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Special Care (special + care)
Terms modified by Special Care Selected AbstractsTransjugular intrahepatic portosystemic shunts: an updateLIVER TRANSPLANTATION, Issue 3 2003Barbara Rosado Transjugular intrahepatic portosystemic shunts (TIPS) have been used in the treatment of complications of portal hypertension. TIPS is used for the control of acute variceal bleeding and for the prevention of vericeal rebleeding when pharmacologic therapy and endoscopic therapy have failed. Patients with refractory ascites with adequate hepatic reserve and renal function who fail to respond to large volume paracentesis may be reasonable candidates for TIPS. Promising indications for TIPS are Budd-Chiari syndrome uncontrolled by medical therapy, severe portal hypertensive gastropathy, refractory hepatic hydrothorax, and hepatorenal syndrome. TIPS cannot be recommended for preoperative portal decompression solely to facilitate liver transplantation. Special care should be taken to insure proper placement of the stent to avoid increasing the technical difficulty of the transplantation procedure. The major limiting factors for TIPS success are shunt dysfunction and hepatic encephalopathy. Because shunt stenosis is the most important cause of recurrent complications of portal hypertension, a surveillance program to monitor shunt patency is mandatory. The MELD score may be useful in predicting post-TIPS survival, and also in counseling patients and their families. [source] Definition of hospital-acquired pneumonia and characteristics of guidelines in JapanRESPIROLOGY, Issue 2009Article first published online: 19 OCT 200 SUMMARY ,,Hospital-acquired pneumonia is defined as pneumonia that appears for the first time within 48 h of hospital admission. Special care is needed in treatment because of poor patient conditions, including the underlying disorder, immunocompetence and general status. ,,The 2002 hospital-acquired pneumonia guidelines were reviewed, and the current revisions were made based on those findings with the aim of producing simple and practical guidelines. ,,Differences are seen between hospital-acquired pneumonia in the USA and Japan, and hospital-acquired pneumonia treatment guidelines matched to circumstances in Japan were considered necessary. [source] Planar distribution of the galaxies in the Local GroupASTRONOMISCHE NACHRICHTEN, Issue 9-10 2008S. Pasetto Abstract Adopting known data on positions and distances, we make use of analytical geometry and look for the plane that minimizes the distances of all galaxies to it. A planar distribution is found. We apply Hamilton's principle of minimum action to investigate the dynamics of the two major systems of the Local Group, the Milky Way and Andromeda, under the action of forces exerted by nearby galaxies or groups external to the Local Group. We find that the planar distribution is fully compatible with the minimum action and that the external force field is likely parallel to the plane. It pulls the galaxies of the Local Group without altering their planar distribution. Special care is paid to evaluate the robustness of this result. We present an explanation in the linear regime of the numerical results based on the compression effect described with the tidal tensor. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Relationships Among Tests for Censored DataBIOMETRICAL JOURNAL, Issue 3 2005Emilio Letón Abstract In this paper we will give the relationships of several Score tests and Weighted tests for right censoring data with other classical tests. Special care will be taken with the case of ties and with the kind of estimation of the variance used. After the description of ten tests, a comparative study will be made among them. Finally, an application with a real example will be included. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] The importance of hormone receptor analysis in osteosarcoma cells growth submitted to treatment with estrogen in association with thyroid hormoneCELL BIOCHEMISTRY AND FUNCTION, Issue 1 2008Patricia Pinto Saraiva Abstract Bone tumor incidence in women peaks at age 50,60, coinciding with the menopause. That estrogen (E2) and triiodothyronine (T3) interact in bone metabolism has been well established. However, few data on the action of these hormones are available. Our purpose was to determine the role of E2 and T3 in the expression of bone activity markers, namely alkaline phosphatase (AP) and receptor activator of nuclear factor ,B ligand (RANKL). Two osteosarcoma cell lines: MG-63 (which has both estrogen (ER) and thyroid hormone (TR) receptors) and SaOs-29 (ER receptors only) were treated with infraphysiological E2 associated with T3 at infraphysiological, physiological, and supraphysiological concentrations. Real-time RT-PCR was used for expression analysis. Our results show that, in MG-63 cells, infraphysiological E2 associated with supraphysiological T3 increases AP expression and decreases RANKL expression, while infraphysiological E2 associated with either physiological or supraphysiological T3 decreases both AP and RANKL expression. On the other hand, in SaOs-2 cells, the same hormone combinations had no significant effect on the markers' expression. Thus, the analysis of hormone receptors was shown to be crucial for the assessment of tumor potential growth in the face of hormonal changes. Special care should be provided to patients with T3 and E2 hormone receptors that may increase tumor growth. Copyright © 2007 John Wiley & Sons, Ltd. [source] An answer to an important controversy and the need for caution when using simple models to predict inelastic earthquake response of buildings with torsionEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 5 2010Stavros A. Anagnostopoulos Abstract This paper presents evidence that the extension of conclusions based on the widely used simplified, one story, eccentric systems of the shear-beam type, to actual, nonsymmetric buildings and consequent assessments of the pertinent code provisions, can be quite erroneous, unless special care is taken to match the basic properties of the simplified models to those of the real buildings. The evidence comes from comparisons of results obtained using three variants of simplified models, with results from the inelastic dynamic response of three- and five-story eccentric buildings computed with detailed MDOF systems, where the members are idealized with the well-known plastic hinge model. In addition, a convincing answer is provided on a pertinent hanging controversy: For frame-type buildings, designed in accordance with the dynamic provisions of modern codes (such as EC8 or IBC2000), which allow reduced shears at the stiff edge due to torsion, the frames at the flexible sides are the critical elements in terms of ductility demands. Copyright © 2009 John Wiley & Sons, Ltd. [source] Effects of Qi therapy (external Qigong) on symptoms of advanced cancer: a single case studyEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2005M.S. LEE phd The aim of this study was to examine the effectiveness of Qi therapy (external Qigong) in the management of symptoms of advanced cancer in a man. We used a single case study design to evaluate the effectiveness of Qi therapy (external Qigong) in a 35-year-old man with advanced cancer (Stage IV) involving metastases in the stomach, lung and bone (Karnofsky performance scale: KPS, 40: requires special care and assistance, disabled). Treatment involved six days of pre-assessment, eight treatment sessions on alternate days over 16 days, and a two-week follow-up phase. A visual analogue scale (VAS) was used to assess the patient's self-reported symptoms of cancer over the intervention and follow-up periods. Following treatment, VAS scores' analysis revealed beneficial effects on pain, vomiting, dyspnoea, fatigue, anorexia, insomnia, daily activity and psychological calmness. These improvements were maintained over the two-week follow-up phase. After the first Qi therapy session, the patient discontinued medication and could sit by himself; after the fourth session, the patient was able to walk and use the toilet without assistance (improvement in KPS: 70: care for self, unable to perform normal activity or to do active work). Although limited by the single case study approach, our results support previous studies on this topic and provide reasons to conduct controlled clinical trials. [source] 2,3,6,7,10,11-Hexamethoxytribenzotriquinacene: Synthesis, Solid-State Structure, and Functionalization of a Rigid Analogue of CyclotriveratryleneEUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 11 2004Marco Harig Abstract The syntheses of several tribenzotriquinacenes bearing six methoxy groups at the outer peripheral positions of the aromatic rings are reported. The centro -methyl derivative is accessible in surprisingly good yield through two-fold cyclodehydration in the final step of a synthesis route which requires special care in the preparation of some electron-rich key intermediates, such as 5,6-dimethoxy-2-methylindane-1,3-dione and bis(3,4-dimethoxyphenyl)methanol. X-ray single-crystal structure analysis of the centro -methyl derivative confirms its C3v -symmetrical molecular structure but, at variance from the parent centro -methyltribenzotriquinacene and the similarly shaped cyclotriveratrylene, the hexamethoxytribenzotriquinacene analog does not form columnar stacks in the solid state. Functionalization of the three benzhydrylic bridgehead positions leads to the tetramethyl analog and the bridgehead triol in good yields. In contrast, attempts to functionalize the ortho positions by nitration or bromination mainly give rise to ring cleavage through electrophilic ipso attack, which parallels the behavior of cyclotribenzylenes and cyclotriveratrylenes. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004) [source] Optimum shapes of tire-treads for avoiding lateral slippage between tires and roadsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 6 2005S. Reaz Ahmed Abstract Optimum design of tire-tread sections is an important practical issue. However, useful study of the problem that can suggest a reliable guideline for determining the optimum tread sections had hardly been made in the past. The present paper describes a new analysis of the state of stresses in tire-tread sections in contact with the road surface, taking special care of the boundary conditions. Based on the analysis, a method is proposed to determine the optimum tread shapes for avoiding lateral slippage between tires and roads. The displacement potential function formulation, an ideal mathematical model for the practical stress problems, has been used in conjunction with finite-difference method of solution. For the present analysis, lateral slipping in absence of frictional resistance as well as the no-slip conditions of the tire-tread contact surface have been considered along with a large number of tread aspect ratios. The present computational approach proves to be a powerful tool for determining the optimum tread shapes for avoiding the lateral slippage of tire-treads. Copyright © 2005 John Wiley & Sons, Ltd. [source] Transient anuria requiring nephrostomy after intravesical bacillus Calmette-Guérin instillations for superficial bladder cancerINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2006TOMOYUKI KANEKO Abstract, A 76-year-old man received intravesical bacillus Calmette-Guérin (BCG) instillations for recurrent superficial bladder cancer. He had undergone right nephroureterectomy for right renal pelvic cancer 9 months previously. He presented with anuria and left hydronephrosis after the fourth instillation, with serum creatinine increasing up to 15.7 mg/dL. Percutaneous nephrostomy was indwelled, and antegrade pyelography showed left vesicoureteral obstruction. There was no sign of recurrent bladder cancer or ureteral cancer. He started spontaneous voiding on day 4 and the nephrostomy was removed on day 8. Most of the side-effects of intravesical BCG therapy are minor, and major adverse reactions are rare. Life-threatening ureteral obstruction would be a rare complication of BCG immunotherapy. Although BCG intravesical instillation after nephroureterectomy is a common practice, special care should be taken of renal function in patients with unilateral kidney during BCG therapy. [source] Risk factors for periodontal disease progression among elderly peopleJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2002Hiroshi Ogawa Abstract The aim of this study was to identify the risk factors for periodontal disease progression by individual characteristics at baseline among elderly people over a 2-year period. Subjects were selected from 4542 people aged 70 years residing in Niigata who were in good general health and who did not require special care for their daily activities. Gender, smoking and alcohol drinking habits were obtained using a questionnaire, while serum levels of disease markers were investigated and attachment levels were clinically recorded. For the assessment of periodontal disease progression, additional attachment loss was used if one or more sites had a 3-mm or more increase in probing attachment level over a 2-year period. In all, 394 subjects (208 males and 186 females) were surveyed. Approximately 75% of subjects exhibited additional attachment loss over a 2-year period. Significant associations were found between additional attachment loss and smoking, and attachment level of 6 mm or more at baseline, with odds ratios of 3.75 and 2.29, respectively. Smoking habit and baseline attachment level of 6 mm or more may be considered risk factors for further attachment loss among healthy elderly people. [source] On the use of large time steps with ELLAM for transport with kinetic reactions over heterogeneous domainsAICHE JOURNAL, Issue 5 2009Marwan Fahs Abstract An Eulerian Lagrangian localized adjoint method (ELLAM) is considered for the resolution of advection-dominated transport problems in porous media. Contrary to standard Eulerian methods, ELLAM can use large time steps because the advection term is approximated accurately without any CFL restriction. However, it is shown in this article that special care must be taken for the approximation of the dispersive and reactive terms when large time steps are used over heterogeneous domains. An alternative procedure is proposed. It is based on an equivalent dispersion coefficient or an equivalent reaction rate when different zones are encountered during the tracking. Numerical experiments are performed with variable dispersion or variable reaction rates over space (including nonlinearity). When classical ELLAM require numerous time steps to handle heterogeneity, the alternative procedure is shown to perform with the same accuracy in a single time step. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source] Comparison of calculated brightness and flux of radiation from a long-period wiggler and a short-period undulatorJOURNAL OF SYNCHROTRON RADIATION, Issue 4 2008T. Shaftan In this article the calculation of brightness and flux for two insertion devices of the 2.8,GeV X-ray storage ring at the NSLS is discussed. The radiation properties from the X25 linearly polarized wiggler and the new X25 short-period undulator are compared at a fixed photon energy (11.3,keV) corresponding to emission from the fifth harmonic of the short-period undulator. For this computation, three commonly available synchrotron radiation programs are used. The capabilities of each of these codes are briefly discussed, and their range of applicability are commented on. It is concluded that special care is needed when modeling the radiation of the classes of insertion devices considered here. [source] The place of serials in referencing practices: Comparing natural sciences and engineering with social sciences and humanitiesJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 