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Successful Use (successful + use)
Kinds of Successful Use Selected AbstractsSuccessful Use of Levosimendan in a Patient During Cardiopulmonary BypassJOURNAL OF CARDIAC SURGERY, Issue 2 2007Erkan Iriz M.D. Positive inotropic support is routinely used for weaning from cardiopulmonary bypass circulation in patients with reduced left ventricular function. This case report represents the successful usage of LS for weaning from cardiopulmonary bypass circulation after coronary artery bypass surgery. Levosimendan infusion was started at the sixth hour of cardiopulmonary bypass circulation. There was a dramatic increase in cardiac output 20 minutes after LS infusion, and weaning from cardiopulmonary bypass circulation was achieved. We suggest that LS enhances cardiac performance during and after cardiopulmonary bypass, and can be useful for patients who are unable to be weaned from cardiopulmonary bypass. [source] Successful use of recombinant factor VIIa in a patient with inhibitor secondary to severe factor XI deficiencyHAEMOPHILIA, Issue 2 2002P. LAWLER Factor XI (FXI) inhibitors are a rare complication of inherited FXI deficiency. We report the successful use of recombinant factor VIIa (FVIIa) in a patient with a high-responding inhibitor undergoing cataract extraction. At the time of surgery there were limited available data on the optimal management of patients with FXI deficiency. A 62-year-old Ashkenazi Jewish woman had a lifelong history of excessive bleeding secondary to severe FXI deficiency (2 U dL,1), and received FXI concentrate (FXI:C) when she underwent a colposuspension procedure. She was subsequently diagnosed with a FXI inhibitor of 16 Bethesda units (BU) when she developed a poor response to FXI:C at the time of total hip replacement. Two months later she was admitted for cataract extraction. The FXI level was < 1 U dL,1 with an inhibitor titre of 48 BU. She received 90 ,g kg,1 of FVIIa immediately preoperatively followed by continuous infusion at a rate of 20 ,g kg,1 h,1 for 24 h. The cataract extraction was successful and there was no excess bleeding during surgery or in the postoperative period. Mutation analysis of the FXI gene showed that the patient was homozygous for the type II genotype [exon 5, Glu117,Ter]. The reason for the low prevalence of inhibitor formation in patients with FXI deficiency is unclear but may reflect a number of factors including reporting bias, the rarity of absent circulating FXI:C activity, and the infrequent use of FXI replacement therapy. [source] The need for venovenous bypass in liver transplantationHPB, Issue 3 2008Hamidreza Fonouni Abstract Since introduction of the conventional liver transplantation (CLTx) by Starzl, which was based on the resection of recipient inferior vena cava (IVC) along the liver, the procedure has undergone several refinements. Successful use of venovenous bypass (VVB) was first introduced by Shaw et al., although in recent decades there has been controversy regarding the routine use of VVB during CLTx. With development of piggyback liver transplantation (PLTx), the use of caval clamping and VVB is avoided, leading to fewer complications related to VVB. However, some authors still advocate VVB in PLTx. The great diversity among centers in their use of VVB during CLTx, or even along the PLTx technique, has led to confusion regarding the indication setting for VVB. For this reason, we present an overview of the use of VVB in CLTx, the target of patients for whom VVB could be beneficial, and the needs assessment of VVB for patients undergoing PLTx. Recent studies have shown that with the advancement of surgical skills, refinement of surgical techniques, and improvements in anesthesiology, there are only limited indications for doing CLTx with VVB routinely. PLTx with preservation of IVC can be performed in almost all primary transplants and in the majority of re-transplantations without the need for VVB. Nevertheless, in a few selective cases with severe intra-operative hemodynamic instability, or with a failed test of transient IVC occlusion, the application of VVB is still justifiable. These indications should be judged intra-operatively and the decision is based on each center's preference. [source] Successful use of adalimumab in treating cutaneous metastatic Crohn's disease: Report of a caseINFLAMMATORY BOWEL DISEASES, Issue 11 2009Faith A. Miller MSIV No abstract is available for this article. [source] Successful use of dapsone in refractory pregnancy-associated idiopathic thrombocytopenic purpuraINTERNAL MEDICINE