The Trout Stream

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Effects of calcium channel blockers on coronary vasoconstriction induced by endothelin-1 in closed chest pigs

AbstractThe purpose of this study was to determine the effects of endothelin-1 on the coronary vascular bed of closed chest pigs. Endothelin-1 (3 to 30 pmol/kg body weight) was selectively administered into the left anterior descending coronary artery. Coronary blood flow and epicardial vessel diameter were measured by quantitative arteriography. Arterial pressure increased after a 30 pmol/kg dose and heart rate was not changed.Coronary blood flow and vessel diameter of the left anterior descending artery significantly decreased by 74% and 32%, respectively (p < 0.01 versus control) after the 30 pmol/kg dose, whereas these variables modestly decreased in the left circumflex artery. Endothelin-1 in doses of 10 to 30 pmol/kg produced electrocardiographic ST segment elevation associated with decreased oxygen saturation of coronary sinus venous blood. Endothelin-induced coronary vasoconstriction was significantly inhibited after treatment with intravenous diltiazem (0.2 mg/kg, n = 6) or nifedipine (0.1 mg/kg, n = 5), but not after vehicle administration (n = 4).This study demonstrates that intracoronary administration of endothelin-1 causes significant myocardial ischemia through coronary vasoconstriction, which is inhibited by a calcium channel blocker. The data suggest that calcium influx into the smooth muscle cells appears to be involved at least in part in the mechanism of endothelin-induced coronary vasoconstriction in vivo

Effectiveness of a Pharmacist-Directed Tdap Immunization Program for a University Campus

Background/Objectives: Despite a slight increase in Tdap immunization rates, the total numbers are still low among adults. The purpose of this study is to determine the impact of a pharmacist-directed immunization program. The primary objective was to assess the increase in vaccination rates among the subjects indicated to receive the Tdap vaccine. The secondary objective was to assess changes in pre and post vaccine knowledge scores.Methods: Employees enrolled in the pharmacist-directed employee wellness clinic on a university campus in Ohio were screened forTdap vaccination at the annual employee health fair during Fall of 2016. Results were cross-referenced with the state vaccination database. Subjects were recruited via email to an educational program. Indicated patients were asked to schedule an appointment with a pharmacist. Assessment data on the educational program was collected before the presentation and after the appointment when the vaccine was administered. The efficacy endpoint for the primary objective was a 20% increase in baseline vaccination rates.Results: Of the 198 subjects recruited, a total of 54 received Tdap vaccination. The baseline vaccination rate of the study populationwas 37.4% and increased by 27.2% after the intervention to a total vaccination rate of 64.6% (p&lt; 0.001). Six knowledge assessmentswere utilized for the secondary objective; however, these results did not show significance.Conclusions: A pharmacist-directed Tdap immunization program is effective at increasing vaccination rates. Even though the changein education assessment data proved more observational, the education provided will empower subjects to make informed healthcaredecisions

Recent Decisions

Admiralty--Workmen\u27s Compensation--Receipt of Benefits under State Workmen\u27s Compensation Act containing Exclusive Remedy Provision does not Bar Subsequent Action against Employer for Unseaworthiness Patricia D. Owen ====================== Common Market--Council Regulations--Regulation Stake Precedence over Provisions of Member States\u27 Constitutions Jeffery R. Rush ===================== Discovery--Aid to Foreign or International Tribunals--United States Courts can Compel Testimony only on Behalf of Foreign or International Tribunals Empowered to make Binding Adjudications Frank R. Krok ===================== Extradition--Statute of Limitations--mere Absence is not Equivalent to Fleeing from Justice under 18 U.S.C. § 3290 Paul P. Sanford ===================== International Court of Justice--Procedure Temporary Relief in the Form of Interim Measures Granted on Prima Facie Evidence of Jurisdiction and Jurisdiction of the Merits Found on Basis of Prior Agreement to Compulsory I.C.J. Jurisdiction Edward N. Perry ==================== Jurisdiction--NATO--North Atlantic Treaty Organization status of Forces Agreement not an Exclusive Remedy for Member of United States Force or Civilian Component Edward A. Betancour

Swing-Free Cranes via Input Shaping of Operator Commands

This paper presents an open-loop control method for suppressing payload oscillation or swing caused by operator commanded maneuvers in rotary boom cranes and the method is experimentally verified on a one-sixteenth scale model of a Hagglunds shipboard crane. The crane configuration consists of a payload mass that swings like a spherical pendulum on the end of a lift-line which is attached to a boom capable of hub rotation (slewing) and elevation (luffing). Positioning of the payload is accomplished through the hub and boom angles and the load-line length. Since the configuration of the crane affects the excitation and response of the payload, the swing control scheme must account for the varying geometry of the system. Adaptive forward path command filters are employed to remove components of the command signal which induce payload swing

Engineered Nanostructures for High Thermal Conductivity Substrates

In the DARPA Thermal Ground Plane (TGP) program[1],we are developing a new thermal technology that will enable a monumental thermal technological leap to an entirely new class of electronics, particularly electronics for use in high-tech military systems. The proposed TGP is a planar, thermal expansion matched heat spreader that is capable of moving heat from multiple chips to a remote thermal sink. DARPA’s final goals require the TGP to have an effective conductivity of 20,000 W/mK, operate at 20g, with minimal fluid loss of less than 0.1%/year and in a large ultra-thin planar package of 10cmx20cm, no thicker than 1mm. The proposed TGP is based on a heat pipe architecture[2], whereby the enhanced transport of heat is made possible by applying nanoengineered surfaces to the evaporator, wick, and condenser surfaces. Ultra-low thermal resistances are engineered using superhydrophilic and superhydrophobic nanostructures on the interior surfaces of the TGP envelope. The final TGP design will be easily integrated into existing printed circuit board manufacturing technology. In this paper, we present the transport design, fabrication and packaging techniques, and finally a novel fluorescence imaging technique to visualize the capillary flow in these nanostructured wicks.United States. Defense Advanced Research Projects Agency (SSC SD Contract No. N66001-08-C-2008

Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US national institutes of health-funded trials

Background The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. Methods and Findings We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972–2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges’ g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. Conclusion The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression