Premedication with midazolam in intellectually disabled dental patients: intramuscular or oral administration? A retrospective study

Background: The use of midazolam for dental care in patients with intellectual disability is poorly documented. The purpose of this study was to determine which method of premedication is more effective for these patients, 0.15 mg/kg of intramuscular midazolam or 0.3 mg/kg of oral midazolam. Material and Methods: This study was designed and implemented as a non-randomized retrospective study. The study population was composed of patients with intellectual disability who required dental treatment under ambulatory general anesthesia from August 2009 through April 2013. Patients were administered 0.15 mg/kg of midazolam intramuscularly (Group IM) or 0.3 mg/kg orally (Group PO). The predictor variable was the method of midazolam administration. The outcome variables measured were Observer’s Assessment of Alertness/ Sedation (OAA/S) Scale scores, the level of cooperation when entering the operation room and for venous cannulation, post-anesthetic agitation and recovery time. Results: Midazolam was administered intramuscularly in 23 patients and orally in 21 patients. More patients were successfully sedated with no resistance behavior during venous cannulation in Group PO than in Group IM ( p =0.034). There were no differences in demographic data and other variables between the groups. Conclusions: The results of this study suggest that oral premedication with 0.3 mg/kg of midazolam is more effective than 0.15 mg/kg of midazolam administered intramuscularly, in terms of patient resistance to venous cannulation. If both oral and intramuscular routes of midazolam are acceptable in intellectually disabled patients, the oral route is recommended

Design and Development of a Legged Robot Research Platform JROB-1

Proceedings of the 1998 IEEE International Conference on Robotics & Automation, Leuven, Belgium, May 199

Factors that contribute to long-term survival in patients with leukemia not in remission at allogeneic hematopoietic cell transplantation

<p>Abstract</p> <p>Background</p> <p>There has been insufficient examination of the factors affecting long-term survival of more than 5 years in patients with leukemia that is not in remission at transplantation.</p> <p>Method</p> <p>We retrospectively analyzed leukemia not in remission at allogeneic hematopoietic cell transplantation (allo-HCT) performed at our institution between January 1999 and July 2009. Forty-two patients with a median age of 39 years received intensified conditioning (n = 9), standard (n = 12) or reduced-intensity conditioning (n = 21) for allo-HCT. Fourteen patients received individual chemotherapy for cytoreduction during the three weeks prior to reduced-intensity conditioning. Diagnoses comprised acute leukemia (n = 29), chronic myeloid leukemia-accelerated phase (n = 2), myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) (n = 10) and plasma cell leukemia (n = 1). In those with acute leukemia, cytogenetic abnormalities were intermediate (44%) or poor (56%). The median number of blast cells in bone marrow (BM) was 26.0% (range; 0.2-100) before the start of chemotherapy for allo-HCT. Six patients had leukemic involvement of the central nervous system. Stem cell sources were related BM (7%), related peripheral blood (31%), unrelated BM (48%) and unrelated cord blood (CB) (14%).</p> <p>Results</p> <p>Engraftment was achieved in 33 (79%) of 42 patients. Median time to engraftment was 17 days (range: 9-32). At five years, the cumulative probabilities of acute graft-versus-host disease (GVHD) and chronic GVHD were 63% and 37%, respectively. With a median follow-up of 85 months for surviving patients, the five-year Kaplan-Meier estimates of leukemia-free survival rate and overall survival (OS) were 17% and 19%, respectively. At five years, the cumulative probability of non-relapse mortality was 38%. In the univariable analyses of the influence of pre-transplant variables on OS, poor-risk cytogenetics, number of BM blasts (>26%), MDS overt AML and CB as stem cell source were significantly associated with worse prognosis (p = .03, p = .01, p = .02 and p < .001, respectively). In addition, based on a landmark analysis at 6 months post-transplant, the five-year Kaplan-Meier estimates of OS in patients with and without prior history of chronic GVHD were 64% and 17% (p = .022), respectively.</p> <p>Conclusion</p> <p>Graft-versus-leukemia effects possibly mediated by chronic GVHD may have played a crucial role in long-term survival in, or cure of active leukemia.</p

Detections of [C II] 158 μ\mum and [O III] 88 μ\mum in a Local Lyman Continuum Emitter, Mrk 54, and its Implications to High-redshift ALMA Studies

We present integral field, far-infrared (FIR) spectroscopy of Mrk 54, a local Lyman Continuum Emitter (LCE), obtained with FIFI-LS on the Stratospheric Observatory for Infrared Astronomy. This is only the second time, after Haro 11, that [C II] 158 $\mu$m and [O III] 88 $\mu$m spectroscopy of the known LCEs have been obtained. We find that Mrk 54 has a strong [C II] emission that accounts for $\sim1$% of the total FIR luminosity, whereas it has only moderate [O III] emission, resulting in the low [O III]/[C II] luminosity ratio of $0.22\pm0.06$. In order to investigate whether [O III]/[C II] is a useful tracer of $f_{\rm esc}$ (LyC escape fraction), we examine the correlations of [O III]/[C II] and (i) the optical line ratio of $\rm O_{32} \equiv$ [O III] 5007 \AA/[O II] 3727 \AA, (ii) specific star formation rate, (iii) [O III] 88 $\mu$m/[O I] 63 $\mu$m ratio, (iv) gas phase metallicity, and (v) dust temperature based on a combined sample of Mrk 54 and the literature data from the Herschel Dwarf Galaxy Survey and the LITTLE THINGS Survey. We find that galaxies with high [O III]/[C II] luminosity ratios could be the result of high ionization (traced by $\rm O_{32}$), bursty star formation, high ionized-to-neutral gas volume filling factors (traced by [O III] 88 $\mu$m/[O I] 63 $\mu$m), and low gas-phase metallicities, which is in agreement with theoretical predictions. We present an empirical relation between the [O III]/[C II] ratio and $f_{\rm esc}$ based on the combination of the [O III]/[C II] and $\rm O_{32}$ correlation, and the known relation between $\rm O_{32}$ and $f_{\rm esc}$. The relation implies that high-redshift galaxies with high [O III]/[C II] ratios revealed by ALMA may have $f_{\rm esc}\gtrsim0.1$, significantly contributing to the cosmic reionization.Comment: 14 pages, 5 figures, Accepted for publication in Ap

RIOJA. Complex Dusty Starbursts in a Major Merger B14-65666 at z=7.15

We present JWST NIRCam imaging of B14-65666 ("Big Three Dragons"), a bright Lyman-break galaxy system ($M_\text{UV}=-22.5$ mag) at $z=7.15$. The high angular resolution of NIRCam reveals the complex morphology of two galaxy components: galaxy E has a compact core (E-core), surrounded by diffuse, extended, rest-frame optical emission, which is likely to be tidal tails; and galaxy W has a clumpy and elongated morphology with a blue UV slope ($\beta_\text{UV}=-2.2\pm0.1$). The flux excess, F356W$-$F444W, peaks at the E-core ($1.05^{+0.08}_{-0.09}$ mag), tracing the presence of strong [OIII] 4960,5008 \r{A} emission. ALMA archival data show that the bluer galaxy W is brighter in dust continua than the redder galaxy E, while the tails are bright in [OIII] 88 $\mathrm{\mu m}$. The UV/optical and sub-mm SED fitting confirms that B14-65666 is a major merger in a starburst phase as derived from the stellar mass ratio (3:1 to 2:1) and the star-formation rate, $\simeq1$ dex higher than the star-formation main sequence at the same redshift. The galaxy E is a dusty ($A_\text{V}=1.2\pm0.1$ mag) starburst with a possible high dust temperature ($\ge63$-$68$ K). The galaxy W would have a low dust temperature ($\le27$-$33$ K) or patchy stellar-and-dust geometry, as suggested from the infrared excess (IRX) and $\beta_\text{UV}$ diagram. The high optical-to-FIR [OIII] line ratio of the E-core shows its lower gas-phase metallicity ($\simeq0.2$ Z$_{\odot}$) than the galaxy W. These results agree with a scenario where major mergers disturb morphology and induce nuclear dusty starbursts triggered by less-enriched inflows. B14-65666 shows a picture of complex stellar buildup processes during major mergers in the epoch of reionization.Comment: 18 pages, 6 figures, 4 tables. Submitted to Ap

Increased expression of PPARγ in high fat diet-induced liver steatosis in mice

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Embedding a sustainability focus in packaging development processes

Despite packaging sustainability aspects often being embedded in companies’ strategic aims, the structured implementation of such targets is limited at the operational level, where a product’s commercial viability (strategic fit, business case feasibility, and a limitation of commercial risks) and development aspects (timing issues, material use, and supply chain efficiency) are prioritized over desired sustainability goals. Packaging acts not as an isolated entity but as a part of a symbiotic product-packaging combination, of which the development is the shared responsibility of stakeholders with different backgrounds and interests. With the development and design process of product-packaging combinations being a concatenation of decisions made by multidisciplinary teams in various organizations, the structured integration of sustainability-related considerations in product-packaging development can benefit from a synthesized focus on development teams’ efforts, decision-making processes, stakeholder interaction and dynamics, and trade-offs. This research addresses a vision on an approach to explore, understand, and analyze this field, specifically its key characteristics that act as enablers and barriers of product-packaging sustainability. This is targeted by interactively modelling the decision-making processes of product-packaging development, both within multidisciplinary development teams, companies, and product-packaging chains, by means of a collection of interactive tools. Key within these tools is the ability to address the multidisciplinarity of stakeholders, the decision-making processes within and beyond development teams, and the proposed and realized inclusion of sustainability-related considerations, all within a framework of tacit and explicit knowledge