Pathophysiology and management of bleeding and thrombosis in patients with liver disease

Patients with liver disease often develop complex changes in their haemostatic system. Frequently observed changes include thrombocytopaenia and altered plasma levels of most of the proteins involved in haemostasis. Although liver disease was historically classified as a haemostasis-related bleeding disorder, it has now been well established that the antihaemostatic changes that promote bleeding are compensated for by prohaemostatic changes. Conventional coagulation tests however do not accurately reflect these prohaemostatic changes, resulting in an underestimation of haemostatic potential. Novel coagulation tests, such as viscoelastic tests (VETs) and thrombin generation assays (TGAs) better reflect the net result of the haemostatic changes in patients with liver disease, and demonstrate a new, “rebalanced” haemostatic status. Although rebalanced, this haemostatic status is more fragile than in patients without liver disease. Patients with liver disease are therefore not only at risk of bleeding but also at risk of thrombosis. Notably, however, many haemostatic complications in liver disease are not related to the haemostatic failure. It is, therefore, crucial to identify the cause of the bleed or thrombotic complication in order to provide adequate treatment. In this paper, we will elaborate on the haemostatic changes that occur in liver disease, reflect on laboratory and clinical studies over the last few years, and explore the pathophysiologies of bleeding and thrombosis in this specific patient group

Weight Management Program for Fire Fighters: Feasibility Pilot

Please view abstract in the attached PDF fil

Effects of craving and DRD4 VNTR genotype on the relative value of alcohol: an initial human laboratory study

BACKGROUND: Craving for alcohol is a highly controversial subjective construct and may be clarified by Loewenstein's visceral theory, which emphasizes craving's behavioral effects on the relative value of alcohol. Based on the visceral theory, this study examined the effects of a craving induction on the relative value of alcohol as measured by a behavioral choice task. In addition, based on previous evidence of its role in the expression of craving, the influence of DRD4 VNTR genotype (DRD4-L vs. DRD4-S) was also examined. METHODS: Thirty-five heavy drinkers (54% male; 31% DRD4-L) were randomly assigned to receive either a craving induction (exposure to personally relevant alcohol cues) or a control induction (exposure to neutral cues), which was followed by an alcohol-money choice task. Participants were assessed for craving and positive/negative affect throughout the procedure, and relative value of alcohol was derived from participant choices for alcohol versus money. DRD4 VNTR status was assessed retrospectively via buccal samples using previously established protocols. RESULTS: Factorial analysis of the craving induction revealed that it was associated with significant increase in craving (p < .001), but not greater relative value of alcohol. Factorial analyses including DRD4 VNTR genotype of did not suggest an influence on reactivity to the craving induction, although this analysis was substantially compromised by small cell sample sizes. Continuous analyses revealed that craving was significantly associated with the relative value of alcohol (p < .05) and possession of the DRD4-L allele further amplified this relationship (p < .001). CONCLUSION: These results are interpreted as generally supporting Loewenstein's visceral theory of craving and evidence of a functional role of DRD4 VNTR genotype in the expression of craving for alcohol. Methodological limitations, mechanisms underlying these findings, and future directions are discussed

Functional Movement Screen Scores in High School Football Players

Please refer to the pdf version of the abstract located adjacent to the title

Efek Penambahan Asam Fenilfosponat-seng, Talk Dan Triasetin Terhadap Laju Kristalisasi Poliasam Laktat

Dalam aplikasi industri, salah satu kekurangan poli asam laktat (PLA) adalah kristalisasi yang lambat, sehingga meneyebabkan waktu yang lebih lama untuk mengolah PLA dibandingkan dengan polimer konvensional seperti polipropilen. Penelitian ini mengevaluasi pengaruh penambahan pengisi atau aditif terhadap laju kristalisasi PLA. PLA dilarutkan dalam diklorometana (DCM) dan dicampur dengan nucleating agent (seng asam fenilfosfonat atau talk) atau pelunak (triasetin) pada konsentrasi yang berbeda diikuti dengan pengeringan pada suhu kamar selama 24 jam dan pengeringan oven selama 2 jam pada suhu 80 °C. Campuran kering PLA ditempa panas pada 180 °C selama 10 menit. Differential Scanning Calorimetry (DSC) dilakukan untuk mengevaluasi tingkat kristalisasi. Hasil studi menunjukkan bahwa penambahan pengisi atau aditif mempercepat proses kristalisasi PLA. Asam seng fenilfosponat (PPA-Zn) adalah pengisi yang paling efektif untuk mempercepat laju kristalisasi PLA

The Heliogyro Reloaded

The heliogyro is a high-performance, spinning solar sail architecture that uses long - order of kilometers - reflective membrane strips to produce thrust from solar radiation pressure. The heliogyro s membrane blades spin about a central hub and are stiffened by centrifugal forces only, making the design exceedingly light weight. Blades are also stowed and deployed from rolls; eliminating deployment and packaging problems associated with handling extremely large, and delicate, membrane sheets used with most traditional square-rigged or spinning disk solar sail designs. The heliogyro solar sail concept was first advanced in the 1960s by MacNeal. A 15 km diameter version was later extensively studied in the 1970s by JPL for an ambitious Comet Halley rendezvous mission, but ultimately not selected due to the need for a risk-reduction flight demonstration. Demonstrating system-level feasibility of a large, spinning heliogyro solar sail on the ground is impossible; however, recent advances in microsatellite bus technologies, coupled with the successful flight demonstration of reflectance control technologies on the JAXA IKAROS solar sail, now make an affordable, small-scale heliogyro technology flight demonstration potentially feasible. In this paper, we will present an overview of the history of the heliogyro solar sail concept, with particular attention paid to the MIT 200-meter-diameter heliogyro study of 1989, followed by a description of our updated, low-cost, heliogyro flight demonstration concept. Our preliminary heliogyro concept (HELIOS) should be capable of demonstrating an order-of-magnitude characteristic acceleration performance improvement over existing solar sail demonstrators (HELIOS target: 0.5 to 1.0 mm/s2 at 1.0 AU); placing the heliogyro technology in the range required to enable a variety of science and human exploration relevant support missions

Spatial representation of temporal information through spike timing dependent plasticity

We suggest a mechanism based on spike time dependent plasticity (STDP) of synapses to store, retrieve and predict temporal sequences. The mechanism is demonstrated in a model system of simplified integrate-and-fire type neurons densely connected by STDP synapses. All synapses are modified according to the so-called normal STDP rule observed in various real biological synapses. After conditioning through repeated input of a limited number of of temporal sequences the system is able to complete the temporal sequence upon receiving the input of a fraction of them. This is an example of effective unsupervised learning in an biologically realistic system. We investigate the dependence of learning success on entrainment time, system size and presence of noise. Possible applications include learning of motor sequences, recognition and prediction of temporal sensory information in the visual as well as the auditory system and late processing in the olfactory system of insects.Comment: 13 pages, 14 figures, completely revised and augmented versio