267 results on '"M. Nyberg"'
Search Results
2. Impacts of Active Versus Passive Re‐Wetting on the Carbon Balance of a Previously Drained Bog
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M. Nyberg, T. A. Black, R. Ketler, S.‐C. Lee, M. Johnson, M. Merkens, K. A. Nugent, and S. H. Knox
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Atmospheric Science ,Ecology ,Paleontology ,Soil Science ,Forestry ,Aquatic Science ,Water Science and Technology - Published
- 2022
3. Robot-assisted nephroureterectomy for upper tract urothelial carcinoma-feasibility and complications: a single center experience
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F. Liedberg, J. Abrahamsson, J. Bobjer, S. Gudjonsson, A. Löfgren, M. Nyberg, and A. Sörenby
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Carcinoma, Transitional Cell ,Treatment Outcome ,Urinary Bladder Neoplasms ,Nephrology ,Urology ,Feasibility Studies ,Humans ,Robotics ,Nephroureterectomy ,Aged ,Retrospective Studies - Abstract
Robot-assisted nephroureterectomy (RANU) is the primary treatment for upper tract urothelial carcinoma (UTUC) at our hospital for patients with clinical stage less than T2, and for patients with invasive tumours, but unfit for major surgery.To assess peri-operative conditions and outcomes of RANU at our unit, and to evaluate the safety of the procedure.The medical records of all 166 patients undergoing RANU for suspected UTUC and followed for more than three months in a large university hospital in Sweden were reviewed retrospectively. After the exclusion of twenty patients because of previous cystectomy, simultaneous surgical procedure, or other tumour types than UTUC in the pathological report, 146 patients remained for the analyses. The primary endpoint was complication rate according to Clavien-Dindo at 90 days. Secondary endpoints were perioperative bleeding, violation of oncological surgical principles, hospital stay, and re-admission within 90 days.The median age was 75 [(Inter Quartile Range) IQR 70-80] years and 57% of the patients had an ASA score above 2. According to Clavien-Dindo, one patient had a grade 3 complication, and no patient had a grade 4-5 complication. The median blood loss was 50 (IQR 20-100) ml and the median hospital stay was 6 (IQR 5-7) days. Twelve patients were re-admitted to the hospital within 90 days (eight with urinary tract infection/haematuria, one with hematoma, and three with other diseases).Robot-assisted nephroureterectomy is a safe procedure for patients with upper tract urothelial carcinoma, with a low risk of major surgical complications.
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- 2022
4. Traumatic Hypopharyngeal Perforation from Football Helmet Chinstrap
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Matthew A Williams, Marcella R Stanley, Eric M Brown, Jimmy Ntelekos, Sue M. Nyberg, and Donald G. Vasquez
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medicine.medical_specialty ,business.industry ,blunt injuries ,Perforation (oil well) ,hypopharynx ,Medicine ,Case Report ,Football ,business ,esophageal perforation ,neck injuries ,Surgery - Published
- 2021
5. Economic Extraction and Recovery of REEs and Production of Clean Value-Added Products from Low-Rank Coal Fly Ash
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Bruce C. Folkedahl, Raymond S. Addleman, and Carolyn M. Nyberg
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Fly ash ,Extraction (chemistry) ,Production (economics) ,Environmental science ,Rank (graph theory) ,Value added ,Pulp and paper industry - Published
- 2020
6. A Survey of Safety Recommendations for All-Terrain Vehicle Dealers and Track Owners in Kansas
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Shawn Rau, Morgan J. Martin, Gina M. Berg, Sue M. Nyberg, and Rychael Morton
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Telephone survey ,All terrain vehicle ,business.industry ,Health care ,Respondent ,Safety Equipment ,Operations management ,business ,Track (rail transport) ,Safety promotion ,Public awareness - Abstract
