Feasibility of overnight electrical stimulation-induced muscle activation in people with a spinal cord injury:A Pilot study

Contains fulltext : 218680.pdf (Publisher’s version ) (Closed access)Study Design: We investigated whether overnight ES is a feasible method to activate gluteal, quadriceps, and hamstrings muscles in a two-week experiment. Electrical stimulation (ES) induced muscle contractions have proven positive effects on risk factors for developing pressure ulcers in people with a spinal cord injury (SCI). Therefore prolonged overnight ES-induced muscle activation is interesting, but has never been studied. Objective: To study feasibility of ES-induced leg muscle activation. In eight participants with motor complete SCI gluteal, hamstrings and quadriceps muscles were activated with a 2-weeks overnight stimulation protocol, 8 h per night, using specially developed ES-shorts. Setting: The Netherlands. Methods: Muscle fatigue was determined with a muscle contraction sensor. Questionnaires on sleep quality (SQ) and the ES-shorts usability were taken. Results: After 8 h of activation muscles still contracted, although fatigue occurred, and mean contraction size was lower at the end of a cycle (p = 0.03). SQ (0-100) after intervention was 75, and 66 after 4 weeks without overnight ES (p = 0.04) indicating ES improves sleep quality. The usability of the ES-shorts was good. Conclusions: This study shows that overnight ES-induced muscle activation using ES-shorts in SCI is a new, feasible method that does not interfere with sleep. The nightly use of the ES-shorts might be considered as an important part of the daily routine in SCI

Abelian Dominance of Chiral Symmetry Breaking in Lattice QCD

Calculations of the chiral condensate on the lattice using staggered fermions and the Lanczos algorithm are presented. Four gauge fields are considered: the quenched non-Abelian field, an Abelian projected field, and monopole and photon fields further decomposed from the Abelian field. Abelian projection is performed in maximal Abelian gauge and in Polyakov gauge. The results show that monopoles in maximal Abelian gauge largely reproduce the chiral condensate values of the full non-Abelian theory, in both SU(2) and SU(3) color.Comment: 13 pages in RevTex including 6 figures, uucompressed, self-extractin

Engineering Development of Advanced Physical Fine Coal Cleaing for Premium Fuel Applications

The ash in six common bituminous coals, Taggart, Winifrede, Elkhorn No. 3, Indiana VII, Sunnyside and Hiawatha, could be liberated by fine grinding to allow preparation of clean coal meeting premium fuel specifications (< 1- 2 lb/ MBtu ash and <0.6 lb/ MBtu sulfur) by laboratory and bench- scale column flotation or selective agglomeration. Over 2,100 tons of coal were cleaned in the PDU at feed rates between 2,500 and 6,000 lb/ h by Microcel� column flotation and by selective agglomeration using recycled heptane as the bridging liquid. Parametric testing of each process and 72- hr productions runs were completed on each of the three test coals. The following results were achieved after optimization of the operating parameters: The primary objective was to develop the design base for commercial fine coal cleaning facilities for producing ultra- clean coals which can be converted into coal-water slurry premium fuel. The coal cleaning technologies to be developed were advanced column flotation and selective agglomeration, and the goal was to produce fuel meeting the following specifications -- Less than 2 pounds of ash per million Btu (860 grams per gigajoule) an

Управление финансовой устойчивостью и рентабельностью предприятия

Целью статьи является изучение значения управления финансовой устойчивостью и рентабельностью предприятия в современных условиях хозяйствования

Pharmacological aspects of neonatal antidepressant withdrawal

Depression is common in reproductive age women, and continued pharmacologic treatment of depression during pregnancy may be necessary to prevent relapse, which could be harmful for both the fetus and the mother. Although data on drug safety are imperfect and incomplete, the benefits of antidepressant therapy during pregnancy generally outweigh the risks. Neonates who are exposed to antidepressant medications during gestation are at increased risk to have neonatal withdrawal syndrome, although the exact incidence of this complication is unknown because the definition of the syndrome is not clear and withdrawal reactions are probably underreported. Tricyclic antidepressant withdrawal syndrome is most likely related to muscarinergic activity and individual drug half-lives, and selective serotonin reuptake inhibitor withdrawal may be due to a decrease in available synaptic serotonin in the face of down-regulated serotonin receptors, the secondary effects of other neurotransmitters, and biological or cognitive sensitivity. Other factors that influence neonatal toxicity or withdrawal include the normal physiologic changes of pregnancy, the altered activity of CYP450 enzymes during pregnancy, drug-drug transporter (PgP and OCT3) interaction, and the presence of genetic polymorphisms in genes influencing drug metabolism. Further research is necessary

