Intravenous ketamine for subacute treatment of refractory chronic migraine: a case series.

BACKGROUND: Refractory migraine is a challenging condition with great impact on health related quality of life. Intravenous (IV) ketamine has been previously used to treat various refractory pain conditions. We present a series of patients with refractory migraine treated with intravenous ketamine in the hospital setting. METHODS: Based on retrospective chart review, we identified six patients with refractory migraine admitted from 2010 through 2014 for treatment with intravenous ketamine. Ketamine was administered using a standard protocol starting with a dose of 0.1 mg/kg/hr and increased by 0.1 mg/kg/hr every 3 to 4 h as tolerated until the target pain score of 3/10 was achieved and maintained for at least 8 h. Visual Analogue Scale (VAS) scores at time of hospital admission were obtained as well as average baseline VAS scores prior to ketamine infusion. A phone interview was conducted for follow-up of migraine response in the 3 to 6 months following ketamine infusion. RESULTS: The study sample had a median age of 36.5 years (range 29-54) and 83% were women. Pre-treatment pain scores ranged from 9 to 10. All patients achieved a target pain level of 3 or less for 8 h; the average ketamine infusion rate at target was 0.34 mg/kg/hour (range 0.12-0.42 mg/kg/hr). One patient reported a transient out-of-body hallucination following an increase in the infusion rate, which resolved after decreasing the rate. There were no other significant side effects. CONCLUSION: IV ketamine was safely administered in the hospital setting to patients with refractory chronic migraine. Treatment was associated with short term improvement in pain severity in 6 of 6 patients with refractory chronic migraine. Prospective placebo-controlled trials are needed to assess short term and long-term efficacy of IV ketamine in refractory chronic migraine

Grounding the Concept of God in the Human Predicament

Contemporary religious epistemology often neglects offering a substantial defense of a particular conception of God, relying instead on appeals to tradition and past great theologians. This neglect is regrettable due to the large impact one’s concept of God has on the kind of expected evidence of God. I aim to correct this deficiency by offering a defensible concept of God grounded in the predicament faced by all human inquirers. My account of this human predicament will focus on three key features that are salient to religious inquiry: death, moral failure, and suffering and severity. I will defend the idea that death, moral failure, and suffering are all bad things that humans do and ought to seek rescue from. I will then argue that we ought to define our concept of God in terms of what it would take to rescue humanity from its predicament, thus allowing our conception of God to capture what matters most to us

Movement and Behavior of Walleye, Stizostedion Vitruem Vitreum (Mitchell), in Jamestown Reservoir, North Dakota, As Determined by Biotelemetry

Radio biotelemetry was used to study the movements and behavior of walleyes in Jamestown Reservoir during the summer of 1980. Four walleyes weighing from 1.7 to 4.4 kg were surgically implanted with radio transmitters. Only one fish could be successfully tracked. It was found that conductivity prevented the reception of radio signals from water deeper than 4.5 m. In 1981, eight walleyes were surgically implanted with ultrasonic transmitters. The ultrasonic transmitters performed as expected. Seven walleyes were successfully tracked throughout the summer. Two of the walleyes appeared to be nomadic and did not form activity areas. Five walleyes formed activity areas, with two fish having multiple activity areas. The average size of the activity area was 45.4 ha. Three types movement patterns were observed; directional, random, and movements following the shoreline. Walleyes were seldom found resting. The walleyes moved into deeper water as the summer progressed. Four to five meters was the average locational depth. Light did not limit the fish\u27s activity in shallow water. No relationship was evident between weather conditions and other outside influences on walleye activity

Performance and power regulation characteristics of two aileron-controlled rotors and a pitchable tip-controlled rotor on the Mod-O turbine

Tests were conducted on the DOE/NASA mod-0 horizontal axis wind turbine to compare and evaluate the performance and the power regulation characteristics of two aileron-controlled rotors and a pitchable tip-controlled rotor. The two aileron-controlled rotor configurations used 20 and 38 percent chord ailerons, while the tip-controlled rotor had a pitchable blade tip. The ability of the control surfaces to regulate power was determined by measuring the change in power caused by an incremental change in the deflection angle of the control surface. The data shows that the change in power per degree of deflection angle for the tip-controlled rotor was four times the corresponding value for the 2- percent chord ailerons. The root mean square power deviation about a power setpoint was highest for the 20 percent chord aileron, and lowest for the 38 percent chord aileron

Summer graduate research program for interns in science and engineering

The goal of the 10 week graduate intern program was to increase the source of candidates for positions in science and engineering at the Goddard Space Flight Center. Students participating in this program submitted papers on the work they performed over the 10 week period and also filled out questionnaires on the program's effectiveness, their own performance, and suggestions on improvements. The topics covered by the student's papers include: microsoft excel applications; fast aurora zone analysis; injection seeding of a Q-switched alexandrite laser; use of high temperature superconductors; modifications on a communication interface board; modeling of space network activities; prediction of atmospheric ozone content; and applications of industrial engineering