Introduction. All-terrain vehicles (ATVs) are associated with injury,mortality, and healthcare costs. ATV related injuries are less severewhen consistent safety practices are followed, however, ATV safetyregulations are varied among states. This study sought to surveyKansas ATV dealers and track owners to determine safety promotionpractices. Methods. A cross-sectional telephone survey was conducted ofKansas ATV dealers and tracks. Survey questions included promotionand sale of safety equipment, provision of ATV safety information,and respondent characteristics. Results. Of those contacted, 32% of dealers and 31% of tracksresponded to the survey. Most ATV dealers sell safety gear (70% -100%) and all recommend safety gear to buyers and riders. All ATVtracks reported requiring helmets (100%) but were varied regardingother forms of safety gear. The majority of ATV dealers (77%) recommendedsafety courses, but only 31% of dealers and 40% of tracksoffered courses. Eighty percent of ATV tracks and 52% of dealers feltthey had a professional responsibility to educate riders/owners onsafety. Conclusions. Safety promotion by ATV dealers in Kansas consistentlywas recommended, but often limited to the sales of safety gear(helmets and gloves) or the provision of manufacturer provided safetymaterials. Further, ATV dealers reported rarely offering skills tests orsafety courses to buyers. In Kansas, safety promotion at the point ofsale or track level could be improved to increase public awareness ofATV safety practices. KS J Med 2017;10(4):76-78.
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- 2019
7. Single institution followed by national implementation of systematic surgical quality control and feedback for radical prostatectomy: a 20-year journey
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Elin Axén, I Franck-Lissbrant, Per Fransson, Pär Stattin, Ali Khatami, K Koss-Modig, M. Nyberg, Jonas Hugosson, Maria Frånlund, Ola Bratt, Pär Lodding, and Johan Stranne
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Surgical results ,Male ,Quality Control ,medicine.medical_specialty ,Time Factors ,Formative Feedback ,Urology ,medicine.medical_treatment ,Control (management) ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Urologi och njurmedicin ,Medicine ,Urology and Nephrology ,Humans ,Single institution ,PROM ,Prostatectomy ,Sweden ,Prostate cancer ,business.industry ,General surgery ,Quality control ,Prostatic Neoplasms ,Topic Paper ,Radical prostatectomy ,Acs nsqip ,030220 oncology & carcinogenesis ,business - Abstract
PURPOSE: The demand for objective and outcome-based facts about surgical results after radical prostatectomy (RP) is increasing. Systematic feedback is also essential for each surgeon to improve his/her performance. METHODS: RP outcome data (e.g., pT-stage and margin status) have been registered at Sahlgrenska University Hospital (SUH) since 1988 and patient-related outcome measures (PROM) have been registered since 2001. The National Prostate Cancer Registry (NPCR) has covered all Regions in Sweden since 1998 and includes PROM-data from 2008. Initially PROM was on-paper questionnaires but due since 2018 all PROMs are collected electronically. In 2014 an on-line "dashboard" panel was introduced, showing the results for ten quality-control variables in real-time. Since 2017 all RP data on hospital, regional, and national levels are publicly accessible on-line on " www.npcr.se/RATTEN ". RESULTS: The early PROM-data from SUH have been used for internal quality control. As national clinical and PROM-data from the NPCR have been made accessible on-line and in real-time we have incorporated this into our pre-existing protocol. Our data are now internally available as real-time NPCR reports on the individual surgeons' results, as well as ePROM data. We can compare the results of each surgeon internally and to other departments' aggregated data. The public can access data and compare hospital level data on "RATTEN". CONCLUSIONS: The process of quality control of RP locally at SUH, and nationally through the NPCR, has been long but fruitful. The online design, with direct real-time feedback to the institutions that report the data, is essential.