JOURNAL, Issue 1 2000R. LUSH No abstract is available for this article. [source] Successful use of short-term mechanical ventilation to manage respiratory failure secondary to profound hypokalemia in a cat with hyperaldosteronismJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 5 2008Tara N. Hammond DVM Abstract Objective , To report successful management of respiratory failure due to severe hypokalemia in a cat with hyperaldosteronism, including short-term mechanical ventilation strategies and aspects of medical and surgical treatment. Case Summary , A cat presented with bilateral pelvic limb weakness that rapidly progressed to tetraparesis and respiratory muscle failure. Point-of-care testing revealed severe hypokalemia (1.9 mmol/L) and mild azotemia. Initial management included endotracheal intubation, mechanical ventilation, and aggressive potassium supplementation. Spironolactone was started due to a high index of suspicion for hyperaldosteronism. A right adrenal mass visualized during abdominal ultrasonographic examination and a serum aldosterone level greater than 3329 pmol/L confirmed the diagnosis. The cat made a full recovery following surgical removal of a right adrenal adenoma. New or Unique Information Provided , We report successful management of respiratory failure in a cat with hyperaldosteronism using short-term mechanical ventilation. Respiratory failure due to severe hypokalemia should be considered a complication of hyperaldosteronism in cats and may require mechanical ventilation. However, full recovery is possible. [source] Successful use of I-gel airway in prone position surgeryPEDIATRIC ANESTHESIA, Issue 2 2009M. Senthil Kumar No abstract is available for this article. [source] Noninvasive ventilation in the pediatric intensive care unit for children with acute respiratory failure,,PEDIATRIC PULMONOLOGY, Issue 6 2003W. Gerald Teague MD Abstract Noninvasive ventilation, a novel treatment to increase alveolar ventilation, is accomplished with either subatmospheric or positive pressure administered via an external interface. In adults with acute respiratory failure, noninvasive positive pressure ventilation (NPPV) is superior to standard therapy in preventing intubation and reducing mortality. The role of NPPV in pediatric-age patients with acute respiratory distress is not as well established. Early case reports showed that NPPV treatment does acutely improve both the clinical manifestations of respiratory distress and respiratory gas exchange in children with respiratory distress. However, it is not clear whether NPPV in this setting can prevent vs. delay endotracheal intubation. Other uses of NPPV in the pediatric intensive care unit include the treatment of upper airway obstruction, atelectasis, and exacerbations of neuromuscular disorders, and to facilitate weaning from invasive mechanical ventilation. Successful use of NPPV in young infants with respiratory distress is impeded by the lack of suitable size interfaces, and the response characteristics of commercially available bilevel ventilators. Despite these challenges, NPPV is a promising alternate to standard therapies in the treatment of acute respiratory distress in the pediatric-age patient. Pediatr Pulmonol. 2003; 35:418,426. © 2003 Wiley-Liss, Inc. [source] Successful use of the anti-CD25 antibody daclizumab in an adult patient with hemophagocytic lymphohistiocytosisAMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2008Rebecca L. Olin Hemophagocytic lymphohistiocytosis (HLH) is a rare and severe inflammatory disorder marked by abnormal cytotoxic T and natural killer cell activity, resulting in impaired clearance of pathogen, excessive cytokine production, and continued immune system activation. Soluble IL-2 receptor (sIL-2R or sCD25) is typically elevated in HLH and can serve as a marker of disease activity, although its role in the pathophysiology of the disease is unclear. Here we present a case of an adult patient with steroid-dependent HLH who was treated successfully with daclizumab, a monoclonal anti-CD25 antibody, allowing successful withdrawal of steroid therapy without an increase in symptoms. Am. J. Hematol., 2008. © 2008 Wiley-Liss, Inc. [source] Successful use of pharyngeal pulse oximetry with the oropharyngeal airway in severely shocked patientsANAESTHESIA, Issue 7 2007H. Yu Summary We describe the successful use of pharyngeal oximetry with the oropharyngeal airway in two patients with severe shock in whom finger pulse oximetry failed. One patient was a 50-year-old man with septic shock and the other a 32-year-old woman with haemorrhagic shock. In both patients, an oropharyngeal airway with a paediatric pulse oximeter probe was inserted adjacent to the tracheal tube. A good waveform was obtained and oxygen saturation was 0,2% lower than arterial samples whereas finger pulse oximetry saturation was unobtainable or much lower than arterial oxygen saturation. Pharyngeal oxygen saturation with the oropharyngeal airway is feasible and more accurate than finger oximetry in low perfusion states. [source] Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndromePEDIATRICS INTERNATIONAL, Issue 2 2006KENJI HOSHINO Abstract Background: Administration of magnesium sulfate (MgSO4) is an effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults. As for children, there are few reports focusing on it. The authors discuss the efficacy of MgSO4 for TdP in children with congenital and acquired LQTS. The authors also discuss the optimal administration dosage and serum magnesium (SMg) concentration during MgSO4 therapy. Methods: The authors studied seven consecutive LQTS children undergoing MgSO4 therapy for TdP. Of the seven children, five were congenital LQTS and two were acquired LQTS. A bolus injection of MgSO4 was given intravenously over 1,2 min followed by continuous infusion for the next 2,7 days. Results: Of the seven patients, six responded completely to the initial bolus. The bolus dosage was 5.9 ± 3.8 mg/kg (range, 2.3,12 mg/kg) in these six, and the other remaining one (neonate with congenital LQTS) required a total of 30 mg/kg until complete abolishment. The continuous infusion was given at rates of 0.3,1.0 mg/kg per h and patients did not show recurrence of TdP. The SMg concentration was 3.9 ± 1.0 mg/dL (2.9,5.4 mg/dL) immediately after bolus injection. The mean corrected QT (QTc) interval before and after bolus injection did not show significant difference. Conclusion: Intravenous infusion of MgSO4 was effective for TdP in children with LQTS, and MgSO4 abolished TdP without shortening the QTc interval. The optimal bolus dosage, infusion rates and SMg concentration were 3,12 mg/kg, 0.5,1.0 mg/kg per h and 3,5 mg/dL, respectively. [source] Refining and testing joint fact-finding for environmental dispute resolution: Ten years of successCONFLICT RESOLUTION QUARTERLY, Issue 4 2001Scott T McCreary For the past decade, we at CONCUR have been mediating complex environmental disputes and using the technique of joint fact-finding as a cornerstone of our model of practice. In this article, we present and reflect on this body of experience, with the goal of better informing both our colleagues in the field and other potential users of alternative dispute resolution (ADR) about the elements and preconditions for successful use of joint fact-finding. We also aim to contribute actively to current initiatives on best practices. [source] Intra-aortic Balloon Pump Use in the Failing Fontan CirculationCONGENITAL HEART DISEASE, Issue 1 2008Adrian M. Moran MB ABSTRACT Acute cardiogenic shock in patients with Fontan physiology, while uncommon, is associated with devastating outcomes. Management of these patients is increasingly relying on the use of mechanical support. The use of intra-aortic balloon pump is underutilized. This report highlights the successful use of this modality in an adult with Fontan physiology and reviews the literature on this approach in such patients. [source] Multiple Conceptualizations of Small Business Web Use and Benefit*DECISION SCIENCES, Issue 3 2003Kurt A. Pflughoeft ABSTRACT Small businesses play an important role in the U.S. economy and there is anecdotal evidence that use of the Web is beneficial to such businesses. There is, however, little systematic analysis of the conditions that lead to successful use of and thereby benefits from the Web for small businesses. Based on the innovation adoption, organizations, and information systems (IS) implementation literature, we identify a set of variables that are related to adoption, use, and benefits of information technology (IT), with particular emphasis on small businesses. These variables are reflective of an organization's contextual characteristics, its IT infrastructure, Web use, and Web benefits. Since the extant research does not suggest a single theoretical model for Web use and benefits in the context of small businesses, we adopt a modeling approach and explore the relationships between "context-IT-use-benefit" (CIUB) through three models,partial-mediator, reduced partial-mediator, and mediator. These models posit that the extent of Web use by small businesses and the associated benefits are driven by