Nonlinear Realization of Chiral Symmetry on the Lattice

We formulate lattice theories in which chiral symmetry is realized nonlinearly on the fermion fields. In this framework the fermion mass term does not break chiral symmetry. This property allows us to use the Wilson term to remove the doubler fermions while maintaining exact chiral symmetry on the lattice. Our lattice formulation enables us to address non-perturbative questions in effective field theories of baryons interacting with pions and in models involving constituent quarks interacting with pions and gluons. We show that a system containing a non-zero density of static baryons interacting with pions can be studied on the lattice without encountering complex action problems. In our formulation one can also decide non-perturbatively if the chiral quark model of Georgi and Manohar provides an appropriate low-energy description of QCD. If so, one could understand why the non-relativistic quark model works.Comment: 34 pages, 2 figures, revised version to be published in J. High Energy Phys. (changes in the 1st paragraph, additional descriptions on the nature of the coordinate singularities in Sec.2, references added

Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer

markdownabstract__Introduction:__ The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). __Methods:__ Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases. Complications were scored using the Dindo-Clavien-classification. __Results:__ Nine patients who underwent surgery for a local recurrence were identified. Median time to local recurrence was 22 months. Recurrences were diagnosed with CT- and/or 18FDG-PET-imaging, with four patients also having a pre-surgical pathological diagnosis. Extensive adhesions were observed during two resections, requiring conversion from a thoracoscopic procedure to thoracotomy during one of these procedures. Three patients experienced complications post-surgery; grade 2 (N = 2) and grade 3a (N = 1), respectively. All resection specimens showed viable tumor cells. Median length of hospital stay was 8 days (range 5-15 days) and 30-day mortality was 0 %. Lymph node dissection revealed mediastinal metastases in 3 patients, all of whom received adjuvant therapy. __Conclusions:__ Our experience with nine surgical procedures for local recurrences post-SABR revealed two grade IIIa complications, and a 30-day mortality of 0 %, suggesting that salvage surgery can be safely performed after SABR

Classification and occurrence of clinically significant drug interactions with irinotecan and oxaliplatin in patients with metastatic colorectal cancer

Background: Pharmacokinetic and pharmacodynamic drug interactions with cytotoxic drugs may significantly influence the efficacy and toxicity of chemotherapy. Objective: The purpose of this study was to identify drug interactions with irinotecan and oxaliplatin reported in the literature, to assess their clinical significance, and to examine the occurrence of these interactions in patients with metastatic colorectal cancer treated with either irinotecan or oxaliplatin or both. Methods: To obtain data on drug-drug interactions with irinotecan and oxaliplatin, a literature search of PubMed and EMBASE was conducted using the search terms irinotecan, oxaliplatin, and interactions (English-language studies only published between 1980 and August 2004). The interactions found were subsequently classified for documentation evidence and severity of clinical effect, according to a 5-level classification system of a standard reference text, by a study panel of medical oncologists and clinical pharmacists. Comedication of patients who were treated with irinotecan or oxaliplatin, or both, was then examined to determine the occurrence of clinically significant interactions. Results: Ninety-eight patients (50 women, 48 men; mean age, 60 years) were included in the study. Seventeen interactions with irinotecan were found in the literature, and 11 were classified as clinically significant. Only 1 nonspecific, clinically significant interaction was identified for oxaliplatin. Irinotecan-treated patients received a mean of 8 different comedications and oxaliplatin-treated patients received a mean of 6. Apart from antiemetic and antidiarrheal drugs that were prescribed for treatment-related toxicities, only 1 patient appeared to be exposed to a possible clinically significant interaction (between irinotecan and phenytoin). Conclusions: Eleven of the 17 interactions with irinotecan that were found in the literature were classified as clinically significant versus 1 clinically significant interaction with oxaliplatin. The occurrence of these interactions in the study patients with metastatic colorectal cancer was low. For medication surveillance purposes, however, the significant interactions should be considered in clinical practice. Copyright (c) 2005 Excerpta Medica, Inc