•Three months of aerobic exercise training (AET) improves fitness in PD patients.•Effects of AET on cognitive and motor skills in PD were evaluated concurrently.•Some executive functions and ...procedural learning capacity improved after AET.•AET can be used as a non-pharmacological intervention to improve functioning in PD.
Background: Aerobic exercise training (AET) has been shown to provide health benefits in individuals with Parkinson’s disease (PD). However, it is yet unknown to what extent AET also improves cognitive and procedural learning capacities, which ensure an optimal daily functioning. Objective: In the current study, we assessed the effects of a 3-month AET program on executive functions (EF), implicit motor sequence learning (MSL) capacity, as well as on different health-related outcome indicators. Methods: Twenty healthy controls (HC) and 19 early PD individuals participated in a supervised, high-intensity, stationary recumbent bike-training program (3 times/week for 12weeks). Exercise prescription started at 20min (+5min/week up to 40min) based on participant’s maximal aerobic power. Before and after AET, EF tests assessed participants’ inhibition and flexibility functions, whereas implicit MSL capacity was evaluated using a version of the Serial Reaction Time Task. Results: The AET program was effective as indicated by significant improvement in aerobic capacity in all participants. Most importantly, AET improved inhibition but not flexibility, and motor learning skill, in both groups. Conclusion: Our results suggest that AET can be a valuable non-pharmacological intervention to promote physical fitness in early PD, but also better cognitive and procedural functioning.
Aerobic exercise training (AET) has been shown to provide general health benefits, and to improve motor behaviours in particular, in individuals with Parkinson's disease (PD). However, the influence ...of AET on their motor learning capacities, as well as the change in neural substrates mediating this effect remains to be explored.
In the current study, we employed functional Magnetic Resonance Imaging (fMRI) to assess the effect of a 3-month AET program on the neural correlates of implicit motor sequence learning (MSL).
20 healthy controls (HC) and 19 early PD individuals participated in a supervised, high-intensity, stationary recumbent bike training program (3 times/week for 12 weeks). Exercise prescription started at 20 min (+ 5 min/week up to 40 min) based on participant's maximal aerobic power. Before and after the AET program, participants' brain was scanned while performing an implicit version of the serial reaction time task.
Brain data revealed pre-post MSL-related increases in functional activity in the hippocampus, striatum and cerebellum in PD patients, as well as in the striatum in HC individuals. Importantly, the functional brain changes in PD individuals correlated with changes in aerobic fitness: a positive relationship was found with increased activity in the hippocampus and striatum, while a negative relationship was observed with the cerebellar activity.
Our results reveal, for the first time, that exercise training produces functional changes in known motor learning related brain structures that are consistent with improved behavioural performance observed in PD patients. As such, AET can be a valuable non-pharmacological intervention to promote, not only physical fitness in early PD, but also better motor learning capacity useful in day-to-day activities through increased plasticity in motor related structures.
•Ionic liquids used to assist bitumen extraction from oil sands in a waterless process.•Bitumen recovery and quality assessed using a mixed-level experimental design.•Flow microcell-near infrared ...spectroscopy used to monitor bitumen extraction kinetics.•EtNH3NO3 as best candidate for fines capture from bitumen.
The use of room temperature ionic liquids (IL) to assist bitumen extraction from oil sands in a waterless process was investigated. Four ILs were selected according to their ability to meet industrial requirements. Their impact on bitumen recovery and bitumen quality (fines content) was assessed through a mixed-level experimental design accounting for temperature, contact time, solvent-to-oil sands ratio, IL-to-oil sands ratio, water-to-IL ratio, solvent and IL types. In parallel, an innovative through-flow microcell coupled to near infrared spectroscopy (NIR) was developed to monitor on-line the IL-assisted bitumen extraction kinetics along with a quantitative reconstruction strategy using projection to latent structure (PLS) method. The choice of solvent rather than IL was the main impacting factor on bitumen recovery while the NIR extraction kinetic tests revealed that IL viscosity drastically reduced the rate constant of bitumen recovery. However, ILs were significant in capturing fines from bitumen with EtNH3NO3 as the best candidate.
A Canadian outbreak investigation into a cluster of Escherichia coli O121 was initiated in late 2016. When initial interviews using a closed-ended hypothesis-generating questionnaire did not point to ...a common source, cases were centrally re-interviewed using an open-ended approach. The open-ended interviews led cases to describe exposures with greater specificity, as well as food preparation activities. Data collected supported hypothesis generation, particularly with respect to flour exposures. In March 2017, an open sample of Brand X flour from a case home, and a closed sample collected at retail of the same brand and production date, tested positive for the outbreak strain of E. coli O121. In total, 76% (16/21) of cases reported that they used or probably used Brand X flour or that it was used or probably was used in the home during their exposure period. Crucial hypothesis-generating techniques used during the course of the investigation included a centralised open-ended interviewing approach and product sampling from case homes. This was the first outbreak investigation in Canada to identify flour as the source of infection.
Bulk analyses of plagioclase and high-alumina orthopyroxene megacrysts (decimetre- to metre-sized crystals with plagioclase lamellae) from the late Proterozoic Egersund–Ogna massif-type anorthosite ...(Rogaland anorthosite province, SW Norway) are used to constrain the parental magma compositions and differentiation processes within this 30 km diameter diapir. Spatial compositional variations show that two types of anorthosite occur: high-Sr (720–1090 ppm) andesine anorthosite (An48 ± 4 ) in the centre of the intrusion and low-Sr (320–620 ppm) labradorite anorthosite (An59 ± 6 ) in the margin. Two populations of orthopyroxene megacrysts are clearly discriminated by their Mn and Cr contents, but display similar ranges of Mg-number (55–79). Interpretation of trace element data and comparison with inversion models suggest that the two types of anorthosite result from crystallization of different parental magma compositions with high-alumina basalt affinities and similar Mg-numbers, but different wollastonite, Sr, Mn and Cr contents. A Rayleigh fractional crystallization model of the trace element concentrations vs MgO content in orthopyroxene constrains the cotectic orthopyroxene:plagioclase proportions to 0·33:0·67 in both magma types before the appearance of Fe–Ti oxide minerals on the liquidus at F ∼0·7 (where F is melt fraction). Polybaric crystallization is recorded by variable alumina contents in the orthopyroxene megacrysts (2·3–8·5 wt %), corresponding to crystallization pressures in the 3–13 kbar range as shown by experimental data. This implies that the high-alumina orthopyroxene megacrysts mainly crystallized en route during diapiric rise of the anorthositic mush. Modelling the plagioclase compositions with experimentally determined partition coefficients for Ca, K, Sr and Ba confirms that pressure variation during polybaric crystallization is the main controlling factor on compositional variations in the anorthosite pluton.
Stoma Complications: A Multivariate Analysis Duchesne, Juan C.; Wang, Yi-Zarn; Weintraub, Sharon L. ...
The American surgeon,
11/2002, Letnik:
68, Številka:
11
Journal Article, Conference Proceeding
Recenzirano
Construction of a gastrointestinal stoma is a frequently performed surgical procedure. We sought to analyze a large cohort to document the frequency and types of ostomy complications and the risk ...factors associated with them. The charts of patients undergoing a procedure which resulted in ostomy during a 3-year period were reviewed. Demographics, indication, ostomy type/location, perioperative risk factors, and complications were recorded. Case-control methodology was used to determine crude odds ratios and multiple logistic regression was used to calculate adjusted odds ratios. A P value of less than 0.05 was considered significant. An ostomy was constructed in 204 patients and records were available for 164. Forty-one patients (25.0%) had ostomy complications. Sixteen of these complications (39.0%) occurred within one month of the procedure. Complications included prolapse in nine (22%), necrosis in nine (22%), stenosis in seven (17%), irritation in seven (17%), infection in six (15%), bleeding in two (5%), and retraction in two (5%). Gender, cancer, trauma, diverticulitis, emergency surgery, ileostomy, and ostomy location/type were not associated with a stoma complication. Significant predictors of ostomy malfunction are presented as odds ratios (ORs) with 95 per cent confidence intervals (CIs) and include inflammatory bowel disease (OR = 4.49; 95% CI = 1.16–17.36) and obesity (OR = 2.66; 95% CI = 1.15–6.16). The care of an enterostomal nurse was found to prevent complications (OR = 0.15; 95% CI = 0.03–0.69). We conclude that ostomies have a high risk of complication, which is not related to stoma location or type. Obesity and inflammatory bowel disease predispose to complications. Enterostomal nursing may be instrumental in preventing complications.
The origin of igneous Fe–Ti oxide ores associated with massif-type anorthosites is investigated through a detailed study of the world-class Tellnes ilmenite deposit, part of the late-Proterozoic ...(930–920 Ma) AMC series of the Rogaland Anorthosite Province (SW Norway). More than 100 samples from drill cores reveal significant petrographical and compositional variations within the ore body. Four zones are defined, based on variations in modal proportions and cumulus mineral assemblages: the Lower and Upper Central Zones and the Lower and Upper Marginal Zones. Plagioclase and whole-rock compositions discriminate the zones and display patterns interpreted as a result of mixing of either plagioclase–ilmenite or plagioclase–ilmenite–orthopyroxene–olivine cumulates with a melt of ferrodioritic (jotunitic) composition with a content decreasing from 80 to 20% from the margins to the central part of the ore body. Phase diagrams for a jotunitic parental magma reproduce the crystallization sequence at 5 kb. The orthopyroxene–olivine liquidus boundary is a peritectic in the Bjerkreim-Sokndal layered intrusion and a cotectic in Tellnes and this explains the differences in the sequence of crystallization of the two intrusions. The high concentration of ilmenite, well above cotectic proportions, resulted from gravity-sorting in the Tellnes ore body, which represents the lower part of a larger magma chamber. Uniform Sr isotope ratios do not support magma mixing. The cryptic layering of the ore body precludes injection as a crystal mush but favours in situ crystallization from an evolving magma in a sill-like magma chamber. The present trough-shape and mineral orientations result from deformation during gravity-induced subsidence and by up-doming of the anorthosite. Fractional crystallization of a TiO
2-rich magma with ilmenite as an early liquidus mineral and plagioclase buoyancy are the principal mechanisms responsible for the formation of Fe–Ti deposits in Proterozoic massif-type anorthosites.
The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control resuscitation (DCR). This guideline evaluates several aspects of DCR including ...the role of massive transfusion (MT) protocols, the optimal target ratio of plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, and the role of recombinant activated factor VII (rVIIa) and tranexamic acid (TXA).
Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a subcommittee of the Practice Management Guidelines (PMG) Section of EAST conducted a systematic review using MEDLINE and EMBASE. Articles in English from1985 through 2015 were considered in evaluating four PICO questions relevant to DCR.
A total of 37 studies were identified for analysis, of which 31 met criteria for quantitative meta-analysis. In these studies, mortality decreased with use of an MT/DCR protocol vs. no protocol (OR 0.61, 95% CI 0.43-0.87, p = 0.006) and with a high ratio of PLAS:RBC and PLT:RBC (relatively more PLAS and PLT) vs. a low ratio (OR 0.60, 95% CI 0.46-0.77, p < 0.0001; OR 0.44, 95% CI 0.28-0.71, p = 0.0003). Mortality and blood product use were no different with either rVIIa vs. no rVIIa or with TXA vs. no TXA.
DCR can significantly improve outcomes in severely injured bleeding patients. After a review of the best available evidence, we recommend the use of a MT/DCR protocol in hospitals that manage such patients and recommend that the protocol target a high ratio of PLAS and PLT to RBC. This is best achieved by transfusing equal amounts of RBC, PLAS, and PLT during the early, empiric phase of resuscitation. We cannot recommend for or against the use of rVIIa based on the available evidence. Finally, we conditionally recommend the in-hospital use of TXA early in the management of severely injured bleeding patients.
Long‐term (1991–2018) thaw tube measurements highlight widespread permafrost thaw and ground surface (GS) subsidence over a large portion of northwest Canada. Statistically significant positive ...trends in thaw penetration (TP), measured with respect to a fixed datum, were observed at 18 of 28 sites with data that span three decades at a median rate of 0.8 cm a−1. This rate implies thawing of about 22 cm of permafrost over the study period. Similarly significant trends in GS subsidence occurred at 21 of 28 sites, at a median rate of 0.4 cm a−1. In contrast with TP and GS elevation, long‐term trends in active layer thickness (ALT) were less consistent, with 10 of 28 sites having statistically significant trends indicating increasing ALT (median rate: 0.6 cm a−1), and 7 sites having trends indicating decrease in ALT (median: 0.3 cm a−1). The ALT measurements underestimated the thawing of ice‐rich permafrost due to GS subsidence. Sites with high rates of thaw had relatively warm permafrost, deep snow cover, and poor drainage. Masking of ice‐rich permafrost degradation by ALT measurements has important implications for modeling permafrost thaw and climate change reporting. Accurate simulation of ice‐rich permafrost thaw is conceivable for sites where conditions are well‐defined. However, the prediction of subsidence and TP at regional or broader scales is only possible in general terms due to variation in surface conditions and ground ice content. Trends in TP and GS subsidence more accurately characterize ice‐rich permafrost degradation than trends in ALT.
Plain Language Summary
Measurements from instruments that account for changes in the ground surface (GS) elevation indicate that permafrost has thawed, and the GS has subsided in the past three decades over a large area in northwest Canada. Traditional measurements that do not account for changes in the GS elevation mask how much permafrost is thawing and are therefore less useful for tracking the effects of climate change in permafrost areas where there is a significant amount of ice in the ground. The results of this study also highlight that it may be difficult to predict permafrost degradation and GS subsidence over large areas using simulations because conditions such as vegetation, soil wetness, snow, and ground ice content may vary over short distances and strongly affect the rates of thawing.
Key Points
Permafrost thaw and ground surface subsidence are widespread in northwest Canada
Active layer thickness (ALT) measurements poorly represent the magnitude of permafrost thaw in ice‐rich settings
ALT is widely used in climate change reporting, but it may be a poor indicator of climate change at ice‐rich sites
Rotary kilns are widely used in industry to achieve effective gas−solid heat transfer at high temperatures by direct contact with hot flue gases obtained by combustion. However, various disturbances ...related to nonpremixed combustion often used in practice introduces undesired variability in product quality and forces overheating, especially when obtaining the desired quality is dependent upon reaching a minimal solids discharge temperature. This paper investigates the use of digital RGB flame images and multivariate image analysis (MIA) techniques to quantify these combustion-related variations and to predict the future behavior of product quality. Very good solids discharge temperature forecasts were obtained over a time window running from current time t to about the mean residence time within the kiln using only a single flame image collected at time t. This information will be used to develop innovative automatic flame image-based control schemes to improve quality control and reduce fuel consumption.
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