organizations' contextual characteristics and their IT infrastructure. They differ in the endogeneity/exogeneity of the extent of IT sophistication, and in the direct/mediated effects of organizational context. We examine whether the relationships between variables identified in the literature hold within the context of these models using two samples of small businesses with national coverage, including various sizes, and representing several industry sectors. The results show that the evidence for patterns of relationships is similar across the two independent samples for two of these models. We highlight the relationships within the reduced partial-mediator and mediator models for which conclusive evidence are given by both samples. Implications for small business managers and providers of Web-based technologies are discussed. [source] Ice Minimizes Discomfort Associated with Injection of Botulinum Toxin Type A for the Treatment of Palmar and Plantar HyperhidrosisDERMATOLOGIC SURGERY, Issue 2007KEVIN C. SMITH MD BACKGROUND The value of botulinum toxin type A (BTX-A) for treatment of palmar and plantar hyperhidrosis (HH) has been limited by injection pain, which in the past has generally required administration of a nerve block. We describe the successful use of ice applied to the intended injection point followed immediately by application of either ice or vibration to skin adjacent to the injection point to reduce discomfort associated with injection of BTX-A for the treatment of palmar and plantar HH. RESULTS During needle insertion and injection of BTX-A, both the application of ice to the intended injection point followed by application of ice adjacent to the injection point (ice+ice) and the application of ice to the intended injection point followed by application of vibration adjacent to the injection point have been preferred by our patients to nerve block. These two techniques allow efficient treatment of both hands and/or both feet in a single session. CONCLUSION By eliminating the need for nerve blocks, the techniques described here will enlarge the pool of physicians who can administer BTX-A for palmar and plantar HH, and will enlarge the pool of patients who are willing to have this treatment. [source] Eruptive Epidermoid Cysts Resulting from Treatment with ImiquimodDERMATOLOGIC SURGERY, Issue 7 2005Chelsy L. Marty MD Background Because of its unique mechanism of action and safety profile, imiquimod, a topical immune response modifier, is used for many benign and malignant dermatologic conditions. Adverse effects are typically limited to treatment site erythema and erosion. Objective To describe a newly recognized adverse effect of imiquimod. Methods A 79-year-old woman being treated with imiquimod 5 days per week for a nodular basal cell developed a verrucous plaque over the treatment area after 7 weeks of therapy. Results Scouting biopsies demonstrated multiple comedones and ruptured epidermoid cysts. There was no evidence of residual basal cell carcinoma. Conclusions Imiquimod is a new and novel treatment option for cutaneous malignancies. We report its successful use in the treatment of a nodular basal cell carcinoma. The multiple comedones and ruptured epidermoid cysts are newly reported adverse effects of imiquimod therapy. [source] Effects of Botulinum Toxin Type A on Contouring of the Lower FaceDERMATOLOGIC SURGERY, Issue 5 2005Seong Wook Choe MD background. Masseteric muscle hypertrophy is an uncommon condition represented as a swelling of the masseter muscle. Recent reports have demonstrated the successful use of botulinum in the treatment of masseteric hypertrophy. objective. This study was a prospective trial to evaluate the effectiveness of botulinum toxin type A (Botox) in the treatment of masseteric muscle hypertrophy according to doses of 10, 20, and 30 U. materials and methods. Twenty-two patients were referred to the dermatologic clinic for the management of masseteric muscle hypertrophy. Ultrasonographic measurements of the thickness of the masseter muscle were performed, and clinical photographs were taken before treatment and 1, 2, 3, 4, 6, and 9 months after the treatment. results. The median values of percentage reduction of muscle mass were 10.3%, 16.5%, 23.7%, 24.7%, 21.6%, 16.5% in the 10 U group; 11.9%, 18.8%, 24.8%, 27.7%, 26.7%, and 21.8% in the 20 U group; and 12.0%, 19.4%, 25.0%, 27.8%, 37.8%, and 24.1% in the 30 U group. conclusion. The adequate dose of botulinum toxin type A for treatment of masseteric muscle hypertrophy should be above 20 U. The effect of botulinum toxin type A is maintained for at least 9 months as the treatment of masseteric muscle hypertrophy. [source] Use of a Living Dermal Equivalent for a Refractory Abdominal Defect after Pediatric Multivisceral TransplantationDERMATOLOGIC SURGERY, Issue 9 2004Carlos A. Charles MD Background. Primary closure is not always possible after pediatric multivisceral transplantation. Reepithelialization may require extended periods of postoperative time, which can be associated with significant morbidity Objective. The objective was to accelerate secondary wound closure thereby minimizing infection or further complications in a pediatric multivisceral transplant patient. Methods. Five applications of human fibroblast-derived dermis (Dermagraft, Smith and Nephew) were applied to the postsurgical defect of a pediatric multivisceral transplant patient over the course of 8 months. Routine wound care and observation was performed between human fibroblast-derived dermis applications. Results. Human fibroblast-derived dermis stimulated healing and accelerated reepithelialization. Signs of clinical rejection or infection were not observed. Conclusion. Reepithelialization can be aided in the postoperative period in pediatric multivisceral transplant patients with human fibroblast-derived dermis, thereby helping to deter complications associated with secondary wound closure. We have illustrated the successful use of a human fibroblast-derived dermis as an adjunct for wound healing in a complicated surgical defect. [source] CO2 Laser Treatment of Epidermal Nevi: Long-Term SuccessDERMATOLOGIC SURGERY, Issue 7 2002Sarah Boyce MD background. Epidermal nevi have been notoriously difficult to treat due to their large size and often conspicuous location. Variable results have been obtained with different laser treatments, and scarring and/or incomplete removal is typical after excisional or other destructive modalities. objective. To outline the successful use of a short-pulsed CO2 laser in the long-term eradication of epidermal nevi in three patients. methods. Three females (ages 15,19) presented with extensive grouped verrucous papules and plaques on the face, trunk, and extremities. A pulsed CO2 laser was used to vaporize the lesions using a 500 mJ pulse energy, 3 mm spotsize, and 7 watts of power. results. All lesions healed without incident. No lesional recurrence was observed 10 to 13 months after treatment except in one small area on the ankle in one patient. conclusions. Carbon dioxide laser vaporization of epidermal nevi provides good clinical effect and offers unique advantages for the treatment of these lesions, including effective intraoperative hemostasis with excellent lesional visualization. It is also possible to treat widespread areas in one laser treatment session. While the results of this series clearly show the benefit of CO2 laser treatment, epidermal nevi may not always respond so favorably, due in part to the variability in their depths of involvement. [source] BLUE RUBBER BLEB NEVUS SYNDROME: TREATMENT OF MULTIPLE GASTROINTESTINAL HEMANGIOMAS WITH ARGON PLASMA COAGULATORDIGESTIVE ENDOSCOPY, Issue 1 2009Enders K.W. Ng Blue rubber bleb nevus syndrome is a rare clinical entity characterized by the formation of multiple blue or purplish rubbery cavernous hemangiomas on the skin and other epithelial surfaces. Involvement of the gastrointestinal tract is common and often presents with crippling anemia as a result of chronic occult blood loss. While surgical extirpation is an option for symptomatic hemangiomas in the intestine, endoscopic therapy is more appealing for lesions found in the stomach and colon. Here we report the successful use of argon plasma coagulation in the management of an adult with multiple hemangiomas in her colon and terminal ileum. [source] Abciximab Treatment for Obstructive Prosthetic Aortic and Mitral Valve Thrombosis in the Presence of Large Thrombi, Cardiogenic Shock, and Acute Evolving Embolic StrokeECHOCARDIOGRAPHY, Issue 1 2004Atiar M Rahman M.D., Ph.D. Obstructive thrombosis of left-sided mechanical prosthetic valves is a life-threatening complication. Intravenous thrombolytic therapy is contraindicated due to risk of clot embolization and surgical treatment is often required for hemodynamically unstable patients. We report for the first time the successful use of abciximab in the management of a patient in cardiogenic shock with multiple prosthetic valve obstructive thrombosis and evolving embolic stroke. Serial Doppler echocardiography and cinefluoroscopy demonstrated resolution of thrombi, improvements in transvalvular gradients and improvement in leaflet motion. This observation suggests abciximab should be considered as a therapeutic option in the treatment of obstructed prosthetic heart valves. (ECHOCARDIOGRAPHY, Volume 21, January 2004) [source] rFVIIa, for acute rebleeding of a cerebral cavernous malformationEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2007K. Engelhardt Recurrent bleeding episodes of cavernomas especially in the brainstem can cause progressive neurological deficits. Therefore brainstem cavernomas are still a therapeutic dilemma and a treatment challenge for the neuro critical care community. We report a 39-year-old woman with spontaneous ataxia diplopia and vomiting, who has been treated for multiple intracerebral cavernomas during the last 10 years. A cerebral computed tomography (cCT) revealed a re-bleeding cavernoma in the left cerebral peduncle with consecutive obstructive hydrocephalus. As a result of the difficult anatomical location, no surgical approach was possible. As an off-label treatment, recombinant activated factor VII (rFVIIa) was administered to prevent possible further bleeding and especially further sequelae. The patient recovered well and no adverse events and especially no further bleeding of the cavernoma were observed. To our knowledge, this is the first report of the safe and successful use of rFVIIa to treat re-bleeding episodes in cavernomas. Further clinical studies are needed to specify the future potential of rFVIIa. [source] Surface temperature measurements on burning materials using an infrared pyrometer: accounting for emissivity and reflection of external radiationFIRE AND MATERIALS, Issue 1 2004Joe Urbas Abstract This paper demonstrates the successful use of an infrared pyrometer, operating in the 8,10 ”m wavelength band, to measure the surface temperature of combustible specimens in a heat release calorimeter. The temperature histories of ten different materials were measured in the ICAL (intermediate scale calorimeter). The set of materials comprised four wood products, gypsum board, polyisocyanurate foam, PVC floor tile, PMMA and two non-combustible boards. A small-diameter bare thermocouple was installed on each specimen in order to determine an accurate temperature for comparison. The spectral emissivity and the spectral flux reflected from the surface were measured simultaneously and used to correct the apparent temperature measured by the pyrometer. The spectral emissivity and reflected spectral flux were both constant prior to ignition for all the combustible materials. During the burning phase all the combustible materials had a spectral emissivity very close to unity. The agreement between the temperatures measured with the pyrometer and thermocouple was not affected by the flame. The wood products, the polyisocyanurate foam and the calcium silicate board required no correction for reflected spectral flux over the whole temperature range. Copyright © 2004 John Wiley & Sons, Ltd. [source] FEIBAź: mode of actionHAEMOPHILIA, Issue 2004P. L. Turecek Summary., FEIBAź(factor eight inhibitor bypassing activity) has a history of more than 30 years of successful use in controlling bleeding in haemophilic patients who have developed inhibitory antibodies against factor (F)VIII or FIX. Recently it was shown that FEIBAź contains the proenzymes of the prothrombin complex factors, prothrombin, FVII, FIX and FX, but only very small amounts of their activation products, with the exception of FVIIa, which is contained in FEIBAź in greater amounts. FEIBAź controls bleeding by induction and facilitation of thrombin generation, a process for which FV is crucial. A number of biochemical in vitro and in vivo studies have shown that FXa and prothrombin play a critical role in the activity of FEIBAź. Consequently, they are considered to be key components of this product. The prothrombinase complex has been found to be a major target site for FEIBAź. Apart from prothrombin and FXa, FEIBAź contains other proteins of the prothrombin complex, which could also facilitate haemostasis in haemophilia patients with inhibitors. [source] Successful use of recombinant factor VIIa in a patient with inhibitor secondary to severe factor XI deficiencyHAEMOPHILIA, Issue 2 2002P. LAWLER Factor XI (FXI) inhibitors are a rare complication of inherited FXI deficiency. We report the successful use of recombinant factor VIIa (FVIIa) in a patient with a high-responding inhibitor undergoing cataract extraction. At the time of surgery there were limited available data on the optimal management of patients with FXI deficiency. A 62-year-old Ashkenazi Jewish woman had a lifelong history of excessive bleeding secondary to severe FXI deficiency (2 U dL,1), and received FXI concentrate (FXI:C) when she underwent a colposuspension procedure. She was subsequently diagnosed with a FXI inhibitor of 16 Bethesda units (BU) when she developed a poor response to FXI:C at the time of total hip replacement. Two months later she was admitted for cataract extraction. The FXI level was < 1 U dL,1 with an inhibitor titre of 48 BU. She received 90 ,g kg,1 of FVIIa immediately preoperatively followed by continuous infusion at a rate of 20 ,g kg,1 h,1 for 24 h. The cataract extraction was successful and there was no excess bleeding during surgery or in the postoperative period. Mutation analysis of the FXI gene showed that the patient was homozygous for the type II genotype [exon 5, Glu117,Ter]. The reason for the low prevalence of inhibitor formation in patients with FXI deficiency is unclear but may reflect a number of factors including reporting bias, the rarity of absent circulating FXI:C activity, and the infrequent use of FXI replacement therapy. [source] GPS tracking of the foraging movements of Manx Shearwaters Puffinus puffinus breeding on Skomer Island, WalesIBIS, Issue 3 2008T. C. GUILFORD We report the first successful use of miniature Global Positioning System loggers to track the ocean-going behaviour of a c. 400 g seabird, the Manx Shearwater Puffinus puffinus. Breeding birds were tracked over three field seasons during the incubation and chick-rearing periods on their foraging excursions from the large colony on Skomer Island, Pembrokeshire, UK. Foraging effort was concentrated in the Irish Sea. Likely foraging areas were identified to the north, and more diffusely to the west of the colony. No foraging excursions were recorded significantly to the south of the colony, conflicting with the conclusions of earlier studies based on ringing recoveries and observations. We discuss several explanations including the hypothesis that foraging may have shifted substantially northwards in recent decades. We found no obvious relationship between birds' positions and water depth, although there was a suggestion that observations at night were in shallower water than those during the day. We also found that, despite the fact that Shearwaters can be observed rafting off-shore from their colonies in the hours prior to making landfall at night, breeding birds are usually located much further from the colony in the last 8 h before arrival, a finding that has significance for the likely effectiveness of marine protection areas if they are only local to the colony. Short sequences of precise second-by-second fixes showed that movement speeds were bimodal, corresponding to sitting on the water (most common at night and around midday) and flying (most common in the morning and evening), with flight behaviour separable into erratic (indicative of searching for food) and directional (indicative of travelling). We also provide a first direct measurement of mean flight speed during directional flight (c. 40 km/h), slower than a Shearwater's predicted maximum range velocity, suggesting that birds are exploiting wave or dynamic soaring during long-distance travel. [source] Preliminary study of ciprofloxacin in active Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 1 2002Dr. George L. Arnold Abstract Based on limited reports of the successful use of antibiotics in the treatment of Crohn's disease (CD) and on the possibility that intestinal bacteria may be one of the etiologic factors playing a role in the pathogenesis of this condition, we undertook a study to evaluate the use of a broad-spectrum antibiotic in CD. Our team studied the efficacy of adding the antibiotic ciprofloxacin to the treatment of moderately active, but resistant cases of CD. Forty-seven adults with moderately active CD were randomly assigned treatment with ciprofloxacin 500 mg twice daily versus placebo twice daily for 6 months. The primary endpoint was the change in scores on the Crohn's Disease Activity Index (CDAI) from baseline to month 6. Although 47 patients were randomized, at 1 month of follow-up 28 patients received ciprofloxacin and 19 received placebo. The mean entry CDAI scores were not significantly different: 187 for the ciprofloxacin group versus 230 for the placebo group (p = 0.638). Mean CDAI scores at the completion of study were 112 for the ciprofloxacin group (n = 25) and 205 for the placebo group (n = 12), (p < 0.001). Disease remission is defined as a decrease in the CDAI score to less than 150 points. Our preliminary study suggests that ciprofloxacin may be an effective agent when added to the treatment of moderately active, resistant CD. [source] A conceptual framework for agent-based agile manufacturing cellsINFORMATION SYSTEMS JOURNAL, Issue 2 2004Jianming Yu Abstract., Agile manufacturing techniques are perceived as the manufacturing systems of the future. Agile manufacturing cells are dynamic and reconfigurable and the modelling of the manufacturing cells and its interaction mechanism is critical to its successful use. This paper deals with the architecture and cooperation mechanism of web-based agile manufacturing cells. Based on an analysis of structure and organization requirements of agile manufacturing cells and a comparison of three basic architectures of manufacturing systems, the quasi-heterarchical architecture is used for the agile manufacturing cell. Functional layers are defined in this architecture to make the cell's control system reconfigurable and reusable. Agent technology is adopted for implementation of each layer's functions to establish an agent-based model of agile manufacturing cells. Four types of agents including cooperation agent, job management agent, resource broker agent, and resource control agent are defined, and their functions discussed. Finally, a real time interaction mechanism of the agents is presented by considering the activities during the agents' cooperation in an agile manufacturing cell. [source] F-bar-based linear triangles and tetrahedra for finite strain analysis of nearly incompressible solids.INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 3 2005Part I: formulation, benchmarking Abstract This paper proposes a new technique which allows the use of simplex finite elements (linear triangles in 2D and linear tetrahedra in 3D) in the large strain analysis of nearly incompressible solids. The new technique extends the F-bar method proposed by de Souza Neto et al. (Int. J. Solids and Struct. 1996; 33: 3277,3296) and is conceptually very simple: It relies on the enforcement of (near-) incompressibility over a patch of simplex elements (rather than the point-wise enforcement of conventional displacement-based finite elements). Within the framework of the F-bar method, this is achieved by assuming, for each element of a mesh, a modified (F-bar) deformation gradient whose volumetric component is defined as the volume change ratio of a pre-defined patch of elements. The resulting constraint relaxation effectively overcomes volumetric locking and allows the successful use of simplex elements under finite strain near-incompressibility. As the original F-bar procedure, the present methodology preserves the displacement-based structure of the finite element equations as well as the strain-driven format of standard algorithms for numerical integration of path-dependent constitutive equations and can be used regardless of the constitutive model adopted. The new elements are implemented within an implicit quasi-static environment. In this context, a closed form expression for the exact tangent stiffness of the new elements is derived. This allows the use of the full Newton,Raphson scheme for equilibrium iterations. The performance of the proposed elements is assessed by means of a comprehensive set of benchmarking two- and three-dimensional numerical examples. Copyright © 2005 John Wiley & Sons, Ltd. [source] Multi-objective turbomachinery optimization using a gradient-enhanced multi-layer perceptronINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 6 2009M. C. Duta Abstract Response surface models (RSMs) have found widespread use to reduce the overall computational cost of turbomachinery blading design optimization. Recent developments have seen the successful use of gradient information alongside sampled response values in building accurate response surfaces. This paper describes the use of gradients to enhance the performance of the RSM provided by a multi-layer perceptron. Gradient information is included in the perceptron by modifying the error function such that the perceptron is trained to fit the gradients as well as the response values. As a consequence, the back-propagation scheme that assists the training is also changed. The paper formulates the gradient-enhanced multi-layer perceptron using algebraic notation, with an emphasis on the ease of use and efficiency of computer code implementation. To illustrate the benefit of using gradient information, the enhanced neural network model is used in a multi-objective transonic fan blade optimization exercise of engineering relevance. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||