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- 2019
8. Improved Characterization and Modeling of Tight Oil Formations for CO2 Enhanced Oil Recovery Potential and Storage Capacity Estimation
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James A. Sorensen, Steven B. Hawthorne, Bethany A. Kurz, José A. Torres, Steven A. Smith, Lu Jin, Loreal V. Heebink, John P. Hurley, Carolyn M. Nyberg, and Nicholas W. Bosshart
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Petroleum engineering ,Tight oil ,Environmental science ,Enhanced oil recovery ,Characterization (materials science) - Published
- 2018
9. PA student assessment of body mass index in children using visual cues
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Carolyn R. Ahlers-Schmidt, Justin Schulte, Evan Ohlman, Francie Ekengren, Paul Casper, Gina M. Berg, and Sue M. Nyberg
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Adult ,Male ,medicine.medical_specialty ,Pediatric Obesity ,Audiology ,Nurse Assisting ,Developmental psychology ,Body Mass Index ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,030225 pediatrics ,medicine ,Photography ,Humans ,In patient ,Young adult ,Students ,Sensory cue ,Self-efficacy ,Observer Variation ,030208 emergency & critical care medicine ,Overweight ,medicine.disease ,Obesity ,Self Efficacy ,Student assessment ,Physician Assistants ,Child, Preschool ,Female ,Psychology ,Observer variation ,Body mass index - Abstract
Pediatric weight or body mass index often is underestimated by providers when relying solely upon visual cues. This study sought to determine physician assistant (PA) students' and recent graduates' ability to accurately assess BMI for age in patients ages 3 to 5 years using visual cues.PA students and recent graduates visually assessed pictures of three children ages 3 to 5 years-one obese, one overweight, and one with healthy weight-for BMI categorization via online survey. Responses were scored for accuracy.Ninety-eight PA students and recent graduates completed the assessment. Accuracy for BMI categorization was low, especially in the obese and overweight children for visual assessment alone. Accuracy improved slightly when height and weight data were provided.PA student and recent graduate visual assessment for categorization of BMI is unreliable, similar to studies with other providers. PAs should be aware of discrepancy and not rely on visual assessment to determine weight-related interventions.
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- 2017
10. Su1495 – Healthcare Resource Utilization, Demographics, and Comorbidities by Diagnosis Codes and Histological Stage in Nonalcoholic Fatty Liver Disease (NAFLD)/Nonalcoholic Steatohepatitis (NASH) in a Large Integrated Healthcare Delivery System in the U.S
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Anders Nyberg, Lisa M. Nyberg, Julie Stern, Kevin M. Chiang, Su-Jau Yang, Heather Patton, and Susan L. Caparosa
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Nonalcoholic steatohepatitis ,medicine.medical_specialty ,Hepatology ,Demographics ,business.industry ,Gastroenterology ,medicine.disease ,Healthcare delivery ,Health care ,Nonalcoholic fatty liver disease ,medicine ,Diagnosis code ,Stage (cooking) ,Intensive care medicine ,business ,Resource utilization - Published
- 2019
11. THU-332-Healthcare resource utilisation, demographics, and comorbidities by diagnosis codes and histological stage in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in a large integrated healthcare delivery system in the U.S
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Heather Patton, Julie Stern, Anders Nyberg, Lisa M. Nyberg, Su-Jau Yang, Susan L. Caparosa, and Kevin M. Chiang
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medicine.medical_specialty ,Hepatology ,business.industry ,Fatty liver ,Non alcoholic ,Disease ,medicine.disease ,Resource (project management) ,Health care ,medicine ,Diagnosis code ,Stage (cooking) ,Steatohepatitis ,Intensive care medicine ,business - Published
- 2019
12. Evaluation of Process Variations in Noncompliance in the Implementation of Evidence-Based Sepsis Care
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Gina M. Berg, Sue M. Nyberg, LaDonna S. Hale, David A. Moran, and Donald G. Vasquez
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Male ,medicine.medical_specialty ,Time Factors ,Evidence-based practice ,Quality management ,MEDLINE ,Disease ,Severity of Illness Index ,Tertiary Care Centers ,Sepsis ,Trauma Centers ,Severity of illness ,medicine ,Humans ,Hospital Mortality ,Intensive care medicine ,Aged ,Retrospective Studies ,Chi-Square Distribution ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Standard of Care ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Evidence-Based Practice ,Regression Analysis ,Female ,Guideline Adherence ,business ,human activities ,Chi-squared distribution ,Hospital Rapid Response Team - Abstract
Introduction Sepsis is recognized as an often-lethal disease. Recommended guidelines are complex and time sensitive. Response teams (RTs) have demonstrated success in implementation of quality initiatives. The purpose of this study was to evaluate variations in noncompliance with recommended sepsis guidelines overall and between a sepsis-focused RT and standard care. Methods This retrospective chart review categorized septic patients based on treatment by a sepsis response team (SRT) versus standard care (non-SRT). Guideline compliance was based upon the Surviving Sepsis evaluation and treatment guidelines. Results Patient records for 123 identified septic patients post first-year implementation were evaluated. Overall, compliance rates were low and there were variations in compliance between the treatment providers. The SRT was more compliant than the non-SRT. SRT noncompliance was more often due to failure to achieve therapeutic goals within the recommended time. Mortality benefit was not statistically significant between groups; however mortality was higher in the non-SRT group. Conclusion Noncompliance is more complex than simple failure to initiate, especially in time-dependent therapies. The development and education of an RT demonstrates improvement in application of sepsis-focused therapies over standard care.
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- 2013
13. A measurement of the proton structure function F-2(x, Q(2)) at low x and low Q(2) at HERA
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C. Adloff, S. Aid, M. Anderson, V. Andreev, B. Andrieu, V. Arkadov, C. Arndt, I. Ayyaz, A. Babaev, J. Bähr, J. Bán, Y. Ban, P. Baranov, E. Barrelet, R. Barschke, W. Bartel, U. Bassler, H.P. Beck, M. Beck, H.-J. Behrend, A. Belousov, Ch. Berger, G. Bernardi, G. Bertrand-Coremans, R. Beyer, P. Biddulph, P. Bispham, J.C. Bizot, K. Borras, F. Botterweck, V. Boudry, S. Bourov, A. Braemer, W. Braunschweig, V. Brisson, W. Brückner, P. Bruel, D. Bruncko, C. Brune, R. Buchholz, L. Büngener, J. Bürger, F.W. Büsser, A. Buniatian, S. Burke, M.J. Burton, G. Buschhorn, D. Calvet, A.J. Campbell, T. Carli, M. Charlet, D. Clarke, B. Clerbaux, S. Cocks, J.G. Contreras, C. Cormack, J.A. Coughlan, A. Courau, M.-C. Cousinou, B.E. Cox, G. Cozzika, D.G. Cussans, J. Cvach, S. Dagoret, J.B. Dainton, W.D. Dau, K. Daum, M. David, C.L. Davis, A. De Roeck, E.A. De Wolf, B. Delcourt, M. Dirkmann, P. Dixon, W. Dlugosz, C. Dollfus, K.T. Donovan, J.D. Dowell, H.B. Dreis, A. Droutskoi, J. Ebert, T.R. Ebert, G. Eckerlin, V. Efremenko, S. Egli, R. Eichler, F. Eisele, E. Eisenhandler, E. Elsen, M. Erdmann, A.B. Fahr, L. Favart, A. Fedotov, R. Felst, J. Feltesse, J. Ferencei, F. Ferrarotto, K. Flamm, M. Fleischer, M. Flieser, G. Flügge, A. Fomenko, J. Formánek, J.M. Foster, G. Franke, E. Gabathuler, K. Gabathuler, F. Gaede, J. Garvey, J. Gayler, M. Gebauer, H. Genzel, R. Gerhards, A. Glazov, L. Goerlich, N. Gogitidze, M. Goldberg, D. Goldner, K. Golec-Biernat, B. Gonzalez-Pineiro, I. Gorelov, C. Grab, H. Grässler, T. Greenshaw, R.K. Griffiths, G. Grindhammer, A. Gruber, C. Gruber, T. Hadig, D. Haidt, L. Hajduk, T. Haller, M. Hampel, W.J. Haynes, B. Heinemann, G. Heinzelmann, R.C.W. Henderson, H. Henschel, I. Herynek, M.F. Hess, K. Hewitt, K.H. Hiller, C.D. Hilton, J. Hladký, M. Höppner, D. Hoffmann, T. Holtom, R. Horisberger, V.L. Hudgson, M. Hütte, M. Ibbotson, Ç. İşsever, H. Itterbeck, A. Jacholkowska, C. Jacobsson, M. Jacquet, M. Jaffre, J. Janoth, D.M. Jansen, L. Jönsson, D.P. Johnson, H. Jung, P.I.P. Kalmus, M. Kander, D. Kant, U. Kathage, J. Katzy, H.H. Kaufmann, O. Kaufmann, M. Kausch, S. Kazarian, I.R. Kenyon, S. Kermiche, C. Keuker, C. Kiesling, M. Klein, C. Kleinwort, G. Knies, T. Köhler, J.H. Köhne, H. Kolanoski, S.D. Kolya, V. Korbel, P. Kostka, S.K. Kotelnikov, T. Krämerkämper, M.W. Krasny, H. Krehbiel, D. Krücker, A. Küpper, H. Küster, M. Kuhlen, T. Kurča, J. Kurzhöfer, B. Laforge, M.P.J. Landon, W. Lange, U. Langenegger, A. Lebedev, F. Lehner, V. Lemaitre, S. Levonian, M. Lindstroem, F. Linsel, J. Lipinski, B. List, G. Lobo, J.W. Lomas, G.C. Lopez, V. Lubimov, D. Lüke, L. Lytkin, N. Magnussen, H. Mahlke-Krüger, E. Malinovski, R. Maraček, P. Marage, J. Marks, R. Marshall, J. Martens, G. Martin, R. Martin, H.-U. Martyn, J. Martyniak, T. Mavroidis, S.J. Maxfield, S.J. McMahon, A. Mehta, K. Meier, P. Merkel, F. Metlica, A. Meyer, H. Meyer, J. Meyer, P.-O. Meyer, A. Migliori, S. Mikocki, D. Milstead, J. Moeck, F. Moreau, J.V. Morris, E. Mroczko, D. Müller, T. Walter, K. Müller, P. Murín, V. Nagovizin, R. Nahnhauer, B. Naroska, Th. Naumann, I. Négri, P.R. Newman, D. Newton, H.K. Nguyen, T.C. Nicholls, F. Niebergall, C. Niebuhr, Ch. Niedzballa, H. Niggli, G. Nowak, T. Nunnemann, M. Nyberg-Werther, H. Oberlack, J.E. Olsson, D. Ozerov, P. Palmen, E. Panaro, A. Panitch, C. Pascaud, S. Passaggio, G.D. Patel, H. Pawletta, E. Peppel, E. Perez, J.P. Phillips, A. Pieuchot, D. Pitzl, R. Pöschl, G. Pope, B. Povh, S. Prell, K. Rabbertz, G. Rädel, P. Reimer, H. Rick, S. Riess, E. Rizvi, P. Robmann, R. Roosen, K. Rosenbauer, A. Rostovtsev, F. Rouse, C. Royon, K. Rüter, S. Rusakov, K. Rybicki, D.P.C. Sankey, P. Schacht, S. Schiek, S. Schleif, P. Schleper, W. von Schlippe, D. Schmidt, G. Schmidt, L. Schoeffel, A. Schöning, V. Schröder, E. Schuhmann, B. Schwab, F. Sefkow, A. Semenov, V. Shekelyan, I. Sheviakov, L.N. Shtarkov, G. Siegmon, U. Siewert, Y. Sirois, I.O. Skillicorn, T. Sloan, P. Smirnov, M. Smith, V. Solochenko, Y. Soloviev, A. Specka, J. Spiekermann, S. Spielman, H. Spitzer, F. Squinabol, P. Steffen, R. Steinberg, J. Steinhart, B. Stella, A. