitals included the counties' urban residents' income, crude death rate, medical beds, business occupancy, professional equipment value, the number of devices valued above 10 000 yuan, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, and utilization rate of hospital beds. Independent variables in the multiple linear regression model on county hospital beds included the the population of aged 65 and above in the counties, disposable income of urban residents, medical personnel of medical institutions in county area, business occupancy, the total value of professional equipment, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, utilization rate of hospital beds, and length of hospitalization. The prediction model shows good explanatory and fitting, and may be used for short- and mid-term forecasting.

Retirada do leito após a descontinuação da ventilação mecânica: há repercussão na mortalidade e no tempo de permanência na unidade de terapia intensiva?

PubMed

Soares, Thiago Rios; Avena, Kátia de Miranda; Olivieri, Flávia Milholo; Feijó, Luciana Ferreira; Mendes, Kristine Menezes Barberino; Souza Filho, Sydney Agareno de; Gomes, André Mansur de Carvalho Guanaes

2010-03-01

To describe the withdrawal of the bed frequency in mechanic ventilation patients and its impact on mortality and length of stay in the intensive care unit. This was a retrospective cohort study in mechanical ventilation patients. Clinical and epidemiological variables, withdrawal of bed related motor therapy, intensive care unit length of stay and mortality were evaluated. We studied 91 patients, mean age of 62.5± 18.8 years, predominantly female (52%) and mean intensive care unit length of stay of 07 days (95% CI, 8-13 days). Considering the withdrawal of the bed or not, no difference was observed between groups regarding length of stay in intensive care unit. Patients who were withdrawn of bed had a lower clinical severity. Their mortality rate was 29.7%. The not withdrawn of bed group had higher both actual and expected mortality. Patients withdrawn of bed following mechanical ventilation discontinuation showed lower mortality. It is suggested that early intensive care unit mobilization and withdrawal of bed should be stimulated.

Research on the Digital Communication and Development of Yunnan Bai Embroidery

NASA Astrophysics Data System (ADS)

Xu, Wu; Jin, Chunjie; Su, Ying; Wu, Lei; He, Jin

2017-12-01

Our country attaches great importance to the protection and development of intangible culture these days, but the shortcoming of discoloration, breakage and occupying too much space still exist in the traditional way of museum protection. This paper starts from the analysis of the above problems, and then cogitates why and how to use the virtual reality (VR) technology to better solve these problems and analyzes this specific object of the Yunnan Bai embroidery in order to achieve its full human value and economic value. Firstly, using 3D MAX to design and produce the three-dimensional model of the embroideries of Bai nationality. Secondly, using the large number of embroidery model data that we collect to construct the Yunnan Bai embroidery model database. Next, creating a digital display system of virtual embroidery and putting the digital display system to the PC client websites and mobile phone applications to achieve information sharing. Finally, through the use of virtual display technology for three-dimensional design of embroidery, the embroidery clothing, bedding and other works with modern style can be designed so as to continuously pursue and give full play to the charm and economic value of embroidery.

Metronidazole stewardship initiative at Christchurch hospitals-achievable with immediate benefits.

PubMed

Gardiner, Sharon J; Metcalf, Sarah Cl; Chin, Paul Kl; Doogue, Matthew P; Dalton, Simon C; Chambers, Stephen T

2018-04-13

To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole. In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV. Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing. In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.

Gender Differences in Bed Rest: Preliminary Analysis of Vascular Function

NASA Technical Reports Server (NTRS)

Platts, Steven H.; Stenger, Michael B.; Martin, David S.; Freeman-Perez, Sondra A.; Phillips, Tiffany; Ribeiro, L. Christine

2008-01-01

Orthostatic intolerance is a recognized consequence of spaceflight. Numerous studies have shown that women are more susceptible to orthostatic intolerance following spaceflight as well as bed rest, the most commonly used ground-based analog for spaceflight. One of the possible mechanisms proposed to account for this is a difference in vascular responsiveness between genders. We hypothesized that women and men would have differing vascular responses to 90 days of 6-degree head down tilt bed rest. Additionally, we hypothesized that vessels in the upper and lower body would respond differently, as has been shown in the animal literature. Thirteen subjects were placed in bedrest for 90 days (8 men, 5 women) at the Flight Analogs Unit, UTMB. Direct arterial and venous measurements were made with ultrasound to evaluate changes in vascular structure and function. Arterial function was assessed, in the arm and leg, during a reactive hyperemia protocol and during sublingual nitroglycerin administration to gauge the contributions of endothelial dependent and independent dilator function respectively. Venous function was assessed in dorsal hand and foot veins during the administration of pharmaceuticals to assess constrictor and dilator function. Both gender and day effects are seen in arterial dilator function to reactive hyperemia, but none are seen with nitroglycerin. There are also differences in the wall thickness in the arm vs the leg during bed rest, which return toward pre-bed rest levels by day 90. More subjects are required, especially females as there is not sufficient power to properly analyze venous function. Day 90 data are most underpowered.

Can volunteer companions prevent falls among inpatients? A feasibility study using a pre-post comparative design

PubMed Central

Giles, Lynne C; Bolch, Denise; Rouvray, Robyn; McErlean, Beth; Whitehead, Craig H; Phillips, Paddy A; Crotty, Maria

2006-01-01

Background Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Methods Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide were used. Ward fall rates (expressed as falls per 1000 occupied bed days) were compared in the baseline period (February-May 2002) with the implementation period (February – May 2003) using incident rate ratios and 95% confidence intervals. The number of hours of volunteered time was also collected. Results No patient falls occurred on either site when volunteers were present. However, there was no significant impact on overall ward fall rates. In the baseline period, there were 70 falls in 4828 OBDs (14.5 falls per 1000 OBDs). During the implementation period, there were 82 falls in 5300 OBDs (15.5 falls per 1000 OBD). The IRR for falls in the implementation versus baseline period was 1.07 (95%CI 0.77 – 1.49; P = 0.346). Volunteers carried out care activities (e.g. cutting up food), provided company, and on occasions advocated on behalf of the patients. Volunteers donated 2345 hours, at an estimated value to the hospitals of almost $57,000. Conclusion Volunteers may play an important and cost-effective role in enhancing health care and can prevent falls in older hospital patients when they are present. Full implementation of this program would require the recruitment of adequate numbers of volunteers willing to sit with all patients considered at risk of falling in hospital. The challenge for future work in this area remains the sustainability of falls prevention strategies. PMID:16895609

Can volunteer companions prevent falls among inpatients? A feasibility study using a pre-post comparative design.

PubMed

Giles, Lynne C; Bolch, Denise; Rouvray, Robyn; McErlean, Beth; Whitehead, Craig H; Phillips, Paddy A; Crotty, Maria

2006-08-09

Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide were used. Ward fall rates (expressed as falls per 1000 occupied bed days) were compared in the baseline period (February-May 2002) with the implementation period (February - May 2003) using incident rate ratios and 95% confidence intervals. The number of hours of volunteered time was also collected. No patient falls occurred on either site when volunteers were present. However, there was no significant impact on overall ward fall rates. In the baseline period, there were 70 falls in 4828 OBDs (14.5 falls per 1000 OBDs). During the implementation period, there were 82 falls in 5300 OBDs (15.5 falls per 1000 OBD). The IRR for falls in the implementation versus baseline period was 1.07 (95%CI 0.77 - 1.49; P = 0.346). Volunteers carried out care activities (e.g. cutting up food), provided company, and on occasions advocated on behalf of the patients. Volunteers donated 2345 hours, at an estimated value to the hospitals of almost $57,000. Volunteers may play an important and cost-effective role in enhancing health care and can prevent falls in older hospital patients when they are present. Full implementation of this program would require the recruitment of adequate numbers of volunteers willing to sit with all patients considered at risk of falling in hospital. The challenge for future work in this area remains the sustainability of falls prevention strategies.

Zero tolerance prescribing: a strategy to reduce prescribing errors on the paediatric intensive care unit.

PubMed

Booth, Rachelle; Sturgess, Emma; Taberner-Stokes, Alison; Peters, Mark

2012-11-01

To establish the baseline prescribing error rate in a tertiary paediatric intensive care unit (PICU) and to determine the impact of a zero tolerance prescribing (ZTP) policy incorporating a dedicated prescribing area and daily feedback of prescribing errors. A prospective, non-blinded, observational study was undertaken in a 12-bed tertiary PICU over a period of 134 weeks. Baseline prescribing error data were collected on weekdays for all patients for a period of 32 weeks, following which the ZTP policy was introduced. Daily error feedback was introduced after a further 12 months. Errors were sub-classified as 'clinical', 'non-clinical' and 'infusion prescription' errors and the effects of interventions considered separately. The baseline combined prescribing error rate was 892 (95 % confidence interval (CI) 765-1,019) errors per 1,000 PICU occupied bed days (OBDs), comprising 25.6 % clinical, 44 % non-clinical and 30.4 % infusion prescription errors. The combined interventions of ZTP plus daily error feedback were associated with a reduction in the combined prescribing error rate to 447 (95 % CI 389-504) errors per 1,000 OBDs (p < 0.0001), an absolute risk reduction of 44.5 % (95 % CI 40.8-48.0 %). Introduction of the ZTP policy was associated with a significant decrease in clinical and infusion prescription errors, while the introduction of daily error feedback was associated with a significant reduction in non-clinical prescribing errors. The combined interventions of ZTP and daily error feedback were associated with a significant reduction in prescribing errors in the PICU, in line with Department of Health requirements of a 40 % reduction within 5 years.

Aquifer test results, Green Swamp area, Florida

USGS Publications Warehouse

Tibbals, C.H.; Grubb, Hayes F.

1982-01-01

An aquifer test conducted in the Green Swamp area December 15-16 , 1975 was designed to stress the uppermost part of the Floridan aquifer so that the leakage characteristics of the overlying confining bed could be determined. A well tapping the upper part of the Floridan aquifer was pumped at a rate of about 1,040 gallons per minute for 35 hours; drawdown was measured in the Floridan aquifer and in two horizons in the confining bed. Analysis of the data indicates that the transmissivity of the uppper 160 feet of the Floridan is 13,000 square feet per day, the storage coefficient is about 0.0002.5, and the overlying confining bed leakance coefficient is about 0.02 to 0.025 per day. The vertical hydraulic diffusivity of the confining bed ranged from 610 square feet per day to 16,000 square feet per day. Results of the test indicate that, in the area of the test site, a Floridan aquifer well field would induce additional recharge to the Floridan. As a result of that increased recharge , water levels in the surficial aquifer would tend to stand lower, runoff from the area would tend to be less, and, perhaps, evapotranspiration would be less than normal.(USGS)

Sediment Transport on Continental Shelves: Storm Bed Formation and Preservation in Heterogeneous Sediments

DTIC Science & Technology

2012-01-01

occurred during the Cretaceous period. The simulated storm bed for such an extratropical cyclone that lasts 4 days was deposited as deep as 75 m and had...Int. Assoc. Sedimentol. Spec. Publ. (2012) 44, 295-310 Sediment transport on continental shelves: storm bed formation and preservation in...xDept. of Earth Science, Memorial University of Newfoundland, St. Johns, Newfoundland, Canada ABSTRACT Many storm beds are constructed of silt/sand

Turning the tide or riding the waves? Impacts of antibiotic stewardship and infection control on MRSA strain dynamics in a Scottish region over 16 years: non-linear time series analysis.

PubMed

Lawes, Timothy; López-Lozano, José-María; Nebot, César; Macartney, Gillian; Subbarao-Sharma, Rashmi; Dare, Ceri R J; Edwards, Giles F S; Gould, Ian M

2015-03-26

To explore temporal associations between planned antibiotic stewardship and infection control interventions and the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). Retrospective ecological study and time-series analysis integrating typing data from the Scottish MRSA reference laboratory. Regional hospital and primary care in a Scottish Health Board. General adult (N=1,051,993) or intensive care (18,235) admissions and primary care registrations (460,000 inhabitants) between January 1997 and December 2012. Hand-hygiene campaign; MRSA admission screening; antibiotic stewardship limiting use of macrolides and '4Cs' (cephalosporins, coamoxiclav, clindamycin and fluoroquinolones). Prevalence density of MRSA clonal complexes CC22, CC30 and CC5/Other in hospital (isolates/1000 occupied bed days, OBDs) and community (isolates/10,000 inhabitant-days). 67% of all clinical MRSA isolates (10,707/15,947) were typed. Regional MRSA population structure was dominated by hospital epidemic strains CC30, CC22 and CC45. Following declines in overall MRSA prevalence density, CC5 and other strains of community origin became increasingly important. Reductions in use of '4Cs' and macrolides anticipated declines in sublineages with higher levels of associated resistances. In multivariate time-series models (R(2)=0.63-0.94) introduction of the hand-hygiene campaign, reductions in mean length of stay (when >4 days) and bed occupancy (when >74 to 78%) predicted declines in CC22 and CC30, but not CC5/other strains. Lower importation pressures, expanded MRSA admission screening, and reductions in macrolide and third generation cephalosporin use (thresholds for association: 135-141, and 48-81 defined daily doses/1000 OBDs, respectively) were followed by declines in all clonal complexes. Strain-specific associations with fluoroquinolones and clindamycin reflected resistance phenotypes of clonal complexes. Infection control measures and changes in population antibiotic use were important predictors of MRSA strain dynamics in our region. Strategies to control MRSA should consider thresholds for effects and strain-specific impacts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Why Don't You Go to Bed on Time? A Daily Diary Study on the Relationships between Chronotype, Self-Control Resources and the Phenomenon of Bedtime Procrastination.

PubMed

Kühnel, Jana; Syrek, Christine J; Dreher, Anne

2018-01-01

Background: This daily diary study investigates the phenomenon of bedtime procrastination. Bedtime procrastination is defined as going to bed later than intended, without having external reasons for doing so. We highlight the role chronotype (interindividual differences in biological preferences for sleep-wake-times) plays for bedtime procrastination. Moreover, we challenge the view that bedtime procrastination is the result of a lack of self-regulatory resources by investigating momentary self-regulatory resources as a predictor of day-specific bedtime procrastination. Methods: One-hundred and eight employees working in various industries completed a general electronic questionnaire (to assess chronotype and trait self-control) and two daily electronic questionnaires (to assess momentary self-regulatory resources before going to bed and day-specific bedtime procrastination) over the course of five work days, resulting in 399 pairs of matched day-next-day measurements. Results: Results of multilevel regression analyses showed that later chronotypes (also referred to as evening types or 'owls') tended to report more bedtime procrastination on work days. Moreover, for late chronotypes, day-specific bedtime procrastination declined over the course of the work week. This pattern is in line with expectations derived from chronobiology and could not be explained by trait self-control. In addition, on evenings on which employees had less self-regulatory resources available before going to bed-compared to evenings on which they had more self-regulatory resources available before going to bed-employees showed lower bedtime procrastination. This finding contradicts the prevailing idea that bedtime procrastination is the result of a lack of self-regulatory resources. Conclusion: The findings of this study provide important implications for how bedtime procrastination should be positioned in the field of procrastination as self-regulatory failure and for how bedtime procrastination should be dealt with in practice.

General hospital resources consumed by an elderly population awaiting long-term care.

PubMed

Coughlan, T; O'Neill, D

2001-01-01

The provision of extended care facilities in urban Ireland has lagged behind the growth in the numbers of older people. A final pathway for placement is often through the general hospital and the attendant delay results in a diversion of resources. We developed a database of the long-term care waiting lists for the years 1994-present and this was analysed for the six years 1994-1999. We calculated the number of bed-days consumed by elderly patients awaiting placement in long-term care facilities and thus the hospital resources consumed during these periods. The total number of bed-days consumed over the study period was 51,923, the mean being 8653.8 days. Approximately 23.9% of patients die in hospital while awaiting long-term placement. Translating these bed-days into opportunity cost losses in areas relevant to the general hospital we found that 560 extra elective orthopaedic procedures and 1,212 extra transurethral prostatectomies could have been performed per year. The problem of overnight stays in casualty could have been totally abolished if only 65% of these beds were free. Elective theatre is often cancelled with one of the primary reasons being lack of beds. If even a proportion of these beds could be freed up few if any theatre sessions would have to be cancelled, assuming bed availability to be the only factor. This study confirms that the lack of appropriate accommodation for older people requiring extended care is consuming a significant proportion of health care resources. An accelerated program of building of publicly funded long-term placement facilities is urgently required to ameliorate this problem, especially in the greater Dublin area. Further study is required to determine whether this problem exists in other health board areas and if so whether it exists to the same extent.

High school start times after 8:30 am are associated with later wake times and longer time in bed among teens in a national urban cohort study.

PubMed

Nahmod, Nicole G; Lee, Soomi; Buxton, Orfeu M; Chang, Anne-Marie; Hale, Lauren

2017-12-01

High school start times are a key contributor to insufficient sleep. This study investigated associations of high school start times with bedtime, wake time, and time in bed among urban teenagers. Daily-diary study nested within the prospective Fragile Families and Child Wellbeing Study. Twenty US cities. Four hundred thirteen teenagers who completed ≥1 daily diary report on a school day. Participating teens were asked to complete daily diaries for 7 consecutive days. School-day daily diaries (3.8±1.6 entries per person) were used in analyses (N=1555 school days). High school start time, the main predictor, was categorized as 7:00-7:29 am (15%), 7:30-7:59 am (22%), 8:00-8:29 am (35%), and 8:30 am or later (28%). Multilevel modeling examined the associations of school start times with bedtime, wake time, and time in bed. Models adjusted for age, sex, race/ethnicity, household income, caregiver's education, and school type. Teens with the earliest high school start times (7:00-7:29 am) obtained 46 minutes less time in bed on average compared with teens with high school start times at 8:30 am or later (P<.001). Teens exhibited a dose-response relationship between earlier school start times and shorter time in bed, primarily due to earlier wake times (P<.05). Start times after 8:30 am were associated with increased time in bed, extending morning sleep by 27-57 minutes (P<.05) when compared with teens with earlier school start times. Later school start times are associated with later wake times in our large, diverse sample. Teens starting school at 8:30 am or later are the only group with an average time in bed permitting 8 hours of sleep, the minimum recommended by expert consensus for health and well-being. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Comparison of batch sorption tests, pilot studies, and modeling for estimating GAC bed life.

PubMed

Scharf, Roger G; Johnston, Robert W; Semmens, Michael J; Hozalski, Raymond M

2010-02-01

Saint Paul Regional Water Services (SPRWS) in Saint Paul, MN experiences annual taste and odor episodes during the warm summer months. These episodes are attributed primarily to geosmin that is produced by cyanobacteria growing in the chain of lakes used to convey and store the source water pumped from the Mississippi River. Batch experiments, pilot-scale experiments, and model simulations were performed to determine the geosmin removal performance and bed life of a granular activated carbon (GAC) filter-sorber. Using batch adsorption isotherm parameters, the estimated bed life for the GAC filter-sorber ranged from 920 to 1241 days when challenged with a constant concentration of 100 ng/L of geosmin. The estimated bed life obtained using the AdDesignS model and the actual pilot-plant loading history was 594 days. Based on the pilot-scale GAC column data, the actual bed life (>714 days) was much longer than the simulated values because bed life was extended by biological degradation of geosmin. The continuous feeding of high concentrations of geosmin (100-400 ng/L) in the pilot-scale experiments enriched for a robust geosmin-degrading culture that was sustained when the geosmin feed was turned off for 40 days. It is unclear, however, whether a geosmin-degrading culture can be established in a full-scale filter that experiences taste and odor episodes for only 1 or 2 months per year. The results of this research indicate that care must be exercised in the design and interpretation of pilot-scale experiments and model simulations for predicting taste and odor removal in full-scale GAC filter-sorbers. Adsorption and the potential for biological degradation must be considered to estimate GAC bed life for the conditions of intermittent geosmin loading typically experienced by full-scale systems. (c) 2009 Elsevier Ltd. All rights reserved.

Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona; Giles, Margaret

2016-11-01

Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Effects of strict prolonged bed rest on cardiorespiratory fitness: systematic review and meta-analysis.

PubMed

Ried-Larsen, Mathias; Aarts, Hugo M; Joyner, Michael J

2017-10-01

The aim of this systematic review and meta-analysis [International Prospective Register of Systematic Reviews (PROSPERO) CRD42017055619] was to assess the effects of strict prolonged bed rest (without countermeasures) on maximal oxygen uptake (V̇o 2max ) and to explore sources of variation therein. Since 1949, 80 studies with a total of 949 participants (>90% men) have been published with data on strict bed rest and V̇o 2max The studies were conducted mainly in young participants [median age (interquartile range) 24.5 (22.4-34.0) yr]. The duration of bed rest ranged from 1 to 90 days. V̇o 2max declined linearly across bed rest duration. No statistical difference in the decline among studies reporting V̇o 2max as l/min (-0.3% per day) compared with studies reporting V̇o 2max normalized to body weight (ml·kg -1 ·min -1 ; -0.43% per day) was observed. Although both total body weight and lean body mass declined in response to bed rest, we did not see any associations with the decline in V̇o 2max However, 15-26% of the variation in the decline in V̇o 2max was explained by the pre-bed-rest V̇o 2max levels, independent of the duration of bed rest (i.e., higher pre-bed-rest V̇o 2max levels were associated with larger declines in V̇o 2max ). Furthermore, the systematic review revealed a gap in the knowledge about the cardiovascular response to extreme physical inactivity, particularly in older subjects and women of any age group. In addition to its relevance to spaceflight, this lack of data has significant translational implications because younger women sometimes undergo prolonged periods of bed rest associated with the complications of pregnancy and the incidence of hospitalization including prolonged periods of bed rest increases with age. NEW & NOTEWORTHY Large interindividual responses of maximal oxygen uptake (V̇o 2max ) to aerobic exercise training exist. However, less is known about the variability in the response of V̇o 2max to prolonged bed rest. This systematic review and meta-analysis showed that pre-bed-rest V̇o 2max values were inversely associated with the change in V̇o 2max independent of the duration of bed rest. Moreover, we identified a large knowledge gap about the causes of decline in V̇o 2max , particularly in postmenopausal women, which may have clinical implications. Copyright © 2017 the American Physiological Society.

Clustering of host-seeking activity of Anopheles gambiae mosquitoes at the top surface of a human-baited bed net

PubMed Central

2013-01-01

Background Knowledge of the interactions between mosquitoes and humans, and how vector control interventions affect them, is sparse. A study exploring host-seeking behaviour at a human-occupied bed net, a key event in such interactions, is reported here. Methods Host-seeking female Anopheles gambiae activity was studied using a human-baited ‘sticky-net’ (a bed net without insecticide, coated with non-setting adhesive) to trap mosquitoes. The numbers and distribution of mosquitoes captured on each surface of the bed net were recorded and analysed using non-parametric statistical methods and random effects regression analysis. To confirm sticky-net reliability, the experiment was repeated using a pitched sticky-net (tilted sides converging at apex, i.e., neither horizontal nor vertical). The capture efficiency of horizontal and vertical sticky surfaces were compared, and the potential repellency of the adhesive was investigated. Results In a semi-field experiment, more mosquitoes were caught on the top (74-87%) than on the sides of the net (p < 0.001). In laboratory experiments, more mosquitoes were caught on the top than on the sides in human-baited tests (p < 0.001), significantly different to unbaited controls (p < 0.001) where most mosquitoes were on the sides (p = 0.047). In both experiments, approximately 70% of mosquitoes captured on the top surface were clustered within a 90 × 90 cm (or lesser) area directly above the head and chest (p < 0.001). In pitched net tests, similar clustering occurred over the sleeper’s head and chest in baited tests only (p < 0.001). Capture rates at horizontal and vertical surfaces were not significantly different and the sticky-net was not repellent. Conclusion This study demonstrated that An. gambiae activity occurs predominantly within a limited area of the top surface of bed nets. The results provide support for the two-in-one bed net design for managing pyrethroid-resistant vector populations. Further exploration of vector behaviour at the bed net interface could contribute to additional improvements in insecticide-treated bed net design or the development of novel vector control tools. PMID:23902661

Multi-microbial compound eliminates Salmonella Typhimurium from one-third of poultry litter samples within eight days

USDA-ARS?s Scientific Manuscript database

Broiler litter is composed of bedding material mixed with chicken manure, feathers, and feed. The bedding material is typically composed of wood shavings; peanut or rice hulls depending on the area of the country where the broilers are being raised. Due to the increasing price of fresh bedding mat...

The metabolic cost of an integrated exercise program performed during 14 days of bed rest.

PubMed

Scott, Jessica M; Hackney, Kyle; Downs, Meghan; Guined, Jamie; Ploutz-Snyder, Robert; Fiedler, James; Cunningham, David; Ploutz-Snyder, Lori

2014-06-01

Exercise countermeasures designed to mitigate muscle atrophy during long-duration spaceflight may not be as effective if crewmembers are in negative energy balance (energy output > energy input). This study determined the energy cost of supine exercise (resistance, interval, aerobic) during the spaceflight analogue of bed rest. Nine subjects (eight men and one woman; 34.5 +/- 8.2 yr) completed 14 d of bed rest and concomitant exercise countermeasures. Body mass and basal metabolic rate (BMR) were assessed before and during bed rest. Exercise energy expenditure was measured during and immediately after [excess post-exercise oxygen consumption (EPOC)] each of five different exercise protocols (30-s, 2-min, and 4-min intervals, continuous aerobic, and a variety of resistance exercises) during bed rest. On days when resistance and continuous aerobic exercise were performed daily, energy expenditure was significantly greater (2879 +/- 280 kcal) than 2-min (2390 +/- 237 kcal), 30-s (2501 +/- 264 kcal), or 4-min (2546 +/- 264 kcal) exercise. There were no significant differences in BMR (pre-bed rest: 1649 +/- 216 kcal; week 1: 1632 +/- 174 kcal; week 2:1657 +/- 176 kcal) or body mass (pre-bed rest: 75.2 +/- 10.1 kg; post-bed rest: 75.2 +/- 9.6 kg). These findings highlight the importance of energy balance for long-duration crewmembers completing a high-intensity exercise program with multiple exercise sessions daily.

Once-Yearly Zoledronic Acid and Days of Disability, Bed Rest, and Back Pain: Randomized, Controlled HORIZON Pivotal Fracture Trial

PubMed Central

Cauley, Jane A.; Black, Dennis; Boonen, Steven; Cummings, Steven R.; Mesenbrink, Peter; Palermo, Lisa; Man, Zulema; Hadji, Peyman; Reid, Ian R.

2016-01-01

The objective of this study was to determine the effect of once-yearly zoledronic acid on the number of days of back pain and the number of days of disability (ie, limited activity and bed rest) owing to back pain or fracture in postmenopausal women with osteoporosis. This was a multicenter, randomized, double-blind, placebo-controlled trial in 240 clinical centers in 27 countries. Participants included 7736 postmenopausal women with osteoporosis. Patients were randomized to receive either a single 15-minute intravenous infusion of zoledronic acid (5 mg) or placebo at baseline, 12 months, and 24 months. The main outcome measures were self-reported number of days with back pain and the number of days of limited activity and bed rest owing to back pain or a fracture, and this was assessed every 3 months over a 3-year period. Our results show that although the incidence of back pain was high in both randomized groups, women randomized to zoledronic acid experienced, on average, 18 fewer days of back pain compared with placebo over the course of the trial (p = .0092). The back pain among women randomized to zoledronic acid versus placebo resulted in 11 fewer days of limited activity (p = .0017). In Cox proportional-hazards models, women randomized to zoledronic acid were about 6% less likely to experience 7 or more days of back pain [relative risk (RR) = 0.94, 95% confidence interval (CI) 0.90–0.99] or limited activity owing to back pain (RR = 0.94, 95% CI 0.87–1.00). Women randomized to zoledronic acid were significantly less likely to experience 7 or more bed-rest days owing to a fracture (RR = 0.58, 95% CI 0.47–0.72) and 7 or more limited-activity days owing to a fracture (RR = 0.67, 95% CI 0.58–0.78). Reductions in back pain with zoledronic acid were independent of incident fracture. Our conclusion is that in women with postmenopausal osteoporosis, a once-yearly infusion with zoledronic acid over a 3-year period significantly reduced the number of days that patients reported back pain, limited activity owing to back pain, and limited activity and bed rest owing to a fracture. PMID:21542001

Focal Gray Matter Plasticity as a Function of Long Duration Head Down Tilted Bed Rest: Preliminary Results

NASA Technical Reports Server (NTRS)

Koppelmans, V.; Erdeniz, B.; DeDios, Y. E.; Wood, S. J.; Reuter-Lorenz, P. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.; Seidler, R. D.

2014-01-01

Long duration spaceflight (i.e., 22 days or longer) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes. Whether these sensorimotor changes are solely related to peripheral changes from reduced vestibular stimulation, body unloading, body fluid shifts or that they may be related to structural and functional brain changes is yet unknown. However, a recent study reported associations between microgravity and flattening of the posterior eye globe and protrusion of the optic nerve [1] possibly as the result of increased intracranial pressure due to microgravity induced bodily fluid shifts [3]. Moreover, elevated intracranial pressure has been related to white matter microstructural damage [2]. Thus, it is possible that spaceflight may affect brain structure and thereby cognitive functioning. Long duration head down tilt bed rest has been suggested as an exclusionary analog to study microgravity effects on the sensorimotor system [4]. Bed rest mimics microgravity in body unloading and bodily fluid shifts. In consideration of the health and performance of crewmembers both in- and post-flight, we are conducting a prospective longitudinal 70-day bed rest study as an analog to investigate the effects of microgravity on brain structure [5]. Here we present results of the first six subjects. Six subjects were assessed at 12 and 7 days before-, at 7, 30, and 70 days in-, and at 8 and 12 days post 70 days of bed rest at the NASA bed rest facility in UTMB, Galveston, TX, USA. At each time point structural MRI scans (i.e., high resolution T1-weighted imaging and Diffusion Tensor Imaging (DTI)) were obtained using a 3T Siemens scanner. Focal changes over time in gray matter density were assessed using the voxel based morphometry 8 (VBM8) toolbox under SPM. Longitudinal processing in VBM8 includes linear registration of each scan to the mean of the subject and subsequently transforming all scans in to MNI space by applying the warp from the mean subject to MNI to the individual gray matter segmentations. Modulation was applied so that all images represented the volume of the original structure in native space. Voxel wise analysis was carried out on the gray matter images after smoothing, using a flexible factorial design with family wise error correction. Focal changes in white matter microstructural integrity were assessed using tract based spatial statistics (TBSS) as part of FMRIB software library (FSL). TBSS registers all DTI scans to standard space. It subsequently creates a study specific white matter skeleton of the major white matter tracts. For each subject, for each DTI metric (i.e. fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD)), the maximum value in a line perpendicular to the skeleton tract is projected to the skeleton. Non-parametric permutation based t-tests and ANOVA's were used for voxel-wise comparison of the skeletons. For both VBM and TBSS, comparison of pre bed rest measurements did not show significant differences. VBM analysis revealed decreased gray matter density in bilateral areas including the frontal medial cortex, the insular cortex and the caudate (see Figure) from 'pre to in bed rest'. Over the same time period, there was an increase in gray matter density in the cerebellum, occipital-, and parietal cortex, including the precuneus (see Figure). The majority of these changes did not recover from 'during to post bed rest'. TBSS analysis did not reveal significant changes in white matter microstructural integrity after correction for multiple comparisons. Uncorrected analyses (p<.015) revealed an increase in RD in the cerebellum and brainstem from pre bed rest to the first week in bed rest that did not recover post bed rest. Extended bed rest, which is an analog for microgravity, can result in gray matter changes and potentially in microstructural white matter changes in areas that are important for neuro motor behavior and cognition. These changes did not recover at two weeks post bed rest. Whether the effects of bed rest wear off at longer times post bed rest, and if they are associated with behavior are important questions that warrant further research.

Geology and mineral resources of the Mud Springs Ranch Quadrangle, Sweetwater County, Wyoming

USGS Publications Warehouse

Roehler, Henry W.

1979-01-01

The Mud Springs Ranch quadrangle occupies an area of 56 mF (square miles) on the southeast flank of the Rock Springs uplift in southwestern Wyoming. The climate is arid and windy. The landscape is mostly poorly vegetated and consists of north-trending ridges and valleys that are dissected by dry drainages. Sedimentary rocks exposed in the quadrangle are 5,400 ft (feet) thick and are mostly gray sandstone, siltstone, and shale, gray and brown carbonaceous shale, and thin beds of coal. They compose the Blair, Rock Springs, Ericson, Almond, and Lewis Formations of Cretaceous age and the Fort Union Formation of Paleocene age. The structure is mostly homoclinal, having southeast dips of 5?-12? in the northern part of the quadrangle, but minor plunging folds and one small fault are present in the southern part of the quadrangle. Three coal beds in the Fort Union Formation and 15 coal beds in the Almond Formation exceed 2.5 ft in thickness, are under less than 3,000 ft of overburden, and are potentially minable. Geographic stratigraphic, and resource data are present for each bed of minable coal. The total minable coal resources are estimated to be about 283 million short tons. Nine coal and rock samples from outcrops were analyzed to determine their quality and chemical composition. Four dry oil and gas test wells have been drilled within the quadrangle area, but structurally controlled stratigraphic-trap prospects remain untested.

Reactor for in situ measurements of spatially resolved kinetic data in heterogeneous catalysis

NASA Astrophysics Data System (ADS)

Horn, R.; Korup, O.; Geske, M.; Zavyalova, U.; Oprea, I.; Schlögl, R.

2010-06-01

The present work describes a reactor that allows in situ measurements of spatially resolved kinetic data in heterogeneous catalysis. The reactor design allows measurements up to temperatures of 1300 °C and 45 bar pressure, i.e., conditions of industrial relevance. The reactor involves reactants flowing through a solid catalyst bed containing a sampling capillary with a side sampling orifice through which a small fraction of the reacting fluid (gas or liquid) is transferred into an analytical device (e.g., mass spectrometer, gas chromatograph, high pressure liquid chromatograph) for quantitative analysis. The sampling capillary can be moved with μm resolution in or against flow direction to measure species profiles through the catalyst bed. Rotation of the sampling capillary allows averaging over several scan lines. The position of the sampling orifice is such that the capillary channel through the catalyst bed remains always occupied by the capillary preventing flow disturbance and fluid bypassing. The second function of the sampling capillary is to provide a well which can accommodate temperature probes such as a thermocouple or a pyrometer fiber. If a thermocouple is inserted in the sampling capillary and aligned with the sampling orifice fluid temperature profiles can be measured. A pyrometer fiber can be used to measure the temperature profile of the solid catalyst bed. Spatial profile measurements are demonstrated for methane oxidation on Pt and methane oxidative coupling on Li/MgO, both catalysts supported on reticulated α -Al2O3 foam supports.

Incident Angle of Saltating Particles in Wind-Blown Sand

PubMed Central

Fu, Lin-Tao; Bo, Tian-Li; Gu, Hai-Hua; Zheng, Xiao-Jing

2013-01-01

Incident angle of saltating particles plays a very important role in aeolian events. In this paper, the incident angles of sand particles near the sand bed were measured in wind tunnel. It reveals that the incident angles range widely from 0° to 180° and thereby the means of angles are larger than published data. Surprisingly, it is found the proportion that angles of 5°–15° occupy is far below previous reports. The measuring height is probably the most important reason for the measurement differences between this study and previous investigations. PMID:23874470

Electrical impedance measurements in the arm and the leg during a thirty day bed rest study

NASA Technical Reports Server (NTRS)

Cardus, David; Jaweed, Mazher; McTaggart, Wesley

1995-01-01

The need to detect, follow, and understand the effects of gravity on body fluid distribution is a constant stimulus to the quest for new techniques in this area of research. One of these techniques is electrical bioimpedance spectroscopy (BIS). Although not new, this is a technique whose applications to biomedical research are fairly recent. What is new is the development of instrumentation that has made practical the use of impedance spectroscopy in the biomedical setting, particularly in studies involving human subjects. The purpose of this paper is to report impedance spectroscopy observations made on a subject who was submitted to bed rest for a period of thirty days. These observations were made as part of a study on muscle atrophy during a thirty day head down bed rest. Since bed rest studies are very costly in human and financial terms, and technically difficult to realize, we felt that even though the present study deals only with a single case it was worthy of reporting because it illustrates kinds of questions impedance spectroscopy may help to answer in microgravity research.

Health resource use after robot-assisted surgery vs open and conventional laparoscopic techniques in oncology: analysis of English secondary care data for radical prostatectomy and partial nephrectomy.

PubMed

Hughes, David; Camp, Charlotte; O'Hara, Jamie; Adshead, Jim

2016-06-01

To evaluate postoperative health resource utilisation and secondary care costs for radical prostatectomy and partial nephrectomy in National Health Service (NHS) hospitals in England, via a comparison of robot-assisted, conventional laparoscopic and open surgical approaches. We retrospectively analysed the secondary care records of 23 735 patients who underwent robot-assisted (RARP, n = 8 016), laparoscopic (LRP, n = 6 776) or open radical prostatectomy (ORP, n = 8 943). We further analysed 2 173 patients who underwent robot-assisted (RAPN, n = 365), laparoscopic (LPN, n = 792) or open partial nephrectomy (OPN, n = 1 016). Postoperative inpatient admissions, hospital bed-days, excess bed-days and outpatient appointments at 360 and 1 080 days after surgery were reviewed. Patients in the RARP group required significantly fewer inpatient admissions, hospital bed-days and excess bed-days at 360 and 1 080 days than patients undergoing ORP. Patients undergoing ORP had a significantly higher number of outpatient appointments at 1 080 days. The corresponding total costs were significantly lower for patients in the RARP group at 360 days (£1679 vs £2031 for ORP; P < 0.001) and at 1 080 days (£3461 vs £4208 for ORP; P < 0.001). In partial nephrectomy, Patients in the RAPN group required significantly fewer inpatient admissions and hospital bed-days at 360 days compared with those in the OPN group; no significant differences were observed in outcomes at 1 080 days. The corresponding total costs were lower for patients in the RAPN group at 360 days (£779 vs £1242 for OPN, P = 0.843) and at 1 080 days (£2122 vs £2889 for ORP; P = 0.570). For both procedure types, resource utilisation and costs for laparoscopic surgeries lay at the approximate midpoint of those for robot-assisted and open surgeries. Our analysis provides compelling evidence to suggest that RARP leads to reduced long-term health resource utilisation and downstream cost savings compared with traditional open and laparoscopic approaches. Furthermore, despite the limitations that arise from the inclusion of a small sample, these results also suggest that robot-assisted surgery may represent a cost-saving alternative to existing surgical options in partial nephrectomy. Further exploration of clinical cost drivers, as well as an extension of the analysis into subsequent years, could lend support to the wider commissioning of robot-assisted surgery within the NHS. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

When felids and hominins ruled at Olduvai Gorge: A machine learning analysis of the skeletal profiles of the non-anthropogenic Bed I sites

NASA Astrophysics Data System (ADS)

Arriaza, Mari Carmen; Domínguez-Rodrigo, Manuel

2016-05-01

In the past twenty years, skeletal part profiles, which are prone to equifinality, have not occupied a prominent role in the interpretation of early Pleistocene sites on Africa. Alternatively, taphonomic studies on bone surface modifications and bone breakage patterns, have provided heuristic interpretations of some of the best preserved archaeological record of this period; namely, the Olduvai Bed I sites. The most recent and comprehensive taphonomic study of these sites (Domínguez-Rodrigo et al., 2007a) showed that FLK Zinj was an anthropogenic assemblage in which hominins acquired carcasses via primary access. That study also showed that the other sites were palimpsests with minimal or no intervention by hominins. The FLK N, FLK NN and DK sequence seemed to be dominated by single-agent (mostly, felid) or multiple-agent (mostly, felid-hyenid) processes. The present study re-analyzes the Bed I sites focusing on skeletal part profiles. Machine learning methods, which incorporate complex algorithms, are powerful predictive and classification methods and have the potential to better extract information from skeletal part representation than past approaches. Here, multiple algorithms (via decision trees, neural networks, random forests and support vector machines) are combined to produce a solid interpretation of bone accumulation agency at the Olduvai Bed I sites. This new approach virtually coincides with previous taphonomic interpretations on a site by site basis and shows that felids were dominant accumulating agents over hyenas during Bed I times. The recent discovery of possibly a modern lion-accumulated assemblage at Olduvai Gorge (Arriaza et al., submitted) provides a very timely analog for this interpretation.

[Mites in mattress dust and relevant environmental factors in student dormitories in Shenzhen].

PubMed

Wang, Bin; Wu, Jie; Liu, Zhi-gang; Ran, Pi-xin; Gao, Qiao; Luo, Chun-hui; Ai, Mei

2009-02-28

Three hundred and eight mattress dust samples were collected from college dormitories in Shenzhen with a mite prevalence of 88% (271/308). From the samples, 6163 mites were isolated and identified. Dermatophagoides farinae, D. pteronyssinus and Blomia tropicalis were three most abundant species, occupying 29.7%, 21.7% and 17.9%, respectively. It was found that sex of the students, mattress cover (bamboo mat or bed sheet), with or without air conditioner installation, and daily using of air conditioner (<2 h, 2-8 h and >8 h) had no significant influence on the mite prevalence (P>0.05). However, logistic regression analysis revealed that the risk of mite sensitization in male student dormitory was significantly lower than that in female dormitory (OR=0.55, P=0.038), and the risk of using bed sheets was significantly higher than using bamboo mats (OR=2.13, P=0.040). Both mite prevalence and the risk of mite sensitization significantly decreased with higher floor of the dormitory building.

Application of simplified bioclean apparatuses for treatment of acute leukemia.

PubMed

Hasegawa, H; Horiuchi, A

1983-01-01

We used a portable horizontal laminar-air-flow clean bed and an open horizontal laminar-air-flow fan (clean wall unit) for treating patients with acute leukemia. The level of cleanliness as shown in the nonviable and viable particle counts was class 100 and class 1,000 at the head and foot, respectively, of the bed in the clean-bed rooms, while it was class 100 and class 10,000 respectively, in the clean-wall-unit rooms. The level of cleanliness in the open wards, on the other hand, was class 1,000,000. The incidence of infectious complications in the clean-bed rooms was 3.1/100 days when the granulocyte count was 1,000/mm3 or less, 3.9/100 days when the count was 500/mm3 or less and 6.1/100 days when it was 100/mm3 or less. In the clean-wall-unit rooms, these values were 3.1, 3.7 and 7.1, respectively, while in the open wards they were 4.6, 6.1 and 15.0. Thus, it was ascertained that, as the granulocyte count decreased, the incidence of infectious complications became significantly higher in the open wards than in the clean-bed rooms or the clean-wall-unit rooms. No complication of pneumonia was found in 37 patients with acute leukemia in the clean-bed rooms or in 40 in the clean-wall-unit rooms. Among 36 patients treated in the open wards, on the other hand, the complication of pneumonia was found in four. From the above results, it is believed that the use of clean-bed rooms or clean-wall-unit rooms is an extremely effective supplementary treatment method for preventing respiratory tract infection complications in patients with acute leukemia.

Time-Series Approaches for Forecasting the Number of Hospital Daily Discharged Inpatients.

PubMed

Ting Zhu; Li Luo; Xinli Zhang; Yingkang Shi; Wenwu Shen

2017-03-01

For hospitals where decisions regarding acceptable rates of elective admissions are made in advance based on expected available bed capacity and emergency requests, accurate predictions of inpatient bed capacity are especially useful for capacity reservation purposes. As given, the remaining unoccupied beds at the end of each day, bed capacity of the next day can be obtained by examining the forecasts of the number of discharged patients during the next day. The features of fluctuations in daily discharges like trend, seasonal cycles, special-day effects, and autocorrelation complicate decision optimizing, while time-series models can capture these features well. This research compares three models: a model combining seasonal regression and ARIMA, a multiplicative seasonal ARIMA (MSARIMA) model, and a combinatorial model based on MSARIMA and weighted Markov Chain models in generating forecasts of daily discharges. The models are applied to three years of discharge data of an entire hospital. Several performance measures like the direction of the symmetry value, normalized mean squared error, and mean absolute percentage error are utilized to capture the under- and overprediction in model selection. The findings indicate that daily discharges can be forecast by using the proposed models. A number of important practical implications are discussed, such as the use of accurate forecasts in discharge planning, admission scheduling, and capacity reservation.

Effects of Long Duration Spaceflight on Venous and Arterial Compliance: Bed Rest

NASA Technical Reports Server (NTRS)

Ribeiro, L. Christine; Platts, Steven H.; Laurie, Steven S.; Lee, Stuart M. C.; Martin, David S.; Ploutz-Snyder, Robert J.; Stenger, Michael B.

2017-01-01

The primary objective was to determine whether a high sodium diet during bed rest induced alterations in vascular compliance and was related to the incidence of VIIP. Ocular structural and functional measures and vascular ultrasound of the head and neck were acquired in bed rest subjects completing 10-14 days in 6deg head-down tilt.

Critical care medicine in the United States 2000-2005: an analysis of bed numbers, occupancy rates, payer mix, and costs.

PubMed

Halpern, Neil A; Pastores, Stephen M

2010-01-01

To analyze the evolving role, patterns of use, and costs of critical care medicine in the United States from 2000 to 2005. Retrospective study of data from the Hospital Cost Report Information System (Centers for Medicare and Medicaid Services, Baltimore, Maryland). Nonfederal, acute care hospitals with critical care medicine beds in the United States. None. None. We analyzed hospital and critical care medicine beds, bed types, days, occupancy rates, payer mix (Medicare and Medicaid), and costs. Critical care medicine costs were compared with national cost indexes. Between 2000 and 2005, the total number of U.S. hospitals with critical care medicine beds decreased by 12.2% (from 3,586 to 3,150). Although the number of hospital beds decreased by 4.2% (from 655,785 to 628,409), both hospital days and occupancy rates increased by 5.1% (from 145.1 to 152.5 million) and 13.7% (from 59% to 67%), respectively. Critical care medicine beds increased by 6.5% (from 88,252 to 93,955), days by 10.6% (from 21.0 to 23.2 million), and occupancy rates by 4.5% (from 65% to 68%). The majority (90%) of critical care medicine beds were classified as intensive care, premature/neonatal, and coronary care unit beds. The percentage of critical care medicine days used by Medicare decreased by 3.8% (from 37.9% to 36.5%) compared with an increase of 15.5% (from 14.5% to 16.8%) by Medicaid. From 2000 to 2005, critical care medicine costs per day increased by 30.4% (from $2698 to $3518). Although annual critical care medicine costs increased by 44.2% (from $56.6 to $81.7 billion), the proportion of hospital costs and national health expenditures allocated to critical care medicine decreased by 1.6% and 1.8%, respectively. However, the proportion of the gross domestic product used by critical care medicine increased by 13.7%. In 2005, critical care medicine costs represented 13.4% of hospital costs, 4.1% of national health expenditures, and 0.66% of the gross domestic product. Critical care medicine continues to grow in a shrinking U.S. hospital system. The critical care medicine payer mix is evolving, with Medicaid increasing in its percentage of critical care medicine use. Critical care medicine is more cost controlled than other healthcare indexes, but is still using an increasing percentage of the gross domestic product. Our updated and comprehensive critical care medicine use and cost analysis provides a contemporary benchmark for the strategic planning of critical care medicine services within the U.S. healthcare system.

The East Africa Oligocene intertrappean beds: Regional distribution, depositional environments and Afro/Arabian mammal dispersals

NASA Astrophysics Data System (ADS)

Abbate, Ernesto; Bruni, Piero; Ferretti, Marco Peter; Delmer, Cyrille; Laurenzi, Marinella Ada; Hagos, Miruts; Bedri, Omar; Rook, Lorenzo; Sagri, Mario; Libsekal, Yosief

2014-11-01

The extensive outpouring of the Oligocene Trap basalts over eastern Africa and western Arabia was interrupted by a period of quiescence marked by the deposition of terrestrial sediments. These so-called intertrappean beds are often lignitiferous and yield recurrent floras and faunas, sometimes represented by endemic mammals. We intended to highlight the peculiar features of these sedimentary intercalations using a large-scale approach including eastern Africa and the western Arabian peninsula. Starting from a new mapping in the Eritrean highland, the intertrappean beds resulted a continuous level that was a few tens of meters thick and traceable for some tens of kilometers. They consist of fluvial red, green and gray mudstones and siltstones with subordinate channelized pebbly sandstones, and lignite seams. Two new 40Ar-39Ar datings constraint the age of the intertrappean beds between 29.0 Ma and 23.6 Ma. The outcrops near Mendefera have yielded the remains of two proboscidean families, the Deinotheriidae and the Gomphoteriidae. The morphological grade of the two Mendefera proboscideans would suggest a more derived stage than that of representatives of the same families from other Oligocene African sites (e.g., Chilga, Ethiopia). An Oligocene age could be inferred for them. The occurrence of the genus Prodeinotherium at Mai Gobro possibly represents the first occurrence of this taxon, while the Gomphotheirum sp. might represent the oldest occurrence of this taxon in Africa before its dispersal towards Asia and Europe. Proboscideans have also been found in the lowland intertrappean beds of Dogali near Massawa. These sediments were contiguous with the Eritrean highland intertrappean beds during the Oligocene, but are now tectonically displaced from them by two thousand meters of vertical topographical distance. Dogali is also known for the occurrence of possible Deinotheriidae remains and the primitive elephantoid Eritreum. Entering the Ethiopian highland, an inspection of the Agere Selam (Mekele) intertrappean beds revealed the occurrence of lacustrine limestones and diatomites, which were contrastingly quite subordinate with respect to the fine clastic sediments found in the nearby Amba Alaji area. Further south, the intertrappean section in the Jema valley (100 km north of Addis Ababa and close to the Blue Nile gorge) is 120 m thick with predominant clastic sediments and a few diatomites at the top. Literature information from 35 additional sites, including northern Kenya, Yemen, Sudan and Saudi Arabia sections, confirms the fluvial and lacustrine depositional environment of the intertrappean beds, underlines the interest in their mammal fauna (Chilga, Losodok), and reports exploitable coal seams for some of them. As for the vegetal landscape in which the intertrappean beds were deposited, pollen and plant analysis results indicative of a tropical wet forest, similar to that of present-day western Africa. Another common feature of the intertrappean beds is their relatively limited thickness, averaging a few tens of meters, but reaching a few hundred meters in graben-related basins, such as Delbi Moye in southern Ethiopia. In most cases only thin, lens-shaped successions were deposited above the hummocky topography of their volcanic substratum, commonly unaffected by significant faulting. An average duration of the intertrappean beds is from one to three million years. This time interval is commonly matched by a few tens (or more rarely, hundreds) of meters of sediments left over after erosive episodes or depositional starvation. As to the lateral continuity of the intertrappean beds, the present-day outcrops show large differences: from some tens of kilometers in the Mendefera area, to a few tens of kilometres in the Jema valley, and to a few hundreds meters in the Agere Selam (Mekele) area. Even if it is difficult to quantify the original size of the sedimentation areas, it nevertheless proves that the intertrappean basins exceed thousands of square kilometers in only a single case (Mendefera), but were quite restricted in most cases. Their most likely endorheic and local character, together with a regional ill-defined fluvial network, was the effect of a water-course rerouting caused by the progressive rising of the eastern African and Arabian plateaux. Chronological constraints for the intertrappean beds can be inferred from the age of the hosting Trap succession and by the stratigraphical position that they occupy. Intervolcanic sedimentary episodes are typically found in the basaltic and subordinately rhyolitic successions that followed the 31-29 Ma old basaltic widespread paroxysm. With due caveats deriving from the discontinuous availability of datings specifically dedicated to this issue, we regard the age of the intertrappean beds as mostly encompassed in the interval from 29 to 27 Ma at the transition between the Early and Late Oligocene in the Ethiopia/Yemen Trap core. In marginal areas, such as SW Arabia, Eritrea and Kenya, the volcanic activity above the intertrappean beds resumed later, and its quiescence allowed a more prolonged period of sedimentation. The intertrappean beds fall in the second cooling event of the Oligocene climatic deterioration. During the contemporaneous apparent drop in the global sea-level and closure of the Tethyan Ocean between Arabia and southwestern Asia, connections were established between the African and the Eurasian continents. At that time, southwestern Asia was experiencing severe aridity with faunal exchanges toward the luxuriously vegetated eastern Africa.

Digital image analysis of striated skeletal muscle tissue injury during reperfusion after induced ischemia

NASA Astrophysics Data System (ADS)

Rosero Salazar, Doris Haydee; Salazar Monsalve, Liliana

2015-01-01

Conditions such as surgical procedures or vascular diseases produce arterial ischemia and reperfusion injuries, which generate changes in peripheral tissues and organs, for instance, in striated skeletal muscle. To determine such changes, we conducted an experimental method in which 42 male Wistar rat were selected, to be undergone to tourniquet application on the right forelimb and left hind limb, to induce ischemia during one and three hours, followed by reperfusion periods starting at one hour and it was prolonged up to 32 days. Extensor carpi radialis longus and soleus respectively, were obtained to be processed for histochemical and morphometric analysis. By means of image processing and detection of regions of interest, variations of areas occupied by muscle fibers and intramuscular extracellular matrix (IM-ECM) throughout reperfusion were observed. In extensor carpi radialis longus, results shown reduction in the area occupied by muscle fibers; this change is significant between one hour and three hours ischemia followed by 16 hours, 48 hours and 32 days reperfusión (p˂0.005). To compare only periods of reperfusión that continued to three hours ischemia, were found significant differences, as well. For area occupied by IM-ECM, were identified increments in extensor carpi radialis longus by three hours ischemia and eight to 16 days reperfusion; in soleus, was observed difference by one hour ischemia with 42 hours reperfusion, and three hours ischemia followed by four days reperfusion (p˂0.005). Skeletal muscle develops adaptive changes in longer reperfusion, to deal with induced injury. Descriptions beyond 32 days reperfusion, can determine recovering normal pattern.

Age-dependent synapse withdrawal at axotomised neuromuscular junctions in Wlds mutant and Ube4b/Nmnat transgenic mice

PubMed Central

Gillingwater, Thomas H; Thomson, Derek; Mack, Till G A; Soffin, Ellen M; Mattison, Richard J; Coleman, Michael P; Ribchester, Richard R

2002-01-01

Axons in WldS mutant mice are protected from Wallerian degeneration by overexpression of a chimeric Ube4b/Nmnat (Wld) gene. Expression of Wld protein was independent of age in these mice. However we identified two distinct neuromuscular synaptic responses to axotomy. In young adult Wlds mice, axotomy induced progressive, asynchronous synapse withdrawal from motor endplates, strongly resembling neonatal synapse elimination. Thus, five days after axotomy, 50–90 % of endplates were still partially or fully occupied and expressed endplate potentials (EPPs). By 10 days, fewer than 20 % of endplates still showed evidence of synaptic activity. Recordings from partially occupied junctions indicated a progressive decrease in quantal content in inverse proportion to endplate occupancy. In Wlds mice aged > 7 months, axons were still protected from axotomy but synapses degenerated rapidly, in wild-type fashion: within three days less than 5 % of endplates contained vestiges of nerve terminals. The axotomy-induced synaptic withdrawal phenotype decayed with a time constant of ∼30 days. Regenerated synapses in mature Wlds mice recapitulated the juvenile phenotype. Within 4–6 days of axotomy 30–50 % of regenerated nerve terminals still occupied motor endplates. Age-dependent synapse withdrawal was also seen in transgenic mice expressing the Wld gene. Co-expression of Wld protein and cyan fluorescent protein (CFP) in axons and neuromuscular synapses did not interfere with the protection from axotomy conferred by the Wld gene. Thus, Wld expression unmasks age-dependent, compartmentally organised programmes of synapse withdrawal and degeneration. PMID:12231635

Caring holistically within new managerialism.

PubMed

Wong, Woon Hau

2004-03-01

This article explains the attempts of nurses to practice humanistic, holistic care in line with their professionalizing strategy. Ideally, the intention of nurses is to broaden their concerns beyond the physiological needs of patients, thereby circumventing biomedical control over their work. However, the author argues that resource constraints, and the coalescing of biomedical and managerial definitions of patients, suggest that holistic notions of care are subjected to a new form of calculus and normalizing technology. Critically, nurses are more preoccupied with the day-to-day struggle to free up resources for healthcare, in particular bed spaces, and to pre-empt the problem of bed blocking. Such work suggests that the "emptying of beds" is not just a symbol of accomplishment for nursing work. From the governmentality theory of Foucault, the administration of "beds" has become part of the managerial power/knowledge discourse and an instrument for making nurses toe the financial bottom-line.

Freestall maintenance: effects on lying behavior of dairy cattle.

PubMed

Drissler, M; Gaworski, M; Tucker, C B; Weary, D M

2005-07-01

In a series of 3 experiments, we documented how sand-bedding depth and distribution changed within freestalls after new bedding was added and the effect of these changes on lying behavior. In experiment 1, we measured changes in bedding depth over a 10-d period at 43 points in 24 freestalls. Change in depth of sand was the greatest the day after new sand was added and decreased over time. Over time, the stall surface became concave, and the deepest part of the stall was at the center. Based on the results of experiment 1, we measured changes in lying behavior when groups of cows had access to freestalls with sand bedding that was 0, 3.5, 5.2, or 6.2 cm at the deepest point, below the curb, while other dimensions remained fixed. We found that daily lying time was 1.15 h shorter in stalls with the lowest levels of bedding compared with stalls filled with bedding. Indeed, for every 1-cm decrease in bedding, cows spent 11 min less time lying down during each 24-h period. In a third experiment, we imposed 4 treatments that reflected the variation in sand depth within stalls: 0, 6.2, 9.9, and 13.7 cm below the curb. Again, lying times reduced with decreasing bedding, such that cows using the stalls with the least amount of bedding (13.7 cm below curb) spent 2.33 h less time per day lying down than when housed with access to freestalls filled with sand (0 cm below curb).

A new model for studying the revascularization of skin grafts in vivo: the role of angiogenesis.

PubMed

Lindenblatt, Nicole; Calcagni, Maurizio; Contaldo, Claudio; Menger, Michael D; Giovanoli, Pietro; Vollmar, Brigitte

2008-12-01

Models of skin graft revascularization are based mostly on histologic evaluations but lack the possibility of analyzing the vascular biology in vivo. The aim of the present study was therefore to develop an animal model that allows continuous monitoring of the microcirculation during skin graft healing. Skin and subcutaneous tissue were removed from the back of dorsal skinfold chamber preparations in mice, leaving one layer of striated muscle and subcutaneous tissue as a wound bed (n = 5). A corresponding full-thickness skin graft was harvested from the groin and sutured into the defect in the back of the chamber. To study graft healing, repetitive intravital microscopy was performed during the first 10 days after engraftment. Capillary widening in the wound bed appeared at day 1 after grafting and increased until day 4. Capillary buds and sprouts first appeared at day 2. Blood filling of autochthonous graft capillaries occurred at day 3, resulting in almost complete restoration of the original skin microcirculation on day 5. This was achieved by interconnections between the microvasculature of the wound bed and the skin graft through a temporary angiogenic response. In principle, angiogenic blood vessel growth originated in the wound bed and was directed toward the graft. This new model allows for repetitive analysis of the microcirculation during skin graft healing. It provides ideal in vivo conditions to further delineate the exact mechanisms of blood vessel interconnection during the complex process of angiogenesis, and may also allow study of the vascularization of tissue-engineered skin substitutes.

A CFD model for biomass combustion in a packed bed furnace

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karim, Md. Rezwanul; Department of Mechanical & Chemical Engineering, Islamic University of Technology, Gazipur 1704; Ovi, Ifat Rabbil Qudrat

Climate change has now become an important issue which is affecting environment and people around the world. Global warming is the main reason of climate change which is increasing day by day due to the growing demand of energy in developed countries. Use of renewable energy is now an established technique to decrease the adverse effect of global warming. Biomass is a widely accessible renewable energy source which reduces CO{sub 2} emissions for producing thermal energy or electricity. But the combustion of biomass is complex due its large variations and physical structures. Packed bed or fixed bed combustion is themore » most common method for the energy conversion of biomass. Experimental investigation of packed bed biomass combustion is difficult as the data collection inside the bed is challenging. CFD simulation of these combustion systems can be helpful to investigate different operational conditions and to evaluate the local values inside the investigation area. Available CFD codes can model the gas phase combustion but it can’t model the solid phase of biomass conversion. In this work, a complete three-dimensional CFD model is presented for numerical investigation of packed bed biomass combustion. The model describes the solid phase along with the interface between solid and gas phase. It also includes the bed shrinkage due to the continuous movement of the bed during solid fuel combustion. Several variables are employed to represent different parameters of solid mass. Packed bed is considered as a porous bed and User Defined Functions (UDFs) platform is used to introduce solid phase user defined variables in the CFD. Modified standard discrete transfer radiation method (DTRM) is applied to model the radiation heat transfer. Preliminary results of gas phase velocity and pressure drop over packed bed have been shown. The model can be useful for investigation of movement of the packed bed during solid fuel combustion.« less

Age-related differences in lean mass, protein synthesis and skeletal muscle markers of proteolysis after bed rest and exercise rehabilitation

PubMed Central

Tanner, Ruth E; Brunker, Lucille B; Agergaard, Jakob; Barrows, Katherine M; Briggs, Robert A; Kwon, Oh Sung; Young, Laura M; Hopkins, Paul N; Volpi, Elena; Marcus, Robin L; LaStayo, Paul C; Drummond, Micah J

2015-01-01

Abstract Bed rest-induced muscle loss and impaired muscle recovery may contribute to age-related sarcopenia. It is unknown if there are age-related differences in muscle mass and muscle anabolic and catabolic responses to bed rest. A secondary objective was to determine if rehabilitation could reverse bed rest responses. Nine older and fourteen young adults participated in a 5-day bed rest challenge (BED REST). This was followed by 8 weeks of high intensity resistance exercise (REHAB). Leg lean mass (via dual-energy X-ray absorptiometry; DXA) and strength were determined. Muscle biopsies were collected during a constant stable isotope infusion in the postabsorptive state and after essential amino acid (EAA) ingestion on three occasions: before (PRE), after bed rest and after rehabilitation. Samples were assessed for protein synthesis, mTORC1 signalling, REDD1/2 expression and molecular markers related to muscle proteolysis (MURF1, MAFBX, AMPKα, LC3II/I, Beclin1). We found that leg lean mass and strength decreased in older but not younger adults after bedrest (P < 0.05) and was restored after rehabilitation. EAA-induced mTORC1 signalling and protein synthesis increased before bed rest in both age groups (P < 0.05). Although both groups had blunted mTORC1 signalling, increased REDD2 and MURF1 mRNA after bedrest, only older adults had reduced EAA-induced protein synthesis rates and increased MAFBX mRNA, p-AMPKα and the LC3II/I ratio (P < 0.05). We conclude that older adults are more susceptible than young persons to muscle loss after short-term bed rest. This may be partially explained by a combined suppression of protein synthesis and a marginal increase in proteolytic markers. Finally, rehabilitation restored bed rest-induced deficits in lean mass and strength in older adults. Key points Five days of bed rest resulted in a reduction in leg lean mass and strength in older adults. After bed rest, older (but not younger) adults had reduced amino acid-induced anabolic sensitivity (blunted muscle protein synthesis; MPS) and enhanced markers associated with the ubiquitin proteasome and autophagy–lysosomal systems (increase in molecular markers related to muscle proteolysis). Younger adults did not lose leg lean mass (via DXA) after 5 days of bed rest despite blunted amino acid-induced mTORC1 signalling and increased skeletal muscle REDD1, REDD2 and MURF1 mRNA expression. Exercise rehabilitation restored bed rest-induced deficits in lean mass, strength, nutrient-induced protein anabolism (protein synthesis and mTORC1 signalling) and select muscle proteolytic markers in older adults. PMID:26173027

A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness.

PubMed

Siskind, Dan; Harris, Meredith; Kisely, Steve; Brogan, James; Pirkis, Jane; Crompton, David; Whiteford, Harvey

2013-07-01

There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban Brisbane. One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the cost of providing the AtH program. AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the year after the index episode. For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house program can reduce acute psychiatric bed-days, providing a cost saving for mental health services.

Intensive care unit mobility practices in Australia and New Zealand: a point prevalence study.

PubMed

Berney, Susan C; Harrold, Megan; Webb, Steven A; Seppelt, Ian; Patman, Shane; Thomas, Peter J; Denehy, Linda

2013-12-01

To develop a comprehensive set of items describing physiotherapy mobilisation practices for critically ill patients, and to document current practices in intensive care units in Australia and New Zealand, focusing on patients having > 48 hours of mechanical ventilation. Prospective, observational, multicentre, single-day, point prevalence study. All patients in 38 Australian and New Zealand ICUs at 10 am on one of three designated days in 2009 and 2010. Demographic data, admission diagnosis and mobilisation practices that had occurred in the previous 24 hours. 514 patients were enrolled, with 498 complete datasets. Mean age was 59.2 years (SD, 16.7 years) and 45% were mechanically ventilated. Mobilisation activities were classified into five categories that were not mutually exclusive: 140 patients (28%) completed an in-bed exercise regimen, 93 (19%) sat over the side of the bed, 182 (37%) sat out of bed, 124 (25%) stood and 89 (18%) walked. Predefined adverse events occurred on 24 occasions (5%). No patient requiring mechanical ventilation sat out of bed or walked. On the study day, 391 patients had been in ICU for > 48 hours. There were 384 complete datasets available for analysis and, of these, 332 patients (86%) were not walked. Of those not walked, 76 (23%) were in the ICU for ≥ 7 days. Patient mobilisation was shown to be low in a single-day point prevalence study. Future observational studies are required to confirm the results.

Artificial Gravity as a Bone Loss Countermeasure in Simulated Weightlessness

NASA Technical Reports Server (NTRS)

Smith, S. M.; Zwart, S. R.; Crawford, G. E.; Gillman, P. L.; LeBlanc, A.; Shackelford, L. C.; Heer, M. A.

2007-01-01

The impact of microgravity on the human body is a significant concern for space travelers. We report here initial results from a pilot study designed to explore the utility of artificial gravity (AG) as a countermeasure to the effects of microgravity, specifically to bone loss. After an initial phase of adaptation and testing, 15 male subjects underwent 21 days of 6 head-down bed rest to simulate the deconditioning associated with space flight. Eight of the subjects underwent 1 h of centrifugation (AG, 1 gz at the heart, 2.5 gz at the feet) each day for 21 days, while 7 of the subjects served as untreated controls (CN). Blood and urine were collected before, during, and after bed rest for bone marker determinations. At this point, preliminary data are available on the first 8 subjects (6 AG, and 2 CN). Comparing the last week of bed rest to before bed rest, urinary excretion of the bone resorption marker n-telopeptide increased 95 plus or minus 59% (mean plus or minus SD) in CN but only 32 plus or minus 26% in the AG group. Similar results were found for another resorption marker, helical peptide (increased 57 plus or minus 0% and 35 plus or minus 13% in CN and AG respectively). Bone-specific alkaline phosphatase, a bone formation marker, did not change during bed rest. At this point, sample analyses are continuing, including calcium tracer kinetic studies. These initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest.

Temporal variation in bed configuration and one-dimensional bottom roughness at the mid-shelf STRESS site

NASA Astrophysics Data System (ADS)

Wheatcroft, Robert A.

1994-08-01

Time-lapse stereophotographs were taken over a 90-day period from mid-November 1990 to late-February 1991 at a 90-m silt-bottom site on the central California shelf as part of the STRESS (Sediment Transport Events on Shelves and Slopes) project. Five distinct bed configurations were observed, in order of decreasing abundance, these are: (1) bioturbated bed; (2) smoothed bed; (3) current-rippled bed; (4) scour-pitted bed; and (5) wave-rippled bed. Concurrent measurements of the flow field implicate along-shelf currents, rather than waves, as the primary agent forming the physical bed configurations. The presence of a wave-induced cross-shelf gradient in near-bottom suspended sediment during storm events and the redistribution of this sediment by upwelling or downwelling currents is postulated to control the appearance of depositional current-ripples (northwest poleward flow, downwelling) and erosional scour-pits (southeast equatorward flow, upwelling). All physical bed forms are destroyed by bioturbation processes in periods of hours to days. Analytical photogrammetric techniques were used to extract high-resolution sea floor height data from the stereophotographs. Results indicate maximal relief over a 0.25-m 2 area at this site never exceeded 5 cm. Root-mean-square (rms) height varied by a factor of 3 (3.2-9.2 mm) and is a weak function of bed configuration. Current ripples have the largest rms-height, smoothed and scour-pitted beds the smallest. Rms-heights of bioturbated beds are variable and appear to depend on the previously produced physical bed configuration. Changes in rms-height can be abrupt with factor of 2 changes observed over a 12-h period. Horizontal descriptors of roughness such as peak spacing or peak width cannot separate bed configurations. Results from surface slope distributions are broadly coherent with the rms-height data, in that surfaces with large rms-heights have broad slope distributions and vice versa. Slope distribution data also indicate that all bed configurations except the current-rippled bed are isotropic. These preliminary data suggest that time series information is needed to adequately resolve both the micro-scale roughness of the sea floor on continental shelves and the presence of short lived, but potentially flow-diagnostic bed configurations.

Using a Medical Intranet of Things System to Prevent Bed Falls in an Acute Care Hospital: A Pilot Study.

PubMed

Balaguera, Henri U; Wise, Diana; Ng, Chun Yin; Tso, Han-Wen; Chiang, Wan-Lin; Hutchinson, Aimee M; Galvin, Tracy; Hilborne, Lee; Hoffman, Cathy; Huang, Chi-Cheng; Wang, C Jason

2017-05-04

Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital. Patients 18 years and older with a Morse fall score of 45 or greater were recruited from a 35-bed medical-surgical ward in a 317-bed Massachusetts teaching hospital. Eligible patients were recruited between August 4, 2015 and July 31, 2016. Participants received a sensor pad placed between the top of their mattress and bed sheet. The sensor pad was positioned to monitor movement from patients' shoulders to their thighs. The SensableCare System was evaluated for monitoring patient movement and delivering timely alerts to nursing staff via mobile devices when there appeared to be a bed-exit attempt. Sensor pad data were collected automatically from the system. The primary outcomes included number of falls, time to turn off bed-exit alerts, and the number of attempted bed-exit events. Data on patient falls were collected by clinical research assistants and confirmed with the unit nurse manager. Explanatory variables included room locations (zones 1-3), day of the week, nursing shift, and Morse Fall Scale (ie, positive fall history, positive secondary diagnosis, positive ambulatory aid, weak impaired gait/transfer, positive IV/saline lock, mentally forgets limitations). We also assessed user experience via nurse focus groups. Qualitative data regarding staff interactions with the system were collected during two focus groups with 25 total nurses, each lasting approximately 1.5 hours. A total of 91 patients used the system for 234.0 patient-days and experienced no bed falls during the study period. On average, patients were assisted/returned to bed 46 seconds after the alert system was triggered. Response times were longer during the overnight nursing shift versus day shift (P=.005), but were independent of the patient's location on the unit. Focus groups revealed that nurses found the system integrated well into the clinical nursing workflow and the alerts were helpful in patient monitoring. A medical IoT system can be integrated into the existing nursing workflow and may reduce patient bed fall risk in acute care hospitals, a high priority but an elusive patient safety challenge. By using an alerting system that sends notifications directly to nurses' mobile devices, nurses can equally respond to unassisted bed-exit attempts wherever patients are located on the ward. Further study, including a fully powered randomized controlled trial, is needed to assess effectiveness across hospital settings. ©Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.05.2017.

Media arrangement impacts cell growth in anaerobic fixed-bed reactors treating sugarcane vinasse: Structured vs. randomic biomass immobilization.

PubMed

de Aquino, Samuel; Fuess, Lucas Tadeu; Pires, Eduardo Cleto

2017-07-01

This study reports on the application of an innovative structured-bed reactor (FVR) as an alternative to conventional packed-bed reactors (PBRs) to treat high-strength solid-rich wastewaters. Using the FVR prevents solids from accumulating within the fixed-bed, while maintaining the advantages of the biomass immobilization. The long-term operation (330days) of a FVR and a PBR applied to sugarcane vinasse under increasing organic loads (2.4-18.0kgCODm -3 day -1 ) was assessed, focusing on the impacts of the different media arrangements over the production and retention of biomass. Much higher organic matter degradation rates, as well as long-term operational stability and high conversion efficiencies (>80%) confirmed that the FVR performed better than the PBR. Despite the equivalent operating conditions, the biomass growth yield was different in both reactors, i.e., 0.095gVSSg -1 COD (FVR) and 0.066gVSSg -1 COD (PBR), indicating a clear control of the media arrangement over the biomass production in fixed-bed reactors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Virtual Design of a 4-Bed Molecular Sieve for Exploration

NASA Technical Reports Server (NTRS)

Giesy, Timothy J.; Coker, Robert F.; O'Connor, Brian F.; Knox, James C.

2017-01-01

Simulations of six new 4-Bed Molecular Sieve configurations have been performed using a COMSOL (COMSOL Multiphysics - commercial software) model. The preliminary results show that reductions in desiccant bed size and sorbent bed size when compared to the International Space Station configuration are feasible while still yielding a process that handles at least 4.0 kilograms a day CO2. The results also show that changes to the CO2 sorbent are likewise feasible. Decreasing the bed sizes was found to have very little negative effect on the adsorption process; breakthrough of CO2 in the sorbent bed was observed for two of the configurations, but a small degree of CO2 breakthrough is acceptable, and water breakthrough in the desiccant beds was not observed. Both configurations for which CO2 breakthrough was observed still yield relatively high CO2 efficiency, and future investigations will focus on bed size in order to find the optimum configuration.

Virtual Design of a 4-Bed Molecular Sieve for Exploration

NASA Technical Reports Server (NTRS)

Giesy, Timothy J.; Coker, Robert F.; O'Connor, Brian F.; Knox, James C.

2017-01-01

Simulations of six new 4-Bed Molecular Sieve configurations have been performed using a COMSOL model. The preliminary results show that reductions in desiccant bed size and sorbent bed size when compared to the International Space Station configuration are feasible while still yielding a process that handles at least 4.0 kg/day CO2. The results also show that changes to the CO2 sorbent are likewise feasible. Decreasing the bed sizes was found to have very little negative effect on the adsorption process; breakthrough of CO2 in the sorbent bed was observed for two of the configurations, but water breakthrough in the desiccant beds was not observed. Nevertheless, both configurations for which CO2 breakthrough was observed still yield relatively high CO2 efficiency, and future investigations will focus on bed size in order to find the optimum configuration.

Association Between Cardiovascular and Intraocular Pressure Changes in a 14-day 6 deg Head Down Tilt (HDT) Bed Rest Study: Possible Implications in Retinal Anatomy

NASA Technical Reports Server (NTRS)

Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Ploutz-Snyder, R.; Taibbi, G.; Brewer, J. L.; Vizzeri, G.

2013-01-01

Mean IOP significantly increased while at 6deg HDT and returned towards pre-bed rest values upon leaving bed rest. While mean IOP increased during bed rest, it remained within the normal limits for subject safety. A diuretic shift and cardiovascular deconditioning occurs during in-bed rest, as expected. There was no demonstrable correlation between the largest change in IOP (pre/post) and cardiovascular measure changes (pre/post). Additional mixed effects linear regression modeling may reveal some subclinical physiological changes that might assist in describing the VIIP syndrome pathophysiology.

Swing-bed services under the Medicare program, 1984-87

PubMed Central

Silverman, Herbert A.

1990-01-01

Under Medicare, swing beds are beds that can be used by small rural hospitals to furnish both acute and post-acute care. The swing-bed program was instituted under the provisions of the Omnibus Reconciliation Act of 1980 (Public Law 96-499). Under Medicare, post-acute care in the hospital would be covered as services equivalent to skilled nursing facility level of care. Data show that the program has had a rapid rate of growth. By 1987, swing beds accounted for 9.7 percent of the admissions to skilled nursing facility services, 6.0 percent of the covered days of care, and 6.2 percent of the reimbursements. Over one-half of the swing-bed services are furnished in the North Central States. PMID:10113275

Exercise thermoregulation with bed rest, confinement, and immersion deconditioning

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.

1997-01-01

Altered thermoregulation following exposure to prolonged (12-14 days) of bed rest and 6 hr of head-down thermoneutral water immersion in humans, and cage confinement (8 weeks) in male, mongrel dogs resulted in occasional increased core temperature (Tcore) at rest, but consistent "excessive" increase in Tcore during submaximal exercise. This excessive increase in Tcore in nonexercising and exercising subjects was independent of the mode (isometric or isotonic) of exercise training during bed rest, and was associated with the consistent hypovolemia in men but not in women taking estrogen supplementation (1.25 mg premarin/ day) which restored plasma volume during bed rest to ambulatory control levels. Post-bed rest exercise sweating (evaporative heat loss) was unchanged or higher than control levels; however, calculated tissue heat conductance was significantly lower in men, and forearm venoconstriction was greater (venous volume was reduced) in women during exercise after bed rest. Because sweating appeared proportional to the increased level of Tcore, these findings suggest that one major factor for the excessive hyperthermia is decreased core to periphery heat conduction. Exercising dogs respond like humans with excessive increase in both rectal (Tre) and exercising muscle temperatures (Tmu) after confinement and, after eight weeks of exercise training on a treadmill following confinement, they had an attenuated rate of increase of Tre even below ambulatory control levels. Intravenous infusion of glucose also attenuated not only the rise in Tre during exercise in normal dogs, but also the excessive rise in Tre and exercising Tmu after confinement. Oral glucose also appeared to reduce the rate of increase in excessive Tre in men after immersion deconditioning. There was a greater rate of rise in Tcore in two cosmonauts during supine submaximal exercise (65% VO2 max) on the fifth recovery day after the 115-day Mir 18 mission. Thus, the excessive rise in core temperature after deconditioning appears to be caused by decreased peripheral vasodilation in humans. Factors related to glucose metabolism may influence this mechanism.

Artificial Gravity as a Multi-System Countermeasure: Effects on Cognitive Function

NASA Technical Reports Server (NTRS)

Sipes, Walter E.; Seaton, Kim; Slack, Kellely; Bowie, Kendra

2007-01-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a medical requirement on the International Space Station, and its purpose is to evaluate cognitive functioning after physical insult (e.g., head trauma, decompression sickness, exposure to toxic gases, medication side effects). The current objective is to assess cognitive functioning in a long duration space mission analog environment where Artificial Gravity is being applied as a countermeasure in a Bed Rest study. Methods: Fifteen male subjects (8 treatment and 7 control) who participated in 21 days of -6 degree head-down bed rest were assessed. Three practice and three baseline WinSCAT test sessions were administered during the pre-bed rest phase of study participation. During the bed rest phase, the WinSCAT test was scheduled every other day, following the centrifuge, for a total of 10 test sessions. (The treatment group received 60 minutes of centrifugation each day during the 21 days of bed rest. The control subjects were strapped to the centrifuge for the same length of time as the treatment group but were not spun.) During the post-bed rest (reconditioning) phase, the test was administered 4 times. Results: Individual differences were found both within and between the treatment and control groups. After controlling for the number of subjects in each group, the treatment group accounted for more off-nominal WinSCAT scores than the control group. Conclusions:There is some preliminary evidence that centrifuge spinning might negatively impact cognitive functioning. However, due to sample size limitations, it cannot be ascertained whether there were significant differences in cognitive performance between the treatment and control groups. If centrifugation had a negative effect on cognitive functioning, consistent decrements would be expected to be found with all treatment subjects across time. Individual differences in underlying cognitive ability and motivation level are other possible explanations for the results found in this study.

Electronic archival tags provide first glimpse of bathythermal habitat use by free-ranging adult lake sturgeon Acipenser fulvescens

USGS Publications Warehouse

Briggs, Andrew S.; Hondorp, Darryl W.; Quinlan, Henry R.; Boase, James C.; Mohr, Lloyd C.

2016-01-01

Information on lake sturgeon (Acipenser fulvescens) depth and thermal habitat use during non-spawning periods is unavailable due to the difficulty of observing lake sturgeon away from shallow water spawning sites. In 2002 and 2003, lake sturgeon captured in commercial trap nets near Sarnia, Ontario were implanted with archival tags and released back into southern Lake Huron. Five of the 40 tagged individuals were recaptured and were at large for 32, 57, 286, 301, and 880 days. Temperatures and depths recorded by archival tags ranged from 0 to 23.5 ºC and 0.1 to 42.4 m, respectively. For the three lake sturgeon that were at large for over 200 days, temperatures occupied emulated seasonal fluctuations. Two of these fish occupied deeper waters during winter than summer while the other occupied similar depths during non-spawning periods. This study provides important insight into depth and thermal habitat use of lake sturgeon throughout the calendar year along with exploring the feasibility of using archival tags to obtain important physical habitat attributes during non-spawning periods.

Effect of prolonged bed rest on lung volume in normal individuals

NASA Technical Reports Server (NTRS)

Beckett, W. S.; Vroman, N. B.; Nigro, D.; Thompson-Gorman, S.; Wilkerson, J. E.

1986-01-01

The effect of prolonged bed rest on the lung function was studied by measuring forced vital capacity (FVC) and total lung capacity (TLC) in normal subjects before, during, and after 11- to 12-day rest periods. It was found that both FVC and TLC increased during bed rest (compared with the ambulatory controls), while residual volume and functional residual capacity of the respiratory system did not change. It is concluded that the increase in TLC by prolonged bed rest is not dependent on alterations in plasma volume.

Factors influencing the nitrification efficiency of fluidized bed filter with a plastic bead medium

USGS Publications Warehouse

Sandu, S.I.; Boardman, G.D.; Watten, B.J.; Brazil, B.L.

2002-01-01

The performance of fluidized bed nitrification filters charged with 2 ?? 4 ABS plastic beads (specific gravity 1.06) was evaluated. Three unique bed-height to diameter ratios were established, in triplicate, using column diameters of 12.7, 15.2 and 17.8 cm. Filters received water spiked with recycled nutrients and ammonia (TAN), from one of the three 500 1 feed tank system. With daily ammonia loading fixed at 8.6 g per system, TAN removal increased with column diameter at each of four tests hydraulic loading rates (6, 8, 10 and 12 Lpm). TAN in recirculated water (influent) rose from 0.5 to 1.0 mg/1 as ammonia loading increased from 180 mg/m2-day to 360 mg/m2-day. When hydraulic loading was fixed at 12 Lpm, TAN removal (%) was maximized with ammonia loadings ranging from 225 to 270 mg/m2-day. Biofilm thickness increased with ammonia loading, but decreased with increased hydraulic loading rates. Fluidized beds of ABS plastic beads were effective in reducing energy costs (head loss) of water treatment. ?? 2002 Elsevier Science B.V. All rights reserved.

Vestibular and Somatosensory Covergence in Postural Equilibrium Control: Insights from Spaceflight and Bed Rest Studies

NASA Technical Reports Server (NTRS)

Mulavara, A. P.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Lee, S. M. C.; Miller, C. A.; Peters, B. T.; Phillips, T.; Platts, S. H.;

Comparison of Structural and Functional Ocular Outcomes Between 14- and 70 Day Bed Rest

NASA Technical Reports Server (NTRS)

Cromwell, R. L.; Taibbi, G.; Zanello, S. B.; Yarbough, P. O.; Ploutz-Snyder, R. J.; Vizzeri, G.

2016-01-01

Purpose: To compare structural and functional ocular outcomes in healthy human subjects undergoing 14- and/or 70-day head-down-tilt bed rest (HDTBR). We hypothesized the amount of HDTBR-induced ocular changes be affected by the HDTBR duration. Methods: The studies were conducted at the NASA Flight Analogs Research Unit, The University of Texas Medical Branch at Galveston, Galveston, TX. Participants were selected using NASA standard screening procedures. Standardized NASA screening procedures and bed rest conditions (e.g., strict sleep-wake cycle, standardized diet, continuous video monitoring) were implemented in both studies. Participants maintained a 6deg HDTBR position for 14 and/or 70 consecutive days and did not engage in exercise. Weekly ophthalmological examinations were conducted in the sitting (pre/post-bed rest only) and HDT positions. Ocular outcomes of interest included: near best-corrected visual acuity (BCVA); spherical equivalent, as determined by cycloplegic autorefraction; Goldmann applanation tonometry and iCare (Icare Finland Oy, Espoo, Finland) intraocular pressure (IOP) measurement; color vision; red dot test; modified Amsler grid test; confrontational visual field; stereoscopic color fundus photography; Spectralis OCT (Heidelberg Engineering, GmbH, Heidelberg, Germany) retinal nerve fiber layer thickness (RNFLT), peripapillary and macular retinal thicknesses. Mixed-effects linear models were used to compare pre- and post-HDTBR observations between 14- and 70-day HDTBR for our continuously scaled outcomes.

Cognitive Functioning in Long Duration Head-down Bed Rest

NASA Technical Reports Server (NTRS)

Seaton, Kimberly A.; Slack, Kelley J.; Sipes, Walter A.; Bowie, Kendra

2008-01-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a self-administered battery of tests used on the International Space Station for evaluating cognitive functioning. Here, WinSCAT was used to assess cognitive functioning during extended head-down bed rest. Thirteen subjects who participated in 60 or 90 days of 6 deg head-down bed rest took WinSCAT during the pre-bed rest phase, the in-bed rest phase, and the post-bed rest (reconditioning) phase of study participation. After adjusting for individual baseline performance, 12 off-nominal scores were observed out of 351 total observations during bed rest and 7 of 180 during reconditioning. No evidence was found for systematic changes in off-nominal incidence as time in bed rest progressed, or during the reconditioning period. Cognitive functioning does not appear to be adversely affected by long duration head-down bed rest. Individual differences in underlying cognitive ability and motivation level are likely explanations for the current findings.

Changes in the retreatment radiation tolerance of the spinal cord with time after the initial treatment.

PubMed

Woolley, Thomas E; Belmonte-Beitia, Juan; Calvo, Gabriel F; Hopewell, John W; Gaffney, Eamonn A; Jones, Bleddyn

2018-06-01

To estimate, from experimental data, the retreatment radiation 'tolerances' of the spinal cord at different times after initial treatment. A model was developed to show the relationship between the biological effective doses (BEDs) for two separate courses of treatment with the BED of each course being expressed as a percentage of the designated 'retreatment tolerance' BED value, denoted [Formula: see text] and [Formula: see text]. The primate data of Ang et al. ( 2001 ) were used to determine the fitted parameters. However, based on rodent data, recovery was assumed to commence 70 days after the first course was complete, and with a non-linear relationship to the magnitude of the initial BED (BED init ). The model, taking into account the above processes, provides estimates of the retreatment tolerance dose after different times. Extrapolations from the experimental data can provide conservative estimates for the clinic, with a lower acceptable myelopathy incidence. Care must be taken to convert the predicted [Formula: see text] value into a formal BED value and then a practical dose fractionation schedule. Used with caution, the proposed model allows estimations of retreatment doses with elapsed times ranging from 70 days up to three years after the initial course of treatment.

Exercise Effects on the Course of Gray Matter Changes Over 70 Days of Bed Rest

NASA Technical Reports Server (NTRS)

Koppelmans, V.; Ploutz-Snyder, L.; DeDios, Y. E.; Wood, S. J.; Reuter-Lorenz, P. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.; Seidler, R. D.

2014-01-01

Long duration spaceflight affects posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes through direct effects on peripheral changes that result from reduced vestibular stimulation and body unloading. Effects of microgravity on sensorimotor function have been investigated on earth using bed rest studies. Long duration bed rest serves as a space-flight analogue because it mimics microgravity in body unloading and bodily fluid shifts. It has been hypothesized that the cephalad fluid shift that has been observed in microgravity could potentially affect central nervous system function and structure, and thereby indirectly affect sensorimotor or cognitive functioning. Preliminary results of one of our ongoing studies indeed showed that 70 days of long duration head down-tilt bed rest results in focal changes in gray matter volume from pre-bed rest to various time points during bed rest. These gray matter changes that could reflect fluid shifts as well as neuroplasticity were related to decrements in motor skills such as maintenance of equilibrium. In consideration of the health and performance of crewmembers both inand post-flight we are currently conducting a study that investigates the potential preventive effects of exercise on gray matter and motor performance changes that we observed over the course of bed rest. Numerous studies have shown beneficial effects of aerobic exercise on brain structure and cognitive performance in healthy and demented subjects over a large age range. We therefore hypothesized that an exercise intervention in bed rest could potentially mitigate or prevent the effects of bed rest on the central nervous system. Here we present preliminary outcomes of our study.

A novel method of continuous measurement of head of bed elevation in ventilated patients.

PubMed

Balonov, Konstantin; Miller, Andrew D; Lisbon, Alan; Kaynar, A Murat

2007-06-01

We developed a novel pressure transducer-based method of continuous measurement of head of bed elevation. Following validation of the method we hypothesized that head of bed angles would be at or above 30 degrees among mechanically ventilated patients throughout the day due to a hospital-wide initiative on ventilator-associated pneumonia prevention and standardized electronic order entry system to keep head of bed at an angle of 30 degrees or greater. Prospective observational study in university hospital intensive care units. Twenty-nine consecutive mechanically ventilated patients with no contraindications for semirecumbency. We acquired 113 pairs of measurements on unused beds for validation of the method at angles between 3 degrees and 70 degrees. Correlation between transducer and protractor was fitted into a linear regression model (R2 = 0.98) with minimal variation of data along the line of equality. Bland-Altman analysis showed a mean difference of 1.6 degrees +/- 1.6 degrees. Ninety-six percent of differences were within 2 SD from the mean. This method was then used among 29 intubated patients to collect head of bed data over a 24-h period for 3 consecutive days. Contrary to our hypothesis, all patients had head of bed angles less than 30 degrees. Our results suggest that this method could be used with high reliability and patients in our institution were not kept even at 30 degrees. The results are in accord with those of a recent study which found that continued maintenance of previously suggested head of bed angles was difficult to attain clinically. This may lead us to reevaluate methods studying the impact of head of bed elevation in VAP prevention.

Geologic controls on the recent evolution of oyster reefs in Apalachicola Bay and St. George Sound, Florida

USGS Publications Warehouse

Twichell, D.; Edmiston, L.; Andrews, Brian; Stevenson, W.; Donoghue, J.; Poore, Richard; Osterman, Lisa E.

2010-01-01

Apalachicola Bay and St. George Sound contain the largest oyster fishery in Florida, and the growth and distribution of the numerous oyster reefs here are the combined product of modern estuarine conditions in the bay and its late Holocene evolution. Sidescan-sonar imagery, bathymetry, high-resolution seismic profiles, and sediment cores show that oyster beds occupy the crests of a series of shoals that range from 1 to 7 km in length, trend roughly north-south perpendicular to the long axes of the bay and sound, and are asymmetrical with steeper sides facing to the west. Surface sediment samples show that the oyster beds consist of shelly sand, while much of the remainder of the bay floor is covered by mud delivered by the Apalachicola River. The present oyster reefs rest on sandy delta systems that advanced southward across the region between 6400 and 4400 yr BP when sea level was 4–6 m lower than present. Oysters started to colonize the region around 5100 yr BP and became extensive by 1200 and 2400 yr BP. Since 1200 yr BP, their aerial extent has decreased due to burial of the edges of the reefs by the prodelta mud that continues to be supplied by the Apalachicola River. Oyster reefs that are still active are narrower than the original beds, have grown vertically, and become asymmetrical in cross-section. Their internal bedding indicates they have migrated westward, suggesting a net westerly transport of sediment in the bay.

An evaluation of service use outcomes in a Recovery College.

PubMed

Bourne, Philippa; Meddings, Sara; Whittington, Adrian

2017-12-23

Recovery Colleges offer educational courses about recovery and mental health which are co-produced by mental health professionals and experts by lived experience. Previous evaluations have found positive effects of Recovery Colleges on a range of outcomes including wellbeing, recovery and quality of life. To evaluate service use outcomes for Sussex Recovery College students who use mental health services. The study used a controlled-before-and-after design. It used archival data to analyse service use before and after participants registered with the Recovery College (n = 463). Participants acted as their own control. Students used mental health services less after attending the Recovery College than before. Students who attended the Recovery College showed significant reductions in occupied hospital bed days, admissions, admissions under section and community contacts in the 18 months post compared with the 18 months before registering. Reductions in service use were greater for those who completed a course than those who registered but did not complete a course. These findings suggest that attending Recovery College courses is associated with reduced service use. The reductions equate to non-cashable cost-savings of £1200 per registered student and £1760 for students who completed a course. Further research is needed to investigate causality.

Dramatic effects of a new antimicrobial stewardship program in a rural community hospital.

PubMed

Libertin, Claudia R; Watson, Stephanie H; Tillett, William L; Peterson, Joy H

2017-09-01

New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia. An educational grand rounds lecture series was provided before implementation of the ASP to all prescribers. After implementation, algorithms to aid the selection of empirical antibiotics for specific infectious disease syndromes based on local antibiograms were provided to prescribers to improve this selection. Rates of C difficile infections, total targeted antimicrobial costs, and drug utilization rates were calculated for 1 year pre-ASP implementation (2013) and 1 year post-ASP implementation (October 2014-December 2015). The patient safety metric of C difficile infections decreased from 3.35 cases per 1,000 occupied bed days (OBDs) in 2013 to 1.35 cases per 1,000 OBDs in 2015. Total targeted antimicrobial costs decreased 50% from $16.93 per patient day in 2013 to $8.44 per patient day in 2015. Overall antimicrobial use decreased 10% from before the ASP initiative to 1 year after it. Annualized savings were $280,000 in 1 year, based on drug savings only. Judicious use of antimicrobials and resources can improve a patient safety metric and decrease costs dramatically in rural institutions where the average hospital census is <100 patients per day. The savings would allow the institutions to spend better while improving the use of antimicrobials. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Changes in prevalence of subjective fatigue during 14-day 6° head-down bed rest

NASA Astrophysics Data System (ADS)

Hirayanagi, Kaname; Natsuno, Toyoki; Shiozawa, Tomoki; Yamaguchi, Nobuhisa; Watanabe, Yoriko; Suzuki, Satomi; Iwase, Satoshi; Mano, Tadaaki; Yajima, Kazuyoshi

2009-06-01

The present study examines the prevalence of subjective fatigue in young healthy males during 14 days of 6° head-down bed rest (HDBR) by using a multidimensional questionnaire. Forty-one subjects completed the Subjective Fatigue Scale questionnaire to assess the fatigue-related complaints and symptoms. The questionnaire is composed of three sections, with 10 items each. The sections measured drowsiness and dullness (Section 1), difficulty in concentration (Section 2), and the projection of physical disintegration (Section 3). The subjects answered simple questions between 1400 and 1700 on 6 measurement days before and during the HDBR period. The prevalence rate of low back pain was markedly high (80.5%) on the second day and more than 50% in the first half of the HDBR period, and any complaints related to either a lack of sleep or a deterioration in the quality of sleep continued until the end of the HDBR period. Our findings may be useful in developing preventive strategies against physical and mental fatigue associated with prolonged HDBR, horizontal bed rest, and microgravity environments.

Fluid and electrolyte shifts in women during +Gz acceleration after 15 days' bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Stinnett, H. O.; Davis, G. L.; Kollias, J.; Bernauer, E. M.

1977-01-01

Experiments were conducted on twelve women aged 23-34 yr - a bed rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects - to determine the effect of bed rest on shifts in plasma volume, electrolytes, and erythrocyte volume during +Gz acceleration on a centrifuge. The BR group underwent the +Gz acceleration during a two-week ambulatory control period, after 15 days of a 17-day BR period, and on the third day of ambulatory recovery. The AMB group underwent the same experimental procedures, but continued their normal daily routine during the BR period without additional prescribed physical exercise. Major conclusions are that (1) the higher the mean control tolerance, the greater the tolerance decline after BR; (2) relative confinement and reduced activity contribute as much to reduction in tolerance as does the horizontal body position during BR; (3) BR deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and (4) about one-half the loss in tolerance after BR can be attributed to plasma volume and electrolyte shifts.

Carotid baroreflex response following 30 days exposure to simulated microgravity

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Doerr, D. F.; Eckberg, D. L.; Fritsch, J. M.; Vernikos-Danellis, J.

1989-01-01

The mechanism of the carotid-baroreflex response to weightlessness was investigated in human subjects exposed to simulated microgravity (30 days of 6-day head-down bed rest followed by 5 days of recovery). Baroreceptor-cardiac reflex responses were elicited by a complex sequence of pressure changes delivered to a neck chamber device. The shape of the sigmoid baroreceptor-cardiac response curve was examined for alterations and the occurrence of resetting, as well as for a possible association of the impaired baroreflex function with hypotension during the postexposure orthostatic stress. It was found that the exposure to head-down bed rest caused a significant shift on the R-R interval axis, which paralleled reductions and elevations in baseline HR such that the baseline R-R (operational point) remained in the same position on the response curve. This shift in the location of the reflex relation indicates a significant resetting of the carotid baroreceptors, which may represent an appropriate adaptation which contributes to the maintenance of a constant resting arterial blood pressure before, during, and after bed rest, observed in these study.

Submaximal exercise VO2 and Qc during 30-day 6 degrees head-down bed rest with isotonic and isokinetic exercise training

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Ertl, A. C.; Bernauer, E. M.

1996-01-01

BACKGROUND: Maintaining intermediary metabolism is necessary for the health and well-being of astronauts on long-duration spaceflights. While peak oxygen uptake (VO2) is consistently decreased during prolonged bed rest, submaximal VO2 is either unchanged or decreased. METHODS: Submaximal exercise metabolism (61 +/- 3% peak VO2) was measured during ambulation (AMB day-2) and on bed rest days 4, 11, and 25 in 19 healthy men (32-42 yr) allocated into no exercise (NOE, N = 5) control, and isotonic exercise (ITE, N = 7) and isokinetic exercise (IKE, N = 7) training groups. Exercise training was conducted supine for two 30-min periods per day for 6 d per week: ITE training was intermittent at 60-90% peak VO2; IKE training was 10 sets of 5 repetitions of peak knee flexion-extension force at a velocity of 100 degrees s-1. Cardiac output was measured with the indirect Fick CO2 method, and plasma volume with Evans blue dye dilution. RESULTS: Supine submaximal exercise VO2 decreased significantly (*p < 0.05) by 10.3%* with ITE and by 7.3%* with IKE; similar to the submaximal cardiac output decrease of 14.5%* (ITE) and 20.3%* (IKE), but different from change in peak VO2 (+1.4% with ITE and -10.2%* with IKE) and decrease in plasma volume of -3.7% (ITE) and -18.0%* (IKE). Reduction of submaximal VO2 during bed rest correlated 0.79 (p < 0.01) with submaximal Qc, but was not related to change in peak VO2 or plasma volume. CONCLUSION: Reduction in submaximal oxygen uptake during prolonged bed rest is related to decrease in exercise but not resting cardiac output; perturbations in active skeletal muscle metabolism may be involved.

The time course of the adaptations of human muscle proteome to bed rest and the underlying mechanisms

PubMed Central

Brocca, Lorenza; Cannavino, Jessica; Coletto, Luisa; Biolo, Gianni; Sandri, Marco; Bottinelli, Roberto; Pellegrino, Maria Antonietta

2012-01-01

In order to get a comprehensive picture of the complex adaptations of human skeletal muscle to disuse and further the understanding of the underlying mechanisms, we participated in two bed rest campaigns, one lasting 35 days and one 24 days. In the first bed rest (BR) campaign, myofibrillar proteins, metabolic enzymes and antioxidant defence systems were found to be down-regulated both post-8 days and post-35 days BR by proteomic analysis of vastus lateralis muscle samples from nine subjects. Such profound alterations occurred early (post-8 days BR), before disuse atrophy developed, and persisted through BR (post-35 days BR). To understand the mechanisms underlying the protein adaptations observed, muscle biopsies from the second bed rest campaign (nine subjects) were used to evaluate the adaptations of master controllers of the balance between muscle protein breakdown and muscle protein synthesis (MuRF-1 and atrogin-1; Akt and p70S6K), of autophagy (Beclin-1, p62, LC3, bnip3, cathepsin-L), of expression of antioxidant defence systems (NRF2) and of energy metabolism (PGC-1α, SREBP-1, AMPK). The results indicate that: (i) redox imbalance and remodelling of muscle proteome occur early and persist through BR; (ii) impaired energy metabolism is an early and persistent phenomenon comprising both the oxidative and glycolytic one; (iii) although both major catabolic systems, ubiquitin proteasome and autophagy, could contribute to the progression of atrophy late into BR, a decreased protein synthesis cannot be ruled out; (iv) a decreased PGC-1α, with the concurrence of SREBP-1 up-regulation, is a likely trigger of metabolic impairment, whereas the AMPK pathway is unaltered. PMID:22848045

Exercise Effects on the Brain and Sensorimotor Function in Bed Rest

NASA Technical Reports Server (NTRS)

Koppelmans, V.; Cassady, K.; De Dios, Y. E.; Szecsy, D.; Gadd, N.; Wood, S. J.; Reuter-Lorenz, R. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.;

STS-37 MS Godwin balances MS Ross using her index finger on OV-104's middeck

NASA Image and Video Library

1991-04-11

STS037-29-002 (5-11 April 1991) --- Astronauts Linda M. Godwin and Jerry L. Ross perform a balancing act on Atlantis' middeck. With little effort Godwin is able to hold Ross up near the ceiling with her index finger. Although the area the two occupy is very small, a number of articles are seen, including two sleep restraints, the escape pole and Bioserve ITA Materials Dispersion Apparatus bioprocessing test bed (attached to stowage lockers at left). This was one of the visuals used by the STS-37 crewmembers during their April 19 post-flight press conference at the Johnson Space Center (JSC).

A Randomized Controlled Trial on the Outcome in Comparing an Alginate Silver Dressing With a Conventional Treatment of a Necrotizing Fasciitis Wound.

PubMed

Meekul, Jarernchon; Chotirosniramit, Arnon; Himakalasa, Woraluck; Orrapin, Saritphat; Wongthanee, Antika; Pongtam, Orapin; Kulprachakarn, Kanokwan; Rerkasem, Kittipan

2017-06-01

Necrotizing fasciitis (NF) is a high morbidity and mortality disease and also demands high economic resources. The standard treatment of NF is surgical debridement and proper dressing for wound bed preparation. The efficacy of silver alginate dressing can inhibit the growth of microorganisms and keep the environment clean for wound bed preparation. However an optimal dressing to manage such wounds has yet to emerge. NF patients who were admitted between April 2013 and May 2016 were randomized to have wound dressing using either silver dressing (Ag group) or normal saline solution gauze (NSS group). The 4 main outcomes for comparison between the 2 groups were the duration of wound bed preparation, total cost during hospital stay, the duration of hospital stay, and the pain score. Thirty-nine patients were included in the study: 19 patients in the NSS group and 20 patients in the Ag group. The mean duration of wound bed preparation in the NSS group was 31.87 days, and in Ag group it was 21.39 days, but this trend was not statistically significant ( P = .057). The mean cost of treatment in the NSS and Ag groups was not significantly different ( P = .434; US$3308.83 and US$2647.82, respectively). The duration of hospital days in the 2 groups was not significantly different either (29.19 days [NSS group] and 20.99 days [Ag group]; P = .222). The pain score was significantly lower in the Ag group than those in the NSS group. Although silver dressing seems to be expensive, the cost of total treatment during hospital stay and the duration of hospital stay were not significantly different between groups. However, the mean duration of wound bed preparation seems to trend favoring toward the silver dressing group.

Effects of two hospital bed design features on physical demands and usability during brake engagement and patient transportation: a repeated measures experimental study.

PubMed

Kim, Sunwook; Barker, Linsey M; Jia, Bochen; Agnew, Michael J; Nussbaum, Maury A

2009-03-01

Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare workers worldwide. While existing research has focused on patient-handling techniques during activities which require direct patient contact (e.g., patient transfer), nursing tasks also involve other patient-handling activities, such as engaging bed brakes and transporting patients in beds, which could render healthcare workers at risk of developing WMSDs. Effectiveness of hospital bed design features (brake pedal location and steering-assistance) was evaluated in terms of physical demands and usability during brake engagement and patient transportation tasks. Two laboratory-based studies were conducted. In simulated brake engagement tasks, three brake pedal locations (head-end vs. foot-end vs. side of a bed) and two hands conditions (hands-free vs. hands-occupied) were manipulated. Additionally, both in-room and corridor patient transportation tasks were simulated, in which activation of steering-assistance features (5th wheel and/or front wheel caster lock) and two patient masses were manipulated. Nine novice participants were recruited from the local student population and community for each study. During brake engagement, trunk flexion angle, task completion time, and questionnaires were used to quantify postural comfort and usability. For patient transportation, dependent measures were hand forces and questionnaire responses. Brake pedal locations and steering-assistance features in hospital beds had significant effects on physical demands and usability during brake engagement and patient transportation tasks. Specifically, a brake pedal at the head-end of a bed increased trunk flexion by 74-224% and completion time by 53-74%, compared to other pedal locations. Participants reported greater overall perceived difficulty and less postural comfort with the brake pedal at the head-end. During in-room transportation, participants generally reported "Neither Low nor High" physical demands with the 5th wheel activated, compared to "Moderately High" physical demands when the 5th wheel was deactivated. Corridor transportation was similarly reported to be easier when a steering-assistance feature (the 5th wheel or front caster lock) was activated. Braking and steering-assistance features of hospital beds can have important effects on task efficiency and physical demands placed on healthcare workers. Selection of specific designs may thus be able to improve productivity and contribute to a reduction in WMSDs risk among healthcare workers.

[A comparative evaluation of surgical methods for treating hydrocele].

PubMed

Dunaevskiĭ, Ia L; Gorokhov, M E

1990-01-01

The authors analysed the results of the surgical treatment of 167 patients with hydrocele who were operated on with the use of Winkelmann's or Bergmann's technique (group I), the same but modified by Grebenshchikov-Shevtsov's (group II), and Lord's method (group III). Sclerotherapy was employed in the group IV patients. A high percentage of complications was associated with Winkelmann and Bergmann's techniques (scrotal edema, hematoma, wound purulence) when the hydropic sac was isolated from the adjacent tissues. Postsurgical staying-in-bed time for those operated on with Winkelmann's and Bergmann's technique was mean 8.6 +/- 1.2 days and 9.4 +/- 1.3 days, respectively. When the same surgery was performed according to the Grebenshchikov-Shevtsov's modification a mean staying-in-bed time reduced to 7.2 +/- 0.9 days due to a lower incidence of postsurgical complications. Analysis of 42 surgeries performed with the Lord's method which avoided the isolation of the hydropic sac from the adjacent tissues demonstrated its efficacy and simplicity. No hematomas, suppurations or relapses were documented. The staying-in-bed time was 3.4 +/- 0.6 days. The pronounced changes in tunica propria and the multilocular character of hydrocele were the contradictions to this pattern of the treatment. In case the performance of the surgery was impossible, sclerotherapy with administration of 2-10 ml of 2.5 per cent of tetracycline solution was performed for the sclerosing and antibacterial effect. A mean staying-in-bed time was 2.1 +/- 0.9 days. Seven out of 8 patients recovered after 1-3 sessions of sclerotherapy.

WISE 2005: Aerobic and resistive countermeasures prevent paraspinal muscle deconditioning during 60-day bed rest in women.

PubMed

Holt, Jacquelyn A; Macias, Brandon R; Schneider, Suzanne M; Watenpaugh, Donald E; Lee, Stuart M C; Chang, Douglas G; Hargens, Alan R

2016-05-15

Microgravity-induced lumbar paraspinal muscle deconditioning may contribute to back pain commonly experienced by astronauts and may increase the risk of postflight injury. We hypothesized that a combined resistive and aerobic exercise countermeasure protocol that included spinal loading would mitigate lumbar paraspinal muscle deconditioning during 60 days of bed rest in women. Sixteen women underwent 60-day, 6° head-down-tilt bed rest (BR) and were randomized into control and exercise groups. During bed rest the control group performed no exercise. The exercise group performed supine treadmill exercise within lower body negative pressure (LBNP) for 3-4 days/wk and flywheel resistive exercise for 2-3 days/wk. Paraspinal muscle cross-sectional area (CSA) was measured using a lumbar spine MRI sequence before and after BR. In addition, isokinetic spinal flexion and extension strengths were measured before and after BR. Data are presented as means ± SD. Total lumbar paraspinal muscle CSA decreased significantly more in controls (10.9 ± 3.4%) than in exercisers (4.3 ± 3.4%; P < 0.05). The erector spinae was the primary contributor (76%) to total lumbar paraspinal muscle loss. Moreover, exercise attenuated isokinetic spinal extension loss (-4.3 ± 4.5%), compared with controls (-16.6 ± 11.2%; P < 0.05). In conclusion, LBNP treadmill and flywheel resistive exercises during simulated microgravity mitigate decrements in lumbar paraspinal muscle structure and spine function. Therefore spaceflight exercise countermeasures that attempt to reproduce spinal loads experienced on Earth may mitigate spinal deconditioning during long-duration space travel.

[Kidney stone formation during space flight and long-term bed rest].

PubMed

Okada, Atsushi; Ichikawa, Jun; Tozawa, Keiichi

2011-10-01

Microgravity environment like space flight or a condition requiring long-term bed-rest increase bone resorption and decrease bone formation, inducing the rapid decrease of bone minerals to osteoporosis. Bone mineral loss increases urinary calcium excretion and the risk of urinary stone formation. To clarify the influence of the conditions on renal stone formation, a 90-day bed rest test was performed to analyze the mechanism of microgravity or bed rest-induced stone formation and prevention by bisphosphonate medication and bed-rest exercise. As the results, renal stone formation was observed in control and exercise groups and no stone was seen in the medication group. In the medication group, urinary calcium excretion and relative supersaturation of calcium oxalate were lower than in the control group throughout the bed-rest and recovery period. Bisphosphonate is useful for the prevention of renal stone formation during space flight and long-term bed-rest.

Exercise countermeasures for bed-rest deconditioning

NASA Technical Reports Server (NTRS)

Greenleaf, John (Editor)

1993-01-01

The purpose for this 30-day bed rest study was to investigate the effects of short-term, high intensity isotonic and isokinetic exercise training on maintenance of working capacity (peak oxygen uptake), muscular strength and endurance, and on orthostatic tolerance, posture and gait. Other data were collected on muscle atrophy, bone mineralization and density, endocrine analyses concerning vasoactivity and fluid-electrolyte balance, muscle intermediary metabolism, and on performance and mood of the subjects. It was concluded that: The subjects maintained a relatively stable mood, high morale, and high esprit de corps throughout the study. Performance improved in nearly all tests in almost all the subjects. Isotonic training, as opposed to isokinetic exercise training, was associated more with decreasing levels of psychological tension, concentration, and motivation; and improvement in the quality of sleep. Working capacity (peak oxygen uptake) was maintained during bed rest with isotonic exercise training; it was not maintained with isokinetic or no exercise training. In general, there was no significant decrease in strength or endurance of arm or leg muscles during bed rest, in spite of some reduction in muscle size (atrophy) of some leg muscles. There was no effect of isotonic exercise training on orthostasis, since tilt-table tolerance was reduced similarly in all three groups following bed rest. Bed rest resulted in significant decreases of postural stability and self-selected step length, stride length, and walking velocity, which were not influenced by either exercise training regimen. Most pre-bed rest responses were restored by the fourth day of recovery.

Dependence of ripple dimensions on cohesive and non-cohesive bed properties in the intertidal Dee Estuary

NASA Astrophysics Data System (ADS)

Lichtman, Ian; Thorne, Peter; Baas, Jacobus; O'Boyle, Louise; Cooke, Richard; Amoudry, Laurent; Bell, Paul; Aspden, Rebecca; Bass, Sarah; Davies, Alan; Hope, Julie; Malarkey, Jonathan; Manning, Andrew; Parsons, Daniel; Paterson, David; Peakall, Jeffrey; Schindler, Robert; Ye, Leiping

2014-05-01

There is a need to better understand the effects of cohesive and mixed sediments on coastal processes, to improve sediment transport models for the management of coastal erosion, siltation of navigation channels and habitat change. Although reasonable sediment transport predictors are available for pure sands, it still is not the case for mixed cohesive and non-cohesive sediments. Existing predictors mostly relate ripple dimensions to hydrodynamic conditions and median sediment grain diameter, assuming a narrow unimodal particle size distribution. Properties typical of mixed conditions, such as composition and cohesion for example, are not usually taken into account. This presents severe shortcomings to predictors' abilities. Indeed, laboratory experiments using mixed cohesive sediments have shown that bedform dimensions decrease with increasing bed mud content. In the field, one may expect current predictors to match data for well-sorted sands closely, but poorly for mixed sediments. Our work is part of the COHBED project and aims to: (1) examine, in field conditions, if ripple dimensions are significantly different for mixed cohesive sediment beds compared to beds with pure sand; (2) compare the field data with laboratory results that showed reduced ripple length due to cohesive mud content; and (3) assess the performance of a selection of ripple predictors for mixed sediment data. The COHBED project was set up to undertake laboratory experiments and fieldwork to study how physical and biological processes influence bedform development in a mixed cohesive-cohesionless sediment environment. As part of COHBED, a suite of instruments was deployed on tidal flats in the Dee Estuary (on the NW coast of England), collecting co-located measurements of the hydrodynamics, suspended sediment properties and bed morphology. The instruments occupied three sites collecting data over different bed compositions during a two week period (21 May to 4 June 2013). One site was located above a sandy bed, and the two others were above mixed beds of different mud content. The tide covered a full cycle from neaps to neaps and the weather provided onshore and offshore winds of varying strength. Bedform measurements were taken every half an hour using an Acoustic Ripple Profiler (ARP) that covered an area of about two square metres. Dynamic measurements of tides and waves were made using an Acoustic Doppler Velocimeter (ADV) at 8 Hz. Bed samples were taken when the tidal flats dried out at low tide and a sediment trap collected suspended load near the bed. In the presentation, comparisons of the sites will be made from measurements of the proportion of mud and biological sediment binders at each site and the ripple dimensions for different hydrodynamic conditions. Key words: bed morphology, current ripple, mixed sediment, cohesion, hydrodynamics, observations, tidal flat, estuary, Dee

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR § 1633.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

Natural Ca Isotope Composition of Urine as a Rapid Measure of Bone Mineral Balance

NASA Astrophysics Data System (ADS)

Skulan, J.; Gordon, G. W.; Morgan, J.; Romaniello, S. J.; Smith, S. M.; Anbar, A. D.

2011-12-01

Naturally occurring stable Ca isotope variations in urine are emerging as a powerful tool to detect changes in bone mineral balance. Bone formation depletes soft tissue of light Ca isotopes while bone resorption releases isotopically light Ca into soft tissue. Previously published work found that variations in Ca isotope composition could be detected at 4 weeks of bed rest in a 90-day bed rest study (data collected at 4, 8 and 12 weeks). A new 30-day bed rest study involved 12 patients on a controlled diet, monitored for 7 days prior to bed rest and 7 days post bed rest. Samples of urine, blood and food were collected throughout the study. Four times daily blood samples and per void urine samples were collected to monitor diurnal or high frequency variations. An improved chemical purification protocol, followed by measurement using multiple collector inductively coupled plasma mass spectrometry (MC-ICP-MS) allowed accurate and precise determinations of mass-dependent Ca isotope variations in these biological samples to better than ±0.2% (δ44/42Ca) on <25 μg of Ca. Results from this new study show that Ca isotope ratios shift in a direction consistent with net bone loss after just 7 days, long before detectible changes in bone density by X-ray measurements occur. Consistent with this interpretation, the Ca isotope variations track changes observed in N-teleopeptide, a bone resorption biomarker. Bone-specific alkaline phosphatase, a bone formation biomarker, is unchanged over this period. Ca isotopes can in principle be used to quantify net changes in bone mass. Using a mass-balance model, our results indicate an average loss of 0.62 ± 0.16 % in bone mass over the course of this 30-day study. This is consistent with the rate of bone loss in longer-term studies as seen by X-ray measurements. This Ca isotope technique should accelerate the pace of discovery of new treatments for bone disease and provide novel insights into the dynamics of bone metabolism.

Evaluation of Treadmill Exercise in a Lower Body Negative Pressure Chamber as a Countermeasure for Weightlessness-Induced Bone Loss: a Bed Rest Study with Identical Twins

NASA Technical Reports Server (NTRS)

Smith, Scott M.; Davis-Street, Janis E.; Fesperman, J. Vernell; Calkins, D. S.; Bawa, Maneesh; Macias, Brandon R.; Meyer, R. Scott; Hargens, Alan R.

2003-01-01

Counteracting bone loss is required for future space exploration. We evaluated the ability of treadmill exercise in a LBNP chamber to counteract bone loss in a 30-day bed rest study. Eight pairs of identical twins were randomly assigned to sedentary control or exercise groups. Exercise within LBNP decreased the bone resorption caused by bed rest and may provide a countermeasure for spaceflight. INTRODUCTION: Bone loss is one of the greatest physiological challenges for extended-duration space missions. The ability of exercise to counteract weightlessness-induced bone loss has been studied extensively, but to date, it has proven ineffective. We evaluated the effectiveness of a combination of two countermeasures-treadmill exercise while inside a lower body negative pressure (LBNP) chamber-on bone loss during a 30-day bed rest study. MATERIALS AND METHODS: Eight pairs of identical twins were randomized into sedentary (SED) or exercise/LBNP (EX/LBNP) groups. Blood and urine samples were collected before, several times during, and after the 30-day bed rest period. These samples were analyzed for markers of bone and calcium metabolism. Repeated measures ANOVA was used to determine statistical significance. Because identical twins were used, both time and group were treated as repeated variables. RESULTS: Markers of bone resorption were increased during bed rest in samples from sedentary subjects, including the collagen cross-links and serum and urinary calcium concentrations. For N-telopeptide and deoxypyridinoline, there were significant (p < 0.05) interactions between group (SED versus EX/LBNP) and phase of the study (sample collection point). Pyridinium cross-links were increased above pre-bed rest levels in both groups, but the EX/LBNP group had a smaller increase than the SED group. Markers of bone formation were unchanged by bed rest in both groups. CONCLUSIONS: These data show that this weight-bearing exercise combined with LBNP ameliorates some of the negative effects of simulated weightlessness on bone metabolism. This protocol may pave the way to counteracting bone loss during spaceflight and may provide valuable information about normal and abnormal bone physiology here on Earth.

In vivo intra-luteal implants of prostaglandin (PG) E(1) or E(2) (PGE(1), PGE(2)) prevent luteolysis in cows. I. Luteal weight, circulating progesterone, mRNA for luteal luteinizing hormone (LH) receptor, and occupied and unoccupied luteal receptors for LH.

PubMed

Weems, Yoshie S; Arreguin-Arevalo, J Alejandro; Nett, Torrance M; Vann, Rhonda C; Ford, Stephen P; Bridges, Phillip J; Welsh, Thomas H; Lewis, Andrew W; Neuendorff, Don A; Randel, Ronald D; Weems, Charles W

2011-08-01

Previously, it was reported that chronic intra-uterine infusion of PGE(1) or PGE(2) every four hours inhibited luteolysis in ewes. However, estradiol-17β or PGE(2) given intra-uterine every 8h did not inhibit luteolysis in heifers, but infusion of estradiol+PGE(2) inhibited luteolysis in heifers. The objective of this experiment was to determine whether and how intra-luteal implants containing PGE(1) or PGE(2) prevent luteolysis in Angus or Brahman cows. On day-13 post-estrus, Angus cows received no intra-luteal implant and corpora lutea were retrieved or Angus and Brahman cows received intra-luteal silastic implants containing Vehicle, PGE(1), or PGE(2) and corpora lutea were retrieved on day-19. Coccygeal blood was collected daily for analysis for progesterone. Breed did not influence the effect of PGE(1) or PGE(2) on luteal mRNA for LH receptors or unoccupied or occupied luteal LH receptors did not differ (P>0.05) so the data were pooled. Luteal weights of Vehicle-treated Angus or Brahman cows from days-13-19 were lower (P<0.05) than those treated with intra-luteal implants containing PGE(1) or PGE(2). Day-13 Angus luteal weights were heavier (P<0.05) than Vehicle-treated Angus cows on day-19 and luteal weights of day-13 corpora lutea were similar (P>0.05) to Angus cows on day-19 treated with intra-luteal implants containing PGE(1) or PGE(2). Profiles of circulating progesterone in Angus or Brahman cows treated with intra-luteal implants containing PGE(1) or PGE(2) differed (P<0.05) from controls, but profiles of progesterone did not differ (P>0.05) between breeds or between cows treated with intra-luteal implants containing PGE(1) or PGE(2). Intra-luteal implants containing PGE(1) or PGE(2) prevented (P<0.05) loss of luteal mRNA for LH receptors and unoccupied or occupied receptors for LH compared to controls. It is concluded that PGE(1) or PGE(2) alone delays luteolysis regardless of breed. We also conclude that either PGE(1) or PGE(2) prevented luteolysis in cows by up-regulating expression of mRNA for LH receptors and by preventing loss of unoccupied and occupied LH receptors in luteal tissue. Copyright © 2011 Elsevier Inc. All rights reserved.

The provision of patient personal hygiene in the intensive care unit: a descriptive exploratory study of bed-bathing practice.

PubMed

Coyer, Fiona M; O'Sullivan, Judy; Cadman, Nicola

2011-08-01

The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses' (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2-5 years ICU experience; and RNs with greater than 5 years ICU experience. During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00h in 161 episodes (30%), took 15-30min to complete (n=195, 36.2%) and was completed within the last 8h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n=379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n=86, 16.1%) or other agents such as pre-packaged washcloths (n=65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three levels of RN ICU experience highlighted a transition of patient hygiene practice philosophy from shades of grey - falling in line for inexperienced clinicians to experienced clinicians concrete beliefs about patient bed-bath needs. This study identified variation in process and products used in patient hygiene practices in four ICUs. Further study to improve patient outcomes is required to determine the appropriate timing of patient hygiene activities and cleansing agents used to improve skin integrity. Copyright © 2010 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

AIR PASSIVATION OF METAL HYDRIDE BEDS FOR WASTE DISPOSAL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klein, J; R. H. Hsu, R

2007-07-02

Metal hydride beds offer compact, safe storage of tritium. After metal hydride beds have reached the end of their useful life, the beds will replaced with new beds and the old beds prepared for disposal. One acceptance criteria for hydride bed waste disposal is that the material inside the bed not be pyrophoric. To determine the pyrophoric nature of spent metal hydride beds, controlled air ingress tests were performed. A simple gas handling manifold fitted with pressure transducers and a calibrated volume were used to introduce controlled quantities of air into a metal hydride bed and the bed temperature risemore » monitored for reactivity with the air. A desorbed, 4.4 kg titanium prototype hydride storage vessel (HSV) produced a 4.4 C internal temperature rise upon the first air exposure cycle and a 0.1 C temperature rise upon a second air exposure. A total of 346 scc air was consumed by the bed (0.08 scc per gram Ti). A desorbed, 9.66 kg LaNi{sub 4.25}Al{sub 0.75} prototype storage bed experienced larger temperature rises over successive cycles of air ingress and evacuation. The cycles were performed over a period of days with the bed effectively passivated after the 12th cycle. Nine to ten STP-L of air reacted with the bed producing both oxidized metal and water.« less

Artificial Gravity: Effects on Bone Turnover

NASA Technical Reports Server (NTRS)

Heer, M.; Zwart, S /R.; Baecker, N.; Smith, S. M.

2007-01-01

The impact of microgravity on the human body is a significant concern for space travelers. Since mechanical loading is a main reason for bone loss, artificial gravity might be an effective countermeasure to the effects of microgravity. In a 21-day 6 head-down tilt bed rest (HDBR) pilot study carried out by NASA, USA, the utility of artificial gravity (AG) as a countermeasure to immobilization-induced bone loss was tested. Blood and urine were collected before, during, and after bed rest for bone marker determinations. Bone mineral density was determined by DXA and pQCT before and after bed rest. Urinary excretion of bone resorption markers (n-telopeptide and helical peptide) were increased from pre-bed rest, but there was no difference between the control and the AG group. The same was true for serum c-telopeptide measurements. Bone formation markers were affected by bed rest and artificial gravity. While bone-specific alkaline phosphatase tended to be lower in the AG group during bed rest (p = 0.08), PINP, another bone formation marker, was significantly lower in AG subjects than CN before and during bed rest. PINP was lower during bed rest in both groups. For comparison, artificial gravity combined with ergometric exercise was tested in a 14-day HDBR study carried out in Japan (Iwase et al. J Grav Physiol 2004). In that study, an exercise regime combined with AG was able to significantly mitigate the bed rest-induced increase in the bone resorption marker deoxypyridinoline. While further study is required to more clearly differentiate bone and muscle effects, these initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest and spaceflight. Future studies will need to optimize not only the AG prescription (intensity and duration), but will likely need to include the use of exercise or other combined treatments.

Horizontal Transfer of Diatomaceous Earth and Botanical Insecticides in the Common Bed Bug, Cimex lectularius L.; Hemiptera: Cimicidae

PubMed Central

Akhtar, Yasmin; Isman, Murray B.

2013-01-01

Background Horizontal transfer of insecticide occurs when insects contact or ingest an insecticide, return to an aggregation or a nest, and transfer the insecticide to other conspecific insects through contact. This phenomenon has been reported in a number of insects including social insects, however it has not been reported in bed bugs. Since horizontal transfer can facilitate the spread of insecticide into hard to reach spaces, it could contribute greatly to the management of these public health pests. Methodology/Results To demonstrate horizontal transfer of diatomaceous earth and botanical insecticides in C. lectularius, an exposed (donor) bed bug, following a 10-minute acquisition period, was placed with unexposed (recipient) bed bugs. Mortality data clearly demonstrates that diatomaceous earth (DE 51) was actively transferred from a single exposed bug to unexposed bugs in a concentration dependent manner. LC50 values varied from 24.4 mg at 48 h to 5.1 mg at 216 h when a single exposed bed bug was placed with 5 unexposed bed bugs. LT50 values also exhibited a concentration response. LT50 values varied from 1.8 days to 8.4 days when a ‘donor’ bug exposed to 20 and 5 mg of dust respectively was placed with 5 ‘recipient’ bugs. Dust was also actively transferred from adult bed bugs to the nymphs. In addition we observed horizontal transfer of botanical insecticides including neem, ryania, and rotenone to varying degrees. Conclusion/Significance Our data clearly demonstrate horizontal transfer of diatomaceous earth and botanical insecticides in the common bed bug, C. lectularius. Use of a fluorescent dust provided visual confirmation that contaminated bed bugs transfer dust to untreated bed bugs in harborage. This result is important because bedbugs live in hard-to-reach places and interaction between conspecifics can be exploited for delivery and dissemination of management products directed at this public health pest. PMID:24086593

Horizontal transfer of diatomaceous earth and botanical insecticides in the common bed bug, Cimex lectularius L.; hemiptera: cimicidae.

PubMed

Akhtar, Yasmin; Isman, Murray B

2013-01-01

Horizontal transfer of insecticide occurs when insects contact or ingest an insecticide, return to an aggregation or a nest, and transfer the insecticide to other conspecific insects through contact. This phenomenon has been reported in a number of insects including social insects, however it has not been reported in bed bugs. Since horizontal transfer can facilitate the spread of insecticide into hard to reach spaces, it could contribute greatly to the management of these public health pests. To demonstrate horizontal transfer of diatomaceous earth and botanical insecticides in C. lectularius, an exposed (donor) bed bug, following a 10-minute acquisition period, was placed with unexposed (recipient) bed bugs. Mortality data clearly demonstrates that diatomaceous earth (DE 51) was actively transferred from a single exposed bug to unexposed bugs in a concentration dependent manner. LC50 values varied from 24.4 mg at 48 h to 5.1 mg at 216 h when a single exposed bed bug was placed with 5 unexposed bed bugs. LT50 values also exhibited a concentration response. LT50 values varied from 1.8 days to 8.4 days when a 'donor' bug exposed to 20 and 5 mg of dust respectively was placed with 5 'recipient' bugs. Dust was also actively transferred from adult bed bugs to the nymphs. In addition we observed horizontal transfer of botanical insecticides including neem, ryania, and rotenone to varying degrees. Our data clearly demonstrate horizontal transfer of diatomaceous earth and botanical insecticides in the common bed bug, C. lectularius. Use of a fluorescent dust provided visual confirmation that contaminated bed bugs transfer dust to untreated bed bugs in harborage. This result is important because bedbugs live in hard-to-reach places and interaction between conspecifics can be exploited for delivery and dissemination of management products directed at this public health pest.

Public hospital bed crisis: too few or too misused?

PubMed

Scott, Ian A

2010-08-01

* Increasing demand on public hospital beds has led to what many see as a hospital bed crisis requiring substantial increases in bed numbers. By 2050, if current bed use trends persist and as the numbers of frail older patients rise exponentially, a 62% increase in hospital beds will be required to meet expected demand, at a cost almost equal to the entire current Australian healthcare budget. * This article provides an overview of the effectiveness of different strategies for reducing hospital demand that may be viewed as primarily (although not exclusively) targeting the hospital sector - increasing capacity and throughput and reducing readmissions - or the non-hospital sector - facilitating early discharge or reducing presentations and admissions to hospital. Evidence of effectiveness was retrieved from a literature search of randomised trials and observational studies using broad search terms. * The principal findings were as follows: (1) within the hospital sector, throughput could be substantially improved by outsourcing public hospital clinical services to the private sector, undertaking whole-of-hospital reform of care processes and patient flow that address both access and exit block, separating acute from elective beds and services, increasing rates of day-only or short stay admissions, and curtailing ineffective or marginally effective clinical interventions; (2) in regards to the non-hospital sector, potentially the biggest gains in reducing hospital demand will come from improved access to residential care, rehabilitation services, and domiciliary support as patients awaiting such services currently account for 70% of acute hospital bed-days. More widespread use of acute care and advance care planning within residential care facilities and population-based chronic disease management programs can also assist. * This overview concludes that, in reducing hospital bed demand, clinical process redesign within hospitals and capacity enhancement of non-hospital care services and chronic disease management programs are effective strategies that should be considered before investing heavily in creating additional hospital beds devoid of any critical reappraisal of current models of care.

A financial ratio analysis of for-profit and non-profit rural referral centers.

PubMed

McCue, Michael J; Nayar, Preethy

2009-01-01

National financial data show that rural referral center (RRC) hospitals have performed well financially. RRC hospitals' median cash flow margin ratio was 10.04% in 2002 and grew to 11.04% in 2004. The aim of this study is to compare the ratio analysis of key operational and financial performance measures of for-profit RRCs to those of private, non-profit RRCs. To control for accounting aberrations within a given year, we selected RRCs that reported 3 consecutive fiscal years of Centers for Medicare and Medicaid Services (CMS) cost report data, starting with fiscal year 2004 and ending with fiscal year 2006. Given a limited sample size of 28 for-profit RRCs and 127 non-profits, we used the non-parametric median test to assess median differences in operational and key financial measures between the 2 groups. For-profit RRCs treated less complex cases and reported fewer discharges per bed and fewer occupied beds than did non-profits. However, for-profit RRCs staffed their beds with fewer full-time-equivalent (FTE) personnel and served a higher proportion of Medicaid patients. For-profit RRCs generated operating cash flow margins in excess of 19%, compared to only 8.1% for non-profits, and maintained newer plant and equipment. For-profit RRCs generated a substantially higher cash flow margin by controlling their operating costs.

[Calmette Hospital, Phnom Penh, Cambodia. Assessment of the implementation of the Medical Information System (SIM). Global analysis of the 1998 results].

PubMed

Fabre-Teste, B; Sokha, O

1999-01-01

Calmette is a national university hospital with 220 adult beds. It has emergency, surgical, medical and gynecology and obstetrics departments, along with a radiology unit, a laboratory for medical analyses, a central pharmacy and an outpatient clinic. This hospital has an unusual statute, with managerial autonomy and a system of cost recovery that currently provides 64% of the hospital's income. Since 1994, it has benefited from a French cooperation program. The French NGO, Médecins du Monde, has been present at Calmette since 1990, providing support for , the indigent sector of the medical department. The aim of the Medical Information System (SIM) is to develop a simple, reliable and reproducible system so that, for every action undertaken at the hospital (hospitalization, day hospital and outpatient clinic) the following pieces of information are recorded: 1) the disease; 2) the type of patient; 3) the type of management; 4) the means used to treat the patient; 5) the cost. Data are collected and analyzed using programs created with EPIINFO software (CDC, WHO), using the EPIGLUE module. In 1998, 10,814 admissions were recorded at Calmette Hospital, 7,811 (72.2%) of which were to the Emergency Department and 3,003 (27.2%) of which were direct admissions to other wards. We analyzed 10,603 (95%) computerized medical summaries (RMI). About 50% of beds were occupied in the maternity and gynecology ward whereas almost 90% of beds were occupied in the surgical and emergency wards. AIDS and tuberculosis were the conditions most frequently treated by the medical department, despite a marked increase in more specialized areas of medicine such as cardiology and diabetology. The surgical department reflected the concentration on emergency services of the hospital, with cranial traumatism the primary reason for admission for the hospital as a whole. The mean age of patients was 27 years for the maternity ward and 49 years for the medicine A ward. The mortality rate was about 5% for the medical wards (mainly due to AIDS) and almost 50% in the emergency department (cerebrovascular neurologic disease, cranial traumatism). The proportion of nonpaying patients was high (about 40% in terms of stays in hospital and about 50% of all days spent in hospital). The training of a Cambodian manager for the SIM is a key priority. The point of the SIM is to use the treated data it produces to improve management and decision-making. The data it produces should be used to define the profile of the patients treated, both from a medical point of view and in terms of their ability to pay. This is a fundamental step towards identifying activities that should receive priority as part of a development strategy for a structure evolving in a highly competitive environment. The SIM data are also invaluable for the short-term management of the hospital through the contribution they make to the development of effective analytical accounting, making it possible to evaluate costs and to adjust charges appropriately. Finally, the involvement of the SIM in the setting up and functioning of the Comité de Lutte Contre les Infections Nosocomiales (CLIN; the Hospital-Acquired Infections Committee) in 1999 to 2000 is not utopia, it is the logical continuation of improvements in the overall quality of care It involves, in particular, the training of nurses and head nurses, initiated by nurses acting as technical assistants in the French cooperation program. The definition of the role of the hygiene nurse and the selection of such a nurse from the trained head nurses are also part of this process.

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2012 CFR

2012-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2010 CFR

2010-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

Neuroprotective Effect of Hydroxytyrosol in Experimental Diabetic Retinopathy: Relationship with Cardiovascular Biomarkers.

PubMed

González-Correa, José Antonio; Rodríguez-Pérez, María Dolores; Márquez-Estrada, Lucía; López-Villodres, Juan Antonio; Reyes, José Julio; Rodriguez-Gutierrez, Guillermo; Fernández-Bolaños, Juan; De La Cruz, José Pedro

2018-01-24

The aim of the study was to test the neuroprotective effect of hydroxytyrosol (HT) on experimental diabetic retinopathy. Animals were divided in four groups: (1) control nondiabetic rats, (2) streptozotocin-diabetic rats (DR), (3) DR treated with 1 mg/kg/day p.o. HT, and (4) DR treated with 5 mg/kg/day p.o. HT. Treatment with HT was started 7 days before inducing diabetes and was maintained for 2 months. In the DR group, total area occupied by extracellular matrix was increased, area occupied by retinal cells was decreased; both returned to near-control values in DR rats treated with HT. The number of retinal ganglion cells in DR was significantly lower (44%) than in the control group, and this decrease was smaller after HT treatment (34% and 9.1%). Linear regression analysis showed that prostacyclin, platelet aggregation, peroxynitrites, and the dose of 5 mg/kg/day HT significantly influenced retinal ganglion cell count. In conclusion, HT exerted a neuroprotective effect on diabetic retinopathy, and this effect correlated significantly with changes in some cardiovascular biomarkers.

Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial.

PubMed

Moradian, Seyed Tayeb; Najafloo, Mohammad; Mahmoudi, Hosein; Ghiasi, Mohammad Saeid

2017-09-01

Atelectasis and pleural effusion are common after coronary artery bypass graft surgery (CABG). Longer stay in the bed is one of the most important contributing factors in pulmonary complications. Some studies confirm the benefits of early mobilization (EM) in critically ill patients, but the efficacy of EM on pulmonary complications after CABG is not clear. This study was designed to examine the effect of EM on the incidence of atelectasis and pleural effusion in patients undergoing CABG. In a single-blinded randomized clinical trial, 100 patients who were undergoing coronary artery bypass graft surgery were randomly assigned into two groups each consisted of 50 patients. Patients in the experimental group were enrolled in a mobilization protocol consisting of the mobilization from the bed in the first 3 days after surgery in the morning and evening. Patients in the control group were mobilized from bed in third postoperation day, according to the hospital routine. Arterial blood gases, pleural effusion, and atelectasis were compared between groups. Atelectasis and pleural effusion was reduced in experimental group. The partial pressure of oxygen in arterial blood in third postoperative day and the percentage of arterial oxygen saturation in the fourth postoperative day were higher in the intervention group (P value < .05). EM from bed could be an effective intervention in reducing atelectasis and pleural effusion in patients undergoing CABG. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

Effect of air-supported, continuous, postural oscillation on the risk of early ICU pneumonia in nontraumatic critical illness.

PubMed

deBoisblanc, B P; Castro, M; Everret, B; Grender, J; Walker, C D; Summer, W R

1993-05-01

We hypothesized that continuous, automatic turning utilizing a patient-friendly, low air loss surface would reduce the incidence of early ICU pneumonia in selected groups of critically ill medical patients. Prospective, randomized, controlled clinical trial. Medical ICU of a large community teaching hospital. One hundred twenty-four critically ill new admissions to the medical ICU at Charity Hospital in New Orleans. Patients were prospectively randomized within one of five diagnosis-related groups (DRG)--sepsis (SEPSIS), obstructive airways disease (OAD), metabolic coma, drug overdose, and stroke--to either routine turning on a standard ICU bed or to continuous turning on an oscillating air-flotation bed for a total of five days. Patients were monitored daily during the treatment period for the development of pneumonia. The incidence of pneumonia during the first five ICU days was 22 percent in patients randomized to the standard ICU bed vs 9 percent for the oscillating bed (p = 0.05). This treatment effect was greatest in the SEPSIS DRG (23 percent vs 3 percent, p = 0.04). Continuous automatic oscillation did not significantly change the number of days of required mechanical ventilation, ICU stay, hospital stay, or hospital mortality overall or within any of the DRGs. We conclude that air-supported automated turning during the first five ICU days reduces the incidence of early ICU pneumonia in selected DRGs; however, this form of automated turning does not reduce other measured clinical outcome parameters.

Design and operation of a batch-feed fluidizing bed aerosol generator for inhalation toxicity studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shiotsuka, R.N.; Peck, R.W. Jr.; Drew, R.T.

1985-02-01

A fluidizing bed aerosol generator (FBG), designed for inhalation toxicity studies, was constructed and tested. A key design feature contributing to its operational stability was the partial masking of the screen supporting the bronze beads. This caused 20-80% of the bed to fluidize under normal operating conditions. The non-fluidizing areas functioned as reservoirs to feed the fluidizing areas. Using a bed volume of 1000 cc of bronze beads and 20 g of MnO/sub 2/ dust, the mass output rate ranged from 0.1 to 1.0 mg/min when operated at plenum pressures of 1.04 x 10/sup 2/ to 2.42 x 10/sup 2/more » kPa (minimum fluidization pressure was approximately 82.8 kPa). During daily operation at three different output rates, the FBG produced aerosols with little change in particle size distributions or concentration when operated six hours/day for five days. Furthermore, when the FBG was operated at a fixed output rate for 15 days with two recharges of MnO/sub 2/ dust, the particle size distribution did not show any cumulative increase. Thus, long-term operation of this FBG should result in a reproducible range of concentration and particle size distribution.« less

Capacity planning for maternal-fetal medicine using discrete event simulation.

PubMed

Ferraro, Nicole M; Reamer, Courtney B; Reynolds, Thomas A; Howell, Lori J; Moldenhauer, Julie S; Day, Theodore Eugene

2015-07-01

Maternal-fetal medicine is a rapidly growing field requiring collaboration from many subspecialties. We provide an evidence-based estimate of capacity needs for our clinic, as well as demonstrate how simulation can aid in capacity planning in similar environments. A Discrete Event Simulation of the Center for Fetal Diagnosis and Treatment and Special Delivery Unit at The Children's Hospital of Philadelphia was designed and validated. This model was then used to determine the time until demand overwhelms inpatient bed availability under increasing capacity. No significant deviation was found between historical inpatient censuses and simulated censuses for the validation phase (p = 0.889). Prospectively increasing capacity was found to delay time to balk (the inability of the center to provide bed space for a patient in need of admission). With current capacity, the model predicts mean time to balk of 276 days. Adding three beds delays mean time to first balk to 762 days; an additional six beds to 1,335 days. Providing sufficient access is a patient safety issue, and good planning is crucial for targeting infrastructure investments appropriately. Computer-simulated analysis can provide an evidence base for both medical and administrative decision making in a complex clinical environment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anaerobic treatment of winery wastewater in fixed bed reactors.

PubMed

Ganesh, Rangaraj; Rajinikanth, Rajagopal; Thanikal, Joseph V; Ramanujam, Ramamoorty Alwar; Torrijos, Michel

2010-06-01

The treatment of winery wastewater in three upflow anaerobic fixed-bed reactors (S9, S30 and S40) with low density floating supports of varying size and specific surface area was investigated. A maximum OLR of 42 g/l day with 80 +/- 0.5% removal efficiency was attained in S9, which had supports with the highest specific surface area. It was found that the efficiency of the reactors increased with decrease in size and increase in specific surface area of the support media. Total biomass accumulation in the reactors was also found to vary as a function of specific surface area and size of the support medium. The Stover-Kincannon kinetic model predicted satisfactorily the performance of the reactors. The maximum removal rate constant (U(max)) was 161.3, 99.0 and 77.5 g/l day and the saturation value constant (K(B)) was 162.0, 99.5 and 78.0 g/l day for S9, S30 and S40, respectively. Due to their higher biomass retention potential, the supports used in this study offer great promise as media in anaerobic fixed bed reactors. Anaerobic fixed-bed reactors with these supports can be applied as high-rate systems for the treatment of large volumes of wastewaters typically containing readily biodegradable organics, such as the winery wastewater.

Grouped comparisons of sleep quality for new and personal bedding systems.

PubMed

Jacobson, Bert H; Wallace, Tia J; Smith, Doug B; Kolb, Tanner

2008-03-01

The purpose of this study was to compare sleep comfort and quality between personal and new bedding systems. A convenience sample (women, n=33; men, n=29) with no clinical history of disturbed sleep participated in the study. Subjects recorded back and shoulder pain, sleep quality, comfort, and efficiency for 28 days each in their personal beds (pre) and in new medium-firm bedding systems (post). Repeated measures ANOVAs revealed significant improvement between pre- and post-test means for all dependent variables. Furthermore, reduction of pain and stiffness and improvement of sleep comfort and quality became more prominent over time. No significant differences were found for the groupings of age, weight, height, or body mass index. It was found that for the cheapest category of beds, lower back pain was significantly (p<0.01) more prominent than for the medium and higher priced beds. Average bed age was 9.5yrs. It was concluded that new bedding systems can significantly improve selected sleep variables and that continuous sleep quality may be dependent on timely replacement of bedding systems.

Atropine unmasks bed-rest effect - A spectral analysis of cardiac interbeat intervals

NASA Technical Reports Server (NTRS)

Goldberger, Ary L.; Goldwater, Danielle; Bhargava, Valmik

1986-01-01

Heart rate spectral data obtained for 10 male subjects between 35-49 years following orthostatic tolerance testing with lower body negative pressure prebed rest and after 7-10 days of bed rest, while on placebo and after intravenous atropine are analyzed. Comparison of the spectral atropine rms for subjects prebed rest and after bed rest reveal a decrease from 63 + or - 24 ms to 40 + or - 23 ms. It is observed that heart rate interval variability for subjects after bed rest and with atropine is reduced; the heart rate at bed rest with atropine is increased from 70.4 + or - 12.4 beats/min prebed rest to 83.7 + or - 18.9 beats/min; and the exercise tolerance time for subjects in the atropine prebed-rest phase (658 + or - 352 s) is higher than the bed-rest phase (505 + or - 252 s). It is noted that bed rest impairs the cardiovascular capacity to adaptively modulate physiological responses, atropine exposes bed-rest deconditioning effects, and spectral analysis is useful for studying the effects of bed-rest deconditioning on cardiac dynamics.

Bed rest from the perspective of the high-risk pregnant woman.

PubMed

Gupton, A; Heaman, M; Ashcroft, T

1997-01-01

To describe the experience of prolonged bed rest from the perspective of women during high-risk pregnancies. A focused ethnographic study that used interviews, participant diaries, and field notes as data sources. Participants were obtained from an acute-care hospital antepartum unit and an antepartum home care program. Twenty-four women with complications of pregnancy requiring prolonged bed rest (range, 7-50 days). A model of the stress process in pregnant women on bed rest emerged from the data analysis. Stressors were grouped into situational (sick role, lack of control, uncertainty, concerns regarding fetus's well-being, and being tired of waiting), environmental (feeling like a prisoner, being bored, and having a sense of missing out), and family (role reversal and worry about older children) categories. Two main mediators of stress were social support and coping. Families, friends, and professionals were perceived as sources of support. Women used coping strategies, such as keeping a positive attitude, taking it 1 day at a time, doing it for the baby, getting used to it, setting goals, and keeping busy. Manifestations of stress were evidenced by adverse physical symptoms, emotional reactions, and altered social relationships. Prolonged bed rest is a stressful experience for pregnant women at high risk. Understanding the stress process in pregnant women confined to bed rest may assist nurses in developing interventions to reduce stressors and enhance mediators.

Retrospective analysis of treatment modalities in diabetic muscle infarction

PubMed Central

Onyenemezu, Ikenna; Capitle, Eugenio

2014-01-01

Background Diabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI. Methods We searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate. Results Mean time to recovery was 149 (95% confidence interval [CI] 113–186), 71 (95% CI 47–96), and 43 (95% CI 30–57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (P<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively. Conclusion Our results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeutic option compared with surgical treatment. PMID:27790029

Clinical treatment of orthostatic hypotension after spinal cord injury with training based on electric uprise bed coupled with remote ECG and BP monitor.

PubMed

Shen, Dantong; Huang, Huai; Yuan, Hui; Zhang, Xu; Li, Min

2014-12-22

The treatment for orthostatic hypotension (OH) after spinal cord injury (SCI) is an important part of rehabilitation in late-stage SCI. Electric uprise bed training is a relatively commonly used method in treating OH, and how to carry out uprise bed training safely and effectively is an urgent problem. In the early stage of SCI, we used a remote monitoring system to monitor the whole process of uprise bed training, and we explored a safe and efficient method of electric uprise bed training. The experimental group consisted of 36 patients diagnosed with orthostatic hypotension (OH) after SCI and who received training with an electric uprise bed coupled with remote monitoring system, and the control group of 18 subjects who used a traditional training method. There were no differences in baseline data between the 2 groups. There were no severe symptoms during training in the experimental group, but 3 patients had severe symptoms in the control group. Among the 32 enrolled subjects reaching upright training status within 30 days (17 subjects in the experimental group and 15 subjects in the control group), time interval of training from horizontal position to erect position in the experimental group was 18.00±3.12 days and 21.40±4.95 days in the control group. Time interval in the experimental group was significantly less than in the control group. However, among all 36 subjects, by combining results of follow-up, there was no significant difference of time interval of training from horizontal position to erect position between the experimental group and the control group. In the experimental group 90.52% of patients finished training compared to 78.19% in the control group (P<0.01). After training, values of OCs and OCd of the experimental group were lower than in the control group. There was no significant difference between groups in number of re-diagnosed OH. Implementation of training with electric uprise bed coupled with remote monitoring system is generally safe for patients with OH after SCI. For patients who could reach standing training status within 30 days, implementation can improve efficiency of training by shortening time interval of training from horizontal position to erect position. It can increase orthostatic blood pressure change during position change.

Skin graft take and healing following 193-nm excimer, continuous-wave carbon dioxide (CO2), pulsed CO2, or pulsed holmium: YAG laser ablation of the graft bed.

PubMed

Green, H A; Burd, E E; Nishioka, N S; Compton, C C

1993-08-01

Ablative lasers have been used for cutaneous surgery for greater than two decades since they can remove skin and skin lesions bloodlessly and efficiently. Because full-thickness skin wounds created after thermal laser ablation may require skin grafting in order to heal, we have examined the effect of the residual laser-induced thermal damage in the wound bed on subsequent skin graft take and healing. In a pig model, four different pulsed and continuous-wave lasers with varying wavelengths and radiant energy exposures were used to create uniform fascial graft bed thermal damage of approximately 25, 160, 470, and 1100 microns. Meshed split-thickness skin graft take and healing on the thermally damaged fascial graft beds were examined on a gross and microscopic level on days 3 and 7, and then weekly up to 42 days. Laser-induced thermal damage on the graft bed measuring greater than 160 +/- 60 microns in depth significantly decreased skin graft take. Other deleterious effects included delayed graft revascularization, increased inflammatory cell infiltrate at the graft-wound bed interface, and accelerated formation of hypertrophied fibrous tissue within the graft bed and underlying muscle. Ablative lasers developed for cutaneous surgery should create less than 160 +/- 60 microns of residual thermal damage to permit optimal skin graft take and healing. Pulsed carbon dioxide and 193-nm excimer lasers may be valuable instruments for the removal of full-thickness skin, skin lesions, and necrotic tissue, since they create wound beds with minimal thermal damage permitting graft take comparable to that achieved with standard surgical techniques.

Caseload of NHS plastic surgeons in Scotland, 2005-2006: analysis of Scottish hospital activity data.

PubMed

Brewster, Colin T; Shoaib, Taimur

2009-04-01

To assess the contemporary caseload of NHS plastic surgeons. Descriptive study. Scotland. Analysis of routinely collected NHS hospital activity data relating to the financial year 2005-2006. Number of inpatient/day-case episodes and bed-days by principal diagnosis and main operative procedure. During the study period, 12,844 inpatient and 9439 day-case episodes were recorded in 19,166 patients, accounting for 36,300 bed-days. There were more female patients, especially among middle-age groups. Socioeconomic deprivation was more common than expected (P < 0.0001), especially among younger age groups and male patients. In terms of episodes, the most common categories of diagnosis were neoplasms (28.4%) and injuries, including burns (22.4%). However, injuries accounted for a higher proportion of bed-days (37.3%) than neoplasms (23.8%). Only approximately half of all surgical procedures were assigned to the skin chapter of the OPCS-4 classification. Despite some limitations, this study provides an insight into the current caseload of NHS plastic surgeons working in Scotland. The data suggest that cosmetic surgery for purely aesthetic reasons represents a relatively small part of NHS plastic surgery activity in Scotland, and that the majority of caseload is in reconstructive plastic surgery.

Effect of prolonged LBNP and saline ingestion on plasma volume and orthostatic responses during bed rest

NASA Technical Reports Server (NTRS)

Fortney, Suzanne M.; Dussack, Larry; Rehbein, Tracy; Wood, Margie; Steinmann, Laura

1991-01-01

Orthostatic intolerance remains a significant problem following space flight despite frequent use of the saline fluid-loading countermeasure and volitional use of an anti-gravity suite during reentry and landing. The purpose of this project is to examine the plasma volume (PV), endocrine, and orthostatic responses of bedrested subjects following 2-hr and 4-hr treatments of lower body negative pressure (LBNP) and saline ingestion. Ten healthy men were randomly assigned into 2 groups. Group A underwent a 4-hr LBNP/saline treatment on best rest day 5 and the 2-hr treatment on day 11. Group B underwent the 2-hr treatment on day 6 and the 4-hr treatment on day 10. Blood volume was determined before and after bed rest using radiolabelling. Changes in PV between measurements were calculated from changes in hematocrit and estimated red cell volume. Urinary excretion of anti-diuretic hormone (ADH) and aldosterone (ALD) were measured each day during the study. Orthostatic responses were measured using a ramp LBNP protocol before bed rest, before each treatment, and 24 hours after each treatment. Both 2-hr and 4-hr treatments resulted in a restoration of PV to pre-bed rest levels which persisted at least 24 hours. This increase in PV was associated with significant increases in urinary excretion of ADH and ALD. Twenty-four hours after the 4-hr treatment, the heart rate and pulse pressure response to LBNP were significantly lower and stroke volumes during LBNP were increased. Twenty-four hours after the 2-hr treatment, there was no evidence of improvement in orthostatic responses. These results suggest that a countermeasure which simply restores PV during space flight may not be sufficient for restoring orthostatic responses.

Effects of space flight and -6 degrees bed rest on the neuroendocrine response to metabolic stress in physically fit subjects.

PubMed

Ksinantová, Lucia; Koska, Juraj; Martinkovic, Miroslav; Vigas, Milan; Macho, Ladislav; Kvetnansky, Richard

2004-06-01

The aim of this study was to evaluate the association of plasma epinephrine (EPI) and norepinephrine (NE) responses to insulin-induced hypoglycemia (ITT) 3 weeks before the space flight (SF), on the fifth day of SF, on days 2 and 16 after landing in the first Slovak astronaut, and before and on the fifth day of prolonged bed rest (BR) in 15 military aircraft pilots, aged 33.5 +/- 1.4 years, body mass index (BMI) 26.5 +/- 0.7 kg/m(2), maximal oxygen uptake (VO(2max)) 55.2 +/- 2.4 mL/kg/min, who volunteered for the study. ITT was induced by i.v. administrations of 0.1 IU/kg body weight insulin (Actrapid HM) in a bolus. Insulin administration led to a comparable hypoglycemia in preflight, actual flight conditions, and before and after bed rest. ITT led to a pronounced increase in EPI levels and moderate increase in NE in preflight studies. However, an evidently reduced plasma elevation of EPI was found after insulin administration during SF and during BR. Thus, during the real microgravity in SF and simulated microgravity in BR, ITT activates the adrenomedullary system to less extent that at conditions of the Earth's gravitation. Post-flight changes in EPI and NE did not differ from those of preflight values, since SF was relatively short (8 days) and the readaptation to Earth's gravitation was fast. It seems that an increased blood flow in brain might be responsible for the reduced EPI response to insulin. Responses to ITT in physically fit subjects indicate the stimulus specificity of the deconditioning effect of 5 days of bed rest on the stress response.

Mortality, Temporary Sterilization, and Maternal Effects of Sublethal Heat in Bed Bugs

PubMed Central

Rukke, Bjørn Arne; Aak, Anders; Edgar, Kristin Skarsfjord

2015-01-01

Adult bed bugs were exposed to the sublethal temperatures 34.0°C, 35.5°C, 37.0°C, 38.5°C, or 40.0°C for 3, 6, or 9 days. The two uppermost temperatures induced 100% mortality within 9 and 2 days, respectively, whereas 34.0°C had no observable effect. The intermediate temperatures interacted with time to induce a limited level of mortality but had distinct effects on fecundity, reflected by decreases in the number of eggs produced and hatching success. Adult fecundity remained low for up to 40 days after heat exposure, and the time until fertility was restored correlated with the temperature-sum experienced during heat exposure. Three or 6 days of parental exposure to 38.5°C significantly lowered their offspring’s feeding and moulting ability, which consequently led to a failure to continue beyond the third instar. Eggs that were deposited at 22.0°C before being exposed to 37.0°C for 3 or 6 days died, whereas eggs that were exposed to lower temperatures were not significantly affected. Eggs that were deposited during heat treatment exhibited high levels of mortality also at 34.0°C and 35.5°C. The observed negative effects of temperatures between 34.0°C and 40.0°C may be utilized in pest management, and sublethal temperature exposure ought to be further investigated as an additional tool to decimate or potentially eradicate bed bug populations. The effect of parental heat exposure on progeny demonstrates the importance of including maternal considerations when studying bed bug environmental stress reactions. PMID:25996999

Reserve Drug Indent Form and Its Impact on Antimicrobial Consumption and Sensitivity Pattern in the Medical Intensive Care Unit of a Tertiary Care Hospital

PubMed Central

Anitha, K.B.; Rai, Mohandas; Fernandes, Anisha

2015-01-01

Objectives: A world without effective antibiotics is a terrifying but a real prospect. Overuse or misuse especially of newer and higher antimicrobials (AM) is of particular concern, as this contributes to development of resistance among microorganisms. To check this trend, the Reserve Drug Indent Form (RDIF) was introduced in our hospital and its impact on AM consumption, cost of therapy and the sensitivity pattern was studied in the medical intensive care unit (MICU). Materials and Methods: A retrospective descriptive study in the medical ICU of a tertiary care hospital from July 2012 to August 2013. From March 2013, RDIF was made mandatory to be filled up prior to prescribing reserve antimicrobials. AM consumption (expressed as DDD/100 bed days) and sensitivity pattern (expressed in percentage) six months prior to and six months after implementation of the form were analysed. Results: The total Reserve AM consumption was 125.79 per 100 bed days during the study period. Average occupancy index was 0.50 and length of ICU stay was 6 days. The total consumption reduced from 85.55/100 to 40.24/100 bed days after the introduction of the RDIF. However, Imipenem usage increased from 11.35/100 to 23.94/100 bed days, which can be attributed to sensitivity profile to Imipenem (82.1%) compared to Meropenem (65.7%). Cost of therapy reduced from Rs 6,27,951 to 4,20,469. Conclusion: Reserve AM consumption showed a declining trend after introduction of the RDIF. Hence, the RDIF served as an important tool to combat inappropriate use, reducing the cost burden and also helped to improve the sensitivity to reserve drugs. PMID:25859466

Effect of high sodium intake during 14 days of bed-rest on acid-base balance

NASA Astrophysics Data System (ADS)

Frings, P.; Baecker, N.; Heer, M.

Lowering mechanical load like in microgravity is the dominant stimulus leading to bone loss However high dietary sodium intake is also considered as a risk factor for osteoporosis and thereby might exacerbate the microgravity induced bone loss In a metabolic balance non bed-rest study we have recently shown that a very high sodium intake leads to an increased bone resorption most likely because of a mild metabolic acidosis Frings et al FASEB J 19 5 A1345 2005 To test if mild metabolic acidosis also occurs during immobilization we examined the effect of increased dietary sodium on bone metabolism and acid-base balance in eight healthy male test subjects mean age 26 25 pm 3 49 years body weight 77 98 pm 4 34 kg in our metabolic ward during a 14-day head-down tilt HDT bed-rest study The study was designed as a randomized crossover study with two study periods Each period was divided into three parts 4 ambulatory days with 200 mmol sodium intake 14 days of bed-rest with either 550 mmol or 50 mmol sodium intake and 3 recovery days with 200 mmol sodium intake The sodium intake was altered by variations in dietary sodium chloride content Blood pH P CO2 and P O2 were analyzed in fasting morning fingertip blood samples several times during the entire study Bicarbonate HCO 3 - and base excess BE were calculated according to the Henderson-Hasselbach equation Preliminary results in the acid-base balance from the first study period 4 subjects with 550 mmol and 4 subjects with 50 mmol sodium intake strongly

Whey protein with potassium bicarbonate supplement attenuates the reduction in muscle oxidative capacity during 19 days of bed rest.

PubMed

Bosutti, Alessandra; Salanova, Michele; Blottner, Dieter; Buehlmeier, Judith; Mulder, Edwin; Rittweger, Jörn; Yap, Moi Hoon; Ganse, Bergita; Degens, Hans

2016-10-01

The effectiveness of whey protein plus potassium bicarbonate-enriched diet (WP+KHCO 3 ) in mitigating disuse-induced changes in muscle fiber oxidative capacity and capillarization was investigated in a 21-day crossover design bed rest study. Ten healthy men (31 ± 6 yr) once received WP+KHCO 3 and once received a standardized isocaloric diet. Muscle biopsies were taken 2 days before and during the 19th day of bed rest (BR) from the soleus (SOL) and vastus lateralis (VL) muscle. Whole-body aerobic power (V̇o 2 max ), muscle fatigue, and isometric strength of knee extensor and plantar flexor muscles were monitored. Muscle fiber types and capillaries were identified by immunohistochemistry. Fiber oxidative capacity was determined as the optical density (OD) at 660 nm of succinate dehydrogenase (SDH)-stained sections. The product of fiber cross-sectional area and SDH-OD (integrated SDH) indicated the maximal oxygen consumption of that fiber. The maximal oxygen consumption supported by a capillary was calculated as the integrated SDH in its supply area. BR reduced isometric strength of knee extensor muscles (P < 0.05), and the fiber oxidative capacity (P < 0.001) and V̇o 2 max (P = 0.042), but had no significant impact on muscle capillarization or fatigue resistance of thigh muscles. The maximal oxygen consumption supported by a capillary was reduced by 24% in SOL and 16% in VL (P < 0.001). WP+KHCO 3 attenuated the disuse-induced reduction in fiber oxidative capacity in both muscles (P < 0.01). In conclusion, following 19 days of bed rest, the decrement in fiber oxidative capacity is proportionally larger than the loss of capillaries. WP+KHCO 3 appears to attenuate disuse-induced reductions in fiber oxidative capacity. Copyright © 2016 the American Physiological Society.

Marginal bed load transport in a gravel bed stream, Sagehen Creek, California

USGS Publications Warehouse

Andrews, E.D.

1994-01-01

Marginal bed load transport describes the condition when relatively few bed particles are moving at any time. Bed particles resting in the shallowest bed pockets will move when the dimensionless shear stress т* exceeds a value of about 0.020. As т* increases, the number of bed particles moving increases. Significant motion of bed particles, i.e., when a substantial fraction of the bed particles are moving, occurs when т* exceeds a value of about 0.060. Thus marginal bed load transport occurs over the domain 0.020 < т* < 0.060. Marginal bed load transport rates and associated hydraulic characteristics of Sagehen Creek, a small mountain gravel bed stream, were measured on 55 days at discharges ranging from slightly less than one half of the bank-full discharge to more than 4 times the bank-full discharge. Dimensionless shear stress varied from 0.032 to 0.042, and bed particles as large as the 80th percentile of the bed surface were transported. The relation between reference dimensionless shear stress and relative particle protrusion for Sagehen Creek was determined by varying т*ri to obtain the best fit of the Parker bed load function to the measured transport rates. During the period of record (water years 1954–1991), the mean annual quantity of bed load transported past the Sagehen Creek gage was 24.7 tons. Forty-seven percent of all bed load transported during the 38 years of record occurred in just 6 years. During 10 of the 38 years of record, essentially no bed load was transported. The median diameter of bed load was 26 mm, compared to 58 mm in the surface bed material.

Reverse transport of children from a tertiary pediatric hospital.

PubMed

McPherson, Mona L; Jefferson, Larry S; Smith, E O'Brian; Sitler, Garry C; Graf, Jeanine M

2007-01-01

The purpose of this study was to determine the epidemiology and resources used and to study the potential savings of pediatric reverse transport patients. A case control study was performed with patients undergoing a reverse or outbound transport from a large, pediatric hospital. Twenty-five children undergoing reverse transport were compared with matched controls. Lengths of stay and costs were compared between the reverse transport and matched control patients. Fifty-two percent of the reverse transport patients returned home, whereas 32% went home for end-of-life care and 16% went to other facilities. The average reverse transport was more than 400 miles and cost $6,064. The reverse transport of these patients did not save pediatric intensive care unit (PICU) days but did result in a shorter hospital stay compared with the matched controls (10 vs. 19 days, P = .03). Decreased utilization of bed days came from less use of intermediate care unit resources. Pediatric patients undergo reverse transports for a variety of reasons, often for end-of-life care. The ability to reverse transport pediatric patients may not save PICU bed days but may offer pediatric tertiary care hospitals a means to provide more intermediate care bed availability.

Coastal tourism and climate change in Tunisia

NASA Astrophysics Data System (ADS)

Henia, Latifa; Hlaoui, Zouhaier; Alouane, Tahar

2014-05-01

Tunisia is a major tourist destination on the southern shore of the Mediterranean. The tourism sector occupies an important place in the Tunisian economy with 816 hotels, 229,873 beds and a more than six million tourists at the end of the first decade of the 21th century, i.e. , more than half of the population. It offers a large number of direct and indirect jobs: One out of five people work in the tourism sector. The 1960s tourism boom was caused by a number of factors including long days of sunshine, 1,300 km of sandy coast, and a location close to Europe. Tunisian tourism is fundamentally based on two natural determinants: the sun and the sea. The coastline accounts for 95% of tourism investments and functional beds. The high season extends from April to October and it records 73% of nonresident tourists. This results in a homogenous growth of the "product" and its "consumers". This standardization is an important factor in the vulnerability of the Tunisian tourism to climate change. Global warming may affect the comfort level of the swimming season as well as its structure. An estimation of air and water temperature evolution near the Tunisian coasts was conducted under the CLIM-RUN project "Climate Local Information in the Mediterranean Region: Responding to User Needs" funded by the European Union's Seventh Framework Program (FP7). The University of Tunis research unit "GREVACHOT", project partner in charge of the case study of Tunisian tourism, has made the study of comfort indices of the present climate. This paper presents: - The climate comfort indices for seaside tourism in Tunisia, - The approach and results of the future evolution of air and water temperatures by the Tunisian coasts, - The future evolution of climate seaside comfort indices of Tunisia as well as the evolution of the swimming season in relation to global warming.

Using Natural Stable Calcium Isotopes to Rapidly Assess Changes in Bone Mineral Balance Using a Bed Rest Model to Induce Bone Loss

NASA Technical Reports Server (NTRS)

Morgan, J. L. L.; Skulan, J. L.; Gordon, G. E.; Smith, Scott M.; Romaniello, S. J.; Anbar, A. D.

2012-01-01

Metabolic bone diseases like osteoporosis result from the disruption of normal bone mineral balance (BMB) resulting in bone loss. During spaceflight astronauts lose substantial bone. Bed rest provides an analog to simulate some of the effects of spaceflight; including bone and calcium loss and provides the opportunity to evaluate new methods to monitor BMB in healthy individuals undergoing environmentally induced-bone loss. Previous research showed that natural variations in the Ca isotope ratio occur because bone formation depletes soft tissue of light Ca isotopes while bone resorption releases that isotopically light Ca back into soft tissue (Skulan et al, 2007). Using a bed rest model, we demonstrate that the Ca isotope ratio of urine shifts in a direction consistent with bone loss after just 7 days of bed rest, long before detectable changes in bone mineral density (BMD) occur. The Ca isotope variations tracks changes observed in urinary N-teleopeptide, a bone resorption biomarker. Bone specific alkaline phosphatase, a bone formation biomarker, is unchanged. The established relationship between Ca isotopes and BMB can be used to quantitatively translate the changes in the Ca isotope ratio to changes in BMD using a simple mathematical model. This model predicts that subjects lost 0.25 0.07% ( SD) of their bone mass from day 7 to day 30 of bed rest. Given the rapid signal observed using Ca isotope measurements and the potential to quantitatively assess bone loss; this technique is well suited to study the short-term dynamics of bone metabolism.

Changes in Cartilage Morphology of the Knee after 14-days of Bed Rest

NASA Astrophysics Data System (ADS)

Liphardt, A.-M.; Mündermann, A.; Koo, S.; Bäcker, N.; Andriacchi, T.; Zange, J.; Mester, J.; Heer, M.

Introduction While there are still many unanswered questions related to the effects of space flight and disuse on cartilage health and cartilage morphology the number of in vivo experiments in humans is small For muscle and bone tissue it is well known that unloading results in degeneration of those tissues Also for cartilage previous studies in patients suggest that unloading causes cartilage degeneration Studies using immobilization as a model of unloading help to investigate the importance of experiencing mechanical loads for the maintenance of healthy biological tissues The goal of our study was to investigate whether bed rest induced immobilization has a negative effect on articular cartilage in healthy subjects and if vibration training is a potential counter-measure for these negative effects Methods Eight male healthy subjects 78 1 pm 9 5 kg 179 pm 9 6 cm 26 pm 5 years performed a 14-day bed rest in 6 r -head down tilt HDT The study was designed in a cross-over-design where each subject received a training intervention vib in one phase and no intervention con in the other phase During the training intervention subjects trained 2 x 5-minutes per day at 20 Hz with 2 -- 4 mm amplitude on a vibration plate Galileo 900 Magnet resonance MR imaging of the right knee was performed to measure articular cartilage thickness MR-images 2 mm slice thickness 0 35 mm x 0 35 mm in-plane resolution 448 x 512 pixels were taken before and after bed rest to investigate the effects of bed rest

Cardiac and Vascular Function in Bedrested Volunteers: Effects of Artificial Gravity Training

NASA Technical Reports Server (NTRS)

Meng, M.; Platts, S.; Stenger, M.; Diedrich, A.; Schlegel, T.; Natapoff, A.; Knapp, C.; Evans, J.

2007-01-01

Cardiovascular effects of an artificial gravity (AG) countermeasure on deconditioned male volunteers were studied. In two groups of men we measured cardiovascular parameters at rest and in response to 30 minutes of 80 deg. head up tilt (HUT) before, at the end of, and four days following 21 days of 6 deg. head down bed rest (HDBR). One group (N=7) underwent no countermeasure while the other (N=8) received a daily, one hour, dose (2.5 gz at the foot, decreasing to 1.0 gz at the heart) of AG training on the Johnson Space Center short radius centrifuge. Cardiovascular parameters measured included heart rate, blood pressure, stroke volume, cardiac output, peripheral vascular resistance, plasma volume shifts, and vasoactive hormones. Untrained subjects exhibited shorter tilt survival (on average 8 minutes shorter) compared to trained subjects. By the end of bed rest, mean heart rate (MHR) was elevated in both groups (both supine and during tilt). In addition, treated subjects demonstrated lower, tilt-induced, increases in MHR four days following HDBR, indicating a more rapid return to pre bed rest conditions. Results from an index of autonomic balance (percentage of MHR spectral power in the respiratory frequency range) in control of heart rate are consistent with the interpretation that parasympathetic nervous system withdrawal was responsible for both tilt- and bed rest-induced increases in MHR. Our data support our pre-study hypothesis that AG treatment would lessen cardiovascular effects of deconditioning in bed rested men and suggest that AG should be further pursued as a space flight countermeasure.

New surface-based observations of the environment beneath Pine Island Glacier ice shelf

NASA Astrophysics Data System (ADS)

Bindschadler, Robert; Truffer, Martin; Stanton, Tim; Peters, Leo; Shortt, Mike; Pomraning, Dale; Stockel, Jim; Shaw, Bill; Steinarson, Einar; Anandakrishnan, Sridhar; Wilson, Kiya; Holland, David; Bushuk, Mitch; Behar, Alberto; Cocaud, Cedric; Stam, Christina

2013-04-01

Extensive surface, sub-shelf cavity and seabed observations of the Pine Island Glacier (PIG) ice shelf environment were collected by a surface field team during the 2012-13 austral summer. Three sites aligned along a central, flow-aligned surface valley were occupied for about one week each during which two hot-water holes were drilled at each site. In one hole, a mast-mounted set of oceanographic sensors recorded water temperature, current and salinity in the few meters immediately below the ice-shelf bottom. In the other hole, a similarly instrumented profiler was deployed to make quasi-daily vertical transects of the sub-shelf cavity by rising and sinking along a cable suspended in the cavity. These instruments are already returning data that provide direct rates of heat and momentum transfer in the boundary layer, basal melt rates and the temporal variation of water movements on daily and longer time scales. Shallow cores of the sea bed and a photographic record of the drill holes, ocean cavity and sea bed were also collected at two of the drill sites. The geophysics program was spatially much broader and consisted of phase-sensitive radars to measure basal melt rates and active seismic instrumentation to explore the character of the sea bed. Continuous profiling between the drill sites established the previously discovered ("Autosub") sea bed ridge is asymmetric with a steeper downstream face. Spot measurements upstream of the drill sites were reached by helicopter and refined the shape of the ocean cavity where extensive melt rates were measured. The field work is concluding as this abstract is being submitted, so most results are not yet available, but will be included in the presentation as first results emerge.

Influence of a dam on fine-sediment storage in a canyon river

USGS Publications Warehouse

Hazel, J.E.; Topping, D.J.; Schmidt, J.C.; Kaplinski, M.

2006-01-01

Glen Canyon Dam has caused a fundamental change in the distribution of fine sediment storage in the 99-km reach of the Colorado River in Marble Canyon, Grand Canyon National Park, Arizona. The two major storage sites for fine sediment (i.e., sand and finer material) in this canyon river are lateral recirculation eddies and the main-channel bed. We use a combination of methods, including direct measurement of sediment storage change, measurements of sediment flux, and comparison of the grain size of sediment found in different storage sites relative to the supply and that in transport, in order to evaluate the change in both the volume and location of sediment storage. The analysis shows that the bed of the main channel was an important storage environment for fine sediment in the predam era. In years of large seasonal accumulation, approximately 50% of the fine sediment supplied to the reach from upstream sources was stored on the main-channel bed. In contrast, sediment budgets constructed for two short-duration, high experimental releases from Glen Canyon Dam indicate that approximately 90% of the sediment discharge from the reach during each release was derived from eddy storage, rather than from sandy deposits on the main-channel bed. These results indicate that the majority of the fine sediment in Marble Canyon is now stored in eddies, even though they occupy a small percentage (???17%) of the total river area. Because of a 95% reduction in the supply of fine sediment to Marble Canyon, future high releases without significant input of tributary sediment will potentially erode sediment from long-term eddy storage, resulting in continued degradation in Marble Canyon. Copyright 2006 by the American Geophysical Union.

Evolution of soil and vegetation cover on the bottom of drained thermokarst lake (a case study in the European Northeast of Russia)

NASA Astrophysics Data System (ADS)

Kaverin, Dmitry; Pastukhov, Alexander

2015-04-01

The evolution of soils and landscapes has been studied in a lake bed of former thermokarst lake, which was totally drained in 1979. Melioration of thermokarst lakes was conducted experimentally and locally under Soviet economics program during 1970-s. The aim of the program was to increase in biomass productivity of virgin tundra permafrost-thermokarst sites under agricultural activities. The former thermokarst lake "Opytnoe" located in the Bolshezemelskaya Tundra, Russian European Northeast. The lake bed is covered by peat-mineral sediments, which serves as soil-forming sediments favoring subsequent permafrost aggradation and cryogenic processes as well. Initially, after drainage, swampy meadows had been developed almost all over the lake bed. Further on, succession of landscape went diversely, typical and uncommon tundra landscapes formed. When activated, cryogenic processes favored the formation of peat mounds under dwarf shrub - lichen vegetation (7% of the area). Frost cracks and peat circles affected flat mounds all over the former lake bottom. On drained peat sites, with no active cryogenic processes, specific grass meadows on Cryic Sapric Histosols were developed. Totally, permafrost-affected soils occupy 77% of the area (2011). In some part of the lake bed further development of waterlogging leads to the formation of marshy meadows and willow communities where Gleysols prevail. During last twenty years, permafrost degradation has occurred under tall shrub communities, and it will progress in future. Water erosion processes in the drained lake bottom promoted the formation of local hydrographic network. In the stream floodplain grassy willow-stands formed on Fluvisols (3% of the area). The study has been conducted under Clima-East & RFBR 14-05-31111 projects.

The Effect of Dogs on Human Sleep in the Home Sleep Environment.

PubMed

Patel, Salma I; Miller, Bernie W; Kosiorek, Heidi E; Parish, James M; Lyng, Philip J; Krahn, Lois E

2017-09-01

To objectively assess whether a dog in the bedroom or bed disturbs sleep. From August 1, 2015, through December 31, 2015, we evaluated the sleep of humans and dogs occupying the same bedroom to determine whether this arrangement was conducive to sleep. The study included 40 healthy adults without sleep disorders and their dogs (no dogs <6 months old). Each participant wore an accelerometer and their dog a validated dog accelerometer for 7 nights. The mean ± SD age of the participants (88% women) was 44±14 years and body mass index was 25±6. The mean ± SD age of the dogs was 5±3 years and weight was 15±13 kg. Mean ± SD actigraphy data showed 475±101 minutes in bed, 404±99 minutes total sleep time, 81%±7% sleep efficiency, and 71±35 minutes wake time after sleep onset. The dogs' accelerometer activity during the corresponding human sleep period was characterized as mean ± SD minutes at rest, active, and at play of 413±102, 62±43, and 2±4. The dogs had mean ± SD 85%±15% sleep efficiency. Human sleep efficiency was lower if the dog was on the bed as opposed to simply in the room (P=.003). Humans with a single dog in their bedroom maintained good sleep efficiency; however, the dog's position on/off the bed made a difference. A dog's presence in the bedroom may not be disruptive to human sleep, as was previously suspected. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Postoperative hypofractionated stereotactic brain radiation (HSRT) for resected brain metastases: improved local control with higher BED10.

PubMed

Kumar, Aryavarta M S; Miller, Jonathan; Hoffer, Seth A; Mansur, David B; Coffey, Michael; Lo, Simon S; Sloan, Andrew E; Machtay, Mitchell

2018-05-10

HSRT directed to large surgical beds in patients with resected brain metastases improves local control while sparing patients the toxicity associated with whole brain radiation. We review our institutional series to determine factors predictive of local failure. In a total of 39 consecutive patients with brain metastases treated from August 2011 to August 2016, 43 surgical beds were treated with HSRT in three or five fractions. All treatments were completed on a robotic radiosurgery platform using the 6D Skull tracking system. Volumetric MRIs from before and after surgery were used for radiation planning. A 2-mm PTV margin was used around the contoured surgical bed and resection margins; these were reviewed by the radiation oncologist and neurosurgeon. Lower total doses were prescribed based on proximity to critical structures or if prior radiation treatments were given. Local control in this study is defined as no volumetric MRI evidence of recurrence of tumor within the high dose radiation volume. Statistics were calculated using JMP Pro v13. Of the 43 surgical beds analyzed, 23 were from NSCLC, 5 were from breast, 4 from melanoma, 5 from esophagus, and 1 each from SCLC, sarcoma, colon, renal, rectal, and unknown primary. Ten were treated with three fractions with median dose 24 Gy and 33 were treated with five fractions with median dose 27.5 Gy using an every other day fractionation. There were no reported grade 3 or higher toxicities. Median follow up was 212 days after completion of radiation. 10 (23%) surgical beds developed local failure with a median time to failure of 148 days. All but three patients developed new brain metastases outside of the treated field and were treated with stereotactic radiosurgery, whole brain radiation and/or chemotherapy. Five patients (13%) developed leptomeningeal disease. With a median follow up of 226 days, 30 Gy/5 fx was associated with the best local control (93%) with only 1 local failure. A lower total dose in five fractions (ie 27.5 or 25 Gy) had a local control rate of 70%. For three fraction SBRT, local control was 100% using a dose of 27 Gy in three fractions (follow up was > 600 days) and 71% if 24 Gy in three fractions was used. A higher total biologically equivalent dose (BED 10 ) was statistically significant for improved local control (p = 0.04) with a threshold BED 10  ≥ 48 associated with better local control. HSRT after surgical resection for brain metastasis is well tolerated and has improved local control with BED 10  ≥ 48 (30 Gy/5 fx and 27 Gy/3 fx). Additional study is warranted.

[Decrease in hospitalizations due to polyvalent medical day hospital].

PubMed

Escobar, M A; García-Egido, A A; Carmona, R; Lucas, A; Márquez, C; Gómez, F

2012-02-01

The day hospital is an alternative to hospitalization. This alternative improves accessibility and comfort of the patients, and avoids hospitalizations. Nevertheless, the efficacy of the polyvalent medical day hospital in avoiding hospitalizations has not been evaluated. To analyze hospital stays avoided by the polyvalent medical day hospital of a university hospital of the Andalusian Health Service. An observational prospective study of the patients studied and/or treated in the polyvalent medical day hospital of the Hospital Universitario Puerto Real over a one year period. A total of 9640 patients were attended to, with 1413 procedures and 4921 i.v. treatments. There were 3182 visits to the priority consultation of the polyvalent medical day hospital. The most frequent consultation complaints were constitutional symptoms (15.9%) and anemia (14.5%). After the first visit, 21.5% of the patients were discharged and fewer than 3% were hospitalized. Hospitalization was avoided in 16.8% of the patients, there being a 6.0% decrease in the need for hospital beds (5.0% reduction in the internal medicine unit). Inadequate hospitalizations and 30-day readmissions decreased 93.3% and 4.2%, respectively. The most frequent diagnosis was neoplasm (26.0%), and most of the beds freed up were generated by patients diagnosed of neoplasm (26.7%). With this type of polyvalent medical day hospital, we have observed improved efficiency of health care, freeing up hospital beds by reducing hospitalizations, inadequate hospitalizations and re-admissions in the medical units involved. Copyright © 2011 Elsevier España, S.L. All rights reserved.

The NASA Performance Assessment Workstation: cognitive performance during head-down bed rest.

PubMed

Shehab, R L; Schlegel, R E; Schiflett, S G; Eddy, D R

1998-01-01

The NASA Performance Assessment Workstation was used to assess cognitive performance changes in eight males subjected to seventeen days of 6 degrees head-down bed rest. PAWS uses six performance tasks to assess directed and divided attention, spatial, mathematical, and memory skills, and tracking ability. Subjective scales assess overall fatigue and mood state. Subjects completed training trials, practice trials, bed rest trials, and recovery trials. The last eight practice trials and all bed rest trials were performed with subjects lying face-down on a gurney. In general, there was no apparent cumulative effect of bed rest. Following a short period of performance stabilization, a slight but steady trend of performance improvement was observed across all trials. For most tasks, this trend of performance improvement was enhanced during recovery. No statistically significant differences in performance were observed when comparing bed rest with the control period. Additionally, fatigue scores showed little change across all periods.

The NASA performance assessment workstation: Cognitive performance during head-down bed rest

NASA Astrophysics Data System (ADS)

Shehab, Randa L.; Schlegel, Robert E.; Schiflett, Samuel G.; Eddy, Douglas R.

The NASA Performance Assessment Workstation was used to assess cognitive performance changes in eight males subjected to seventeen days of 6 ° head-down bed rest. PAWS uses six performance tasks to assess directed and divided attention, spatial, mathematical, and memory skills, and tracking ability. Subjective scales assess overall fatigue and mood state. Subjects completed training trials, practice trials, bed rest trials, and recovery trials. The last eight practice trials and all bed rest trials were performed with subjects lying face-down on a gurney. In general, there was no apparent cumulative effect of bed rest. Following a short period of performance stabilization, a slight but steady trend of performance improvement was observed across all trials. For most tasks, this trend of performance improvement was enhanced during recovery. No statistically significant differences in performance were observed when comparing bed rest with the control period. Additionally, fatigue scores showed little change across all periods.

Technical Note: Bed conduction impact on fiber optic DTS water temperature measurements

NASA Astrophysics Data System (ADS)

O'Donnell Meininger, T.; Selker, J. S.

2014-07-01

Error in Distributed Temperature Sensor (DTS) water temperature measurements may be introduced by contact of the fiber optic cable sensor with bed materials (e.g., seafloor, lakebed, stream bed). Heat conduction from the bed materials can affect cable temperature and the resulting DTS measurements. In the Middle Fork John Day River, apparent water temperature measurements were influenced by cable sensor contact with aquatic vegetation and fine sediment bed materials. Affected cable segments measured a diurnal temperature range reduced by 10% and lagged by 20-40 min relative to that of ambient stream temperature. The diurnal temperature range deeper within the vegetation-sediment bed material was reduced 70% and lagged 240 min relative to ambient stream temperature. These site-specific results illustrate the potential magnitude of bed-conduction impacts with buried DTS measurements. Researchers who deploy DTS for water temperature monitoring should understand the importance of the environment into which the cable is placed on the range and phase of temperature measurements.

Psychogeriatrics in England in the 1950s: greater knowledge with little impact on provision of services.

PubMed

Hilton, Claire

2016-03-01

In the 1950s, the population aged over 65 years continued to increase, and older people occupied mental hospital beds disproportionately. A few psychiatrists and geriatricians demonstrated what could be done to improve the wellbeing of mentally unwell older people, who were usually labelled as having irreversible 'senile dementia'. Martin Roth demonstrated that 'senile dementia' comprised five different disorders, some of which were reversible. These findings challenged established teaching and were doubted by colleagues. Despite diagnostic improvements and therapeutic successes, clinical practice changed little. Official reports highlighted the needs, but government commitment to increase and improve services did not materialize. © The Author(s) 2016.

K/T boundary stratigraphy: Evidence for multiple impacts and a possible comet stream

NASA Technical Reports Server (NTRS)

Shoemaker, E. M.; Izett, G. A.

1992-01-01

A critical set of observations bearing on the K/T boundary events were obtained from several dozen sites in western North America. Thin strata at and adjacent to the K/T boundary are locally preserved in association with coal beds at these sites. The strata were laid down in local shallow basins that were either intermittently flooded or occupied by very shallow ponds. Detailed examination of the stratigraphy at numerous sites led to the recognition of two distinct strata at the boundary. From the time that the two strata were first recognized, E.M. Shoemaker has maintained that they record two impact events. We report some of the evidence that supports this conclusion.

Effect of artificial gravity with exercise load by using a short-arm centrifuge with bicycle ergometer as a countermeasure against disused osteoporosis

NASA Astrophysics Data System (ADS)

Shiozawa, Youke; Iwase, Satoshi; Kamiya, Atsunori; Takada, Hiroki; Michikami, Daisaku; Hiriayanagi, Kaname; Watanabe, Yoriko; Sugenoya, Jun-ichi; Mano, Tada-aki; Yajima, Kazuyoshi

2005-08-01

To evaluate the effectiveness of centrifuge-induced artificial gravity with ergometric exercise to disused osteoporosis, 9 young healthy men were exposed to -6° head-down bed-rest for 14 days. Four out of nine subjects were loaded by intermittent artificial gravity with ergometric workload. The rest of subjects were the control group. The concentrations of urine deoxy-pyridinoline were examined in each subject before and after the bed-rests. The rate of increase of urine deoxy-pyridinoline of the countermeasure group was significantly more suppressed than the control group. This countermeasure can definitely suppress the bone absorption which is caused by 14 days head-down bed-rest; however the effectiveness is still insufficient. More gravitational load or exercise load is still required.

Assessment of Appalachian Basin Oil and Gas Resources: Carboniferous Coal-bed Gas Total Petroleum System

USGS Publications Warehouse

Milici, Robert C.

2004-01-01

The Carboniferous Coal-bed Gas Total Petroleum System, lies within the central and northern parts of the Appalachian coal field. It consists of five assessment units (AU): the Pocahontas Basin in southwestern Virginia, southern West Virginia, and eastern Kentucky, the Central Appalachian Shelf in Tennessee, eastern Kentucky and southern West Virginia, East Dunkard (Folded) in western Pennsylvania and northern West Virginia, West Dunkard (Unfolded) in Ohio and adjacent parts of Pennsylvania and West Virginia, and the Appalachian Anthracite and Semi-Anthracite AU in Pennsylvania and Virginia. Of these, only the Pocahontas Basin and West Dunkard (Folded) AU were assessed quantitatively by the U.S. Geological survey in 2002 as containing about 3.6 and 4.8 Tcf of undiscovered, technically recoverable gas, respectively (Milici and others, 2003). In general, the coal beds of this Total Petroleum System, which are both the source rock and reservoir, were deposited together with their associated sedimentary strata in Mississippian and Pennsylvanian (Carboniferous) time. The generation of biogenic (microbial) gas probably began almost immediately as the peat deposits were first formed. Microbial gas generation is probably occurring at present to some degree throughout the basin, where the coal beds are relatively shallow and wet. With sufficient depth of burial, compaction, and coalification during the late Paleozoic and Early Mesozoic, the coal beds were heated sufficiently to generate thermogenic gas in the eastern part of the Appalachian basin. Trap formation began initially with the deposition of the paleopeat deposits during the Mississippian, and continued into the Late Pennsylvanian and Permian as the Appalachian Plateau strata were deformed during the Alleghanian orogeny. Seals are the connate waters that occupy fractures and larger pore spaces within the coal beds as well as the fine-grained siliciclastic sedimentary strata that are intercalated with the coal. The critical moment for the petroleum system occurred during this orogeny, when deformation created geologic structures in the eastern part of the basin that enhanced fracture porosity within the coal beds. In places, burial by thrust sheets (thrust loading) within the Appalachian fold-and-thrust belt may have resulted in additional generation of thermogenic CBM in the anthracite district of Pennsylvania and in the semianthracite deposits of Virginia and West Virginia.

Land factors affecting soil erosion during snow melting: a case study from Lebanon

NASA Astrophysics Data System (ADS)

Darwich, Talal

2014-05-01

Soil erosion is one of the major problems facing the mountainous agricultural lands in Lebanon. In order to assess the land factors acting on soil erosion; a study was conducted in the upper watershed of Ibrahim River in the spring months of April, May and June. Water and bed load sediments from six locations alimented by six sub-basins were sampled. Four sub-basins (1, 2, 3 and 6) were dominated by agricultural lands while lands in sub-basins 4 and 7 were occupied by grassland and bare soils. The highest quantities of suspended sediments were found in waters originating from watersheds dominated by agricultural lands, such as Location 2 (713.72 mg L-1 in April 2012). Low clay content and the combination of land occupation (orchards = 71%) and slope (20.7 degrees) caused this ecosystem disturbance. Locations 1, 2, 3 and 6 were alimented by runoff water due to the melting of the snow. For this, the concentrations of sediments decreased by 4 fold between April and May in sub-basin 1 and by 11-14 fold in sub-basins 2, 3 and 6. Globally, some 1669.4 tons of sediments were delivered in the upper river during April. Bed load sediments were separated into 4 classes according to their size. The size of the particles found in the bed load reflected to a large extent the type of soils surrounding the watershed. The range of sand in the regions surrounding locations 6 and 7 was 64% and 82%, while the average in the bed load was 80.9% and 78.25% respectively. The silt content in locations 2, 3 and 5 was well reflected in the concentrations of silt in the bed load. In bed load samples, the exchangeable potassium ranged from 70-250 mg kg-1 in sub-basins dominated by agricultural lands against 20-50 mg kg-1 in sub-basins dominated by grassland and bare rocks. Further quantitative studies need to be conducted especially during the first rains to fully estimate the water load sediments after a prolonged dry season, characterizing the east Mediterranean. Action must be taken for land conservation by improving the farmer's practices, modifying the frequency of plowing and introducing no tillage beside the maintenance of terraces. Keywords: Mountains, erosion, sediments, East Mediterranean, river, bed load quality.

Use and selection of bridges as day roosts by Rafinesque's Big Eared Bats.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bennett, Frances, M.; Loeb, Susan, C.; Bunch, Mary, S.

ABSTRACT.—Rafinesque’s big-eared bats (Corynorhinus rafinesquii) use bridges as day roosts in parts of their range, but information on bridge use across their range is lacking. From May to Aug. 2002 we surveyed 1129 bridges (12.5%) within all 46 counties of South Carolina to determine use and selection of bridges as day roosts by big-eared bats and to document their distribution across the state. During summer 2003, we visited 235 bridges in previously occupied areas of the state to evaluate short-term fidelity to bridge roosts. We found colonies and solitary big-eared bats beneath 38 bridges in 2002 and 54 bridges inmore » 2003. Construction type and size of bridges strongly influenced use in both years; bats selected large, concrete girder bridges and avoided flat-bottomed slab bridges. The majority of occupied bridges (94.7%) were in the Upper and Lower Coastal Plains, but a few bridges (5.3%) were located in the Piedmont. Rafinesque’s big-eared bats were absent beneath bridges in the Blue Ridge Mountains. We established new records of occurrence for 10 counties. In the Coastal Plains, big-eared bats exhibited a high degree of short-term fidelity to roosts in highway bridges. For bridges that were occupied at least once, mean frequency of use was 65.9%. Probability of finding bats under a bridge ranged from 0.46 to 0.73 depending on whether the bridge was occupied in the previous year. Thus, bridges should be inspected three to five times in a given year to determine whether they are being used. Regional bridge roost surveys may be a good method for determining the distribution of C. rafinesquii, particularly in the Coastal Plains, and protection of suitable bridges may be a viable conservation strategy where natural roost sites are limited.« less

Effects of exercise on fluid exchange and body composition in man during 14-day bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Bernauer, E. M.; Juhos, L. T.; Young, H. L.; Morse, J. T.; Staley, R. W.

1977-01-01

A description is presented of an investigation in which body composition, fluid intake, and fluid and electrolyte losses were measured in seven normal, healthy men during three 2-wk bed-rest periods, separated by two 3-wk recovery periods. During bed rest the subjects remained in the horizontal position continuously. During the dietary control periods, body mass decreased significantly with all three regimens, including no exercise, isometric exercise, and isotonic excercise. During bed rest, body mass was essentially unchanged with no exercise, but decreased significantly with isotonic and isometric exercise. With one exception, there were no statistically significant changes in body density, lean body mass, or body fat content by the end of each of the three bed-rest periods.

Induced venous pooling and cardiorespiratory responses to exercise after bed rest

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Sandler, H.; Webb, P.; Annis, J. F.

1982-01-01

Venous pooling induced by a specially constructed garment is investigated as a possible means for reversing the reduction in maximal oxygen uptake regularly observed following bed rest. Experiments involved a 15-day period of bed rest during which four healthy male subjects, while remaining recumbent in bed, received daily 210-min venous pooling treatments from a reverse gradient garment supplying counterpressure to the torso. Results of exercise testing indicate that while maximal oxygen uptake endurance time and plasma volume were reduced and maximal heart rate increased after bed rest in the control group, those parameters remained essentially unchanged for the group undergoing venous pooling treatment. Results demonstrate the importance of fluid shifts and venous pooling within the cardiovascular system in addition to physical activity to the maintenance of cardiovascular conditioning.

Focal Gray Matter Plasticity as a Function of Long Duration Head-down Tilt Bed Rest

NASA Technical Reports Server (NTRS)

Koppelmans, Vincent; Erdeniz, Burak; DeDios, Yiri; Wood, Scott; Reuter-Lorenz, Patricia; Kofman, Igor; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael

2014-01-01

Long duration spaceflight (i.e., 22 days or longer) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes. Whether these sensorimotor changes may be related to structural and functional brain changes is yet unknown. However, increased intracranial pressure that by itself has been related to microgravity-induced bodily fluid shifts: [1] has been associated with white matter microstructural damage, [2] Thus, it is possible that spaceflight may affect brain structure and thereby cognitive functioning. Long duration head-down tilt bed rest has been suggested as an exclusionary analog to study microgravity effects on the sensorimotor system, [3] Bed rest mimics microgravity in body unloading and bodily fluid shifts. In consideration of the health and performance of crewmembers both in- and post-flight, we are conducting a prospective longitudinal 70-day bed rest study as an analog to investigate the effects of microgravity on brain structure, and [4] Here we present results of the first eight subjects.

TryCYCLE: A Prospective Study of the Safety and Feasibility of Early In-Bed Cycling in Mechanically Ventilated Patients.

PubMed

Kho, Michelle E; Molloy, Alexander J; Clarke, France J; Ajami, Daana; McCaughan, Magda; Obrovac, Kristy; Murphy, Christina; Camposilvan, Laura; Herridge, Margaret S; Koo, Karen K Y; Rudkowski, Jill; Seely, Andrew J E; Zanni, Jennifer M; Mourtzakis, Marina; Piraino, Thomas; Cook, Deborah J

2016-01-01

The objective of this study was to assess the safety and feasibility of in-bed cycling started within the first 4 days of mechanical ventilation (MV) to inform a future randomized clinical trial. We conducted a 33-patient prospective cohort study in a 21-bed adult academic medical-surgical intensive care unit (ICU) in Hamilton, ON, Canada. We included adult patients (≥ 18 years) receiving MV who walked independently pre-ICU. Our intervention was 30 minutes of in-bed supine cycling 6 days/week in the ICU. Our primary outcome was Safety (termination), measured as events prompting cycling termination; secondary Safety (disconnection or dislodgement) outcomes included catheter/tube dislodgements. Feasibility was measured as consent rate and fidelity to intervention. For our primary outcome, we calculated the binary proportion and 95% confidence interval (CI). From 10/2013-8/2014, we obtained consent from 34 of 37 patients approached (91.9%), 33 of whom received in-bed cycling. Of those who cycled, 16(48.4%) were female, the mean (SD) age was 65.8(12.2) years, and APACHE II score was 24.3(6.7); 29(87.9%) had medical admitting diagnoses. Cycling termination was infrequent (2.0%, 95% CI: 0.8%-4.9%) and no device dislodgements occurred. Cycling began a median [IQR] of 3 [2, 4] days after ICU admission; patients received 5 [3, 8] cycling sessions with a median duration of 30.7 [21.6, 30.8] minutes per session. During 205 total cycling sessions, patients were receiving invasive MV (150 [73.1%]), vasopressors (6 [2.9%]), sedative or analgesic infusions (77 [37.6%]) and dialysis (4 [2.0%]). Early cycling within the first 4 days of MV among hemodynamically stable patients is safe and feasible. Research to evaluate the effect of early cycling on patient function is warranted. Clinicaltrials.gov: NCT01885442.

Incidence, duration and cost of futile treatment in end-of-life hospital admissions to three Australian public-sector tertiary hospitals: a retrospective multicentre cohort study.

PubMed

Carter, Hannah E; Winch, Sarah; Barnett, Adrian G; Parker, Malcolm; Gallois, Cindy; Willmott, Lindy; White, Ben P; Patton, Mary Anne; Burridge, Letitia; Salkield, Gayle; Close, Eliana; Callaway, Leonie; Graves, Nicholas

2017-10-16

To estimate the incidence, duration and cost of futile treatment for end-of-life hospital admissions. Retrospective multicentre cohort study involving a clinical audit of hospital admissions. Three Australian public-sector tertiary hospitals. Adult patients who died while admitted to one of the study hospitals over a 6-month period in 2012. Incidences of futile treatment among end-of-life admissions; length of stay in both ward and intensive care settings for the duration that patients received futile treatments; health system costs associated with futile treatments; monetary valuation of bed days associated with futile treatment. The incidence rate of futile treatment in end-of-life admissions was 12.1% across the three study hospitals (range 6.0%-19.6%). For admissions involving futile treatment, the mean length of stay following the onset of futile treatment was 15 days, with 5.25 of these days in the intensive care unit. The cost associated with futile bed days was estimated to be $AA12.4 million for the three study hospitals using health system costs, and $A988 000 when using a decision maker's willingness to pay for bed days. This was extrapolated to an annual national health system cost of $A153.1 million and a decision maker's willingness to pay of $A12.3 million. The incidence rate and cost of futile treatment in end-of-life admissions varied between hospitals. The overall impact was substantial in terms of both the bed days and cost incurred. An increased awareness of these economic costs may generate support for interventions designed to reduce futile treatments. We did not include emotional hardship or pain and suffering, which represent additional costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Commissioning for COPD care: a new, recordable metric that supports the patient interest.

PubMed

Walker, Paul Phillip; Thompson, E; Hill, S L; Holton, K; Bodger, K; Pearson, M G

2016-06-01

Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care services. Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation. There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001). Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Biological treatment process of air loaded with an ammonia and hydrogen sulfide mixture.

PubMed

Malhautier, Luc; Gracian, Catherine; Roux, Jean-Claude; Fanlo, Jean-Louis; Le Cloirec, Pierre

2003-01-01

The physico-chemical characteristics of granulated sludge lead us to develop its use as a packing material in air biofiltration. Then, the aim of this study is to investigate the potential of unit systems packed with this support in terms of ammonia and hydrogen sulfide emissions treatment. Two laboratory scale pilot biofilters were used. A volumetric load of 680 g H2S m(-3) empty bed day(-1) and 85 g NH3 m(-3) empty bed day(-1) was applied for eight weeks to a unit called BGSn (column packed with granulated sludge and mainly supplied with hydrogen sulfide); a volumetric load of 170 g H2S m(-3) empty bed day(-1) and 340 g NH3 m(-3) empty bed day(-1) was applied for eight weeks to the other called BGNs (column packed with granulated sludge and mainly supplied with ammonia). Ammonia and hydrogen sulfide elimination occur in the biofilters simultaneously. The hydrogen sulphide and ammonia removal efficiencies reached are very high: 100% and 80% for BGSn; 100% and 80% for BGNs respectively. Hydrogen sulfide is oxidized into sulphate and sulfur. The ammonia oxidation products are nitrite and nitrate. The nitrogen error mass balance is high for BGSn (60%) and BGNs (36%). This result could be explained by the denitrification process which would have occurred in anaerobic zones. High percentages of ammonia or hydrogen sulfide are oxidized on the first half of the column. The oxidation of high amounts of hydrogen sulfide would involve some environmental stress on nitrifying bacterial growth and activity.

Exploring emergency department 4-hour target performance and cancelled elective operations: a regression analysis of routinely collected and openly reported NHS trust data.

PubMed

Keogh, Brad; Culliford, David; Guerrero-Ludueña, Richard; Monks, Thomas

2018-05-24

To quantify the effect of intrahospital patient flow on emergency department (ED) performance targets and indicate if the expectations set by the National Health Service (NHS) England 5-year forward review are realistic in returning emergency services to previous performance levels. Linear regression analysis of routinely reported trust activity and performance data using a series of cross-sectional studies. NHS trusts in England submitting routine nationally reported measures to NHS England. 142 acute non-specialist trusts operating in England between 2012 and 2016. The primary outcome measures were proportion of 4-hour waiting time breaches and cancelled elective operations. Univariate and multivariate linear regression models were used to show relationships between the outcome measures and various measures of trust activity including empty day beds, empty night beds, day bed to night bed ratio, ED conversion ratio and delayed transfers of care. Univariate regression results using the outcome of 4-hour breaches showed clear relationships with empty night beds and ED conversion ratio between 2012 and 2016. The day bed to night bed ratio showed an increasing ability to explain variation in performance between 2015 and 2016. Delayed transfers of care showed little evidence of an association. Multivariate model results indicated that the ability of patient flow variables to explain 4-hour target performance had reduced between 2012 and 2016 (19% to 12%), and had increased in explaining cancelled elective operations (7% to 17%). The flow of patients through trusts is shown to influence ED performance; however, performance has become less explainable by intratrust patient flow between 2012 and 2016. Some commonly stated explanatory factors such as delayed transfers of care showed limited evidence of being related. The results indicate some of the measures proposed by NHS England to reduce pressure on EDs may not have the desired impact on returning services to previous performance levels. © 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.

The effects of twelve weeks of bed rest on bone histology, biochemical markers of bone turnover, and calcium homeostasis in eleven normal subjects

NASA Technical Reports Server (NTRS)

Zerwekh, J. E.; Ruml, L. A.; Gottschalk, F.; Pak, C. Y.; Blomqvist, C. G. (Principal Investigator)

1998-01-01

This study was undertaken to examine the effects of 12 weeks of skeletal unloading on parameters of calcium homeostasis, calcitropic hormones, bone histology, and biochemical markers of bone turnover in 11 normal subjects (9 men, 2 women; 34 +/- 11 years of age). Following an ambulatory control evaluation, all subjects underwent 12 weeks of bed rest. An additional metabolic evaluation was performed after 12 days of reambulation. Bone mineral density declined at the spine (-2.9%, p = 0.092) and at the hip (-3.8%, p = 0.002 for the trochanter). Bed rest prompted a rapid, sustained, significant increase in urinary calcium and phosphorus as well as a significant increase in serum calcium. Urinary calcium increased from a pre-bed rest value of 5.3 mmol/day to values as high as 73 mmol/day during bed rest. Immunoreactive parathyroid hormone and serum 1,25-dihydroxyvitamin D declined significantly during bed rest, although the mean values remained within normal limits. Significant changes in bone histology included a suppression of osteoblastic surface for cancellous bone (3.1 +/- 1.3% to 1.9 +/- 1.5%, p = 0.0142) and increased bone resorption for both cancellous and cortical bone. Cortical eroded surface increased from 3.5 +/- 1.1% to 7.3 +/- 4.0% (p = 0.018) as did active osteoclastic surface (0.2 +/- 0.3% to 0.7 +/- 0.7%, p = 0.021). Cancellous eroded surface increased from 2.1 +/- 1.1% to 4.7 +/- 2.2% (p = 0.002), while mean active osteoclastic surface doubled (0.2 +/- 0.2% to 0.4 +/- 0.3%, p = 0.020). Serum biochemical markers of bone formation (osteocalcin, bone-specific alkaline phosphatase, and type I procollagen extension peptide) did not change significantly during bed rest. Urinary biochemical markers of bone resorption (hydroxyproline, deoxypyridinoline, and N-telopeptide of type I collagen) as well as a serum marker of bone resorption (type I collagen carboxytelopeptide) all demonstrated significant increases during bed rest which declined toward normal during reambulation. Thus, under the conditions of this study, the human skeleton appears to respond to unloading by a rapid and sustained increase in bone resorption and a more subtle decrease in bone formation.

Effects of acuity-adaptable rooms on flow of patients and delivery of care.

PubMed

Hendrich, Ann L; Fay, Joy; Sorrells, Amy K

2004-01-01

Delayed transfers of patients between nursing units and lack of available beds are significant problems that increase costs and decrease quality of care and satisfaction among patients and staff. To test whether use of acuity-adaptable rooms helps solve problems with transfers of patients, satisfaction levels, and medical errors. A pre-post method was used to compare the effects of environmental design on various clinical and financial measures. Twelve outcome-based questions were formulated as the basis for inquiry. Two years of baseline data were collected before the unit moved and were compared with 3 years of data collected after the move. Significant improvements in quality and operational cost occurred after the move, including a large reduction in clinician handoffs and transfers; reductions in medication error and patient fall indexes; improvements in predictive indicators of patients' satisfaction; decrease in budgeted nursing hours per patient day and increased available nursing time for direct care without added cost; increase in patient days per bed, with a smaller bed base (number of beds per patient days). Some staff turnover occurred during the first year; turnover stabilized thereafter. Data in 5 key areas (flow of patients and hospital capacity, patients' dissatisfaction, sentinel events, mean length of stay, and allocation of nursing productivity) appear to be sufficient to test the business case for future investment in partial or complete replication of this model with appropriate populations of patients.

REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial

PubMed Central

Sahota, Opinder; Drummond, Avril; Kendrick, Denise; Grainge, Matthew J.; Vass, Catherine; Sach, Tracey; Gladman, John; Avis, Mark

2014-01-01

Background: falls in hospitals are a major problem and contribute to substantial healthcare burden. Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care. However, whether these are clinically effective and cost effective in the UK setting has not been evaluated. Methods: pragmatic, parallel-arm, individual randomised controlled trial of bed and bedside chair pressure sensors using radio-pagers (intervention group) compared with standard care (control group) in elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. Primary outcome measure number of in-patient bedside falls per 1,000 bed days. Results: 1,839 participants were randomised (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, falls rate 8.71 per 1,000 bed days compared with 83 bedside falls (64 fallers) in the control group, falls rate 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66–1.22; P = 0.51). There was no significant difference between the two groups with respect to time to first bedside fall (adjusted hazard ratio (HR), 0.95; 95% CI: 0.67–1.34; P= 0.12). The mean cost per patient in the intervention group was £7199 compared with £6400 in the control group, mean difference in QALYs per patient, 0.0001 (95% CI: −0.0006–0.0004, P= 0.67). Conclusions: bed and bedside chair pressure sensors as a single intervention strategy do not reduce in-patient bedside falls, time to first bedside fall and are not cost-effective in elderly patients in acute, general medical wards in the UK. Trial registration: isrctn.org identifier: ISRCTN44972300. PMID:24141253

Duloxetine in the treatment of binge eating disorder with depressive disorders: a placebo-controlled trial.

PubMed

Guerdjikova, Anna I; McElroy, Susan L; Winstanley, Erin L; Nelson, Eric B; Mori, Nicole; McCoy, Jessica; Keck, Paul E; Hudson, James I

2012-03-01

This study evaluated duloxetine in the treatment of binge eating disorder (BED) with comorbid current depressive disorders. In this 12-week, double-blind, placebo-controlled trial, 40 patients with Diagnostic and Statistical Manual of Mental Disorders-IV-TR BED and a comorbid current depressive disorder received duloxetine (N = 20) or placebo (N = 20). The primary outcome measure was weekly binge eating day frequency. In the primary analysis, duloxetine (mean 78.7 mg/day) was superior to placebo in reducing weekly frequency of binge eating days (p = .04), binge eating episodes (p = .02), weight (p = .04), and Clinical Global Impression-Severity of Illness ratings for binge eating (p = .02) and depressive disorders (p = .01). Changes in body mass index and measures of eating pathology, depression, and anxiety did not differ between the two groups. Duloxetine may be effective for reducing binge eating, weight, and global severity of illness in BED with a comorbid current depressive disorder, but this finding needs confirmation in larger, placebo-controlled trials. Copyright © 2011 Wiley Periodicals, Inc.

Submaximal Exercise VO2 and Q During 30-Day 6 degree Head-Down Bed Rest with Isotonic and Isokinetic Exercise Training

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Bernauer, E. M.; Erti, A. C.

1995-01-01

Submaximal exercise (61+3% peak VO2) metabolism was measured before (AC day-2) and on bed rest day 4, 11, and 25 in 19 healthy men (32-42 yr) allocated into no exercise (NOE, N=5) control, and isotonic exercise (ITE, N=7)and isokinetic exercise (IKE, N=7) training groups. Training was conducting supine for two 30-min periods/d for 6 d/wk: ITE was 60-90% peak VO2: IKE was peak knee flexion-extension at 100 deg/s. Supine submaximal exercise 102 decreased significantly (*p<0.05) by 10.3%, with ITE and by 7.3%* with IKE; similar to the submaximal cardiac output (Q) change of -14.5%* (ITE) and -203%* (IKE), but different from change in peak VO2 (+1.4% with ITE and - 10.2%, with IKE) and plasma volume of -3.7% (ITE) and - 18.0% * (IKE). Thus, reduction of submaximal V02 during prolonged bed rest appears to respond to submaximal Q but is not related to change in peak VO2 or plasma volume.

Factors associated with Iowa rural hospitals' decision to convert to critical access hospital status.

PubMed

Li, Pengxiang; Ward, Marcia M; Schneider, John E

2009-01-01

The Balanced Budget Act (BBA) of 1997 allowed some rural hospitals meeting certain requirements to convert to Critical Access Hospitals (CAHs) and changed their Medicare reimbursement from prospective to cost-based. Some subsequent CAH-related laws reduced restrictions and increased payments, and the number of CAHs grew rapidly. To examine factors related to hospitals' decisions to convert and time to CAH conversion. Eighty-nine rural hospitals in Iowa were characterized and observed from 1998 to 2005. Cox proportional hazards models were used to identify the determinants of time to CAH conversion. T-test and one-covariate Cox regression indicated that, in 1998, Iowa rural hospitals with more staffed beds, discharges, and acute inpatient days, higher operating margin, lower skilled swing bed days relative to acute days, and located in relatively high density counties were more likely to convert later or not convert before 2006. Multiple Cox regression with baseline covariates indicated that lower number of discharges and average length of stay (ALOS) were significant after controlling all other covariates. Iowa rural hospitals' decisions regarding CAH conversion were influenced by hospital size, financial condition, skilled swing bed days relative to acute days, length of stay, proportion of Medicare acute days, and geographic factors. Although financial concerns are often cited in surveys as the main reason for conversion, lower number of discharges and ALOS are the most prominent factors affecting rural hospitals' decision on when to convert.

Triiodothyronine increases calcium loss in a bed rest antigravity model for space flight.

PubMed

Smith, Steven R; Lovejoy, Jennifer C; Bray, George A; Rood, Jennifer; Most, Marlene M; Ryan, Donna H

2008-12-01

Bed rest has been used as a model to simulate the effects of space flight on bone metabolism. Thyroid hormones accelerate bone metabolism. Thus, supraphysiologic doses of this hormone might be used as a model to accelerate bone metabolism during bed rest and potentially simulate space flight. The objective of the study was to quantitate the changes in bone turnover after low doses of triiodothyronine (T(3)) added to short-term bed rest. Nine men and 5 women were restricted to bed rest for 28 days with their heads positioned 6 degrees below their feet. Subjects were randomly assigned to receive either placebo or oral T(3) at doses of 50 to 75 microg/d in a single-blind fashion. Calcium balance was measured over 5-day periods; and T(3), thyroxine, thyroid-stimulating hormone, immunoreactive parathyroid hormone, osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline were measured weekly. Triiodothyronine increased 2-fold in the men and 5-fold in the women during treatment, suppressing both thyroxine and thyroid-stimulating hormone. Calcium balance was negative by 300 to 400 mg/d in the T(3)-treated volunteers, primarily because of the increased fecal loss that was not present in the placebo group. Urinary deoxypyridinoline to creatinine ratio, a marker of bone resorption, increased 60% in the placebo group during bed rest, but more than doubled in the T(3)-treated subjects (P < .01), suggesting that bone resorption was enhanced by treatment with T(3). Changes in serum osteocalcin and bone-specific alkaline phosphatase, markers of bone formation, were similar in T(3)- and placebo-treated subjects. Triiodothyronine increases bone resorption and fecal calcium loss in subjects at bed rest.

Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study.

PubMed

Dunnigan, Matthew G; Pollock, Allyson M

2003-04-26

To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; P<0.001). The planning targets and increase in clinical activity in acute specialties in Lothian hospitals associated with PFI had not been achieved by 2000-1. The effect on clinical activity has been a steeper decline in the number of acute beds and rates of admission in Lothian hospitals compared with the rest of Scotland between 1995-6 and 2000-1.

Thresholds of flow-induced bed disturbances and their effects on stream metabolism in an agricultural river

USGS Publications Warehouse

O'Connor, Ben L.; Harvey, Judson W.; McPhillips, Lauren E.

2012-01-01

Storm-driven flow pulses in rivers destroy and restructure sediment habitats that affect stream metabolism. This study examined thresholds of bed disturbances that affected patch- and reach-scale sediment conditions and metabolism rates. A 4 year record of discharge and diel changes in dissolved oxygen concentrations (ΔDO) was analyzed for disturbances and recovery periods of the ΔDO signal. Disturbances to the ΔDO signal were associated with flow pulses, and the recovery times for the ΔDO signal were found to be in two categories: less than 5 days (30% of the disturbances) or greater than 15 days (70% of the disturbances). A field study was performed during the fall of 2007, which included a storm event that increased discharge from 3.1 to 6.9 m3/s over a 7 h period. During stable flow conditions before the storm, variability in patch-scale stream metabolism values were associated with sediment texture classes with values ranging from −16.4 to 2.3 g O22/d (negative sign indicates net respiration) that bounded the reach-averaged rate of −5.6 g O22/d. Hydraulic modeling of bed shear stresses demonstrated a storm-induced flow pulse mobilized approximately 25% of the bed and reach-scale metabolism rates shifted from −5 to −40 g O22/d. These results suggest that storm-induced bed disturbances led to threshold behavior with respect to stream metabolism. Small flow pulses resulted in partial-bed mobilization that disrupted stream metabolism by increased turbidity with short recovery times. Large flow pulses resulted in full-bed mobilization that disrupted stream metabolism by destroying periphyton habitats with long recovery times.

Hospital waste management in Brazil: a case study.

PubMed

Mattoso, V D; Schalch, V

2001-12-01

The evaluation of the current definition, classification and quantification of hospital waste being carried out by hospitals in different countries is extremely important to avoid improper waste management practices. In this work, the waste management from a 400-bed Brazilian hospital which generates about 386 kg per day of hospital waste was studied. The generation rate of just over one kg per bed per day was considered small, although more than 50% of the waste from non-isolation wards consisted of food waste. It was also interesting to note that the highest generation rate per patient per day was found in private rooms and the lowest rate in the public ones. The waste practices used in this hospital are discussed in terms of current Brazilian legislation.

A case for the expansion of day surgery.

PubMed

Ogg, T; Heath, P; Brownlie, G

1989-12-01

The efficiency of the National Health Service (NHS) is currently under scrutiny and the problems faced by the surgical services include a shortage of financial resources, fewer beds, poor nursing recruitment and rising waiting lists. During 1984-1988 a purpose built, separate 12-bedded day surgery unit at Addenbrooke's Hospital, Cambridge operated upon 13,000 patients, with a readmission rate of less than 1%. Senior medical staff are involved and the overall surgical waiting list has been reduced by 40.9%. Nurse recruitment has been excellent, and the community medical and nursing services have not been overburdened. The results detailed in this paper suggest that day surgery deserves special consideration as one acceptable solution to some of the current NHS problems.

Responses to salinity stress in bivalves: Evidence of ontogenetic changes in energetic physiology on Cerastoderma edule.

PubMed

Peteiro, Laura G; Woodin, Sarah A; Wethey, David S; Costas-Costas, Damian; Martínez-Casal, Arantxa; Olabarria, Celia; Vázquez, Elsa

2018-05-29

Estuarine bivalves are especially susceptible to salinity fluctuations. Stage-specific sensibilities may influence the structure and spatial distribution of the populations. Here we investigate differences on the energetic strategy of thread drifters (3-4 mm) and sedentary settlers (9-10 mm) of Cerastoderma edule over a wide range of salinities. Several physiological indicators (clearance, respiration and excretion rates, O:N) were measured during acute (2 days) and acclimated responses (7 days of exposure) for both size classes. Our results revealed a common lethal limit for both developmental stages (Salinity 15) but a larger physiological plasticity of thread drifters than sedentary settlers. Acclimation processes in drifters were initiated after 2 days of exposure and they achieved complete acclimation by day 7. Sedentary settlers delay acclimation and at day 7 feeding activity had not resumed and energetic losses through respiration and excretion were higher at the lowest salinity treatment. Different responses facing salinity stress might be related to differences in habitat of each stage. For sedentary settlers which occupy relatively stable niches, energy optimisation include delaying the initiation of the energetically expensive acclimation processes while drifters which occupy less stable environments require a more flexible process which allow them to optimize energy acquisition as fast as possible.

49 CFR 192.5 - Class locations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assembly) that is occupied by 20 or more persons on at least 5 days a week for 10 weeks in any 12-month period. (The days and weeks need not be consecutive.) (4) A Class 4 location is any class location unit... 2, 3, and 4 may be adjusted as follows: (1) A Class 4 location ends 220 yards (200 meters) from the...

Vitamin D in Real and Simulated Weightlessness: Implications for Earth

NASA Technical Reports Server (NTRS)

Rice, Barbara L.; Zwart, Sara R.; Smith, Scott M.

2006-01-01

Vitamin D deficiency has reemerged as a public health concern in the United States. It is also a concern for astronauts because spacecraft are shielded from ultraviolet light, leaving diet as the sole source of vitamin D. We report here the findings from four studies: one evaluation of astronauts before and after 4- to 6-month missions to the International Space Station, and the other three from a ground-based analog for space flight, long-term bed rest. For the space flight study, blood samples were collected before the flight and within hours of landing after it. Crewmembers (n = 11) were provided vitamin D supplements (as cholecalciferol (10 g/d) throughout the mission. The average number of vitamin D supplements reported to be consumed per week was 5.7 plus or minus 4.0. The vitamin D status indicator serum 25-hydroxycholecalciferol was 25% less after landing (48 plus or minus 20) than before flight (63 plus or minus 16) (P less than 0.01). A series of three studies was undertaken to evaluate nutritional changes during and after 60 or 90 days of -6 deg. head-down-tilt bed rest. A total of 11 subjects (8 M, 3 F; age 26-55 y) participated in the studies. Blood and urine were collected twice before bed rest and once per month during bed rest. During bed rest the average dietary intake of vitamin D for the three studies was 4.84 plus or minus 0.16 (study 1), 6.24 plus or minus 0.81 (study 2), and 7.16 plus or minus 1.40 (study 3) micrograms/day. In study 1 only, subjects were given a daily supplement of 10 g vitamin D (as ergocalciferol). Data were analyzed using repeated-measures ANOVA. In the first study, 7 days after the end of the bed rest, serum 25-hydroxycholecalciferol was 30% less than it was before bed rest (p less than 0.05). In the second and third studies, during or after bed rest the serum 25-hydroxycholecalciferol concentration was not significantly different from its concentration before bed rest. These data demonstrate that vitamin D intake is critical for individuals not exposed to the sun. Although we studied astronauts and healthy subjects in bed rest, the implications of our results also apply to people living in northern latitudes and others who receive little exposure to sunlight, such as elderly people who seldom go outdoors. The inability of supplements to maintain vitamin D status is also an important finding, and highlights the need for careful food selection to ensure adequate vitamin D intake.

A 13-year retrospective study evaluating the efficacy of using air-fluidised beds for toxic epidermal necrolysis patients.

PubMed

Xia, Weidong; Mao, Cong; Luo, Xu; Xu, Jianjun; Chen, Xiaofeng; Lin, Cai

2016-08-01

Toxic epidermal necrolysis (TEN) is a potentially life-threatening dermatological disease involving large areas of skin loss with systemic symptoms. This study evaluated the efficacy of air-fluidised bed therapy for TEN patients. Of 27 people with TEN, 11 used air-fluidised beds (the air-fluidised group) and 16 used standard beds (the control group). Days to complete re-epithelialisation, re-epithelialisation rate, incidence of complications, mortality, pain measured by visual analogue score and the incidence of cutaneous infection were compared in these groups. The mean body surface area of involvement was 77.0 ± 11.8% and baseline mean severity-of-illness score for TEN (SCORTEN) was 2.81 ± 1.08. The re-epithelialisation rate in the air-fluidised group was 100% but was only 56.3% in the control group (P < 0.05). There was a significant difference in the time taken to complete re-epithelialisation between the air-fluidised group (13 days [95% CI: 9.0-17.0]) and the control group (21 days [16.5-25.5], P < 0.05). Furthermore, the incidence of complications was 18% in the air-fluidised group versus 75% in the control group, including fewer cutaneous infections (P < 0.05). There was a significant reduction in pain among the air-fluidised group compared with the control group (P < 0.05). There were no deaths in the air-fluidised group while 19% of the control group died. Air-fluidised beds can reduce the time to complete re-epithelialisation, relieve pain and increase the re-epithelialisation rate of TEN patients, but there was no significant difference between them in mortality rate in our study. © 2015 The Australasian College of Dermatologists.

Effects of 14 days of head-down tilt bed rest on cutaneous vasoconstrictor responses in humans

NASA Technical Reports Server (NTRS)

Wilson, Thad E.; Shibasaki, Manabu; Cui, Jian; Levine, Benjamin D.; Crandall, Craig G.

2003-01-01

This study tested the hypothesis that head-down tilt bed rest (HDBR) reduces adrenergic and nonadrenergic cutaneous vasoconstrictor responsiveness. Additionally, an exercise countermeasure group was included to identify whether exercise during bed rest might counteract any vasoconstrictor deficits that arose during HDBR. Twenty-two subjects underwent 14 days of strict 6 degrees HDBR. Eight of these 22 subjects did not exercise during HDBR, while 14 of these subjects exercised on a supine cycle ergometer for 90 min a day at 75% of pre-bed rest heart rate maximum. To assess alpha-adrenergic vasoconstrictor responsiveness, intradermal microdialysis was used to locally administer norepinephrine (NE), while forearm skin blood flow (SkBF; laser-Doppler flowmetry) was monitored over microdialysis membranes. Nonlinear regression modeling was used to identify the effective drug concentration that caused 50% of the cutaneous vasoconstrictor response (EC(50)) and minimum values from the SkBF-NE dose-response curves. In addition, the effects of HDBR on nonadrenergic cutaneous vasoconstriction were assessed via the venoarteriolar response of the forearm and leg. HDBR did not alter EC(50) or the magnitude of cutaneous vasoconstriction to exogenous NE administration regardless of whether the subjects exercised during HDBR. Moreover, HDBR did not alter the forearm venoarteriolar response in either the control or exercise groups during HDBR. However, HDBR significantly reduced the magnitude of cutaneous vasoconstriction due to the venoarteriolar response in the leg, and this response was similarly reduced in the exercise group. These data suggest that HDBR does not alter cutaneous vasoconstrictor responses to exogenous NE administration, whereas cutaneous vasoconstriction of the leg due to the venoarteriolar response is reduced after HDBR. It remains unclear whether attenuated venoarteriolar responses in the lower limbs contribute to reduced orthostatic tolerance after bed rest and spaceflight.

Bed Rest is an Analog to Study the Physiological Changes of Spaceflight and to Evaluate Countermeasures

NASA Technical Reports Server (NTRS)

Pfannenstiel, P.; Ottenbacher, M.; Inniss, A.; Ware, D.; Anderson, K.; Stranges, S.; Keith, K.; Cromwell, R.; Neigut. J.; Powell, D.

2012-01-01

The UTMB/NASA Flight Analog Research Unit is an inpatient unit with a bionutrition kitchen and unique testing areas for studying subjects subjected to 6 degree head-down complete bed rest for prolonged periods as an analog for zero gravity. Bed rest allows study of physiological changes and performance of functional tasks representative of critical interplanetary mission operations and measures of the efficacy of countermeasures designed to protect against the resulting deleterious effects. METHODS/STUDY POPULATION: Subjects are healthy adults 24-55 years old; 60 75 in tall; body mass index 18.5-30; and bone mineral density normal by DXA scan. Over 100 subjects have been studied in 7 campaigns since 2004. The iRAT countermeasure combines high intensity interval aerobic exercises on alternating days with continuous aerobic exercise. Resistance exercise is performed 3 days per week. Subjects are tested on an integrated suite of functional and interdisciplinary physiological tests before and after 70 days of total bed rest. RESULTS/ANTICIPATED RESULTS: It is anticipated that post-bed rest functional performance will be predicted by a weighted combination of sensorimotor, cardiovascular and muscle physiological factors. Control subjects who do not participate in the exercise countermeasure will have significantly greater decreases in these parameters. DISCUSSION/SIGNIFICANCE OF IMPACT: Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity, leading to disruption in the ability to perform functional tasks after reintroduction to a gravitational environment. Current flight exercise countermeasures are not fully protective of cardiovascular, muscle and bone health. There is a need to refine and optimize countermeasures to mitigate health risks associated with long-term space missions.

Potential population growth and harmful effects on humans from bed bug populations exposed to different feeding regimes.

PubMed

Pereira, R M; Taylor, A S; Lehnert, M P; Koehler, P G

2013-06-01

Effects of host availability and feeding period on bed bugs, Cimex lectularius (L.) (Hemiptera: Cimicidae), were measured. Population growth and the potential harmful effect of bed bug populations on human hosts were modelled. Bloodmeal sizes were affected by both feeding length and frequency, with >2-fold difference between insects fed daily or weekly. Blood consumption increased >2-fold between bed bugs fed occasionally and often, and 1.5-fold between occasional and daily feeding. Bed bugs fed more often than once a week, potentially every 2-4 days. Egg production was associated with nutrition, being strongly correlated with blood consumption in the previous week. Bed bug populations can grow under different feeding regimes and are hard to control with <80% mortality. Bed bugs can survive and grow even in locations with a limited blood supply, where bed bug persistence may be important for the continual spread of populations. Persistence in non-traditional locations and a potential association with human pathogens increase the health risks of bed bugs. Potential blood loss as a result of a bed bug can have serious consequences because uncontrolled populations can reach harmful levels in 3-8 months. The reproduction potential of bed bug populations suggests serious consequences to human health and the need for efficacious control measures. © 2012 The Royal Entomological Society.

Deep-coal potential in the Appalachian Coal Basin, USA: The Kentucky model

USGS Publications Warehouse

Haney, D.C.; Chesnut, D.R.

1997-01-01

The Eastern Kentucky Coal Field is located in the Appalachian Basin of the United States and occupies an area of approximately 15,000 square kilometers. The coal beds range from a few centimeters to several meters in thickness and consist of high-grade bituminous coal. Currently the amount of coal mined by surface methods exceeds underground extraction; however, there is a steady and gradual shift toward underground mining. In the future, as near-surface resources are depleted, this trend toward increased underground mining will continue. Knowledge about deeper coals is essential for future economic development of resources. Preliminary investigations indicate that coal-bearing strata with deep-mining potential exist in several parts of eastern Kentucky, especially along the Eastern Kentucky Syncline. Eastern Kentucky coals are Westphalian A through D; however, current production is from major beds of Westphalian A and B. Because coals that occur above drainage are more easily accessible and are generally of better quality, most of the current mining takes place in formations that are at or near the surface. In the future, however, due to environmental regulations and increased demands, it will be necessary to attempt to utilize deeper coals about which little is known. Future development of deep resources will require data from boreholes and high-resolution geophysical-logging techniques. There is also potential for coal-bed methane from the deeper coals which could be an important resource in the Appalachian Coal Basin where a natural gas distribution system already exists.

Development of a Reactor Model for Chemical Conversion of Lunar Regolith

NASA Technical Reports Server (NTRS)

Hegde, U.; Balasubramaniam, R.; Gokoglu, S.

2009-01-01

Lunar regolith will be used for a variety of purposes such as oxygen and propellant production and manufacture of various materials. The design and development of chemical conversion reactors for processing lunar regolith will require an understanding of the coupling among the chemical, mass and energy transport processes occurring at the length and time scales of the overall reactor with those occurring at the corresponding scales of the regolith particles. To this end, a coupled transport model is developed using, as an example, the reduction of ilmenite-containing regolith by a continuous flow of hydrogen in a flow-through reactor. The ilmenite conversion occurs on the surface and within the regolith particles. As the ilmenite reduction proceeds, the hydrogen in the reactor is consumed, and this, in turn, affects the conversion rate of the ilmenite in the particles. Several important quantities are identified as a result of the analysis. Reactor scale parameters include the void fraction (i.e., the fraction of the reactor volume not occupied by the regolith particles) and the residence time of hydrogen in the reactor. Particle scale quantities include the time for hydrogen to diffuse into the pores of the regolith particles and the chemical reaction time. The paper investigates the relationships between these quantities and their impact on the regolith conversion. Application of the model to various chemical reactor types, such as fluidized-bed, packed-bed, and rotary-bed configurations, are discussed.

Development of a Reactor Model for Chemical Conversion of Lunar Regolith

NASA Technical Reports Server (NTRS)

Hedge, uday; Balasubramaniam, R.; Gokoglu, S.

2007-01-01

Lunar regolith will be used for a variety of purposes such as oxygen and propellant production and manufacture of various materials. The design and development of chemical conversion reactors for processing lunar regolith will require an understanding of the coupling among the chemical, mass and energy transport processes occurring at the length and time scales of the overall reactor with those occurring at the corresponding scales of the regolith particles. To this end, a coupled transport model is developed using, as an example, the reduction of ilmenite-containing regolith by a continuous flow of hydrogen in a flow-through reactor. The ilmenite conversion occurs on the surface and within the regolith particles. As the ilmenite reduction proceeds, the hydrogen in the reactor is consumed, and this, in turn, affects the conversion rate of the ilmenite in the particles. Several important quantities are identified as a result of the analysis. Reactor scale parameters include the void fraction (i.e., the fraction of the reactor volume not occupied by the regolith particles) and the residence time of hydrogen in the reactor. Particle scale quantities include the time for hydrogen to diffuse into the pores of the regolith particles and the chemical reaction time. The paper investigates the relationships between these quantities and their impact on the regolith conversion. Application of the model to various chemical reactor types, such as fluidized-bed, packed-bed, and rotary-bed configurations, are discussed.

The use of actimetry to assess changes to the rest-activity cycle.

PubMed

Carvalho Bos, Sandra; Waterhouse, Jim; Edwards, Ben; Simons, Ries; Reilly, Thomas

2003-11-01

The endogenous circadian oscillator (the body clock) is slow to adjust to altered rest-activity patterns. As a result, several negative consequences arise during night work and after time-zone transitions. The process of adjustment can be assessed by measurements of the sleep electroencephalogram (EEG), core temperature or melatonin secretion, for example, but these techniques are very difficult to apply in field studies, and make very great demands upon both experimenters and subjects. We have sought to establish if the activity record, measured conveniently and unobtrusively by a monitor attached to the wrist, can be treated in ways that enable estimates to be made of the disruption caused by changes to the rest-activity cycle, and the process of adjustment to them. In Part A, we describe the calculation and assessment of a series of "activity indices" that measure the overall activity pattern, activity when out of bed or in bed, or the activity in the hours adjacent to going to bed or getting up. The value of the indices was assessed by measuring changes to them in subjects undergoing night work or undergoing time-zone transitions. In both cases, there is a large body of literature describing the changes that would be expected. First, night workers (working 2 to 4 successive night shifts) were investigated during rest days and night shifts. The indices indicated that night work was associated with lower activity when the subjects were out of bed and higher activity when in bed. Some indices also measured when subjects took an afternoon nap before starting a series of night shifts and gave information about the process of adjustment to night work and recovery from it. Second, in studies from travelers crossing six or more time zones to the east or west, the indices indicated that there were changes to the rest-activity cycle immediately after the flights, both in its overall profile and when activity of the subjects in bed or out of bed was considered, and that adjustment took place on subsequent days. By focusing on those indices describing the activity records during the last hour in bed (LHIB) and the first hour out of bed (FHOB), some evidence was found for incomplete adjustment of the body clock, and for differences between westward and eastward flights. In Part B, the battery of indices are applied to the activity records of long-haul pilots, whose activity patterns showed a mixture of effects due to night work and time-zone transitions. Actimetry was performed during the flights themselves and during the layover days (which were either rest or work days). The indices indicated that all pilots had disrupted rest-activity cycles caused by night flights, and that there were added problems for those who had also undergone time-zone transitions. Rest days were valuable for normalizing the activity profile. For those pilots who flew to the west, adjustment was by delay, though not all aspects of the rest-activity cycle adjusted immediately; for those who flew to the east, some attempted to advance their rest-activity cycle while others maintained home-based activity profiles. The indices indicated that the activity profile was disrupted more in those pilots who attempted to advance their rest-activity cycle. We conclude that objective estimates of the disruption caused to the rest-activity cycle and the circadian system can be obtained by suitable analysis of the activity record.

Diagnosing binge eating disorder in a primary care setting.

PubMed

Montano, C Brendan; Rasgon, Natalie L; Herman, Barry K

2016-01-01

Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that it is not merely a subtype of obesity.

Changes in size and compliance of the calf after 30 days of simulated microgravity

NASA Technical Reports Server (NTRS)

Convertino, Victor A.; Doerr, Donald F.; Stein, Stewart L.

1989-01-01

The hypothesis that reducing muscle compartment by a long-term exposure to microgravity would cause increased leg venous compliance was tested in eight men who were assessed for vascular compliance and for serial circumferences of the calf before and after 30 days of continuous 6-deg head-down bed rest. It was found that head-down bed rest caused decreases in the calculated calf volume and the calf-muscle compartment, as well as increases in calf compliance. The percent increases in calf compliance correlated significantly with decreases in calf muscle compartment.

Implementation of the NASA AG-Bed Rest Pilot

NASA Technical Reports Server (NTRS)

Warren, L. E.; Paloski, W. H.; Young, L. R.

2007-01-01

To examine the efficacy of artificial gravity (AG) as a countermeasure to spaceflight deconditioning, intermittent AG produced by a horizontal short-radius centrifuge (SRC) was utilized on human test subjects deconditioned by bed rest. This poster will present the subject screening, study design, logistics, and implementation of the 41 day pilot study conducted at the University of Texas Medical Branch, Galveston, TX bed rest facility. An extensive screening process was employed to exclude subjects that were dissimilar to the U.S. astronaut population. Candidates underwent a modified U.S. Air Force Class III physical and tests of bone density, cardiovascular fitness, vestibular system function, psychological fitness and centrifuge tolerance. 15 subjects completed the study; 7 control and 8 AG treatment. All provided written consent to volunteer after the nature of the study and its hazards were clearly explained to them. Standard conditions were strictly regulated; Ta = 72 +/- 2 F, humidity = 70 +/- 5%, light/dark cycle 16h:8h. All fluid intake (minimum 28.5 ml/kg body weight/day) and urine output was monitored. Caloric intake was adjusted as necessary to maintain body weight. Carbohydrate, fat and protein were provided in a ratio of 55:30:15. Phosphorus intake was 1400 mg/d, sodium intake was 2 mmol/kg/d, potassium intake was 1.3 mmol/kg/d, and dietary calcium intake was 1000 mg/d. A physician examined each subject daily. During the first 11 days of the study protocol, subjects were ambulatory, but confined to the facility. Subjects participated in multiple baseline tests of bone, muscle, cardiovascular, sensory-motor, immunological, and psychological function. On the 12th day, subjects entered the bed rest phase of the study, during which they were confined to strict 6? head down tilt bed rest for 21 days. Beginning 24 hrs into this period, treatment subjects received 1 hour daily exposures to artificial gravity which was produced by spinning the subjects on a 3.0 m radius SRC. They were oriented radially in the supine position so that the centrifugal force was aligned with their long body axis, and while spinning, they #stood# on a force plate, supporting the centrifugal loading (2.5 g at the feet, 1.0 g at the heart). The subject station allowed free translation over approximately 10 cm to ensure full loading of the lower extremities and to allow for anti-orthostatic muscle contractions. Control subjects were positioned on the centrifuge but did not spin. Following the bed rest phase, subjects were allowed to ambulate again, but remained within the facility for an additional 9 days and participated in multiple follow-up tests of physiological function.

Baby Boomers and Beds: a Demographic Challenge for the Ages.

PubMed

Song, Zirui; Ferris, Timothy G

2018-03-01

The United States is facing a significant demographic transition, with about 10,000 baby boomers turning age 65 each day. At the same time, the nation is experiencing a similarly striking transition in hospital capacity, as the supply of hospital beds has declined in recent decades. The juxtaposition of population aging and hospital capacity portends a potentially widening divergence between supply and demand for hospital care. We provide a closer look at current hospital capacity and a rethinking of the future role of hospital beds in meeting the needs of an aging population.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gagne, Nolan L.; Leonard, Kara L.; Rivard, Mark J.

Purpose: Clinical optimization of Collaborative Ocular Melanoma Study (COMS) eye plaque brachytherapy is currently limited to tumor coverage, consensus prescription dosage, and dose calculations to ocular structures. The biologically effective dose (BED) of temporary brachytherapy treatments is a function of both chosen radionuclide R and implant duration T. This study endeavored to evaluate BED delivered to the tumor volume and surrounding ocular structures as a function of plaque position P, prescription dose, R, and T. Methods: Plaque-heterogeneity-corrected dose distributions were generated with MCNP5 for the range of currently available COMS plaques loaded with sources using three available low-energy radionuclides. Thesemore » physical dose distributions were imported into the PINNACLE{sup 3} treatment planning system using the TG-43 hybrid technique and used to generate dose volume histograms for a T = 7 day implant within a reference eye geometry including the ciliary body, cornea, eyelid, foveola, lacrimal gland, lens, optic disc, optic nerve, retina, and tumor at eight standard treatment positions. The equation of Dale and Jones was employed to create biologically effective dose volume histograms (BEDVHs), allowing for BED volumetric analysis of all ROIs. Isobiologically effective prescription doses were calculated for T = 5 days down to 0.01 days, with BEDVHs subsequently generated for all ROIs using correspondingly reduced prescription doses. Objective functions were created to evaluate the BEDVHs as a function of R and T. These objective functions are mathematically accessible and sufficiently general to be applied to temporary or permanent brachytherapy implants for a variety of disease sites. Results: Reducing T from 7 to 0.01 days for a 10 mm plaque produced an average BED benefit of 26%, 20%, and 17% for {sup 103}Pd, {sup 125}I, and {sup 131}Cs, respectively, for all P; 16 and 22 mm plaque results were more position-dependent. {sup 103}Pd produced a 16%-35% BED benefit over {sup 125}I, whereas {sup 131}Cs produced a 3%-7% BED detriment, independent of P, T, and plaque size. Additionally, corresponding organ at risk physical doses were lowest using {sup 103}Pd in all circumstances. Conclusions: The results suggest that shorter implant durations may correlate with more favorable outcomes compared to 7 day implants when treating small or medium intraocular lesions. The data also indicate that implant duration may be safely reduced if the prescription physical dose is likewise diminished and that {sup 103}Pd offers a substantial radiobiological benefit over {sup 125}I and {sup 131}Cs irrespective of plaque position, implant duration, and tumor size.« less

The bedding of laboratory animals as a source of airborne contaminants.

PubMed

Kaliste, E; Linnainmaa, M; Meklin, T; Torvinen, E; Nevalainen, A

2004-01-01

In work environments with laboratory animals, the bedding of animals binds the excreta as well as other compounds originating from the animals and their environment. These may be generated into the ambient air when the personnel handle bedding in different procedures. This study compares the dustiness of different types of six clean and four soiled beddings from rat or mouse cages. The dust generation of clean bedding varied from <1 to 25 mg/m(3). When used in the cages of rats or mice for 4 days, the dust concentration of the beddings decreased, increased or stayed the same, depending on the type of bedding and animal species. A decrease in dustiness was, however, more common. The levels in the soiled beddings varied from <1 to 8.6 mg/m(3). In the case of the aspen chip bedding, the contents of bedding used in mouse, rat or rabbit cages were analysed for mesophilic bacteria and fungi, mycobacteria and endotoxins. All of these contaminants were variably found in the bedding samples, the maximal concentrations for bacteria were >6 500 000 colony-forming units (cfu)/g, for fungi 212 000 cfu/g, and for endotoxins 6500 ng/g (81 000 EU/g). The results showed that the bedding of laboratory animals may contain biologically effective compounds, and that these may be distributed into the ambient air depending on the characteristics of the bedding material. The dustiness of different bedding types is an important factor affecting the amount and quality of the occupational exposure of the personnel to airborne contaminants.

Automated electroencephalography system and electroencephalographic correlates of space motion sickness, part 2. [sleep characteristics

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.

1976-01-01

Sleep pattern alterations were detected in two subjects by electroencephalographic, electrographic, and electromyographic monitoring before, during and after a 28 day bed rest. Standardized criteria were used for data analysis. During the second half of the bed-rest period, sleep latency and stage 3 increased, while total sleep time, stage 2, and REM latency decreased. In addition, during bed rest both subjects showed an increase in the number of REM periods and a slight increase in stage REM amount. No major alterations were seen in the recovery period. Of the alterations found to be associated with bed rest, only one, the increase in stage 3 sleep, was also seen consistently during Skylab. Conversely, none of the postflight changes seen following Skylab were observed during the post-bed-rest recovery period.

Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.; Zanello, S. B.; Yarbough, P. O.; Tabbi, G.; Vizzeri, G.

2012-01-01

Reports of astronauts' visual changes have raised concern about ocular health during long-duration spaceflight. Some of these findings include globe flattening with hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, it is hypothesized that, in predisposed individuals, hypertension in the brain may follow cephalad fluid shifts during spaceflight. This possible mechanism of ocular changes may also apply to analogous cases of idiopathic intracranial hypertension (IIH) or pseudotumor cerebri on Earth patients. Head-down t ilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. Previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP) but the conditions of bed rest varied among experiments, making it difficult to compare data and draw conclusions. For these reasons, vision evaluation of bed rest subjects was implemented for NASA bed rest studies since 2010, in an attempt to monitor vision health in subjects subjected to bed rest. Vision monitoring is thus currently performed in all NASA-conducted bed rest campaigns

Mean 24-hours sympathetic nervous system activity decreases during head-down tilted bed rest but not during microgravity

NASA Astrophysics Data System (ADS)

Christensen, Nj; Heer, M.; Ivanova, K.; Norsk, P.

Sympathetic nervous system activity is closely related to gravitational stress in ground based experiments. Thus a high activity is present in the standing-up position and a very low activity is observed during acute head-out water immersion. Adjustments in sympathetic activity are necessary to maintain a constant blood pressure during variations in venous return. Head-down tilted bed rest is applied as a model to simulate changes observed during microgravity. The aim of the present study was to test the hypothesis that mean 24-hours sympathetic activity was low and similar during space flight and in ground based observation obtained during long-term head-down tilted bed rest. Forearm venous plasma noradrenaline was measured by a radioenzymatic technique as an index of muscle sympathetic activity and thrombocyte noradrenaline and adrenaline were measured as indices of mean 24-hours sympathoadrenal activity. Previous results have indicated that thrombocyte noradrenaline level has a half-time of 2 days. Thus to reflect sympathetic activity during a specific experiment the study period must last for at least 6 days and a sample must be obtained within 12 hours after the experiment has ended. Ten normal healthy subjects were studied before and during a 14 days head-down tilted bed rest as well as during an ambulatory study period of a similar length. The whole experiment was repeated while the subjects were on a low calorie diet. Thrombocyte noradrenaline levels were studied in 4 cosmonauts before and within 12 hours after landing after more than 7 days in flight. Thrombocyte noradrenaline decreased markedly during the head-down tilted bed rest (p<0.001), whereas there were no significant changes in the ambulatory study. Plasma noradrenaline decreased in the adaptation period but not during the intervention. During microgravity thrombocyte noradrenaline increased in four cosmonauts and the percentage changes were significantly different in cosmonauts and in subjects participating in the head down tilted bed rest study (170± 29% (Mean± SEM) vs. 57± 7%, respectively; p<0.001). The elevated sympathetic nervous system activity is most likely a regulatory response to combined effects of a reduced plasma volume and an increased vascular capacity in flight.

Bed conduction impact on fiber optic distributed temperature sensing water temperature measurements

NASA Astrophysics Data System (ADS)

O'Donnell Meininger, T.; Selker, J. S.

2015-02-01

Error in distributed temperature sensing (DTS) water temperature measurements may be introduced by contact of the fiber optic cable sensor with bed materials (e.g., seafloor, lakebed, streambed). Heat conduction from the bed materials can affect cable temperature and the resulting DTS measurements. In the Middle Fork John Day River, apparent water temperature measurements were influenced by cable sensor contact with aquatic vegetation and fine sediment bed materials. Affected cable segments measured a diurnal temperature range reduced by 10% and lagged by 20-40 min relative to that of ambient stream temperature. The diurnal temperature range deeper within the vegetation-sediment bed material was reduced 70% and lagged 240 min relative to ambient stream temperature. These site-specific results illustrate the potential magnitude of bed-conduction impacts with buried DTS measurements. Researchers who deploy DTS for water temperature monitoring should understand the importance of the environment into which the cable is placed on the range and phase of temperature measurements.

Patterns of morbidity and rehospitalisation following spinal cord injury.

PubMed

Middleton, J W; Lim, K; Taylor, L; Soden, R; Rutkowski, S

2004-06-01

Longitudinal, descriptive design. The aim of this study was to investigate the frequency, cause and duration of rehospitalisations in individuals with spinal cord injury (SCI) living in the community. Australian spinal cord injury unit in collaboration with State Health Department. A data set was created by linking records from the NSW Department of Health Inpatient Statistics Collection between 1989-1990 and 1999-2000 with data from the Royal North Shore Hospital (RNSH) Spinal Cord Injuries Database using probabilistic record linkage techniques. Records excluded were nontraumatic injuries, age <16 years, spinal column injury without neurological deficit, full recovery (ASIA Grade E) and index admission not at RNSH. Descriptive statistics and time to readmission using survival analysis, stratified by ASIA impairment grade, were calculated. Over the 10-year period, 253 persons (58.6%) required one or more spinal-related readmissions, accounting for 977 rehospitalisations and 15,127 bed-days (average length of stay (ALOS) 15.5 days; median 5 days). The most frequent causes for rehospitalisation were genitourinary (24.1% of readmissions), gastrointestinal (11.0%), further rehabilitation (11.0%), skin-related (8.9%), musculoskeletal (8.6%) and psychiatric disorders (6.8%). Pressure sores accounted for only 6.6% of all readmissions, however, contributed a disproportionate number of bed-days (27.9%), with an ALOS of 65.9 (median 49) days and over 50% of readmissions (33 out of 64) occurred in only nine individuals aged under 30 years. Age, level and completeness of neurological impairment, all influenced differential rates of readmission depending on the type of complication. Overall rehospitalisation rates were high in the first 4 years after initial treatment episode, averaging 0.64 readmissions (12.6 bed-days) per person at risk in the first year and fluctuating between 0.52 and 0.61 readmissions (5.1-8.3 bed-days) per person at risk per year between the second to fourth years, before trending downwards to reach 0.35 readmissions (2.0 bed-days) as 10th year approaches. Time to readmission was influenced by degree of impairment, with significantly fewer people readmitted for ASIA D (43.2%) versus ASIA A, B and C (55.2-67.0%) impairments (P<0.0001). The mean duration to first readmission was 46 months overall, however, differed significantly between persons with ASIA A-C impairments (26-36 months) and ASIA D impairment (60 months). Identifying rates, causes and patterns of morbidity is important for future resource allocation and targeting preventative measures. For instance, the late complication of pressure sores in a small subgroup of young males, consuming disproportionately large resources, warrants further research to better understand the complex psychosocial and environmental factors involved and to develop effective countermeasures.

Influence of pharmacy students on the attitudes of medical students following an interprofessional course.

PubMed

Dabaghzadeh, Fatemeh; Zihayat, Bahare; Sarafzadeh, Farhad

2017-01-01

Clinical interprofessional education (IPE) can promote mutual understanding of other health professions and respectful behaviors among health-care professionals. The aims of this study were to evaluate the effects of IPE on the attitudes of medical and pharmacy students in an inpatient hospital setting and, in particular, the influence of pharmacy students on the attitudes of medical students. The 6th year doctor of pharmacy students and medical students were enrolled in a prospective cohort study. They were paired and each pair was responsible for three beds and all the patients occupying these mentioned beds over the 2-week course. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was used to assess the students' attitudes before and after the course. The attitudes of the medical students changed positively after the IPE course based on RIPLS teamwork and collaboration and professional identity subscales. Changes in the attitudes of the pharmacy students were not statistically significant based on the mentioned scale and subscales. IPE could improve the attitudes of the medical students regarding interprofessional teamwork, communication, and sharing learning experience. Based on the current investigation, IPE did not have an effect on pharmacy students.

Diagnosis according to time of arrival at "The Great New York State Fair".

PubMed

Nacca, Katherine; Scott, Jay; Grant, William

2014-02-01

To study the diagnoses of patients presenting to a medical facility within a mass-gathering public event, "The Great New York State Fair" (NYSF) based on chief complaints, diagnoses, and time of arrival. The goal of the study was to assess the need for increased staffing, services, or supplies during certain times of day for an event that gathers approximately 1 million patrons over a 12-day span. Patrons occupy the grounds between the hours of 10 am and 11 pm, while workers and staff are on the grounds around the clock. Triage data gathered by trained medical students was collected from all of the patients seen during the 2009 NYSF from 12 am to 11:59 pm. Triage information was categorized based on the nature of complaint, physician impression, and time of arrival to assess for trends in the distribution of common chief complaints and diagnoses at a mass-gathering medical care facility. The early hours of the NYSF were occupied mostly with treatment of minor first aid complaints, while later hours were occupied more commonly by orthopedic complaints. Insect stings were the most frequent complaint throughout the day. Daytime and evening hours at the fair have a significant number of orthopedic diagnoses and may benefit from specific staff and equipment sufficient to handle these complaints. Stings and minor first aid injuries are also significant and may benefit from adequate stocking of the infirmary for such events. Major medical complaints, including cardiac and neurological complaints, did occur but were a minor part of the total patient population.

Bed occupancy monitoring: data processing and clinician user interface design.

PubMed

Pouliot, Melanie; Joshi, Vilas; Goubran, Rafik; Knoefel, Frank

2012-01-01

Unobtrusive and continuous monitoring of patients, especially at their place of residence, is becoming a significant part of the healthcare model. A variety of sensors are being used to monitor different patient conditions. Bed occupancy monitoring provides clinicians a quantitative measure of bed entry/exit patterns and may provide information relating to sleep quality. This paper presents a bed occupancy monitoring system using a bed pressure mat sensor. A clinical trial was performed involving 8 patients to collect bed occupancy data. The trial period for each patient ranged from 5-10 weeks. This data was analyzed using a participatory design methodology incorporating clinician feedback to obtain bed occupancy parameters. The parameters extracted include the number of bed exits per night, the bed exit weekly average (including minimum and maximum), the time of day of a particular exit, and the amount of uninterrupted bed occupancy per night. The design of a clinical user interface plays a significant role in the acceptance of such patient monitoring systems by clinicians. The clinician user interface proposed in this paper was designed to be intuitive, easy to navigate and not cause information overload. An iterative design methodology was used for the interface design. The interface design is extendible to incorporate data from multiple sensors. This allows the interface to be part of a comprehensive remote patient monitoring system.

Aspects of design, structure, performance and operation of reed beds--eight years' experience in northeastern New South Wales, Australia.

PubMed

Davison, L; Headley, T; Pratt, K

2005-01-01

Reed beds (horizontal subsurface flow constructed wetlands) have been employed as secondary treatment devices in on-site and decentralised wastewater management systems in the northeast of the Australian state of New South Wales (NSW) for over a decade. This paper summarises some of the practical and research findings that have come to light in that time. Experience with various aspects of reed bed structure is discussed. A study of the evaporative performance of four small beds planted with Phragmites australis yielded an annual crop factor of 2.6. A total of 28 studies on reed beds treating a variety of commonly encountered wastewater streams yielded the following mean pollutant removal efficiencies: total suspended solids (TSS) 83%, biochemical oxygen demand (BOD) 81%, total nitrogen (TN) 57%, total phosphorus (TP) 35% and faecal coliforms (FC) 1.9 logs. The reed bed is becoming the preferred on-site technology for removing TN and BOD and polishing TSS from primary settled domestic wastewater. Sizing beds for a residence time of approximately five days has become standard practice. A study of six reed beds found six different species of earthworm present, mainly Perionyx excavatus (Indian Blue). A mesocosm experiment subsequently showed that the worms were translocating clogging material from the substrate interstices to the surface of the bed thereby indicating a possible method for prolonging reed bed life.

Effect Of Leg Exercise On Vascular Volumes During Bed Rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Vernikos, J.; Wade, C. E.; Barnes, P. R.

1993-01-01

Report describes experiments on effects of no-exercise regimen and of two leg-exercise regimens on volumes of plasma, volumes of red blood cells, densities of bodies, and water balances of 19 men (32 to 42 years old) confined to minus 6 degrees-head-down bed rest for 30 days. Purpose of study to determine whether either or both exercise regimens maintain plasma volume and to relate levels of hypovolemia to body fluid balances. Results showed during bed rest, plasma volume maintained in isotomic group but not in other two groups, and no significant differences in body densities, body weights, or water balances among three groups. Concludes isotonic-exercise regimen better than isokinetic-exercise regimen for maintaining plasma volume during prolonged exposure to bed rest.

Changes in plasma volume during bed rest - Effects of menstrual cycle and estrogen administration

NASA Technical Reports Server (NTRS)

Fortney, S. M.; Beckett, W. S.; Carpenter, A. J.; Davis, J.; Drew, H.

1988-01-01

The effect of increased blood estrogen concentration, caused either during normal menstrual cycles or by exogenous administration of premarin, on the bed-rest (BR) induced decrease in plasma volume (PV) was investigated. In women who underwent duplicate 11-day BR without estrogen supplementation, the PV was found to decrease significantly, during the first 5 days of BR, to a lower level at which it remained for the rest of the BR period. In women who began BR in the periovulatory stage of the menstrual cycle, the loss of PV was delayed, while women who began BR during other stages of the cycle exhibited the usual trend of the PV decrease during the BR. In women who underwent a single 12-day BR period while taking premarin (1.25 mg/day), PV was found to decrease during the first 4-5 days of BR, but then returned toward the pre-BR level during the remainder of the BR, indicating that estrogens have a role in stabilizing body fluid volume.

Late Consequential Surgical Bed Soft Tissue Necrosis in Advanced Oropharyngeal Squamous Cell Carcinomas Treated With Transoral Robotic Surgery and Postoperative Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lukens, J. Nicholas; Lin, Alexander, E-mail: alexander.lin@uphs.upenn.edu; Gamerman, Victoria

Purpose: A subset of patients with oropharyngeal squamous cell carcinoma (OP-SCC) managed with transoral robotic surgery (TORS) and postoperative radiation therapy (PORT) developed soft tissue necrosis (STN) in the surgical bed months after completion of PORT. We investigated the frequency and risk factors. Materials and Methods: This retrospective analysis included 170 consecutive OP-SCC patients treated with TORS and PORT between 2006 and 2012, with >6 months' of follow-up. STN was defined as ulceration of the surgical bed >6 weeks after completion of PORT, requiring opioids, biopsy, or hyperbaric oxygen therapy. Results: A total of 47 of 170 patients (28%) hadmore » a diagnosis of STN. Tonsillar patients were more susceptible than base-of-tongue (BOT) patients, 39% (41 of 104) versus 9% (6 of 66), respectively. For patients with STN, median tumor size was 3.0 cm (range 1.0-5.6 cm), and depth of resection was 2.2 cm (range 1.0-5.1 cm). Median radiation dose and dose of fraction to the surgical bed were 6600 cGy and 220 cGy, respectively. Thirty-one patients (66%) received concurrent chemotherapy. Median time to STN was 2.5 months after PORT. All patients had resolution of STN after a median of 3.7 months. Multivariate analysis identified tonsillar primary (odds ratio [OR] 4.73, P=.01), depth of resection (OR 3.12, P=.001), total radiation dose to the resection bed (OR 1.51 per Gy, P<.01), and grade 3 acute mucositis (OR 3.47, P=.02) as risk factors for STN. Beginning May 2011, after implementing aggressive avoidance of delivering >2 Gy/day to the resection bed mucosa, only 8% (2 of 26 patients) experienced STN (all grade 2). Conclusions: A subset of OP-SCC patients treated with TORS and PORT are at risk for developing late consequential surgical bed STN. Risk factors include tonsillar location, depth of resection, radiation dose to the surgical bed, and severe mucositis. STN risk is significantly decreased with carefully avoiding a radiation dosage of >2 Gy/day to the surgical bed.« less

The effect of moisture content on solid-state anaerobic digestion of dairy manure from a sawdust-bedded pack barn

USDA-ARS?s Scientific Manuscript database

The effect of moisture content on solid-state anaerobic digestion of dairy manure from a Korean sawdust-bedded pack barn was determined using laboratory-scale digesters operated at three moisture levels (70, 76, and 83% on a wet basis) at 37 C for 85 days. Results showed that digesters containing m...

Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia.

PubMed

Sachetti, Amanda; Rech, Viviane; Dias, Alexandre Simões; Fontana, Caroline; Barbosa, Gilberto da Luz; Schlichting, Dionara

2014-01-01

To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia. A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia. Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389). The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.

Double dissociation in the neural substrates of acute opiate dependence as measured by withdrawal-potentiated startle.

PubMed

Harris, A C; Atkinson, D M; Aase, D M; Gewirtz, J C

2006-01-01

The basolateral amygdala and portions of the "extended" amygdala (i.e. central nucleus of the amygdala, bed nucleus of the stria terminalis and shell of the nucleus accumbens) have been implicated in the aversive aspects of withdrawal from chronic opiate administration. Given that similar withdrawal signs are observed following a single opiate exposure, these structures may also play a role in "acute opiate dependence." In the current study, drug-naïve rats underwent naloxone-precipitated withdrawal from acute morphine (10 mg/kg) exposure on two successive days. On either the first or second day of testing, the basolateral amygdala, central nucleus of the amygdala, bed nucleus of the stria terminalis, or nucleus accumbens was temporarily inactivated immediately prior to naloxone injection by microinfusion of the glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoxazole proprionic acid receptor antagonist 1,2,3,4-tetrahydro-6-nitro-2,3-dioxo-benzo(f)quinoxaline-7-sulfonamide (3 microg/0.5 microl). On the first day, inactivation of the basolateral amygdala, central nucleus of the amygdala, or bed nucleus of the stria terminalis, but not the nucleus accumbens blocked withdrawal-potentiated startle, a behavioral measure of the anxiogenic effects of withdrawal. On the second day, inactivation of the nucleus accumbens, but not the basolateral amygdala, central nucleus of the amygdala, or bed nucleus of the stria terminalis disrupted the withdrawal effect. Effects of structural inactivations on withdrawal-potentiated startle were not influenced by differences in withdrawal severity on the two days of testing. A fear-potentiated startle procedure provided functional confirmation of correct cannulae placement in basolateral amygdale- and central nucleus of the amygdala-implanted animals. Our findings indicate a double dissociation in the neural substrates of withdrawal-potentiated startle following a first versus second morphine exposure, and may reflect a reorganization of the neural circuitry underlying the expression of withdrawal-induced negative affect during the earliest stages of opiate dependence.

Climate change, keystone predation, and biodiversity loss.

PubMed

Harley, Christopher D G

2011-11-25

Climate change can affect organisms both directly via physiological stress and indirectly via changing relationships among species. However, we do not fully understand how changing interspecific relationships contribute to community- and ecosystem-level responses to environmental forcing. I used experiments and spatial and temporal comparisons to demonstrate that warming substantially reduces predator-free space on rocky shores. The vertical extent of mussel beds decreased by 51% in 52 years, and reproductive populations of mussels disappeared at several sites. Prey species were able to occupy a hot, extralimital site if predation pressure was experimentally reduced, and local species richness more than doubled as a result. These results suggest that anthropogenic climate change can alter interspecific interactions and produce unexpected changes in species distributions, community structure, and diversity.

Design and performance of a trickle-bed bioreactor with immobilized hybridoma cells.

PubMed

Phillips, H A; Scharer, J M; Bols, N C; Moo-Young, M

1992-01-01

A trickle-bed system employing inert matrices of vermiculite or polyurethane foam packed in the downcomer section of a split-flow air-lift reactor has been developed for hybridoma culture to enhance antibody productivity. This quiescent condition favoured occlusion and allowed the cells to achieve densities twelve fold greater (12.8 x 10(6) cells/ml reactor for polyurethane foam) than in free cell suspension. The reactor was operated in a cyclic batch mode whereby defined volumes of medium were periodically withdrawn and replaced with equal volumes of fresh medium. The pH of the medium was used as the indicator of the feeding schedule. Glucose, lactate and ammonia concentrations reached a stationary value after 5 days. With vermiculite packing, a monoclonal antibody (MAb) concentration of 2.4 mg/l was achieved after 12 days. The MAb concentration declined then increased to a value of 1.8 mg/l. In the polyurethane foam average monoclonal antibody (MAb) concentrations reached a stationary value of 1.1 mg/l in the first 20 days and increased to a new stationary state value of 2.1 mg/l for the remainder of the production. MAb productivity in the trickle-bed reactor was 0.3 mg/l.d (polyurethane foam) and 0.18 mg/l.d (vermiculite) in comparison to 0.12 mg/l.d for free cell suspension. This trickle-bed system seems to be an attractive way of increasing MAb productivity in culture.

The dynamic response of Kennicott Glacier, Alaska, USA, to the Hidden Creek Lake outburst flood

USGS Publications Warehouse

Anderson, R. Scott; Walder, J.S.; Anderson, S.P.; Trabant, D.C.; Fountain, A.G.

2005-01-01

Glacier sliding is commonly linked with elevated water pressure at the glacier bed. Ice surface motion during a 3 week period encompassing an outburst of ice-dammed Hidden Creek Lake (HCL) at Kennicott Glacier, Alaska, USA, showed enhanced sliding during the flood. Two stakes, 1.2 km from HCL, revealed increased speed in two episodes, both associated with uplift of the ice surface relative to the trajectory of bed-parallel motion. Uplift of the surface began 12 days before the flood, initially stabilizing at a value of 0.25 m. Two days after lake drainage began, further uplift (reaching 0.4 m) occurred while surface speed peaked at 1.2 m d-1. Maximum surface uplift coincided with peak discharge from HCL, high water level in a down-glacier ice-marginal basin, and low solute concentrations in the Kennicott River. Each of these records is consistent with high subglacial water pressure. We interpret the ice surface motion as arising from sliding up backs of bumps on the bed, which enlarges cavities and produces bed separation. The outburst increased water pressure over a broad region, promoting sliding, inhibiting cavity closure, and blocking drainage of solute-rich water from the distributed system. Pressure drop upon termination of the outburst drained water from and depressurized the distributed system, reducing sliding speeds. Expanded cavities then collapsed with a 1 day time-scale set by the local ice thickness.

Water contamination in fallout areas. Project No. 7806

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robeck, G.G.; Woodward, R.L.; Muschler, W.K.

1958-05-01

An evaluation of the potential radiological hazard to Air Force personnel from drinking water contaminated with fission products is presented. Ground water supplies should be safe from fallout contamination and only surface supplies may need special treatment. Even in untreated water, the radioactivity in surface supplies is not likely to reduce significantly the military effectiveness of personnel using it except where the general level of contamination is greater than 1000 r/hr at H + 1. Dust samples were collected at the Priscilla shot of Operation Plumbbob 24 June 1957. In each of the samples, material containing approximately 10% of themore » activity was soluble; however, strontium was preferentially dissolved by a factor of 5. For the first 10 days after fallout, a supply of one gallon of water per person per day will suffice for drinking and culinary purposes. Ion-exchange, which is over 99% efficient, is the most practical and economical method of supplying decontaminated water. For immediate demand, small mixed-bed demineralizers, which are easily installed and maintained, are recommended; for long term demand, pressure cation-exchange beds operated on the sodium cycle are recommended. A shelter accommodating 100 people would require a small mixed-bed demineralizer with an initial cost of $81 and an operating cost of $9 per day. A pressure cation-exchange bed could be installed for $7,500 which would have an operating cost of 15 cents per 1,000 gallons. This could supply an average daily water requirement of 50,000 gallons.« less

WATER CONTAMINATION IN FALLOUT AREAS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robeck, G.G.; Woodward, R.L.; Muschler, W.K.

1958-05-01

An evaluation of the potential radiological hazard to Air Force personnel from drinking water contaminated with fission products is presented. Ground water supplies should be safe from fall-out contamination and only surface supplies may need special treatment. Even in untreated water, the radioactivity in surface supplies is not likely to reduce significantly the military effectiveness of personnel using it except where the general level of contamination is greater than 1000 r/hr at H + 1. Dust samples were collected at the Priscilla shot of Operation Plumbbob 24 June 1957. In each of the samples, material containing approximately 10% of themore » activity was soluble; however, strontium was preferentially dissolved by a factor of 5. For the first 10 days after fall-out, a supply of one gallon of water per person per day will suffice for drinking and culinary purposes, Ion-exchange, which is over 99% efficient, is the most practical and economical method of supplying decontaminated water, For immediate demand, small mixed-bed demineralizers, which are easily installed and maintained, are recommended; for long term demand, pressure cation-exchange beds operated on the sodium cycle are recommended. A shelter accommodating 100 people would require a small mixed-bed demineralizer with an initial cost of and an operating cost of per day. A pressure cation-exchange bed could be installed for 500 which would have an operating cost of 15 cents per 1,000 gallons. This could supply an average daily water requirement of 50,000 gallons. (auth)« less

A THIRD OF PATIENTS TREATED AT A TERTIARY LEVEL SURGICAL SERVICE COULD BE TREATED AT A SECONDARY LEVEL FACILITY.

PubMed

Van Straten, S K; Stannard, C J; Bulabula, J; Paul, K; Leong, J; Klipin, M

2017-06-01

South Africa has an overburdened public healthcare system. Some admissions to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) may not require tertiary care. The numbers and details thereof are uncertain. Clinical research is limited by skills and access to data. A retrospective analysis of Electronic Discharge (ED) summaries from the Department of Surgery at CMJAH between 01 April 2015 and 01 April 2016. An SQL-query of the database generated a .csv file of all discharges with the fields database reference number, length of stay and level of care. The details and level of care of each record were verified by MBBCh 5 medical students using a defined level of care template with review of the full discharge summary. The data was reviewed by a senior clinician. There were 3007 discharge summaries, 97 were not classifiable, two were test records and one was a duplicate. These 100 records were excluded. There were no primary level records. Secondary level patients represented 29% (854) of patients discharged and 19% of total bed days. Tertiary and quaternary together represented 71% of the total patients and 81% of bed days. The average length of stay was 4.31 days for secondary, 6.98 days for tertiary and 9.77 days for quaternary level of care allocation. Almost a third (29%) of patients discharged from CMJAH Department of Surgery were deemed suitable for secondary level care. These admissions have a shorter length of stay and comprise 19% of total bed days. Students and electronic databases are useful research resources.

Infant's bed climate and bedding in the Japanese home.

PubMed

Nakamura Ikeda, Rie; Fukai, Kiyoko; Okamoto Mizuno, Kazue

2012-06-01

to assess the bed climate of infants in their homes in Japan. descriptive, exploratory, non-experimental research design. the data were collected at the participants' homes under normal circumstances. nineteen healthy infants between the ages of two and five months. Their mothers, who joined a parenting class organised by a maternity clinic in Okayama, Japan, consented to participate in this study. we visited the infants' homes and interviewed their mothers concerning the types and use of bedding. The temperature and relative humidity of the bed climate at the back and foot of the bedding, and in the room were measured every minute for four consecutive days. Differences among the bed climates measured during three seasons (spring, summer, and autumn) were assessed by one-way analysis of variance. The bed temperature was higher for infants than for adults. No significant difference in temperature was noted among the three seasons. The bed temperature was about 36.0°C when waterproof sheets and futon mattresses for children or adult were used. The average relative humidity of the bed climate at the back was highest in summer, followed by that in spring and autumn; the differences were significant. The use of waterproof sheets and futon mattresses for children in summer increased the relative humidity to 80% or more. The use of infant beds, sunoko drainboards, and cotton futon mattresses in summer was effective in reducing the bed humidity. these results suggest that nurse-midwives should advise the parents on comfortable bed climates for their infants, as well as how to select and use bedding for them. Copyright © 2010 Elsevier Ltd. All rights reserved.

Human thermoregulatory function during exercise and immersion after 35 days of horizontal bed-rest and recovery.

PubMed

Mekjavic, Igor B; Golja, Petra; Tipton, Michael J; Eiken, Ola

2005-10-01

The present study evaluated the effect of 35 days of experimental horizontal bed-rest on exercise and immersion thermoregulatory function. Fifteen healthy male volunteers were assigned to either a Control (n = 5) or Bed-rest (n = 10) group. Thermoregulatory function was evaluated during a 30-min bout of submaximal exercise on a cycle ergometer, followed immediately by a 100-min immersion in 28 degrees C water. For the Bed-rest group, exercise and immersion thermoregulatory responses observed post-bed-rest were compared with those after a 5 week supervised active recovery period. In both trials, the absolute work load during the exercise portion of the test was identical. During the exercise and immersion, we recorded skin temperature, rectal temperature, the difference in temperature between the forearm and third digit of the right hand (DeltaT(forearm-fingertip))--an index of skin blood flow, sweating rate from the forehead, oxygen uptake and heart rate at minute intervals. Subjects provided ratings of temperature perception and thermal comfort at 5-min intervals. Exercise thermoregulatory responses after bed-rest and recovery were similar. Subjective ratings of temperature perception and thermal comfort during immersion indicated that subjects perceived similar combinations of Tsk and Tre to be warmer and thermally less uncomfortable after bed-rest. The average (SD) exercise-induced increase in Tre relative to resting values was not significantly different between the Post-bed-rest (0.4 (0.2) degrees C) and Recovery (0.5 (0.2) degrees C) trials. During the post-exercise immersion, the decrease in Tre, relative to resting values, was significantly (P < 0.05) greater in the Post-bed-rest trial (0.9 (0.5) degrees C) than after recovery (0.4 (0.3) degrees C). DeltaT(forearm-fingertip) was 5.2 (0.9) degrees C and 5.8 (1.0) degrees C at the end of the post-bed-rest and recovery immersions, respectively. The gain of the shivering response (increase in VO(2) relative to the decrease in Tre; VO(2)/Tre) was 1.19 l min(-1) degrees C(-1) in the Recovery trial, and was significantly attenuated to 0.51 l min(-1) degrees C(-1) in the Post-bed-rest trial. The greater cooling rate observed in the post-bed-rest trial is attributed to the greater heat loss and reduced heat production. The former is the result of attenuated cold-induced vasoconstriction and enhanced sweating rate, and the latter a result of a lower shivering VO(2) response.

Use of bed rest and head-down tilt to simulate spaceflight-induce immune system changes

NASA Technical Reports Server (NTRS)

Schmitt, D. A.; Schaffar, L.; Taylor, G. R.; Loftin, K. C.; Schneider, V. S.; Koebel, A.; Abbal, M.; Sonnenfeld, G.; Lewis, D. E.; Reuben, J. R.;

Cardiac atrophy in women following bed rest.

PubMed

Dorfman, Todd A; Levine, Benjamin D; Tillery, Tommy; Peshock, Ronald M; Hastings, Jeff L; Schneider, Suzanne M; Macias, Brandon R; Biolo, Gianni; Hargens, Alan R

2007-07-01

Both chronic microgravity exposure and long-duration bed rest induce cardiac atrophy, which leads to reduced standing stroke volume and orthostatic intolerance. However, despite the fact that women appear to be more susceptible to postspaceflight presyncope and orthostatic hypotension than male astronauts, most previous high-resolution studies of cardiac morphology following microgravity have been performed only in men. Because female athletes have less physiological hypertrophy than male athletes, we reasoned that they also might have altered physiological cardiac atrophy after bed rest. Magnetic resonance imaging was performed in 24 healthy young women (32.1 +/- 4 yr) to measure left ventricular (LV) and right ventricular (RV) mass, volumes, and morphology accurately before and after 60 days of 6 degrees head-down tilt (HDT) bed rest. Subjects were matched and then randomly assigned to sedentary bed rest (controls, n = 8) or two treatment groups consisting of 1) exercise training using supine treadmill running within lower body negative pressure plus resistive training (n = 8), or 2) protein (0.45 g x kg(-1) x day(-1) increase) plus branched-chain amino acid (BCAA) (7.2 g/day) supplementation (n = 8). After sedentary bed rest without nutritional supplementation, there were significant reductions in LV (96 +/- 26 to 77 +/- 25 ml; P = 0.03) and RV volumes (104 +/- 33 to 86 +/- 25 ml; P = 0.02), LV (2.2 +/- 0.2 to 2.0 +/- 0.2 g/kg; P = 0.003) and RV masses (0.8 +/- 0.1 to 0.6 +/- 0.1 g/kg; P < 0.001), and the length of the major axis of the LV (90 +/- 6 to 84 +/- 7 mm. P < 0.001), similar to what has been observed previously in men (8.0%; Perhonen MA, Franco F, Lane LD, Buckey JC, Blomqvist Zerwekh JE, Peshock RM, Weatherall PT, Levine BD. J Appl Physiol 91: 645-653, 2001). In contrast, there were no significant reductions in LV or RV volumes in the exercise-trained group, and the length of the major axis was preserved. Moreover, there were significant increases in LV (1.9 +/- 0.4 to 2.3 +/- 0.3 g/kg; P < 0.001) and RV masses (0.7 +/- 0.1 to 0.8 +/- 0.2 g/kg; P = 0.002), as well as mean wall thickness (9 +/- 2 to 11 +/- 1 mm; P = 0.02). The interaction between sedentary and exercise LV and RV masses was highly significant (P < 0.0001). Protein and BCAA supplementation led to an intermediate phenotype with no change in LV or RV mass after bed rest, but there remained a significant reduction in LV volume (103 +/- 14 to 80 +/- 16 ml; P = 0.02) and major-axis length (91 +/- 5 to 88 +/- 7 mm; P = 0.003). All subjects lost an equivalent amount of body mass (3.4 +/- 0.2 kg control; 3.1 +/- 0.04 kg exercise; 2.8 +/- 0.1 kg protein). Cardiac atrophy occurs in women similar to men following sedentary 60 days HDT bed rest. However, exercise training and, to a lesser extent, protein supplementation may be potential countermeasures to the cardiac atrophy associated with chronic unloading conditions such as in spaceflight and prolonged bed rest.

Rapid Anastomosis of Endothelial Progenitor Cell–Derived Vessels with Host Vasculature Is Promoted by a High Density of Cotransplanted Fibroblasts

PubMed Central

Chen, Xiaofang; Aledia, Anna S.; Popson, Stephanie A.; Him, Linda; Hughes, Christopher C.W.

2010-01-01

To ensure survival of engineered implantable tissues thicker than approximately 2–3 mm, convection of nutrients and waste products to enhance the rate of transport will be required. Creating a network of vessels in vitro, before implantation (prevascularization), is one potential strategy to achieve this aim. In this study, we developed three-dimensional engineered vessel networks in vitro by coculture of endothelial cells (ECs) and fibroblasts in a fibrin gel for 7 days. Vessels formed by cord blood endothelial progenitor cell–derived ECs (EPC-ECs) in the presence of a high density of fibroblasts created an interconnected tubular network within 4 days, compared with 5–7 days in the presence of a low density of fibroblasts. Vessels derived from human umbilical vein ECs (HUVECs) in vitro showed similar kinetics. Implantation of the prevascularized tissues into immune-compromised mice, however, revealed a dramatic difference in the ability of EPC-ECs and HUVECs to form anastomoses with the host vasculature. Vascular beds derived from EPC-ECs were perfused within 1 day of implantation, whereas no HUVEC vessels were perfused at day 1. Further, while almost 90% of EPC-EC–derived vascular beds were perfused at day 3, only one-third of HUVEC-derived vascular beds were perfused. In both cases, a high density of fibroblasts accelerated anastomosis by 2–3 days. We conclude that both EPC-ECs and a high density of fibroblasts significantly accelerate the rate of functional anastomosis, and that prevascularizing an engineered tissue may be an effective strategy to enhance convective transport of nutrients in vivo. PMID:19737050

Subjective and objective observation of skin graft recovery on Indonesian local cat with different periods of transplantation time.

PubMed

Erwin; Gunanti; Handharyani, Ekowati; Noviana, Deni

2016-05-01

The success of a skin graft in a cat is highly dependent on the granulation formed by the base of recipient bed. Granulation by the base of recipient bed will form after several days after injury. This research aimed to observe subjective and objective profile of skin graft recovery on forelimb of cats with different periods of donor skin placement. Nine male Indonesian local cats aged 1-2 years old, weighing 3-4 kg were divided into three groups. The first surgery for creating defect wound of 2 cm×2 cm in size was performed in the whole group. The wound was left for several days with the respective interval for each group, respectively: Group I (for 2 days), Group II (for 4 days), and Group III (for 6 days). In the whole group, the second surgery was done by the harvesting skin of thoracic area which then applied on recipient bed of respective groups. The donor skin on Group II was accepted faster compared to Group I and Group III. The donor skin did not show color differences compared to surrounding skin, painless, bright red in bleeding test had faster both hair growth and drug absorption. Test toward the size of donor skin and the effect of drugs did not show a significant difference between each group. The observe subjective and objective profile of skin graft recovery on forelimb of cats on Group II were accepted faster compared to Group I and III.

Integrated Resistance and Aerobic Training Maintains Cardiovascular and Skeletal Muscle Fitness During 14 Days of Bed Rest

NASA Technical Reports Server (NTRS)

Ploutz-Snyder, Lori; Goetchius, Elizabeth; Crowell, Brent; Hackney, Kyle; Wickwire, Jason; Ploutz-Snyder, Robert; Snyder, Scott

2012-01-01

Background: Known incompatibilities exist between resistance and aerobic training. Of particular importance are findings that concurrent resistance and aerobic training reduces the effectiveness of the resistance training and limits skeletal muscle adaptations (example: Dudley & Djamil, 1985). Numerous unloading studies have documented the effectiveness of resistance training alone for the maintenance of skeletal muscle size and strength. However the practical applications of those studies are limited because long ]duration crew members perform both aerobic and resistance exercise throughout missions/spaceflight. To date, such integrated training on the International Space Station (ISS) has not been fully effective in the maintenance of skeletal muscle function. Purpose: The purpose of this study was to evaluate the efficacy of high intensity concurrent resistance and aerobic training for the maintenance of cardiovascular fitness and skeletal muscle strength, power and endurance over 14 days of strict bed rest. Methods: 9 subjects (8 male and 1 female; 34.5 +/- 8.2 years) underwent 14 days of bed rest with concurrent training. Resistance and aerobic training were integrated as shown in table 1. Days that included 2 exercise sessions had a 4-8 hour rest between exercise bouts. The resistance training consisted of 3 sets of 12 repetitions of squat, heel raise, leg press and hamstring curl exercise. Aerobic exercise consisted of periodized interval training that included 30 sec, 2 min and 4 min intervals alternating by day with continuous aerobic exercise.

Healthy Smile for Your Young Child: Tips to Keep Your Child Healthy

MedlinePlus

... teeth with a soft toothbrush and toothpaste with fluoride, twice a day, after breakfast and before bed. ... m Brush your child’s teeth with toothpaste with fluoride (floor-ide) twice a day, after breakfast and ...

Posture analysis on young women before and after 60 days of -6 degrees head down bed rest (Wise 2005).

PubMed

Viguier, Marion; Dupui, Philippe; Montoya, Richard

2009-02-01

Twenty-four women divided into three groups: control, exercise and nutrition, have been involved in a -6 degrees head down bed rest (HDBR) experiment for 60 days. The objective was to analyse the effects of microgravity on balance function regulation. Group comparisons assessed the efficiency of countermeasures (specific exercises and in particular diet) on the deleterious effects of simulated microgravity. Measurements of orthostatic and dynamic balance were taken 9 and 2 days prior to the experiment, on the first day of getting up, the following day and 4 and 10 days after, under two visual conditions: eyes open and eyes closed. The results confirmed that, as in any other test performed with ordinary subjects, the postural balance performances are better with eyes open than with eyes closed. The static and dynamic postural performances were impaired on the first day of recovery (R0) following HDBR. This impairment lasted up to 4 days after getting up and, afterwards the volunteers recovered their initial performances. The exercise group recovered static postural performances more quickly than the other groups whereas there were no differences in the recovery of the dynamic balance performances.

Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals.

PubMed

Banks, M D; Graves, N; Bauer, J D; Ash, S

2013-01-01

This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Statistical models were developed to predict 'cases of pressure ulcer avoided', 'number of bed days gained' and 'change to economic costs' in public hospitals in 2002-2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12, 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Reduced Incidence of Foot-Related Hospitalisation and Amputation amongst Persons with Diabetes in Queensland, Australia

PubMed Central

Lazzarini, Peter A.; O’Rourke, Sharon R.; Russell, Anthony W.; Derhy, Patrick H.; Kamp, Maarten C.

2015-01-01

Objective To determine trends in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland (Australia) between 2005 and 2010 that coincided with changes in state-wide ambulatory diabetic foot-related complication management. Methods All data from cases admitted for the principal reason of diabetes foot-related hospitalisation or amputation in Queensland from 2005–2010 were obtained from the Queensland Hospital Admitted Patient Data Collection dataset. Incidence rates for foot-related hospitalisation (admissions, bed days used) and amputation (total, minor, major) cases amongst persons with diabetes were calculated per 1,000 person-years with diabetes (diabetes population) and per 100,000 person-years (general population). Age-sex standardised incidence and age-sex adjusted Poisson regression models were also calculated for the general population. Results There were 4,443 amputations, 24,917 hospital admissions and 260,085 bed days used for diabetes foot-related complications in Queensland. Incidence per 1,000 person-years with diabetes decreased from 2005 to 2010: 43.0% for hospital admissions (36.6 to 20.9), 40.1% bed days (391 to 234), 40.0% total amputations (6.47 to 3.88), 45.0% major amputations (2.18 to 1.20), 37.5% minor amputations (4.29 to 2.68) (p < 0.01 respectively). Age-sex standardised incidence per 100,000 person-years in the general population also decreased from 2005 to 2010: 23.3% hospital admissions (105.1 to 80.6), 19.5% bed days (1,122 to 903), 19.3% total amputations (18.57 to 14.99), 26.4% major amputations (6.26 to 4.61), 15.7% minor amputations (12.32 to 10.38) (p < 0.01 respectively). The age-sex adjusted incidence rates per calendar year decreased in the general population (rate ratio (95% CI)); hospital admissions 0.949 (0.942–0.956), bed days 0.964 (0.962–0.966), total amputations 0.962 (0.946–0.979), major amputations 0.945 (0.917–0.974), minor amputations 0.970 (0.950–0.991) (p < 0.05 respectively). Conclusions There were significant reductions in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in the population of Queensland over a recent six-year period. PMID:26098890

Tracking bed bugs (Cimex lectularius): a study of the effect of physiological and extrinsic factors on the response to bed bug-derived volatiles.

PubMed

Weeks, E N I; Logan, J G; Birkett, M A; Pickett, J A; Cameron, M M

2013-02-01

The common bed bug, Cimex lectularius, feeds on the blood of mammal and bird hosts, and is a pest of global importance. Semiochemicals are chemicals involved in animal communication that may affect behaviour and/or physiology. Attractive semiochemicals that play a role in mediating bed bug behaviour could be exploited for the development of a highly effective novel monitoring device. Tracking software was used to record the response of bed bugs to volatiles from paper previously exposed to conspecific bugs in a still-air olfactometer illuminated by infrared lights, through a variety of activity variables. The effect of time of day as an extrinsic factor, and sex, stage, mating status and nutritional status as physiological factors on the response of bed bugs to the volatiles was examined. Bed bugs of both sexes and all stages responded to the volatiles from bed bug-exposed papers, showing significant attraction and orientation towards the volatile source whether they were starved or engorged. Confirmation that the physiological factors examined do not affect the response of bed bugs to the volatiles from bed bug-exposed papers provides evidence that these bed bug-derived volatiles contain aggregation cues, as semiochemicals that promote aggregation should by definition be detected by both sexes and all life stages. A device baited with such semiochemicals could play a major role in limiting the impact of the current bed bug resurgence by enabling timely detection of infestations, along with quantitative evaluation of control and effective surveillance of the geographical distribution of the pest species.

Hubble space telescope six-battery test bed

NASA Technical Reports Server (NTRS)

Pajak, J. A.; Bush, J. R., Jr.; Lanier, J. R., Jr.

1990-01-01

A test bed for a large space power system breadboard for the Hubble Space Telescope (HST) was designed and built to test the system under simulated orbital conditions. A discussion of the data acquisition and control subsystems designed to provide for continuous 24 hr per day operation and a general overview of the test bed is presented. The data acquisition and control subsystems provided the necessary monitoring and protection to assure safe shutdown with protection of test articles in case of loss of power or equipment failure over the life of the test (up to 5 years).

Characterization of Solute Transport in Subsurface Using Permeable Pavement and Artificial Precipitation

NASA Astrophysics Data System (ADS)

HAN, K.; Hong, U.; Yeum, Y.; Yoon, J.; Lee, J.; Song, K.; Kwon, S.; Kim, Y.

2016-12-01

Permeable block as low impact development (LID) management can reduce storm water runoff, improve surface water quality and increase groundwater recharge. Recently, in Korea, application of the permeable block has growing trend for urban planning. However, few studies have evaluated how infiltrated rainfall through permeable block affect groundwater quality. Therefore, we conducted monitoring and evaluating of contaminants transport from permeable block surface to aquifer at LID installed three test-bed site. Pollutant materials as total nitrogen (T-N), nitrate (NO3-), ammonium (NH4+), total phosphorus (T-P), phosphate (PO42-), total organic carbon (TOC), sodium (Na+) and bromide (Br-) such as nonreactive tracer were sprinkled under permeable block and sprayed artificial precipitation of 100 mm/hr intensity during a 4 hours by rainfall simulator. All the test-bed area is 2 m x 2 m and monitoring wells were drilled a maximum depth of 10 m. Test-bed 1,2 and 3 groundwater level was approximately 1.9 m, 3.6 m and 4.6 m below ground surface, respectively. Test-bed 1 and 2, time to maximum concentration of Br- as tracer were 0.15 day and 1.71 day after simulated rainfall. In the test-bed 1, average normalized concentration (C* = Cmonitoring/C0, C0 is mass of sprinkled pollutant divide by sprayed water volume) of Br-, T-N, NO3-, NH4+, T-P, PO42-, TOC and Na+ were observed 0.26, 0.08, 0.14, N.D(not detected), 0.05, 0.05, 0.13 and 0.11, respectively. C* of tracer and other solutes on test-bed 2 were 0.52, 0.15, 0.25, N.D, 0.02, 0.02, 0.16 and 0.15, respectively. These phenomena that distinctions between C* of Br-and other solutes indicate to occur retardation by physical/chemical and biological process while pollutant containing water permeate from unsaturated soil to saturated aquifer. However, at the test-bed 3 distinct concentration of all solutes were not detected until 40 days. In this study evaluated the effects of groundwater quality by rainfall leachate from permeable block. Infiltration rate of solutes were measured NO3- > TOC > Na+ >>> PO42- > NH4+. Especially, these results suggested that organic N and T-P (PO42-) need not consideration for groundwater quality at permeable LID system.

Effects of bedding with recycled sand on lying behaviors, udder hygiene, and preference of lactating Holstein dairy cows.

PubMed

Kull, J A; Ingle, H D; Black, R A; Eberhart, N L; Krawczel, P D

2017-09-01

Effects of bedding with recycled sand and season on lying behaviors, hygiene, and preferences of late-lactation Holstein cows were studied. It was hypothesized that recycled sand will decrease lying time and increase hygiene scores due to increased moisture content and organic matter, and thus a preference for the control sand will be evident. Cows (n = 64) were divided into 4 groups (n = 8 per group) per season. In summer (August to September), cows were balanced by days in milk (268.1 ± 11.9 d) and parity (2.0 ± 0.2). In winter (January to February), mean DIM was 265.5 ± 34.1 d. Cows were assigned to 1 of 2 treatments using a crossover design with each treatment lasting 7 d (no-choice phase): bedding with recycled sand (RS; n = 32) or control (CO; clean sand; n = 32). Stocking density was maintained at 100%. The choice phase allowed cows to have access to either treatment with stocking density at 50%. Accelerometers recorded daily lying time, number of lying bouts per day, lying bout duration (min/bout), and total steps per day. Teat swabs, milk, sand samples, and udder hygiene scores were collected on d 0, 3, and 7 of each experimental week. Samples were cultured for streptococci, staphylococci, and gram-negative bacteria. Video data were used to assess bedding preferences. All data were analyzed using the MIXED and GLIMMIX procedures of SAS 9.4 (SAS Institute Inc., Cary, NC). Lying time was not affected by treatment, but cows did take more steps during winter. Bacterial counts were elevated for cows on recycled sand. A preference was observed for clean sand during the summer, but no preference was observed for sand during the winter. Regardless of bedding, the most commonly observed behavior was lying in the stalls, which suggested either bedding might be suitable. Caution should be used with this interpretation of preference, as sand was recycled only once. This limited reclamation was still sufficient to potentially alter the composition of sand, driving the observed preference. If these changes in composition continue, then the strength of the preference may also change. However, considering all variables within the current study, recycled sand is a viable bedding source to use for dairy cows. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Evaluation of High-Temporal-Resolution Bedload Sensors for Tracking Channel Bed Movement and Transport Thresholds in Forested Mountain Headwater Catchments.

NASA Astrophysics Data System (ADS)

Martin, S.; Conklin, M. H.; Bales, R. C.

2014-12-01

High temporal resolution data is required to take channel bed movement data beyond time integrated changes between measurements where many of the subtleties of bedload movement patterns are often missed. This study used continuous bedload scour sensors (flexible, fluid-filled pans connected to a pressure transducer) to collect high temporal resolution, long term bedload movement data for 4 high elevation (1500-1800 m) Sierra Nevada headwater streams draining 1 km2 catchments and to investigate the physical channel characteristics under which they perform best. Data collected by the scour sensors were used to investigate the disturbance and recovery patterns of these streams, to relate the observed patterns to channel bed stability, and to evaluate whether the channel bed is acting as a sediment source, sink, or storage across various temporal scales. Finally, attempts are made to identify discharge thresholds for bed movement from scour sensor and discharge data and to compare these threshold values to observed changes in the channel bed. Bedload scour data, turbidity data, and stream discharge data were collected at 15 minute intervals for (WY 2011 to WY 2014), including both above average (2011) and below average (2012, 2013, 2014) water years. Bedload scour sensors were found to have a relatively high (60%) failure rate in these systems. In addition, they required in situ calibrations as the factory and laboratory calibrations did not translate well to the field deployments. Data from the working sensors, showed patterns of abrupt channel bed disturbance (scour and/or fill) on an hour to day temporal scale followed by gradual recovery on a day to month scale back to a stable equilibrium bed surface elevation. These observed patterns suggest the bed acts as a short term source or sink for sediment, but is roughly sediment neutral over longer time periods implying the changes in bed elevation are reflective of fluctuations in storage rather than a true source or sink. Overall, these sensors show promise for collecting continuous data for high gradient, forested, mountain streams. Additional benefits include their relatively low cost both monetarily (under $1000) and in labor compared to traditional methods as well as not requiring the trade-off between temporal resolution and length of study that traditional methods do.

The impact of rifaximin-α on the hospital resource use associated with the management of patients with hepatic encephalopathy: a retrospective observational study (IMPRESS).

PubMed

Hudson, Mark; Radwan, Amr; Di Maggio, Paola; Cipelli, Riccardo; Ryder, Stephen D; Dillon, John F; Cash, William Jonathan; Przemioslo, Robert T; Wright, Mark; Shawcross, Debbie L; Jalan, Rajiv; Saksena, Sushma; Allison, Michael; Richardson, Paul; Farrington, Elizabeth; Aspinall, Richard J

2017-10-01

To compare all-cause and liver-related hospital resource use in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation in UK patients with hepatic encephalopathy (HE). A UK multicentre, retrospective, observational study. Patients' medical records were reviewed for demographics, clinical outcomes and adverse events (AEs) to rifaximin-α. Details of hospital admissions/attendances in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation were extracted from hospital electronic databases. 13 National Health Service centres. 207 patients with HE who initiated rifaximin-α between July 2008 and May 2014. Hospital resource use data were available for 145/207 patients. Change in mean number of liver-related hospital bed days/patient (total and critical care) between the 6 months pre-rifaximin-α and post-rifaximin-α initiation. Comparing the 6 months pre-rifaximin-α and post-rifaximin-α initiation in alive patients at the end of the observation period (N=114): there were significant reductions in the mean number of hospitalisations/patient (liver-related 1.3 to 0.5, p<0.001; all-cause 1.9 to 0.9, p<0.001), hospital bed days/patient (liver-related 17.8 to 6.8, p<0.001; all-cause 25.4 to 10.6, p<0.001), 30-day hospital readmissions/patient (liver-related 0.5 to 0.2, p=0.039; all-cause 0.8 to 0.4, p=0.024) and emergency department (ED) attendances/patient (all-cause, 1.0 to 0.5, p<0.001). The mean critical care bed days/patient reduced significantly for all-cause admissions (1.3 to 0.3, p=0.049); non-significant reduction for liver-related admissions. 4% of patients (9/207) developed AEs. In UK clinical practice, treatment with rifaximin-α for HE is well-tolerated and associated with significant reductions in hospitalisations, bed days (including critical care), ED attendances and 30-day readmissions.

Bed rest attenuates sympathetic and pressor responses to isometric exercise in antigravity leg muscles in humans.

PubMed

Kamiya, Atsunori; Michikami, Daisaku; Shiozawa, Tomoki; Iwase, Satoshi; Hayano, Junichiro; Kawada, Toru; Sunagawa, Kenji; Mano, Tadaaki

2004-05-01

Although spaceflight and bed rest are known to cause muscular atrophy in the antigravity muscles of the legs, the changes in sympathetic and cardiovascular responses to exercises using the atrophied muscles remain unknown. We hypothesized that bed rest would augment sympathetic responses to isometric exercise using antigravity leg muscles in humans. Ten healthy male volunteers were subjected to 14-day 6 degrees head-down bed rest. Before and after bed rest, they performed isometric exercises using leg (plantar flexion) and forearm (handgrip) muscles, followed by 2-min postexercise muscle ischemia (PEMI) that continues to stimulate the muscle metaboreflex. These exercises were sustained to fatigue. We measured muscle sympathetic nerve activity (MSNA) in the contralateral resting leg by microneurography. In both pre- and post-bed-rest exercise tests, exercise intensities were set at 30 and 70% of the maximum voluntary force measured before bed rest. Bed rest attenuated the increase in MSNA in response to fatiguing plantar flexion by approximately 70% at both exercise intensities (both P < 0.05 vs. before bed rest) and reduced the maximal voluntary force of plantar flexion by 15%. In contrast, bed rest did not alter the increase in MSNA response to fatiguing handgrip and had no effects on the maximal voluntary force of handgrip. Although PEMI sustained MSNA activation before bed rest in all trials, bed rest entirely eliminated the PEMI-induced increase in MSNA in leg exercises but partially attenuated it in forearm exercises. These results do not support our hypothesis but indicate that bed rest causes a reduction in isometric exercise-induced sympathetic activation in (probably atrophied) antigravity leg muscles.

Upper Cenozoic sediments of the lower Delaware Valley and the northern Delmarva Peninsula, New Jersey, Pennsylvania, Delaware, and Maryland

USGS Publications Warehouse

Owens, James Patrick; Minard, James Pierson

1979-01-01

The 'yellow gravels' referred to by R. D. Salisbury in 1898 and the 'Trenton gravel,' as defined by H. C. Lewis in 1880, were investigated along the inner edge of the New Jersey Coastal Plain in southern New Jersey and in the northern Delmarva Peninsula. The highest level deposits, the Beacon Hill gravel, are found on only the highest hills in the New Jersey Coastal Plain. Their distribution suggests deposition from north to south across the plain. After deposition of the Beacon Hill, probably in middle or late Miocene time, a narrow valley was formed paralleling the inner edge of the New Jersey Coastal Plain between Raritan Bay and Camden. South of Camden, the valley broadened, covering much of southern New Jersey. The deposits in this valley are largely the Bridgeton Formation as we have redefined it. A second narrow valley was entrenched through the Bridgeton between Trenton and Salem, N.J. This valley broadens and covers much of the northern Delmarva Peninsula west of the Delaware River. The fill in the valley is largely the Pensauken Formation, as we have redefined it in our report. Collectively, the Beacon Hill, the Bridgeton, and the Pensauken were originally the 'yellow gravels' of Salisbury. These deposits are all fluviatile in origin and were largely formed as a series of step like downcutting channels. The Delaware Valley between Trenton and the lower Delaware Bay region is occupied by the 'Trenton gravel,' which is below the average level of the 'yellow gravels.' Two units recognized throughout the area and informally named the Spring Lake beds and the Van Sciver Lake beds are lithologically distinct from the 'yellow gravel' formations. The lithologies of the Spring Lake beds and the Van Sciver Lake beds are much more heterogeneous than those of the older formations. These two units, particularly, contain much greater amounts of silt and clay, often in thick beds. The depositional environments associated with the two units include fluviatile, estuarine, and marginal marine. Both these units are interpreted to be late Pleistocene (Sangamonian) in age.

Mark-Release-Recapture Reveals Extensive Movement of Bed Bugs (Cimex lectularius L.) within and between Apartments

PubMed Central

Cooper, Richard; Wang, Changlu; Singh, Narinderpal

2015-01-01

Understanding movement and dispersal of the common bed bug (Cimex lectularius L.) under field conditions is important in the control of infestations and for managing the spread of bed bugs to new locations. We investigated bed bug movement within and between apartments using mark-release-recapture (m-r-r) technique combined with apartment-wide monitoring using pitfall-style interceptors. Bed bugs were collected, marked, and released in six apartments. The distribution of marked and unmarked bed bugs in these apartments and their 24 neighboring units were monitored over 32 days. Extensive movement of marked bed bugs within and between apartments occurred regardless of the number of bed bugs released or presence/absence of a host. Comparison of marked and unmarked bed bug distributions confirms that the extensive bed bug activity observed was not an artifact of the m-r-r technique used. Marked bed bugs were recovered in apartments neighboring five of six m-r-r apartments. Their dispersal rates at 14 or 15 d were 0.0–5.0%. The estimated number of bed bugs per apartment in the six m-r-r apartments was 2,433–14,291 at 4–7 d after release. Longevity of bed bugs in the absence of a host was recorded in a vacant apartment. Marked large nymphs (3rd– 5th instar), adult females, and adult males continued to be recovered up to 57, 113, and 134 d after host absence, respectively. Among the naturally existing unmarked bed bugs, unfed small nymphs (1st– 2nd instar) were recovered up to 134 d; large nymphs and adults were still found at 155 d when the study ended. Our findings provide important insight into the behavioral ecology of bed bugs in infested apartments and have significant implications in regards to eradication programs and managing the spread of bed bugs within multi-occupancy dwellings. PMID:26352145

Effects of ablation depth and repair time on the corneal elastic modulus after laser in situ keratomileusis.

PubMed

Wang, Xiaojun; Li, Xiaona; Chen, Weiyi; He, Rui; Gao, Zhipeng; Feng, Pengfei

2017-01-17

The biomechanical properties of the cornea should be taken into account in the refractive procedure in order to perform refractive surgery more accurately. The effects of the ablation depth and repair time on the elastic modulus of the rabbit cornea after laser in situ keratomileusis (LASIK) are still unclear. In this study, LASIK was performed on New Zealand rabbits with different ablation depth (only typical LASIK flaps were created; residual stroma bed was 50 or 30% of the whole cornea thickness respectively). The animals without any treatment were served as normal controls. The corneal thickness was measured by ultrasonic pachymetry before animals were humanly killed after 7 or 28 days post-operatively. The corneal elastic modulus was measured by uniaxial tensile testing. A mathematical procedure considering the actual geometrics of the cornea was created to analyze the corneal elastic modulus. There were no obvious differences among all groups in the elastic modulus on after 7 days post-operatively. However, after 28th days post-operatively, there was a significant increase in the elastic modulus with 50 and 30% residual stroma bed; only the elastic modulus of the cornea with 30% residual stroma bed was significantly higher than that of 7 days. Changes in elastic modulus after LASIK suggest that this biomechanical effect may correlate with the ablation depth and repair time.

Effects of rehydration on +Gz tolerance after 14-days' bed rest.

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Van Beaumont, W.; Bernauer, E. M.; Haines, R. F.; Sandler, H.; Staley, R. W.; Young, H. L.; Yusken, J. W.

1973-01-01

Investigation of the magnitude of reduction in human tolerance to centrifugation following 2 weeks of bed rest with moderate daily exercise. The degree of hypovolemia associated with these exposures is assessed, and the possibility to improve or to return to control levels the tolerance to acceleration forces acting in the head-to-foot direction through rehydration prior to acceleration is explored.

Impact of long-stay beds on the performance of a tertiary hospital in emergencies

PubMed Central

Pazin, Antonio; de Almeida, Edna; Cirilo, Leni Peres; Lourençato, Frederica Montanari; Baptista, Lisandra Maria; Pintyá, José Paulo; Capeli, Ronaldo Dias; da Silva, Sonia Maria Pirani Felix; Wolf, Claudia Maria; Dinardi, Marcelo Marcos; Scarpelini, Sandro; Damasceno, Maria Cecília

2015-01-01

ABSTRACT OBJECTIVE To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index – 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) – the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors. PMID:26603353

Understanding the Effects of Long-duration Space Flight on Astronant Functional Task Performance

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob J.; Batson, Crystal D.; Buxton, Roxanne E.; Feiveson, Al H.; Kofman, Igor S.; Lee, Stuart M. C.; Miller, Chris A.; Mulavara, Ajitkumar P.; Peters, Brian T.; Phillips, Tiffany;

Hydrodynamics study on drying of pepper in swirling fluidized bed dryer (SFBD)

NASA Astrophysics Data System (ADS)

Syaif Haron, Nazrul; Hazri Zakaria, Jamal; Faizal Mohideen Batcha, Mohd

2017-08-01

Malaysia is one of the pepper producer with exports quantity reaching more than 90000 tonnes between 2010 until 2016. Drying of pepper is mandatory before their export and at present, pepper was dried by sun drying to reduce cost. This conventional drying method was time consuming and may take four days during rainy season, which retards the production of pepper. This paper proposes the swirling fluidized bed drying (SFBD) method, which was known to have high mixing ability and improved solid-gas contact to shorten the drying time of products. A lab scale SFBD system was constructed to carry out this study. Hydrodynamic study was conducted for three beds loadings of 1.0 kg, 1.4 kg at a drying temperature of 90°C. The SFBD has shown excellent potential to dry the pepper with a relatively short drying time compared to the conventional method. Batch drying for the bed loads studied only took 3 hours of drying time only. It was found that bed higher bed loading of wet pepper requires longer drying time due to higher amount of moisture content in the bed. Four distinct regimes of operation were found during drying in the SFBD and these regimes offer flexibility of operation. The total bed pressure drop was relatively low during drying.

Reduction in peak oxygen uptake after prolonged bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Kozlowski, S.

1982-01-01

The hypothesis that the magnitude of the reduction in peak oxygen uptake (VO2) after bed rest is directly proportional to the level of pre-bed rest peak VO2 is tested. Complete pre and post-bed rest working capacity and body weight data were obtained from studies involving 24 men (19-24 years old) and 8 women (23-34 years old) who underwent bed rest for 14-20 days with no remedial treatments. Results of regression analyses of the present change in post-bed rest peak VO2 on pre-bed rest peak VO2 with 32 subjects show correlation coefficients of -0.03 (NS) for data expressed in 1/min and -0.17 for data expressed in ml/min-kg. In addition, significant correlations are found that support the hypothesis only when peak VO2 data are analyzed separately from studies that utilized the cycle ergometer, particularly with subjects in the supine position, as opposed to data obtained from treadmill peak VO2 tests. It is concluded that orthostatic factors, associated with the upright body position and relatively high levels of physical fitness from endurance training, appear to increase the variability of pre and particularly post-bed rest peak VO2 data, which would lead to rejection of the hypothesis.

Depression, mood state, and back pain during microgravity simulated by bed rest

NASA Technical Reports Server (NTRS)

Styf, J. R.; Hutchinson, K.; Carlsson, S. G.; Hargens, A. R.

2001-01-01

OBJECTIVE: The objective of this study was to develop a ground-based model for spinal adaptation to microgravity and to study the effects of spinal adaptation on depression, mood state, and pain intensity. METHODS: We investigated back pain, mood state, and depression in six subjects, all of whom were exposed to microgravity, simulated by two forms of bed rest, for 3 days. One form consisted of bed rest with 6 degrees of head-down tilt and balanced traction, and the other consisted of horizontal bed rest. Subjects had a 2-week period of recovery between the studies. The effects of bed rest on pain intensity in the lower back, depression, and mood state were investigated. RESULTS: Subjects experienced significantly more intense lower back pain, lower hemisphere abdominal pain, headache, and leg pain during head-down tilt bed rest. They had higher scores on the Beck Depression Inventory (ie, were more depressed) and significantly lower scores on the activity scale of the Bond-Lader questionnaire. CONCLUSIONS: Bed rest with 6 degrees of head-down tilt may be a better experimental model than horizontal bed rest for inducing the pain and psychosomatic reactions experienced in microgravity. Head-down tilt with balanced traction may be a useful method to induce low back pain, mood changes, and altered self-rated activity level in bed rest studies.

Nutritional Status in Humans during Long-Duration Bed Rest

NASA Technical Reports Server (NTRS)

Smith, Scott M.; MatthewsOliver, Susan A.; Dillon, E. Lichar; Fesperman, Vernell

2006-01-01

Bed rest is a valuable ground-based model for many of the physiological changes associated with space flight. A series of studies was undertaken to evaluate nutritional changes during and after 60 or 90 days of -6 head-down-tilt bed rest. A total of 11 subjects (8 M, 3 F; age 26-55 y) participated in the studies. Blood and urine were collected twice before bed rest and once per month during bed rest. Samples were analyzed in batch at the end of each study. Data were analyzed using repeated-measures ANOVA. Markers of bone resorption (such as n-telopeptide excretion, p less than 0.05) increased during bed rest, and 25-OH vitamin D status tended to decline (p=0.06). During bed rest oxidative damage markers, such as superoxide dismutase increased (p less than 0.01) and 8-(OH)-2'-deoxyguanosine tended to increase (p=0.07); whereas total antioxidant capacity decreased (p less than 0.02). Iron status indices showed patterns of increased iron stores, with decreased transferrin receptors (p less than 0.001). Biochemical markers revealed a tendency toward a loss of muscle mass, by lower excretion of creatinine and 3-methyl-histidine during bed rest. All of these changes are very similar to those observed during space flight, and further document the utility of bed rest as a model of space flight.

Regulation of muscle sympathetic nerve activity after bed rest deconditioning

NASA Technical Reports Server (NTRS)

Pawelczyk, J. A.; Zuckerman, J. H.; Blomqvist, C. G.; Levine, B. D.

2001-01-01

Cardiovascular deconditioning reduces orthostatic tolerance. To determine whether changes in autonomic function might produce this effect, we developed stimulus-response curves relating limb vascular resistance, muscle sympathetic nerve activity (MSNA), and pulmonary capillary wedge pressure (PCWP) with seven subjects before and after 18 days of -6 degrees head-down bed rest. Both lower body negative pressure (LBNP; -15 and -30 mmHg) and rapid saline infusion (15 and 30 ml/kg body wt) were used to produce a wide variation in PCWP. Orthostatic tolerance was assessed with graded LBNP to presyncope. Bed rest reduced LBNP tolerance from 23.9 +/- 2.1 to 21.2 +/- 1.5 min, respectively (means +/- SE, P = 0.02). The MSNA-PCWP relationship was unchanged after bed rest, though at any stage of the LBNP protocol PCWP was lower, and MSNA was greater. Thus bed rest deconditioning produced hypovolemia, causing a shift in operating point on the stimulus-response curve. The relationship between limb vascular resistance and MSNA was not significantly altered after bed rest. We conclude that bed rest deconditioning does not alter reflex control of MSNA, but may produce orthostatic intolerance through a combination of hypovolemia and cardiac atrophy.

Evaluation of a clay-based acidic bedding conditioner for dairy cattle bedding.

PubMed

Proietto, R L; Hinckley, L S; Fox, L K; Andrew, S M

2013-02-01

This study investigated the effects of a clay-based acidic bedding conditioner on sawdust bedding pH, dry matter (DM), environmental pathogen counts, and environmental bacterial counts on teat ends of lactating dairy cows. Sixteen lactating Holstein cows were paired based on parity, days in milk, milk yield, and milk somatic cell count, and were negative for the presence of an intramammary pathogen. Within each pair, cows were randomly assigned to 1 of 2 treatments with 3-wk periods in a crossover design. Treatment groups consisted of 9 freestalls per group bedded with either untreated sawdust or sawdust with a clay-based acidic bedding conditioner, added at 3- to 4-d intervals over each 21-d period. Bedding and teat ends were aseptically sampled on d 0, 1, 2, 7, 14, and 21 for determination of environmental bacterial counts. At the same time points, bedding was sampled for DM and pH determination. The bacteria identified in the bedding material were total gram-negative bacteria, Streptococcus spp., and coliform bacteria. The bacteria identified on the teat ends were Streptococcus spp., coliform bacteria, and Klebsiella spp. Teat end score, milk somatic cell count, and intramammary pathogen presence were measured weekly. Bedding and teat cleanliness, environmental high and low temperatures, and dew point data were collected daily. The bedding conditioner reduced the pH, but not the DM, of the sawdust bedding compared with untreated sawdust. Overall environmental bacterial counts in bedding were lower for treated sawdust. Total bacterial counts in bedding and on teat ends increased with time over both periods. Compared with untreated sawdust, the treated bedding had lower counts of total gram-negative bacteria and streptococci, but not coliform counts. Teat end bacterial counts were lower for cows bedded on treated sawdust for streptococci, coliforms, and Klebsiella spp. compared with cows bedded on untreated sawdust. The clay-based acidic bedding conditioner reduced environmental pathogens in sawdust bedding and teat ends without affecting teat end integrity. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Sleep duration or bedtime? Exploring the association between sleep timing behaviour, diet and BMI in children and adolescents.

PubMed

Golley, R K; Maher, C A; Matricciani, L; Olds, T S

2013-04-01

To determine whether sleep timing behaviour is associated with energy intake and diet quality in children and adolescents. Cross-sectional analysis of nationally representative survey data. A total of 2200 participants of the 2007 Australian National Children's Nutrition and Physical Activity Survey aged 9-16 years with 2 days of food intake data, 4 days of use of time data and complete anthropometry. Participants were grouped into one of four sleep-wake behaviour categories: early bed-early rise (EE); early bed-late rise (EL); late bed-early rise (LE) and late bed-late rise (LL). The four categories were compared for body mass index (BMI) z-score, energy intake and diet quality assessed using the Dietary Guideline Index for Children and Adolescents. Analyses were adjusted for survey design, sociodemographic characteristics, sleep duration and physical activity level (PAL). In adjusted multivariate regression models with sleep timing behaviour group as the independent variable, the 'LL' category compared with the 'EE' category had a higher BMI z-score (β=0.20, 95% confidence interval (CI) 0.06 to 0.34, P=0.007), and lower diet quality (β=-4.0, 95% CI -5.7 to -2.3, P<0.001). Children and adolescents who went to bed late also had a higher intake of extra foods (that is, energy-dense, nutrient-poor foods) while those whom went to bed early consumed more fruit and vegetables. Energy intake was associated with sleep duration (β=-4.5 kJ, 95% CI -6.7 to -2.4, P<0.001), but not sleep timing behaviour. Late bedtimes and late wake up times are associated with poorer diet quality, independent of sleep duration, PAL and child and sociodemographic characteristics.

Effects of Cage-Change Frequency and Bedding Volume on Mice and Their Microenvironment

PubMed Central

Rosenbaum, Matthew D; VandeWoude, Susan; Johnson, Thomas E

2009-01-01

The frequency at which mouse cages are changed has important implications for the animals, animal care personnel, and facility managers. The objective of this study was to determine how bedding volume and the interval between changes affect microenvironmental conditions, health, and behavior of mice housed in individually ventilated cages (IVC). A total of 15 cages (n = 5 cages per bedding volume) housing ICR female mice (n = 5 animals per cage) were monitored for 17 d. Parameters monitored included clinical evaluation of each animal, appearance of the cage, fecal corticosterone levels, bedding weight, and mouse mass. Atmospheric analysis was performed daily to determine intracage ammonia cage humidity and temperature on a daily basis. Mice were videotaped for 10 min on days 1, 8, and 15, and videos were analyzed for abnormal behaviors. On day 17, 1 mouse from each cage was euthanized, and bronchoalveolar lavage was performed. Statistical differences in parameters were most often noted between low- and high-volume bedding groups. Correlation between visual appearance and actual intracage environmental conditions and mouse health and behavior at specific time points indicated cages that appear dirty to most observers did not have measurably adverse effects on the animals for any of the many parameters evaluated in this study. This study demonstrated that a 2-wk interval between cage changes for ICR female mice housed in IVC caging (with approximately 90 air changes per hour) and aspen chip bedding did not significantly affect measures of animal well-being in this study. This lack of effect occurred despite the appearance of excessive soiling by the 2-wk time point. PMID:19930825

Inter- and Intrafraction Uncertainty in Prostate Bed Image-Guided Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Kitty; Palma, David A.; Department of Oncology, University of Western Ontario, London

2012-10-01

Purpose: The goals of this study were to measure inter- and intrafraction setup error and prostate bed motion (PBM) in patients undergoing post-prostatectomy image-guided radiotherapy (IGRT) and to propose appropriate population-based three-dimensional clinical target volume to planning target volume (CTV-PTV) margins in both non-IGRT and IGRT scenarios. Methods and Materials: In this prospective study, 14 patients underwent adjuvant or salvage radiotherapy to the prostate bed under image guidance using linac-based kilovoltage cone-beam CT (kV-CBCT). Inter- and intrafraction uncertainty/motion was assessed by offline analysis of three consecutive daily kV-CBCT images of each patient: (1) after initial setup to skin marks, (2)more » after correction for positional error/immediately before radiation treatment, and (3) immediately after treatment. Results: The magnitude of interfraction PBM was 2.1 mm, and intrafraction PBM was 0.4 mm. The maximum inter- and intrafraction prostate bed motion was primarily in the anterior-posterior direction. Margins of at least 3-5 mm with IGRT and 4-7 mm without IGRT (aligning to skin marks) will ensure 95% of the prescribed dose to the clinical target volume in 90% of patients. Conclusions: PBM is a predominant source of intrafraction error compared with setup error and has implications for appropriate PTV margins. Based on inter- and estimated intrafraction motion of the prostate bed using pre- and post-kV-CBCT images, CBCT IGRT to correct for day-to-day variances can potentially reduce CTV-PTV margins by 1-2 mm. CTV-PTV margins for prostate bed treatment in the IGRT and non-IGRT scenarios are proposed; however, in cases with more uncertainty of target delineation and image guidance accuracy, larger margins are recommended.« less

Bupropion versus sertraline in the treatment of depressive patients with binge eating disorder: retrospective cohort study.

PubMed

Calandra, Carmela; Russo, Rina Giuseppa; Luca, Maria

2012-06-01

This study sought to compare Bupropion versus Sertraline in the treatment of depressed patients with Binge Eating Disorder (BED) prescribed off-label. Medical records of outpatients with diagnosis of BED and Depression (DSM-IV-TR criteria) were selected: 15 patients were treated with bupropion 150 mg/per day, and 15 with sertraline 200 mg/per day. During the screening and control visits (2°-6°-14°-24° week), the selected patients were first weighed and then evaluated using the following questionnaires: Binge Eating Disorder-Clinical Interview (BEDCI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory X (STAI-X) and Arizona Sexual Experience Scale (ASEX). Both drugs reduced anxious-depressive symptoms and binge frequency: Bupropion showed a better effectiveness in reducing weight and improving sexual performances; weight loss related to it was proportional to the body mass index. Bupropion may be associated with more weight loss in BED, depressed patients than sertraline.

Litter Species Composition and Topographic Effects on Fuels and Modeled Fire Behavior in an Oak-Hickory Forest in the Eastern USA

PubMed Central

Hutchinson, Todd F.; Dietenberger, Mark; Matt, Frederick; Peters, Matthew P.

2016-01-01

Mesophytic species (esp. Acer rubrum) are increasingly replacing oaks (Quercus spp.) in fire-suppressed, deciduous oak-hickory forests of the eastern US. A pivotal hypothesis is that fuel beds derived from mesophytic litter are less likely than beds derived from oak litter to carry a fire and, if they do, are more likely to burn at lower intensities. Species effects, however, are confounded by topographic gradients that affect overstory composition and fuel bed decomposition. To examine the separate and combined effects of litter species composition and topography on surface fuel beds, we conducted a common garden experiment in oak-hickory forests of the Ohio Hills. Each common garden included beds composed of mostly oak and mostly maple litter, representative of oak- and maple-dominated stands, respectively, and a mixture of the two. Beds were replenished each fall for four years. Common gardens (N = 16) were established at four topographic positions (ridges, benches on south- and northeast-facing slopes, and stream terraces) at each of four sites. Litter source and topographic position had largely independent effects on fuel beds and modeled fire dynamics after four years of development. Loading (kg m-2) of the upper litter layer (L), the layer that primarily supports flaming spread, was least in more mesic landscape positions and for maple beds, implying greater decomposition rates for those situations. Bulk density in the L layer (kg m-3) was least for oak beds which, along with higher loading, would promote fire spread and fireline intensity. Loading and bulk density of the combined fermentation and humic (FH) layers were least on stream terrace positions but were not related to species. Litter- and FH-layer moistures during a 5-day dry-down period after a rain event were affected by time and topographic effects while litter source effects were not evident. Characteristics of flaming combustion determined with a cone calorimeter pointed to greater fireline intensity for oak fuel beds and unexpected interactions between litter source and topography. A spread index, which synthesizes a suite of fuel bed, particle, and combustion characteristics to indicate spread (vs extinction) potential, was primarily affected by litter source and, secondarily, by the low spread potentials on mesic landscape positions early in the 5-day dry-down period. A similar result was obtained for modeled fireline intensity. Our results suggest that the continuing transition from oaks to mesophytic species in the Ohio Hills will reduce fire spread potentials and fire intensities. PMID:27536964

Litter Species Composition and Topographic Effects on Fuels and Modeled Fire Behavior in an Oak-Hickory Forest in the Eastern USA.

PubMed

Dickinson, Matthew B; Hutchinson, Todd F; Dietenberger, Mark; Matt, Frederick; Peters, Matthew P

2016-01-01

Mesophytic species (esp. Acer rubrum) are increasingly replacing oaks (Quercus spp.) in fire-suppressed, deciduous oak-hickory forests of the eastern US. A pivotal hypothesis is that fuel beds derived from mesophytic litter are less likely than beds derived from oak litter to carry a fire and, if they do, are more likely to burn at lower intensities. Species effects, however, are confounded by topographic gradients that affect overstory composition and fuel bed decomposition. To examine the separate and combined effects of litter species composition and topography on surface fuel beds, we conducted a common garden experiment in oak-hickory forests of the Ohio Hills. Each common garden included beds composed of mostly oak and mostly maple litter, representative of oak- and maple-dominated stands, respectively, and a mixture of the two. Beds were replenished each fall for four years. Common gardens (N = 16) were established at four topographic positions (ridges, benches on south- and northeast-facing slopes, and stream terraces) at each of four sites. Litter source and topographic position had largely independent effects on fuel beds and modeled fire dynamics after four years of development. Loading (kg m-2) of the upper litter layer (L), the layer that primarily supports flaming spread, was least in more mesic landscape positions and for maple beds, implying greater decomposition rates for those situations. Bulk density in the L layer (kg m-3) was least for oak beds which, along with higher loading, would promote fire spread and fireline intensity. Loading and bulk density of the combined fermentation and humic (FH) layers were least on stream terrace positions but were not related to species. Litter- and FH-layer moistures during a 5-day dry-down period after a rain event were affected by time and topographic effects while litter source effects were not evident. Characteristics of flaming combustion determined with a cone calorimeter pointed to greater fireline intensity for oak fuel beds and unexpected interactions between litter source and topography. A spread index, which synthesizes a suite of fuel bed, particle, and combustion characteristics to indicate spread (vs extinction) potential, was primarily affected by litter source and, secondarily, by the low spread potentials on mesic landscape positions early in the 5-day dry-down period. A similar result was obtained for modeled fireline intensity. Our results suggest that the continuing transition from oaks to mesophytic species in the Ohio Hills will reduce fire spread potentials and fire intensities.

Countermeasures against lumbar spine deconditioning in prolonged bed rest: resistive exercise with and without whole body vibration.

PubMed

Belavý, Daniel L; Armbrecht, Gabriele; Gast, Ulf; Richardson, Carolyn A; Hides, Julie A; Felsenberg, Dieter

2010-12-01

To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise (n = 7), resistive exercise only (n = 8), or no exercise (n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups (P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only (P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen (P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.

[The structural functional analysis of functioning of day-hospitals of the Russian Federation].

PubMed

2012-01-01

The article deals with the results of structural functional analysis of functioning of day-hospitals in the Russian Federation. The dynamic analysis is presented concerning day-hospitals' network, capacity; financial support, beds stock structure, treated patients structure, volumes of diagnostic tests and curative procedures. The need in developing of population medical care in conditions of day-hospitals is demonstrated.

Exploring the cost and value of private versus shared bedrooms in nursing homes.

PubMed

Calkins, Margaret; Cassella, Christine

2007-04-01

There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the merits of three different bedroom configurations: traditional shared, enhanced shared, and private. We developed a framework of four broad domains that were related to the different bedroom configurations: psychosocial, clinical, operational, and construction or building factors. Within each dimension, we identified individual factors through the literature, interviews, and focus groups, with the goal of determining the breadth, depth, and quality of evidence supporting the benefits of one configuration over another. The vast majority of factors identified in this study, regardless of whether there was solid empirical data, information from the focus groups, or other anecdotal evidence, indicated better outcomes associated with private rooms over shared rooms in nursing homes. Cost estimates suggest that construction cost (plus debt service) differences range from roughly $20,506 per bed for a traditional shared room to $36,515 for a private one, and that such differences are recouped in less than 2 years if beds are occupied, and in less than 3 months if a shared bed remains unoccupied at average private-pay room costs. Despite limited empirical evidence in some areas, this project provides the foundation for an evidence-based life-cycle costing perspective regarding the relative merits of different bedroom configurations.

Effect of ionization, bedding, and feeding on air quality in a horse stable.

PubMed

Siegers, Esther Willemijn; Anthonisse, Milou; van Eerdenburg, Frank J C M; van den Broek, Jan; Wouters, Inge M; Westermann, Cornélie Martine

2018-05-01

Organic dust is associated with Equine asthma. Ionization should reduce airborne dust levels. To determine the effect of ionization of air, type of bedding, and feed on the levels of airborne dust, endotoxin, and fungal colonies in horse stables. 24 healthy University-owned horses occupied the stables. A randomized controlled cross-over study. Four units with 6 stables were equipped with an ionization installation (25 VA, 5000 Volt Direct Current). Horses were kept either on wood shavings and fed haylage (2 units), or on straw and fed dry hay (2 units). Measurements were performed with and without activated ionization, during daytime and nighttime, repeatedly over the course of a week and repeatedly during 4-6 weeks. Statistical analysis was performed using a mixed effect model with Akaike's Information Criterion for model reduction and 95% profile (log) likelihood confidence intervals (CI). Ionization did not alter concentrations of dust, endotoxin, or fungi, fewer. In the units with straw and hay, the concentration of dust, endotoxin, and fungi (difference in logarithmic mean 1.92 (95%CI 1.71-2.12); 2.86 (95%CI 2.59-3.14); 1.75 (95%CI 1.13-2.36)) were significantly higher compared to wood shavings and haylage. The installation of a negative air-ionizer in the horse stable did not reduce concentrations of dust, endotoxin, and viable fungal spores. The substantial effect of low dust bedding and feed is confirmed. Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Bedding material affects mechanical thresholds, heat thresholds and texture preference

PubMed Central

Moehring, Francie; O’Hara, Crystal L.; Stucky, Cheryl L.

2015-01-01

It has long been known that the bedding type animals are housed on can affect breeding behavior and cage environment. Yet little is known about its effects on evoked behavior responses or non-reflexive behaviors. C57BL/6 mice were housed for two weeks on one of five bedding types: Aspen Sani Chips® (standard bedding for our institute), ALPHA-Dri®, Cellu-Dri™, Pure-o’Cel™ or TEK-Fresh. Mice housed on Aspen exhibited the lowest (most sensitive) mechanical thresholds while those on TEK-Fresh exhibited 3-fold higher thresholds. While bedding type had no effect on responses to punctate or dynamic light touch stimuli, TEK-Fresh housed animals exhibited greater responsiveness in a noxious needle assay, than those housed on the other bedding types. Heat sensitivity was also affected by bedding as animals housed on Aspen exhibited the shortest (most sensitive) latencies to withdrawal whereas those housed on TEK-Fresh had the longest (least sensitive) latencies to response. Slight differences between bedding types were also seen in a moderate cold temperature preference assay. A modified tactile conditioned place preference chamber assay revealed that animals preferred TEK-Fresh to Aspen bedding. Bedding type had no effect in a non-reflexive wheel running assay. In both acute (two day) and chronic (5 week) inflammation induced by injection of Complete Freund’s Adjuvant in the hindpaw, mechanical thresholds were reduced in all groups regardless of bedding type, but TEK-Fresh and Pure-o’Cel™ groups exhibited a greater dynamic range between controls and inflamed cohorts than Aspen housed mice. PMID:26456764

Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial.

PubMed

Hofmeijer, Jeannette; Kappelle, L Jaap; Algra, Ale; Amelink, G Johan; van Gijn, Jan; van der Worp, H Bart

2009-04-01

Patients with space-occupying hemispheric infarctions have a poor prognosis, with case fatality rates of up to 80%. In a pooled analysis of randomised trials, surgical decompression within 48 h of stroke onset reduced case fatality and improved functional outcome; however, the effect of surgery after longer intervals is unknown. The aim of HAMLET was to assess the effect of decompressive surgery within 4 days of the onset of symptoms in patients with space-occupying hemispheric infarction. Patients with space-occupying hemispheric infarction were randomly assigned within 4 days of stroke onset to surgical decompression or best medical treatment. The primary outcome measure was the modified Rankin scale (mRS) score at 1 year, which was dichotomised between good (0-3) and poor (4-6) outcome. Other outcome measures were the dichotomy of mRS score between 4 and 5, case fatality, quality of life, and symptoms of depression. Analysis was by intention to treat. This trial is registered, ISRCTN94237756. Between November, 2002, and October, 2007, 64 patients were included; 32 were randomly assigned to surgical decompression and 32 to best medical treatment. Surgical decompression had no effect on the primary outcome measure (absolute risk reduction [ARR] 0%, 95% CI -21 to 21) but did reduce case fatality (ARR 38%, 15 to 60). In a meta-analysis of patients in DECIMAL (DEcompressive Craniectomy In MALignant middle cerebral artery infarction), DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY), and HAMLET who were randomised within 48 h of stroke onset, surgical decompression reduced poor outcome (ARR 16%, -0.1 to 33) and case fatality (ARR 50%, 34 to 66). Surgical decompression reduces case fatality and poor outcome in patients with space-occupying infarctions who are treated within 48 h of stroke onset. There is no evidence that this operation improves functional outcome when it is delayed for up to 96 h after stroke onset. The decision to perform the operation should depend on the emphasis patients and relatives attribute to survival and dependency.

Mechanical and Structural Behavior of Granular Material Packed Beds for Space Life Support System Applications

NASA Technical Reports Server (NTRS)

Malla, Ramesh B.; Anandakumar, Ganesh

2005-01-01

Long-term human mission to space, such as living in International Space Station (ISS), Lunar, and Martian bases, and travel to Mars, must m ake use of Advanced Life Support Systems (ALSS) to generate and recycle critical life supporting elements like oxygen and water. Oxygen Gen eration Assembly (OGA) and Water Processor Assembly (WPA), critical c omponents of ALSS, make use of series of granular material packed beds for generation and recycling of oxygen and water. Several granular m aterials can be used for generation, recycling, processing and recovery of oxygen and water. For example, they may include soft bed media, e.g. ion exchange resins for oxygen generation assembly and hard bed media such as, activated alumina, magchem (Magnesium oxide) and activa ted carbon to remove organic species like ethanol, methanol, and urea from wastewater in Water recovery/processing assembly. These beds are generally packed using a plate-spring mechanism to provide sufficien t compaction to the bed media throughout the course of operation. This paper presents results from an experimental study of a full-scale, 3 8.1 cm (15 inches) long and 3.7 cm (1.44 inches) diameter. activated alumina bed enclosed in a cylinder determining its force-displacement behavior, friction mobilizing force, and axial normal stress distribu tion under various axially applied loads and at different levels of packing. It is observed that force-displacement behavior is non-linear for low compaction level and becomes linear with increase in compaction of the bed media. Axial normal stress distribution along the length of the bed media decreased non-linearly with increase in depth from the loading end of the granular media. This paper also presents experimental results on the amount of particulates generated corresponding to various compaction levels. Particulates generated from each of the tests were measured using standard US sieves. It was found that the p articulates and the overall displacement of the bed media increased with decrease in initial compaction of the bed media. This effect could be attributed to the greater tendency for inter-particle sliding/rub bing due to smaller internal friction angles, as seen from the shear tests, at lesser initial compacted levels. Upon unloading, it was obse rved that there was no change in displacement (especially rebounding) in the bed media. This effect could be attributed to the fact that th e porous activated alumina particles fracture/break upon increase in applied load (during loading phase) and occupy void spaces in between the material grains; thereby leading to settling of the media. The lo ad-displacement curve becomes more linear with increase in initial compaction of the bed media. It is concluded that compaction considerabl y affects the load-displacement behavior of the bed media. A series of tests were also conducted on the packed bed media to determine the f orce required to mobilize the friction between the bed media and the housing cylinder. The results from these tests showed the existence of significant friction between the bed media and the encasing stainles s steel cylinder. Further, it was found that friction effects were more pronounced for media with higher initial compaction. Internal frict ion of the granular media was measured using direct shear apparatus. It was observed that the internal friction increased with increase in initial compaction of the bed media. In this study, a computational m odel (CM) is also developed using finite element software ANSYS to verify experimental results obtained for the distribution of the axial n ormal stress and axial displacement along the length of the full-scal e activated alumina bed media. In the computational model, the granular material is considered to have appropriate failure and frictional c ontact exists between the wall and the granular media. It is observed that the model predicts results closely with the experimental method. The compational results show that the axial normal stress distribution along the length of the activated alumina media decreases non-linea rly from the loading end and is negligible beyond a certain depth. Th is can be attributed to the existence of friction between the walls and the media and that the friction takes up most of the applied load.

Trickle-bed root culture bioreactor design and scale-up: growth, fluid-dynamics, and oxygen mass transfer.

PubMed

Ramakrishnan, Divakar; Curtis, Wayne R

2004-10-20

Trickle-bed root culture reactors are shown to achieve tissue concentrations as high as 36 g DW/L (752 g FW/L) at a scale of 14 L. Root growth rate in a 1.6-L reactor configuration with improved operational conditions is shown to be indistinguishable from the laboratory-scale benchmark, the shaker flask (mu=0.33 day(-1)). These results demonstrate that trickle-bed reactor systems can sustain tissue concentrations, growth rates and volumetric biomass productivities substantially higher than other reported bioreactor configurations. Mass transfer and fluid dynamics are characterized in trickle-bed root reactors to identify appropriate operating conditions and scale-up criteria. Root tissue respiration goes through a minimum with increasing liquid flow, which is qualitatively consistent with traditional trickle-bed performance. However, liquid hold-up is much higher than traditional trickle-beds and alternative correlations based on liquid hold-up per unit tissue mass are required to account for large changes in biomass volume fraction. Bioreactor characterization is sufficient to carry out preliminary design calculations that indicate scale-up feasibility to at least 10,000 liters.

Comparing the Efficacy of Peritonsillar Injection of Tramadol With Honey in Controlling Post-Tonsillectomy Pain in Adults.

PubMed

Hatami, Maryam; Mirjalili, Mahdieh; Ayatollahi, Vida; Vaziribozorg, Sedighe; Zand, Vahid

2018-06-01

The authors investigated the effect of honey on post-tonsillectomy pain and compare its efficacy with tramadol. This clinical trial was performed on 60 patients with American Society of Anesthesia I and II aged between 18 and 55 years and underwent tonsillectomy. Induction of anesthesia was carried out using 2 mg/kg propofol and 0.5 atracurium following 1.5 μg/kg fentanyl administration. Group B was given tramadol at dose of 2 mg/kg and with volume of 4 mL and Group A was given normal saline with the same volume 2 mL of medications were injected using needle (25) into tonsil bed and anterior old of each tonsil by an anesthesiologist. Three minutes after injection, the surgery was performed by the same ENT residents for all patients. In the recovery room Group B received antibiotics and oral acetaminophen. Group A was given antibiotics, oral acetaminophen, and honey dissolved in 40 mL warm water every 6 hours from when the patient was fully awake. Patients in Group A were told to eat honey 3 times a day 7 days postoperatively. Pain was scored using Numeric Rating Scale at the time points of 2, 6, 12, and 24 hours as well as 3 and 7 days postoperatively. Moreover, the healing status and epithelialization degree of tonsillar bed were considered on 1 and 7 days after the surgery by ENT specialist. The mean of pain score was significantly higher in Group A within 24 hours postoperatively as compared with Group B (P < 0.01). The mean of pain score was lower in Group B after 3 and 7 days but this difference was not statistically significant (P > 0.05). Considering restoration status and epithelialization degree of tonsillar bed on the 1st and 7th days, there was no statistically significant difference between 2 groups; however, tonsillar bed healing process was better in Group B on the 7th day. The current investigation confirmed the positive impact of tramadol on post-tonsillectomy pain relief in adults. The authors also found that honey can be used as a complementary treatment along with acetaminophen and other analgesics for reducing post-tonsillectomy pain. Considering honey impact on wound healing and its anti-inflammatory effect, it is suggested for relieving complications after surgery.

A third of patients treated at a tertiary-level surgical service could be treated at a secondary-level facility.

PubMed

Van Straten, S; Stannard, C; Bulabula, J; Boodhia, K; Paul, K; Leong, J; Klipin, M J

2017-08-25

South Africa (SA) has an overburdened public healthcare system. Some patients admitted to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), SA, may not require tertiary care, but the numbers and details are uncertain. Clinical research in SA is limited by scarce skills and limited access to data. To determine the proportion of and length of stay for secondary-, tertiary- and quaternary-level patients discharged from the Department of Surgery at CMJAH over 1 year. This is a retrospective analysis of electronic discharge (ED) summaries from the Department of Surgery at CMJAH between 1 April 2015 and 1 April 2016. An SQL query of the database generated a .csv file of all discharges with the following fields: database reference number, length of stay and level of care. The details of each record were verified by MBBCh V students, using a defined level-ofcare template and the full discharge summary. The data were reviewed by a senior clinician. There were 3 007 discharge summaries - 97 were not classifiable, two were test records and one was a duplicate. These 100 records were excluded. There were no primary-level records. Secondary-level patients represented 29% (854) of those discharged and 19% of total bed days. Tertiary- and quaternary-level patients together represented 71% of the total and 81% of bed days. The average length of stay was 4.31 days for secondary, 6.98 days for tertiary and 9.77 days for quaternary level-of-care allocation. Almost one-third (29%) of patients discharged from CMJAH's Department of Surgery were deemed suitable for secondarylevel care. These patients had a shorter length of stay and comprised 19% of total bed days. Students and electronic databases represent an important research resource.

Time trends in hospital stay after hip fracture in Canada, 2004-2012: database study.

PubMed

Sobolev, Boris; Guy, Pierre; Sheehan, Katie Jane; Kuramoto, Lisa; Bohm, Eric; Beaupre, Lauren; Sutherland, Jason M; Dunbar, Michael; Griesdale, Donald; Morin, Suzanne N; Harvey, Edward

2016-01-01

Changes in bed management and access policy aimed to shorten Canadian hip fracture hospital stay. Secular trends in hip fracture total, preoperative, and postoperative stay are unknown. Hip fracture stay shortened from 2004 to 2012, mostly from shortening postoperative stay. This may reflect changes in bed management rather than access policy. To compare the probability of discharge by time after patient admission to hospital with first-time hip fracture over a period of nine calendar years. We retrieved acute hospitalization records for 169,595 patients 65 years and older, who were admitted to an acute care hospital with hip fracture between 2004 and 2012 in Canada (outside of Quebec). The main outcome measure was cumulative incidence of discharge by inpatient day, accounting for competing events that end hospital stay. The probability of surgical discharge within 30 days of admission increased from 57.2 % in 2004 to 67.3 % in 2012. The probability of undergoing surgery on day of admission or day after fluctuated around 58.5 % over the study period. For postoperative stay, the discharge probability increased from 6.8 to 12.2 % at day 4 after surgery and from 57.2 to 66.6 % at day 21 after surgery, between 2004 and 2012. The differences across years persisted after adjustment for characteristics of patients, fracture, comorbidity, treatment, type and timing of surgery, and access to care. Hospital stay following hip fracture shortened substantially between 2004 and 2012 in Canada, mostly due to shortening of postoperative stays. Shorter hospital stays may reflect changes in bed management protocols rather than in access policy.

Cacao bean husk: an applicable bedding material in dairy free-stall barns.

PubMed

Yajima, Akira; Owada, Hisashi; Kobayashi, Suguru; Komatsu, Natsumi; Takehara, Kazuaki; Ito, Maria; Matsuda, Kazuhide; Sato, Kan; Itabashi, Hisao; Sugimura, Satoshi; Kanda, Shuhei

2017-07-01

The objectives of the study were to assess the effect of cacao bean husk as bedding material in free-stall barn on the behavior, productivity, and udder health of dairy cattle, and on the ammonia concentrations in the barn. Four different stall surfaces (no bedding, cacao bean husk, sawdust, and chopped wheat straw) were each continuously tested for a period of 1 week to determine their effects on nine lactating Holstein cows housed in the free-stall barn with rubber matting. The lying time and the milk yield were measured between d 4 and d 7. Blood samples for plasma cortisol concentration and teat swabs for bacterial counts were obtained prior to morning milking on d 7. The time-averaged gas-phase ammonia concentrations in the barn were measured between d 2 and d 7. The cows spent approximately 2 h more per day lying in the stalls when bedding was available than without bedding. The milk yield increased in the experimental periods when cows had access to bedding materials as compared to the period without bedding. The lying time was positively correlated with the milk yield. Bacterial counts on the teat ends recorded for cows housed on cacao bean husk were significantly lower than those recorded for cows housed without bedding. Ammonia concentration under cacao bean husk bedding decreased by 6%, 15%, and 21% as compared to no bedding, sawdust, and chopped wheat straw, respectively. The cortisol concentration was lowest in the period when cacao bean husk bedding was used. We observed a positive correlation between the ammonia concentrations in the barn and the plasma cortisol concentrations. Cacao bean husk is a potential alternative of conventional bedding material, such as sawdust or chopped wheat straw, with beneficial effects on udder health and ammonia concentrations in the barns.

The varying stability of benthic homes: hydrologic regime and sediment supply control the timing and intensity of bed mobility

NASA Astrophysics Data System (ADS)

Pfeiffer, A.; Finnegan, N. J.

2017-12-01

Gravel river beds provide an ephemeral architecture for the benthic inhabitants of river ecosystems. Periphyton and benthic macroinvertebrates that live on or within the gravel are subject to catastrophic disruption upon mobilization of the surface gravel during floods. Because sediment supply varies by orders of magnitude across North America, and rivers have adjusted to convey their imposed loads, river bed surface mobility varies enormously. Climate also varies widely across the continent, yielding a range of flood timing, duration, and intermittency. Together, the differences in sediment supply and hydrologic patterns result in diverse regimes of benthic habitat stability. To quantitatively characterize these regimes, we calculate decades-scale time series of estimated bed surface mobility using sediment transport equations (Wilcock and Crowe, 2003). The method requires measurements of the bed surface grainsize distribution, channel slope, and standard USGS stream gauging records. We calculate the fraction of the bed surface grain size distribution that is mobile at any given flow, as well as the intensity of transport. We use the time series of bed mobility to compare between rivers and regions. In many snowmelt-dominated rivers in Idaho, a period of moderate bed mobility (W* > 0.002) generally occurs during the annual melt, and can last for days. In rivers draining the central and northern Appalachians, bed mobility is comparatively rare and occurs during short duration floods. Rivers on the tectonically active West Coast tend to experience bed mobility during most winter storms, with brief (hours long) periods of high transport rates (W* > 0.02) during storm peaks. The timing and intensity of bed mobility varies with hydrologic regime and sediment supply; these contrasts in bed mobility lead to diverse structural templates for river ecosystems.

Sedimentology and architecture of De Geer moraines in the western Scottish Highlands, and implications for grounding-line glacier dynamics

NASA Astrophysics Data System (ADS)

Golledge, Nicholas R.; Phillips, Emrys

2008-07-01

Sedimentary exposures in moraines in a Scottish Highland valley (Glen Chaorach), reveal stacked sequences of bedded and laminated silt, sand and gravel, interspersed or capped with diamicton units. In four examples, faults and folds indicate deformation by glaciotectonism and syndepositional loading. We propose that these sediments were laid down in an ice-dammed lake, close to the last ice margin to occupy this glen. Individual units within cross-valley De Geer moraine ridges are interpreted by comparison with examples from similar environments elsewhere: stratified diamictons containing laminated or bedded lenses are interpreted as subaqueous ice-marginal debris-flow deposits; massive fine-grained deposits as hyperconcentrated flow deposits, and massive gravel units as high-density debris-flow deposits. Using an allostratigraphic approach we argue that glaciotectonically deformed coarsening-upward sand and gravel sequences that culminate in deposition of subglacial diamicton represent glacier advances into the ice-marginal lake, whereas undisturbed cross-bedded sand and gravel reflects channel or fan deposits laid down during glacier retreat. A flat terrace of bedded sand and gravel at the northern end of Glen Chaorach is interpreted as subaerial glaciofluvial outwash. On the basis of these inferences we propose the following three stage deglacial event chronology for Glen Chaorach. During glacier recession, ice separation and intra-lobe ponding first led to subaquaeous deposition of sorted and unsorted facies. Subsequent glacier stabilisation and ice-marginal oscillation produced glaciotectonic structures in the ice-marginal sediment pile and formed De Geer moraines. Finally, drainage of the ice-dammed lake allowed a subaerial ice-marginal drainage system to become established. Throughout deglaciation, deposition within the lake was characterized by abrupt changes in grain size and in the architecture of individual sediment bodies, reflecting changing delivery paths and sediment supply, and by dynamic margin oscillations typical of water-terminating glaciers.

Perception of Human-Derived Risk Influences Choice at Top of the Food Chain

PubMed Central

Cristescu, Bogdan; Stenhouse, Gordon B.; Boyce, Mark S.

2013-01-01

On human-used landscapes, animal behavior is a trade-off between maximizing fitness and minimizing human-derived risk. Understanding risk perception in wildlife can allow mitigation of anthropogenic risk, with benefits to long-term animal fitness. Areas where animals choose to rest should minimize risk from predators, which for large carnivores typically equate to humans. We hypothesize that high human activity leads to selection for habitat security, whereas low activity enables trading security for forage. We investigated selection of resting (bedding) sites by GPS radiocollared adult grizzly bears (n = 10) in a low density population on a multiple-use landscape in Canada. We compared security and foods at resting and random locations while accounting for land use, season, and time of day. On reclaimed mines with low human access, bears selected high horizontal cover far from trails, but did not avoid open (herbaceous) areas, resting primarily at night. In protected areas bears also bedded at night, in areas with berry shrubs and Hedysarum spp., with horizontal cover selected in the summer, during high human access. On public lands with substantial human recreation, bears bedded at day, selected resting sites with high horizontal cover in the summer and habitat edges, with bedding associated with herbaceous foods. These spatial and temporal patterns of selection suggest that bears perceive human-related risk differentially in relation to human activity level, season and time of day, and employ a security-food trade-off strategy. Although grizzly bears are presently not hunted in Alberta, their perceived risks associated with humans influence resting-site selection. PMID:24367549

Development of early comprehensive stroke inpatient rehabilitation in Poland - current status and future requirements.

PubMed

Sarzyńska-Długosz, Iwona; Krawczyk, Maciej; Członkowska, Anna

2011-01-01

Every stroke patient should undergo early rehabilitation. We aimed to evaluate accessibility, development and needs in early stroke inpatient rehabilitation in Poland. A questionnaire evaluating rehabilitation departments was prepared and sent (in 2004 and 2008) to rehabilitation wards in Poland, where stroke patients are treated and undergo early rehabilitation. We divided departments into classes: class A - having comprehensive rehabilitation (physiotherapy minimum 60 minutes/day, speech therapy minimum 30 minutes/5 days/week, rehabilitation of other cognitive impairments minimum 30 minutes/5 days/week, group physiotherapy); B - having the possibility of all types of therapy, but done less frequently; C - physiotherapy and speech therapy; D - physiotherapy and cognitive rehabilitation; E - only physiotherapy. In 2004, we obtained responses from 115 of 172 (66.9%) rehabilitation departments. According to prespecified criteria there were 11 class A, 31 class B, 28 class C, 4 class D, and 41 class E wards. In 2008, we received response from 89 of 149 (59.7%) rehabilitation departments. According to prespecified criteria there were 17 class A, 40 class B, 22 class C, 0 class D, and 10 class E wards. In 2004, 159 beds and in 2008, 294 beds in class A departments were available for stroke patients. The minimal number of needed but lacking beds was 604 in 2004 and 469 in 2008. Development of departments providing early comprehensive stroke rehabilitation from 2004 to 2008 is marked, but still insufficient. In 2008, 19% of rehabilitation departments could provide comprehensive stroke rehabilitation and this was 38.5% of beds actually needed.

Using the Abitibi Greenstone Belt to Understand Martian Hydrothermal Systems and the Potential for Biosignature Preservation in High Temperature Aqueous Environments

NASA Technical Reports Server (NTRS)

Hurowitz, J.; Abelson, J.; Allwood, A.; Anderson, R.; Atkinson, B.; Beaty, D.; Bristow, T.; Ehlmann, B.; Eigenbrode, J.; Grotzinger, J.;

A super high-rate sulfidogenic system for saline sewage treatment.

PubMed

Tsui, To-Hung; Chen, Lin; Hao, Tianwei; Chen, Guang-Hao

2016-11-01

This study proposes a novel approach to resolve the challenging issue of sludge bed clogging in a granular sulfate-reducing upflow sludge bed (GSRUSB) reactor by means of introducing intermittent gas sparging to advance it into a super high-rate anaerobic bioreactor. Over a 196-day lab-scale trial, the GSRUSB system was operated from nominal hydraulic retention time of 4-hr to 40-min and achieved the highest organic loading rate of 13.31 kg COD/m 3 ·day which is substantially greater than the typical loading of 2.0-3.5 kg COD/m 3 ·day in a conventional upflow anaerobic sludge bed reactor treating dilute organic strength wastewater. The average organic removal efficiency and total dissolved sulfide of this system were 90 ± 4.2% and 158 ± 28 mg S/L, while organics residual in the effluent was 34 ± 14 mg COD/L. The control stage (without gas sparging) revealed that the sludge bed clogging happened concomitantly with the significant drop in extracellular polymeric substance content of granular sludge, through relevant chemical measurements and confocal laser scanning microscopy analyses. On the other hand, compared with increasing the effluent recirculation ratio (from 1.4 to 5), the three-dimensional computational fluid dynamics modeling in combination with energy dissipation analysis demonstrated that the gas sparging (at a superficial gas velocity of 0.8 m s -1 ) can create a 23 times higher liquid shear as well as enhanced particle attrition. Overall, this study not only developed a super high-rate anaerobic bioreactor for saline sewage treatment, but also shed light on the role of intermittent gas sparging in control of sludge bed clogging for anaerobic bioreactors. Copyright © 2016 Elsevier Ltd. All rights reserved.

LBNP/ergometer effects on female cardiovascular and muscle deconditioning in 15d head-down bed rest

NASA Astrophysics Data System (ADS)

Wang, Lin-Jie

2012-07-01

Female has already been an important part of astronaut corps but gender characteristics in weightlessness and countermeasure effects still not clearly elucidated. In this study the LBNP/Ergometer effects on female cardiovascular deconditioning and muscle atrophy in 15d head-down bed rest were explored. 22 female university students were recruited as volunteers that participated in the 15d head-down bed rest. They were divided into control group (Con,n=8), LBNP exercise group (LBNP,n=7) and LBNP combined with ergometer exercise group (LBNP+Ergo, n=7). Grade negative pressures of -10,-20,-30,-40mmHg 20 or 55min were used in LBNP exercise. In ergometer exercises the subjects must maintain 60-80% VO2peak of pre-bed rest at pedal speed of about 70cycle/min for 15min and the entire exercise duration was 30min. LBNP were performed at 6th,8th,10th,12th,and 13th day and Ergometer were operated at 4th,5th,7th,9th,11th day during bed rest. Before and after bed rest, cardiovascular tilt test were performed to evaluate orthostatic intolerance, supine cycle ergometer were used to test the cardiopulmonary function, MRI tests were operated to examine the volume variations of leg muscle groups and isokinetic test were given to test the muscle strength and endurance of knee. 40% of female subjects did not pass the tilt table test after bed rest and exercises made no difference. Compared with pre-BR, VO2max and VO2max /body weight, VO2/HRmax, maximal power and duration significantly decreased in CON group and LBNP group. For the ERGO+LBNP group, there were no visible different in the parameters of cardiopulmonary function except that maximal power and duration decreased. Muscle maximal voluntary contraction and muscle (quadriceps, rectus femoris, gastrocnemius and soleus) volume decreasing in non-predominant leg was larger in Con group than in LBNP+Ergo group. It is suggested that LBNP combined with ergometer in some degrees can counteract the cardiovascular and muscle deconditioning induced by 15d head-down bed rest.

Rapid-cycle testing cuts bed turnaround by 85%.

PubMed

2004-11-01

You can use rapid-cycle testing to try out new approaches to overcrowding much more frequently than with more traditional process improvement strategies. Improving bed turnaround notification can yield dramatic improvements. Telling staff they have to try a new process only for three days makes it easier to gain buy-in. Look for old policies that are no longer needed, yet continue to keep your staff bogged down.

500-Gray γ-Irradiation May Increase Adhesion Strength of Lyophilized Cadaveric Split-Thickness Skin Graft to Wound Bed.

PubMed

Wei, Lin-Gwei; Chen, Chieh-Feng; Wang, Chi-Hsien; Cheng, Ya-Chen; Li, Chun-Chang; Chiu, Wen-Kuan; Wang, Hsian-Jenn

2017-03-01

Human cadaveric skin grafts are considered as the "gold standard" for temporary wound coverage because they provide a more conductive environment for natural wound healing. Lyophilization, packing, and terminal sterilization with gamma-ray can facilitate the application of cadaveric split-thickness skin grafts, but may alter the adhesion properties of the grafts. In a pilot study, we found that 500 Gy γ-irradiation seemed not to reduce the adherence between the grafts and wound beds. We conducted this experiment to compare the adherences of lyophilized, 500-Gy γ-irradiated skin grafts to that of lyophilized, nonirradiated grafts. Pairs of wounds were created over the backs of Sprague- Dawley rats. Pairs of "lyophilized, 500-Gy γ-irradiated" and "lyophilized, nonirradiated" cadaveric split-thickness skin grafts were fixed to the wound beds. Adhesion strength between the grafts and the wound beds was measured and compared. On post-skin-graft day 7 and day 10, the adhesion strength of γ-irradiated grafts was greater than that of the nonirradiated grafts. Because lyophilized cadaveric skin grafts can be vascularized and the collagen of its dermal component can be remodeled after grafting, the superior adhesion strength of 500-Gy γ-irradiated grafts can be explained by the collagen changes from irradiation.

Effects of listening to music on pain intensity and pain distress after surgery: an intervention.

PubMed

Vaajoki, Anne; Pietilä, Anna-Maija; Kankkunen, Päivi; Vehviläinen-Julkunen, Katri

2012-03-01

To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day. Music has been found to relieve pain intensity in surgery patients. There are only a few studies on music intervention in abdominal surgery. Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce. Prospective clinical study with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were divided into either a music group (n = 83) or a control group (n = 85). Patients assessed pain intensity and pain distress in bed rest, during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning, at noon and in the evening. On the third postoperative day, the patients assessed their pain intensity and pain distress only once. In the music group, the patients' pain intensity and pain distress in bed rest, during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients. On the third postoperative day, when long-term effects of music on pain intensity and pain distress were assessed, there were no significant differences between music and control groups. This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest, during deep breathing and in shifting position after abdominal surgery on the second postoperative day. Music intervention is safe, inexpensive and easily used to improve the healing environment for abdominal surgery patients. Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice. © 2011 Blackwell Publishing Ltd.

Excercise Within LBNP as an Artificial Gravity Countermeasure

NASA Technical Reports Server (NTRS)

Hargens, A. R.; Watenpaugh, D. E.; Lee, S. M. C.; Meyer, R. S.; Macias, B.; Tanaka, K.; Kimura, S.; Steinbach, G.; Groppo, E.; Khalili, N.;

24 CFR 203.674 - Eligibility for continued occupancy.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Servicing Responsibilities Occupied Conveyance § 203.674... allow access to the property (during normal business hours and upon a minimum of two days advance notice... necessary repairs accomplished, or by a sales broker. (5) The occupant discloses and verifies Social...

Today's sediment budget of the Rhine River channel, focusing on the Upper Rhine Graben and Rhenish Massif

NASA Astrophysics Data System (ADS)

Frings, Roy M.; Gehres, Nicole; Promny, Markus; Middelkoop, Hans; Schüttrumpf, Holger; Vollmer, Stefan

2014-01-01

The river bed of the Rhine River is subject to severe erosion and sedimentation. Such high geomorphological process rates are unwanted for economical, ecological, and safety reasons. The objectives of this study were (1) to quantify the geomorphological development of the Rhine River between 1985 and 2006; (2) to investigate the bed erosion process; and (3) to distinguish between tectonic, hydrological, and human controls. We used a unique data set with thousands of bedload and suspended-load measurements and quantified the fluxes of gravel, sand, silt, and clay through the northern Upper Rhine Graben and the Rhenish Massif. Furthermore, we calculated bed level changes and evaluated the sediment budget of the channel. Sediment transport rates were found to change in the downstream direction: silt and clay loads increase because of tributary supply; sand loads increase because of erosion of sand from the bed; and gravel loads decrease because of reduced sediment mobility caused by the base-level control exerted by the uplifting Rhenish Massif. This base-level control shows tectonic setting, in addition to hydrology and human interventions, to represent a major control on morphodynamics in the Rhine. The Rhine bed appears to be in a state of disequilibrium, with an average net bed degradation of 3 mm/a. Sand being eroded from the bed is primarily washed away in suspension, indicating a rapid supply of sand to the Rhine delta. The degradation is the result of an increased sediment transport capacity caused by nineteenth and twentieth century's river training works. In order to reduce degradation, huge amounts of sediment are fed into the river by river managers. Bed degradation and artificial sediment feeding represent the major sources of sand and gravel to the study area; only small amounts of sediment are supplied naturally from upstream or by tributaries. Sediment sinks include dredging, abrasion, and the sediment output to the downstream area. Large uncertainties exist about the amounts of sediment deposited on floodplains and in groyne fields. Compared to the natural situation during the middle Holocene, the present-day gravel and sand loads seem to be lower, whereas the silt and clay loads seem to be higher. This is probably caused by the present-day absence of meander migration, the deforestation, and the reduced sediment trapping efficiency of the floodplains. Even under natural conditions no equilibrium bed level existed.

Decoding a Dark Splotch

NASA Image and Video Library

2017-10-09

Geologists aren't quite sure what to make of the dark splotch in the middle of this image from NASA's Mars Reconnaisance Orbiter (MRO) -- one of several similar dark splotches that extend east and west for over 100 kilometers. From measurements made in infrared, this and other dark splotches have what we call "high thermal inertia," meaning that it heats up and cools down slowly. Scientists use thermal inertia to assess how rocky, sandy, or dusty a place is. A higher thermal inertia than the surrounding area means it's less dusty. Wavy, banded patterns in the dark splotch (possibly due to cross bedding from sand dunes that once occupied the area) were lithified into sandstone, and then eroded away. These clues could help geologists figure out what's going on there. https://photojournal.jpl.nasa.gov/catalog/PIA22042

VO2 kinetics of constant-load exercise following bed-rest-induced deconditioning

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Goldwater, D. J.; Sandler, H.

1984-01-01

Previous studies have shown that the oxygen uptake kinetics during exercise and recovery may be changed by alterations in work intensity, prior exercise, muscle group involvement, ambient conditions, posture, disease state, and level of physical conditioning. However, the effects of detraining on oxygen uptake kinetics have not been determined. The present investigation has the objective to determine the effects of deconditioning following seven days of continuous head-down bed rest on changes in steady-state oxygen uptake, O2 deficit, and recovery oxygen uptake during the performance of constant-load exercise. The obtained results may provide support for previous proposals that submaximal oxygen uptake was significantly reduced following bed rest. The major finding was that bed-rest deconditioning resulted in a reduction of total O2 transport/utilization capacity during the transient phase of upright but not supine exercise.

Vinyl chloride removal from an air stream by biotrickling filter.

PubMed

Faraj, S H Esmaeili; Esfahany, M Nasr; Kadivar, M; Zilouei, H

2012-01-01

A biofiltration process was used for degradation of vinyl chloride as a hazardous material in the air stream. Three biotrickling filters in series-parallel allowing uniform feed and moisture distribution all over the bed were used. Granular activated carbon mixed with compost was employed as carrier bed. The biological culture consisted of mixture of activated sludge from PVC wastewater treatment plant. Concurrent flow of gas and liquid was used in the bed. Results indicated that during the operation period of 110 days, the biotrickling bed was able to remove over 35% of inlet vinyl chloride. Maximum elimination capacity was calculated to be 0.56 g.m(-3).hr(-1). The amount of chlorine accumulated in the circulating liquid due to the degradation of vinyl chloride was measured to be equal to the vinyl chloride removed from the air stream.

NASA's Functional Task Test: Providing Information for an Integrated Countermeasure System

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Feiveson, A. H.; Laurie, S. S.; Lee, S. M. C.; Mulavara, A. P.; Peters, B. T.; Platts, S. H.; Ploutz-Snyder, L. L.; Reschke, M. F.; Ryder, J. W.;

Binge Abstinence is Associated with Reduced Energy Intake After Treatment in Patients with Binge Eating Disorder and Obesity

PubMed Central

Masheb, Robin M.; Dorflinger, Lindsey M.; Rolls, Barbara J.; Mitchell, Diane C.; Grilo, Carlos M.

2016-01-01

Objective Binge eating disorder (BED) is strongly associated with obesity and related medical and psychiatric morbidities. Cognitive behavioral therapy (CBT) has consistently been shown to reduce binge eating frequency and improve psychological functioning, as well as to produce abstinence rates of roughly 50%. This study examined the relationship between binge abstinence and dietary and psychological outcomes after CBT for BED. Methods Fifty adult patients with BED received 6-month treatments using a combination of CBT and dietary counseling. Trained interviewers conducted two 24-hour dietary recall interviews on randomly selected days at baseline and at 6 months. Results Participants had significant reductions in energy, macronutrient, and sugar intake and an increase in fruit intake. They reported significant reductions in BMI and binge eating frequency (from mean = 14.24 to mean = 1.90 binge eating episodes during the previous 28 days), as well as improvements in psychological functioning. Those who became binge abstinent reported eating roughly 400 fewer calories per day and experienced greater improvements in psychological functioning than those who did not. Conclusions Findings from this study suggest that individuals who achieve complete cessation from binge eating have significantly improved dietary and psychological outcomes that could potentially improve weight status, compared with those who continue to binge eat post-treatment. PMID:27797154

Binge abstinence is associated with reduced energy intake after treatment in patients with binge eating disorder and obesity.

PubMed

Masheb, Robin M; Dorflinger, Lindsey M; Rolls, Barbara J; Mitchell, Diane C; Grilo, Carlos M

2016-12-01

Binge eating disorder (BED) is strongly associated with obesity and related medical and psychiatric morbidities. Cognitive behavioral therapy (CBT) has consistently been shown to reduce binge eating frequency and improve psychological functioning, as well as to produce abstinence rates of roughly 50%. This study examined the relationship between binge abstinence and dietary and psychological outcomes after CBT for BED. Fifty adult patients with BED received 6-month treatments using a combination of CBT and dietary counseling. Trained interviewers conducted two 24-hour dietary recall interviews on randomly selected days at baseline and at 6 months. Participants had significant reductions in energy, macronutrient, and sugar intake and an increase in fruit intake. They reported significant reductions in BMI and binge eating frequency (from mean = 14.24 to mean = 1.90 binge eating episodes during the previous 28 days), as well as improvements in psychological functioning. Those who became binge abstinent reported eating roughly 400 fewer calories per day and experienced greater improvements in psychological functioning than those who did not. Findings from this study suggest that individuals who achieve complete cessation from binge eating have significantly improved dietary and psychological outcomes that could potentially improve weight status, compared with those who continue to binge eat post-treatment. © 2016 The Obesity Society.

Costs associated with the management of waste from healthcare facilities: An analysis at national and site level.

PubMed

Vaccari, Mentore; Tudor, Terry; Perteghella, Andrea

2018-01-01

Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day -1 bed -1 ), paediatric and intensive care (3.37 kg day -1 bed -1 ) and gastroenterology-digestive endoscopy (3.09 kg day -1 bed -1 ). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg -1 , with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.

Biomedical waste disposal: A systems analysis

PubMed Central

Jindal, A.K.; Gupta, Arun; Grewal, V.S.; Mahen, Ajoy

2012-01-01

Background In view of the contemporary relevance of BMW Management, a system analysis of BMW management was conducted to ascertain the views of Service hospitals/HCE's on the current system in BMW management in-vogue; to know the composition and quantity of waste generated; to get information on equipment held & equipment required and to explore the possibility of outsourcing, its relevance and feasibility. Methods A qualitative study in which various stake holders in BMW management were studied using both primary (Observation, In-depth Interview of Key Personnel, Group Discussions: and user perspective survey) and secondary data. Results All the stake holders were of the opinion that where ever possible outsourcing should be explored as a viable method of BMW disposal. Waste generated in Colour code Yellow (Cat 1,2,3,5,6) ranged from 64.25 to 27.345 g/day/bed; in Colour code Red (Cat 7) from 19.37 to 10.97 g/day/bed and in Colour code Blue (Cat 4) from 3.295 to 3.82 g/day/bed in type 1 hospitals to type 5 hospitals respectively. Conclusion Outsourcing should be explored as a viable method of BMW disposal, were there are government approved local agencies. Facilities authorized by the Prescribed Authority should be continued and maintained where outsourcing is not feasible. PMID:24600142

Classifying nursing errors in clinical management within an Australian hospital.

PubMed

Tran, D T; Johnson, M

2010-12-01

Although many classification systems relating to patient safety exist, no taxonomy was identified that classified nursing errors in clinical management. To develop a classification system for nursing errors relating to clinical management (NECM taxonomy) and to describe contributing factors and patient consequences. We analysed 241 (11%) self-reported incidents relating to clinical management in nursing in a metropolitan hospital. Descriptive analysis of numeric data and content analysis of text data were undertaken to derive the NECM taxonomy, contributing factors and consequences for patients. Clinical management incidents represented 1.63 incidents per 1000 occupied bed days. The four themes of the NECM taxonomy were nursing care process (67%), communication (22%), administrative process (5%), and knowledge and skill (6%). Half of the incidents did not cause any patient harm. Contributing factors (n=111) included the following: patient clinical, social conditions and behaviours (27%); resources (22%); environment and workload (18%); other health professionals (15%); communication (13%); and nurse's knowledge and experience (5%). The NECM taxonomy provides direction to clinicians and managers on areas in clinical management that are most vulnerable to error, and therefore, priorities for system change management. Any nurses who wish to classify nursing errors relating to clinical management could use these types of errors. This study informs further research into risk management behaviour, and self-assessment tools for clinicians. Globally, nurses need to continue to monitor and act upon patient safety issues. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

The association between bedding material and the bacterial counts of Staphylococcus aureus, Streptococcus uberis and coliform bacteria on teat skin and in teat canals in lactating dairy cattle.

PubMed

Paduch, Jan-Hendrik; Mohr, Elmar; Krömker, Volker

2013-05-01

Several mastitis-causing pathogens are able to colonize the bovine teat canal. The objective of this study was to investigate the association between the treatment of sawdust bedding with a commercial alkaline conditioner and the bacterial counts on teat skin and in the teat canal. The study used a crossover design. Ten lactating Holstein cows that were free of udder infections and mastitis were included in the study. The animals were bedded on either untreated sawdust or sawdust that had been treated with a hydrated lime-based conditioner. Once a day, fresh bedding material was added. After 3 weeks, the bedding material was removed from the cubicles, fresh bedding material was provided, and the cows were rotated between the two bedding material groups. Teat skin and teat canals were sampled using the wet and dry swab technique after weeks 1, 2, 3, 4, 5 and 6. Staphylococcus aureus, Streptococcus uberis, Escherichia coli and other coliform bacteria were detected in the resulting agar plate cultures. The treatment of the bedding material was associated with the teat skin bacterial counts of Str. uberis, Esch. coli and other coliform bacteria. An association was also found between the bedding material and the teat canal bacterial counts of coliform bacteria other than Esch. coli. For Staph. aureus, no associations with the bedding material were found. In general, the addition of a hydrated lime-based conditioner to sawdust reduces the population sizes of environmental pathogens on teat skin and in teat canals.

Lattice strain measurements on sandstones under load using neutron diffraction

NASA Astrophysics Data System (ADS)

Frischbutter, A.; Neov, D.; Scheffzük, Ch.; Vrána, M.; Walther, K.

2000-11-01

Neutron diffraction methods (both time-of-flight- and angle-dispersive diffraction) are applied to intracrystalline strain measurements on geological samples undergoing uniaxial increasing compressional load. The experiments were carried out on Cretaceous sandstones from the Elbezone (East Germany), consisting of >95% quartz which are bedded but without crystallographic preferred orientation of quartz. From the stress-strain relation the Young's modulus for our quartz sample was determined to be (72.2±2.9) GPa using results of the neutron time-of-flight method. The influence of different kinds of bedding in sandstones (laminated and convolute bedding) could be determined. We observed differences of factor 2 (convolute bedding) and 3 (laminated bedding) for the elastic stiffness, determined with angle dispersive neutron diffraction (crystallographic strain) and with strain gauges (mechanical strain). The data indicate which geological conditions may influence the stress-strain behaviour of geological materials. The influence of bedding on the stress-strain behaviour of a laminated bedded sandstone was indicated by direct residual stress measurements using neutron time-of-flight diffraction. The measurements were carried out six days after unloading the sample. Residual strain was measured for three positions from the centre to the periphery and within two radial directions of the cylinder. We observed that residual strain changes from extension to compression in a different manner for two perpendicular directions of the bedding plane.

Insulin and glucose responses during bed rest with isotonic and isometric exercise

NASA Technical Reports Server (NTRS)

Dolkas, C. B.; Greenleaf, J. E.

1977-01-01

The effects of daily intensive isotonic (68% maximum oxygen uptake) and isometric (21% maximum extension force) leg exercise on plasma insulin and glucose responses to an oral glucose tolerance test (OGTT) during 14-day bed-rest (BR) periods were investigated in seven young healthy men. The OGTT was given during ambulatory control and on day 10 of the no-exercise, isotonic, and isometric exercise BR periods during the 15-wk study. The subjects were placed on a controlled diet starting 10 days before each BR period. During BR, basal plasma glucose concentration remained unchanged with no exercise, but increased (P less 0.05) to 87-89 mg/100 ml with both exercise regimens on day 2, and then fell slightly below control levels on day 13. The fall in glucose content during BR was independent of the exercise regimen and was an adjustment for the loss of plasma volume. The intensity of the responses of insulin and glucose to the OGTT was inversely proportional to the total daily energy expenditure during BR. It was estimated that at least 1020 kcal/day must be provided by supplemental exercise to restore the hyperinsulinemia to control levels.

Bed site selection by neonate deer in grassland habitats on the northern Great Plains

USGS Publications Warehouse

Grovenburg, T.W.; Jacques, C.N.; Klaver, R.W.; Jenks, J.A.

2010-01-01

Bed site selection is an important behavioral trait influencing neonate survival. Vegetation characteristics of bed sites influence thermal protection of neonates and concealment from predators. Although previous studies describe bed site selection of neonatal white-tailed deer (Odocoileus virginianus) in regions of forested cover, none determined microhabitat effects on neonate bed site selection in the Northern Great Plains, an area of limited forest cover. During summers 2007–2009, we investigated bed site selection (n  =  152) by 81 radiocollared neonate white-tailed deer in north-central South Dakota, USA. We documented 80 (52.6%) bed sites in tallgrass–Conservation Reserve Program lands, 35 (23.0%) bed sites in forested cover, and 37 (24.3%) in other habitats (e.g., pasture, alfalfa, wheat). Bed site selection varied with age and sex of neonate. Tree canopy cover (P < 0.001) and tree basal area (P < 0.001) decreased with age of neonates, with no bed sites observed in forested cover after 18 days of age. Male neonates selected sites with less grass cover (P < 0.001), vertical height of understory vegetation (P < 0.001), and density of understory vegetation (P < 0.001) but greater bare ground (P  =  0.047), litter (P  =  0.028), and wheat (P  =  0.044) than did females. Odds of bed site selection increased 3.5% (odds ratio  =  1.035, 95% CI  =  1.008–1.062) for every 1-cm increase in vertical height of understory vegetation. Management for habitat throughout the grasslands of South Dakota that maximizes vertical height of understory vegetation would enhance cover characteristics selected by neonates.

A hybrid genetic algorithm-queuing multi-compartment model for optimizing inpatient bed occupancy and associated costs.

PubMed

Belciug, Smaranda; Gorunescu, Florin

2016-03-01

Explore how efficient intelligent decision support systems, both easily understandable and straightforwardly implemented, can help modern hospital managers to optimize both bed occupancy and utilization costs. This paper proposes a hybrid genetic algorithm-queuing multi-compartment model for the patient flow in hospitals. A finite capacity queuing model with phase-type service distribution is combined with a compartmental model, and an associated cost model is set up. An evolutionary-based approach is used for enhancing the ability to optimize both bed management and associated costs. In addition, a "What-if analysis" shows how changing the model parameters could improve performance while controlling costs. The study uses bed-occupancy data collected at the Department of Geriatric Medicine - St. George's Hospital, London, period 1969-1984, and January 2000. The hybrid model revealed that a bed-occupancy exceeding 91%, implying a patient rejection rate around 1.1%, can be carried out with 159 beds plus 8 unstaffed beds. The same holding and penalty costs, but significantly different bed allocations (156 vs. 184 staffed beds, and 8 vs. 9 unstaffed beds, respectively) will result in significantly different costs (£755 vs. £1172). Moreover, once the arrival rate exceeds 7 patient/day, the costs associated to the finite capacity system become significantly smaller than those associated to an Erlang B queuing model (£134 vs. £947). Encoding the whole information provided by both the queuing system and the cost model through chromosomes, the genetic algorithm represents an efficient tool in optimizing the bed allocation and associated costs. The methodology can be extended to different medical departments with minor modifications in structure and parameterization. Copyright © 2016 Elsevier B.V. All rights reserved.

Fluidized bed combustion residue as an alternative liming material and Ca source. [Prunus persica

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edwards, J.H.; Horton, B.D.; White, A.W. Jr.

1985-01-01

Fluidized bed combustion residue (FBCR), a by-product of fossil fuel fired boilers, was evaluated as a liming material and a source of calcium for peaches (Prunus persica (L.) Batsch). Incubation studies involving a medium textured soil indicated that FBCR (calcite (FBCRC) or dolomitic (FBCRD) sources) was as effective a liming amendment as the respective agricultural limestone. Maximum soil pH occurred after 26 days incubation with FBCRC, but soil pH increased continuously throughout 137 days incubation with dolomitic limestone. Ammonium acetate extractable Ca was not affected by calcitic source, but Mg concentration increased with rates with the two dolomitic sources, andmore » was highest in the FBCRD source after 137 days incubation. In greenhouse studies with Elberta peach seedlings, FBCRC was more effective in neutralizing soil acidity and increasing extractable soil Ca than calcitic limestone.« less

[Liver stiffness measured by acoustic radiation force impulse imaging in assessing hepatic functional reserve in patients with space-occupying lesions in the liver].

PubMed

Yan, Hui-tong; Luo, Yu-kun; Tang, Wen-bo; Jiao, Zi-yu; Yao, Chun-xiao; Lv, Fa-qin; Tang, Jie

2013-04-01

To investigate the value of liver stiffness measured by acoustic radiation force impulse imaging(ARFI) in assessing hepatic functional reserve in patients with space-occupying lesions in the liver. Sixty-three patients with space-occupying lesions in the liver were enrolled. Liver stiffness (LS) measurements with ARFI and indocyanine green(ICG) retention test were performed in the same day, and plasma clearance rate of indocyanine green(ICG-K), ICG retention at 15 minutes(ICGR15) as well as 10 effective values of LS were recorded. The correlation between Child-Pugh score, ICGR15, ICG-K, and LS were evaluated. The LS measurements with ARFI failed in one patient. A strong correlation between LS and ICGR15(r=0.789, P<0.01) and an inverse correlation between LS and ICG-K(r=-0.738, P<0.01) were observed. Besides, there was a significant correlation between LS measurements and Child-Pugh score(r=0.929, P<0.01) . The LS significantly differed among patients with Child-Pugh class A, B, and C(P<0.01) . ARFI is a simple, feasible and non-invasive method for assessing hepatic functional reserve in patients with space-occupying lesions in the liver.

Surgical decompression for space-occupying cerebral infarction: outcomes at 3 years in the randomized HAMLET trial.

PubMed

Geurts, Marjolein; van der Worp, H Bart; Kappelle, L Jaap; Amelink, G Johan; Algra, Ale; Hofmeijer, Jeannette

2013-09-01

We assessed whether the effects of surgical decompression for space-occupying hemispheric infarction, observed at 1 year, are sustained at 3 years. Patients with space-occupying hemispheric infarction, who were enrolled in the Hemicraniectomy After Middle cerebral artery infarction with Life-threatening Edema Trial within 4 days after stroke onset, were followed up at 3 years. Outcome measures included functional outcome (modified Rankin Scale), death, quality of life, and place of residence. Poor functional outcome was defined as modified Rankin Scale >3. Of 64 included patients, 32 were randomized to decompressive surgery and 32 to best medical treatment. Just as at 1 year, surgery had no effect on the risk of poor functional outcome at 3 years (absolute risk reduction, 1%; 95% confidence interval, -21 to 22), but it reduced case fatality (absolute risk reduction, 37%; 95% confidence interval, 14-60). Sixteen surgically treated patients and 8 controls lived at home (absolute risk reduction, 27%; 95% confidence interval, 4-50). Quality of life improved between 1 and 3 years in patients treated with surgery. In patients with space-occupying hemispheric infarction, the effects of decompressive surgery on case fatality and functional outcome observed at 1 year are sustained at 3 years. http://www.controlled-trials.com. Unique identifier: ISRCTN94237756.

Reducing emergency bed-days for older people? Network governance lessons from the 'Improving the Future for Older People' programme.

PubMed

Sheaff, Rod; Windle, Karen; Wistow, Gerald; Ashby, Sue; Beech, Roger; Dickinson, Angela; Henderson, Catherine; Knapp, Martin

2014-04-01

In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the 'Improving the Future for Older People' initiative (IFOP), one strand of the national 'Innovation Forum' programme, set up in 2003. The nine sites set themselves one headline target to be achieved jointly over three years; a 20 per cent reduction in the number of emergency bed-days used by people aged 75 and over. Three ancillary targets were also monitored: emergency admissions, delayed discharges and project sustainability. Collectively the sites exceeded their headline target. Using a realistic evaluation approach, we explored which aspects of network governance appeared to have contributed to these emergency bed-day reductions. We found no simple link between network governance type and outcomes. The governance features associated with an effective IFOP network appeared to suggest that the selection and implementation of a small number of evidence-based services was central to networks' effectiveness. Each service needed to be coordinated by a network-based strategic group and hierarchically implemented at operational level by the responsible network member. Having a network-based implementation group with a 'joined-at-the-top' governance structure also appeared to promote network effectiveness. External factors, including NHS incentives, health reorganisations and financial targets similarly contributed to differences in performance. Targets and financial incentives could focus action but undermine horizontal networking. Local networks should specify which interventions network structures are intended to deliver. Effective projects are those likely to be evidence based, unique to the network and difficult to implement through vertical structures alone. Copyright © 2014 Elsevier Ltd. All rights reserved.

An evaluation of the costs and consequences of Children Community Nursing teams.

PubMed

Hinde, Sebastian; Allgar, Victoria; Richardson, Gerry; Spiers, Gemma; Parker, Gillian; Birks, Yvonne

2017-08-01

Recent years have seen an increasing shift towards providing care in the community, epitomised by the role of Children's Community Nursing (CCN) teams. However, there have been few attempts to use robust evaluative methods to interrogate the impact of such services. This study sought to evaluate whether reduction in secondary care costs, resulting from the introduction of 2 CCN teams, was sufficient to offset the additional cost of commissioning. Among the potential benefits of the CCN teams is a reduction in the burden placed on secondary care through the delivery of care at home; it is this potential reduction which is evaluated in this study via a 2-part analytical method. Firstly, an interrupted time series analysis used Hospital Episode Statistics data to interrogate any change in total paediatric bed days as a result of the introduction of 2 teams. Secondly, a costing analysis compared the cost savings from any reduction in total bed days with the cost of commissioning the teams. This study used a retrospective longitudinal study design as part of the transforming children's community services trial, which was conducted between June 2012 and June 2015. A reduction in hospital activity after introduction of the 2 nursing teams was found, (9634 and 8969 fewer bed days), but this did not reach statistical significance. The resultant cost saving to the National Health Service was less than the cost of employing the teams. The study represents an important first step in understanding the role of such teams as a means of providing a high quality of paediatric care in an era of limited resource. While the cost saving from released paediatric bed days was not sufficient to demonstrate cost-effectiveness, the analysis does not incorporate wider measures of health care utilisation and nonmonetary benefits resulting from the CCN teams. © 2017 John Wiley & Sons, Ltd.

Does smoking affect hospital use before death? A comparison of ever- and never-smokers in the last years of life.

PubMed

McGhee, Sarah M; Schooling, C Mary; Wong, Lai Chin; Leung, Gabriel M; Ho, Lai Ming; Thomas, G Neil; Ho, Daniel S Y; Lam, Tai Hing; Hedley, Anthony J

2008-06-01

Given the apparent greater use of health care services by smokers and predictions of higher costs for a never-smoking population, we aimed in this study to determine whether the acute hospital costs in the last years of life of never- and ever-smokers differed before death using a database of the decedents in 1 year in Hong Kong. To compare the acute hospital use of ever- and never-smoker decedents. The data on cause of death, personal characteristics, and public hospital discharges were linked for all decedents in 1998 in Hong Kong. The incidence rate ratio was used to compare, for ever- and never-smokers, the number of days spent in an acute hospital over the prior 7 years. Analyses were done using specific and all cause mortality, adjusted for sex, lifestyle factors, and life expectancy. Compared with never-smokers who died of the same condition, ever-smokers who died of chronic obstructive pulmonary disease used 28% more acute hospital bed days and those dying of smoking-related cancer 9% fewer. These differences cancelled out over the case-mix of deaths with no net difference in acute bed day use by smoking status for all-cause mortality. There was no difference in acute hospital bed days in the last years of life of ever- and never-smokers but some differences by cause of death. Reducing smoking in this population will not increase acute hospital use.

Trends in the supply of inpatient rehabilitation facilities services: 1996 to 2004.

PubMed

Mallinson, Trudy R; Manheim, Larry M; Almagor, Orit; Demark, Holly M; Heinemann, Allen W

2008-11-01

Describe the supply of inpatient rehabilitation facilities (IRFs) services in 1996 and examine changes between 1996 and 2004, including the impact of the IRF prospective payment system (PPS) in 2002 on organizational trends. Retrospective pre-post design. Freestanding and subprovider (distinct-part units) IRFs. IRFs (N=1424), including 257 freestanding IRFs and 1167 IRF units reported in the Healthcare Cost Report Information System database, from years 1996 to 2004. Not applicable. Number of IRF openings, IRF closures, beds, and inpatient days. The number of IRFs grew from 1037 to 1183 between 1996 and 2001 and grew to 1235 between 2001 and 2004. The likelihood of IRF closures trended lower after PPS, and there was a significant increase in the likelihood of openings when PPS was introduced. For-profit, rural, and small IRFs were more likely to open over the entire period. There was a 12.9% increase in the number of total inpatient days, somewhat less than the 15.7% growth in IRF beds over the period. There was no impact of PPS on beds available but a significant decline in total inpatient days after PPS. Inpatient days rose under the Tax Equity and Fiscal Responsibility Act and declined after 2002. Yet the likelihood of openings and closures did not appear to respond to these changes, perhaps because they were modest compared with changes in local IRF markets. The IRF PPS did little to affect service distribution in less well-served areas, although we did find growth in rural areas. Occupancy rates in 2004 were close to rates at the start of the period (70%). This observation implies that IRFs were implementing strategies to recruit a sufficient number of patients, even though bed numbers were increasing and length of stay was declining. Consequently, policy that limits the potential of IRFs to increase patient admissions, such as the limits on admissions to IRFs of patients with conditions other than those included in the 75% rule, is likely to produce substantial decreases in total inpatient days.

Financial impact of surgical site infections on hospitals: the hospital management perspective.

PubMed

Shepard, John; Ward, William; Milstone, Aaron; Carlson, Taylor; Frederick, John; Hadhazy, Eric; Perl, Trish

2013-10-01

Surgical site infections (SSIs) may increase health care costs, but few studies have conducted an analysis from the perspective of hospital administrators. To determine the change in hospital profit due to SSIs. Retrospective study of data from January 1, 2007, to December 31, 2010. The study was performed at 4 of The Johns Hopkins Health System acute care hospitals in Maryland: Johns Hopkins Bayview (560 beds); Howard County General Hospital (238 beds); The Johns Hopkins Hospital (946 beds); and Suburban Hospital (229 beds). Eligible patients for the study included those patients admitted to the 4 hospitals between January 1, 2007, and December 31, 2010, with complete data and the correct International Classification of Diseases, Ninth Revision code, as determined by the infection preventionist. Infection preventionists performed complete medical record review using National Healthcare Safety Network definitions to identify SSIs. Patients were stratified using the All Patient Refined Diagnosis Related Groups to estimate the change in hospital profit due to SSIs. Surgical site infections. The outcomes of the study were the difference in daily total charges, length of stay (LOS), 30-day readmission rate, and profit for patients with an SSI when compared with patients without an SSI. The hypothesis, formulated prior to data collection, that patients with an SSI have higher daily total costs, a longer LOS, and higher 30-day readmission rates than patients without an SSI, was tested using a nonpaired Mann-Whitney U test, an analysis of covariance, and a Pearson χ2 test. Hospital charges were used as a proxy for hospital cost. RESULTS The daily total charges, mean LOS, and 30-day readmission rate for patients with an SSI compared with patients without an SSI were $7493 vs $7924 (P = .99); 10.56 days vs 5.64 days (P < .001); and 51.94 vs 8.19 readmissions per 100 procedures (P < .001). The change in profit due SSIs was $2 268 589. The data suggest that hospitals have a financial incentive to reduce SSIs, but hospitals should expect to see an increase in both cost and revenue when SSIs are reduced.

SU-D-BRB-06: Treating Glioblastoma Multiforme (GBM) as a Chronic Disease: Implication of Temporal-Spatial Dose Fractionation Optimization Including Cancer Stem Cell Dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, V; Nguyen, D; Pajonk, F

Purpose: To explore the feasibility of improving GBM treatment outcome with temporal-spatial dose optimization of an ordinary differential equation (ODE) that models the differentiation and distinct radiosensitivity between cancer stem cells (CSC) and differentiated cancer cells (DCC). Methods: The ODE was formulated into a non-convex optimization problem with the objective to minimize remaining total cancer cells 500 days from the onset of radiotherapy when the total cancer cell number was 3.5×10{sup 7}, while maintaining normal tissue biological effective dose (BED) of 100Gy resulted from standard prescription of 2Gyx30. Assuming spatially separated CSC and DCC, optimization was also performed to exploremore » the potential benefit from dose-painting the two compartments. Dose escalation to a sub-cell-population in the GTV was also examined assuming that a 2 cm margin around the GTV allows sufficient dose drop-off to 100Gy BED. The recurrence time was determined as the time at which the total cancer cell number regrows to 10{sup 9} cells. Results: The recurrence time with variable fractional doses administered once per week, bi-week and month for one year were found to be 615, 593 and 570 days, superior to the standard-prescription recurrence time of 418 days. The optimal dose-fraction size progression for both uniform and dose-painting to the tumor is low and relatively constant in the beginning and gradually increases to more aggressive fractions at end of the treatment course. Dose escalation to BED of 200Gy to the whole tumor alongside with protracted weekly treatment was found to further delay recurrence to 733 days. Dose-painting of 200 and 500Gy BED to CSC on a year-long weekly schedule further extended recurrence to 736 and 1076 days, respectively. Conclusion: GBM treatment outcome can possibly be improved with a chronic treatment approach. Further dose escalation to the entire tumor or CSC targeted killing is needed to achieve total tumor control. This work is supported by the NSF Graduate Research Fellowship (DGE-1144087)« less

Strategies for cutting hospital beds: the impact on patient service.

PubMed Central

Green, L V; Nguyen, V

2001-01-01

OBJECTIVE: To develop insights on the impact of size, average length of stay, variability, and organization of clinical services on the relationship between occupancy rates and delays for beds. DATA SOURCES: The primary data source was Beth Israel Deaconess Medical Center in Boston. Secondary data were obtained from the United Hospital Fund of New York reflecting data from about 150 hospitals. STUDY DESIGN: Data from Beth Israel Deaconess on discharges and length of stay were analyzed and fit into appropriate queueing models to generate tables and graphs illustrating the relationship between the variables mentioned above and the relationship between occupancy levels and delays. In addition, specific issues of current concern to hospital administrators were analyzed, including the impact of consolidation of clinical services and utilizing hospital beds uniformly across seven days a week rather than five. PRINCIPAL FINDINGS: Using target occupancy levels as the primary determinant of bed capacity is inadequate and may lead to excessive delays for beds. Also, attempts to reduce hospital beds by consolidation of different clinical services into single nursing units may be counterproductive. CONCLUSIONS: More sophisticated methodologies are needed to support decisions that involve bed capacity and organization in order to understand the impact on patient service. Images Figure 2 PMID:11409821

A Poll about Children and Weight: Crunch Time during the American Work and School Week--3 P.M. to Bed. Summary

ERIC Educational Resources Information Center

Robert Wood Johnson Foundation, 2013

2013-01-01

Childhood obesity is a major public health challenge today, with complex roots interwoven into nearly every facet of American life. This poll addresses one narrow slice of this web: the challenges that families face during the "crunch time" of the work and school week, between 3 p.m. and the time children go to bed. Compared to the school day,…

A Poll about Children and Weight: Crunch Time during the American Work and School Week--3 P.M. to Bed

ERIC Educational Resources Information Center

Robert Wood Johnson Foundation, 2013

2013-01-01

Childhood obesity is a major public health challenge today, with complex roots interwoven into nearly every facet of American life. This poll addresses one narrow slice of this web: the challenges that families face during the "crunch time" of the work and school week, between 3 pm and the time children go to bed. Compared to the school day, this…

Animal and management factors influencing grower and finisher pig performance and efficiency in European systems: a meta-analysis.

PubMed

Douglas, S L; Szyszka, O; Stoddart, K; Edwards, S A; Kyriazakis, I

2015-07-01

A meta-analysis on the effects of management and animal-based factors on the performance and feed efficiency of growing pigs can provide information on single factor and interaction effects absent in individual studies. This study analysed the effects of such factors on average daily gain (ADG), feed intake (FI) and feed conversion ratio (FCR) of grower and finisher pigs. The multivariate models identified significant effects of: (1) bedding (P<0.01), stage of growth (P<0.001) and the interaction bedding×lysine (P<0.001) on ADG. ADG was higher on straw compared with no bedding (710 v. 605 g/day). (2) FI was significantly affected by stage of growth (P<0.01), bedding (P<0.01), group composition (P<0.05), group size (P<0.01), feed CP content (P<0.01), ambient temperature (P<0.01) and the interaction between floor space and feed energy content (P<0.001). Pigs housed on straw had a lower FI in comparison with those without (1.44 v. 2.04 kg/day); a higher FI was seen for pigs separated by gender in comparison with mixed groups (2.05 v. 1.65 kg/day); FI had a negative linear relationship with group size, the CP content of the feed and ambient temperature. (3) Stage of growth (P<0.001), feed CP (P<0.001) and lysine content (P<0.001), ambient temperature (P<0.001) and feed crude fibre (CF) content (P<0.01) significantly affected FCR; there were no significant interactions between any factors on this trait. There was an improvement in FCR at higher ambient temperatures, increased feed CP and lysine content, but a deterioration of FCR at higher CF contents. For ADG, the interaction of bedding×lysine was caused by pigs housed without bedding (straw) having higher ADG when on a feed lower in lysine, whereas those with bedding had a higher ADG when on a feed higher in lysine. Interaction effects on FI were caused by animals with the least amount of floor space having a higher FI when given a feed with a low metabolisable energy (ME) content, in contrast to all other pigs, which showed a higher FI with increased ME content. The meta-analysis confirmed the significant effect of several well-known factors on the performance and efficiency of grower and finisher pigs, the effects of some less established ones and, importantly, the interactions between such factors.