8 2006Vincent Larivière Journal articles constitute the core documents for the diffusion of knowledge in the natural sciences. It has been argued that the same is not true for the social sciences and humanities where knowledge is more often disseminated in monographs that are not indexed in the journal-based databases used for bibliometric analysis. Previous studies have made only partial assessments of the role played by both serials and other types of literature. The importance of journal literature in the various scientific fields has therefore not been systematically characterized. The authors address this issue by providing a systematic measurement of the role played by journal literature in the building of knowledge in both the natural sciences and engineering and the social sciences and humanities. Using citation data from the CD-ROM versions of the Science Citation Index (SCI), Social Science Citation Index (SSCI), and Arts and Humanities Citation Index (AHCI) databases from 1981 to 2000 (Thomson ISI, Philadelphia, PA), the authors quantify the share of citations to both serials and other types of literature. Variations in time and between fields are also analyzed. The results show that journal literature is increasingly important in the natural and social sciences, but that its role in the humanities is stagnant and has even tended to diminish slightly in the 1990s. Journal literature accounts for less than 50% of the citations in several disciplines of the social sciences and humanities; hence, special care should be used when using bibliometric indicators that rely only on journal literature. [source] A Comparison of Two Quadratic Approaches to Hedging in Incomplete MarketsMATHEMATICAL FINANCE, Issue 4 2001David Heath This paper provides comparative theoretical and numerical results on risks, values, and hedging strategies for local risk-minimization versus mean-variance hedging in a class of stochastic volatility models. We explain the theory for both hedging approaches in a general framework, specialize to a Markovian situation, and analyze in detail variants of the well-known Heston (1993) and Stein and Stein (1991) stochastic volatility models. Numerical results are obtained mainly by PDE and simulation methods. In addition, we take special care to check that all of our examples do satisfy the conditions required by the general theory. [source] Structural and mechanical remodelling of the common bile duct after obstructionNEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2002B. U. DUCH Biliary obstruction in man, most often caused by cholelithiasis, induces remodelling of the bile ducts. Obstruction-induced structural remodelling of the common bile duct (CBD) has been previously described. The mechanical changes that accompany the structural remodelling, however, have not been studied in detail. The aim of this study is to quantify the structural and mechanical changes in the CBD at different time intervals after acute obstruction. The CBD was ligated in the pig, near the duodenum, and studied after 3 h, 12 h, 2 days, 8 days and 32 days (n=5 in each group). One additional animal in each group was sham-operated. At each scheduled time, the CBD was mechanically tested in vitro with a computer-controlled volume infusion system to study the pressure,volume relationship of the CBD segment. A video camera provided simultaneous measurements of the outer dimensions of the CBD at the various pressures. The diameter and wall thickness of the CBD increased about three-fold in the 32-day group compared to the sham group (P < 0.001). The circumferential stress,strain relationship differed between groups (P < 0.001); it was shifted to the right, indicating softening, in the 3-h, 12-h, and 2-day groups and to the left, indicating stiffening, in the 8-day and 32-day group, compared to the sham group. The longitudinal stress,strain curves were all shifted to the left of the circumferential stress,strain curves (P < 0.05). The collagen area increased during obstruction (P < 0.001) but no correlation between the size of the collagen area and the biomechanical parameters was found. A practical implication of the present study serves as a warning to surgeons. A reduction in the wall stiffness in the first several days of obstruction along with an increased duct diameter and a decreased wall thickness suggest that operative procedures such as suturing, anastomosis and procedures related to ERCP must be performed with special care to avoid damage to the CBD. [source] Model reduction of interconnected linear systemsOPTIMAL CONTROL APPLICATIONS AND METHODS, Issue 3 2009H. Sandberg Abstract The problem of model reduction of linear systems with certain interconnection structure is considered in this paper. To preserve the interconnection structure between subsystems in the reduction, special care needs to be taken. This problem is important and timely because of the recent focus on complex networked systems in control engineering. Two different model reduction methods are introduced and compared in this paper. Both methods are extensions to the well-known balanced truncation method. Compared with earlier work in the area these methods use a more general linear fractional transformation framework, and utilize linear matrix inequalities. Furthermore, new approximation error bounds that reduce to classical bounds in special cases are derived. The so-called structured Hankel singular values are used in the methods, and indicate how important states in the subsystems are with respect to a chosen input,output map for the entire interconnected system. It is shown how these structured Hankel singular values can be used to select an approximation order. Finally, the two methods are applied to a model of a mechanical device. Copyright © 2008 John Wiley & Sons, Ltd. [source] High-pressure properties of icosahedron-based solid boronsPHYSICA STATUS SOLIDI (B) BASIC SOLID STATE PHYSICS, Issue 14 2004Koun Shirai Abstract High-pressure experiments have led to significant contributions to understanding of physical properties of icosahedron-based solid boron. In this paper, we critically review recent results on properties of boron polytypes. The topics discussed are stability of , - and , -boron, elastic properties, phonon properties. In interpreting high-pressure experiments, special care is needed. In many cases, confusion is emerged from difference between the macroscopic applied deformation and the resulting microscopic displacement of atoms. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Women's experiences of student presence in consultations for problematic uterine bleedingBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2004Jennifer Guise Research suggests that although a high proportion of patients accept the presence of students in gynaecological consultations, issues of consent, privacy and comfort are important. This study considers women's views on the impact of student presence on communication in the consultation. Our research suggests that student presence may distort the flow of communication in the gynaecological consultation. There are implications for both patient satisfaction and clinician training. If students are introduced into the consultation, clinical tutors should take special care to maintain dedicated communication with the patient. [source] Metal Triflates as Highly Stable and Active Catalysts for the "Immortal" Ring-Opening Polymerization of Trimethylene CarbonateCHEMCATCHEM, Issue 3 2010Marion Helou Abstract The controlled "immortal" ring-opening polymerization of trimethylene carbonate (TMC) using a two-component catalyst system based on a metal Lewis acid, such as a metal triflate M(OTf)n(M=Ca, Sc, Zn, Al, Bi; OTf=CF3SO3,) or the metallic salt Fe(acac)3, (acac=acetylacetonate) and an alcohol (ROH) as co-initiator and chain-transfer agent, is carried out in bulk at 110,150,°C. As a result of the water-tolerance of these systems, experimental operating conditions do not require any special care. The approach, valorized both with various ROH transfer agents and with either purified or unpurified monomer sources, is highly versatile. Functional telechelic polycarbonates HPTMCOR, devoid of decarboxylation sequences, are obtained [PTMC=poly(trimethylene carbonate)]. The molar mass of the PTMCs can be readily predicted by a simple model, taking into account the [TMC]0/[ROH]0 ratio and the amount of transferring impurities present in the raw/unpurified reagents. Such simple, air- and moisture-robust catalytic systems, which display quite high activities (TOF up to 28,200,h,1) and productivities (TON up to 45,000) are thus extremely valuable, especially industrially. The performances of these systems are described in comparison to the previously established valuable inorganic and organometallic catalytic systems, namely metal amido complexes ([M{N(SiMe3)2}3]) and [(BDI)Zn{N(SiMe3)2}] (BDI=,-diiminate ligand) derivatives. [source] Skin care for preterm and term neonatesCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 8 2009F. S. Afsar Summary Neonatal skin experiences a progressive adaptation to the extrauterine environment during which special care is needed. The immaturity of the epidermal barrier in the neonatal period may cause dry skin, vulnerability to trauma, rapid onset of microbial colonization and percutaneous drug toxicity. This article reviews the practical implications for hygiene, bathing practices, skin integrity, emollient use, infection control and exposure to percutaneous toxic agents in preterm and term infants. [source] As-consistent-As-possible compositing of virtual objects and video sequencesCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 3-4 2006Guofeng Zhang Abstract We present an efficient approach that merges the virtual objects into video sequences taken by a freely moving camera in a realistic manner. The composition is visually and geometrically consistent through three main steps. First, a robust camera tracking algorithm based on key frames is proposed, which precisely recovers the focal length with a novel multi-frame strategy. Next, the concerned 3D models of the real scenes are reconstructed by means of an extended multi-baseline algorithm. Finally, the virtual objects in the form of 3D models are integrated into the real scenes, with special cares on the interaction consistency including shadow casting, occlusions, and object animation. A variety of experiments have been implemented, which demonstrate the robustness and efficiency of our approach. Copyright © 2006 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||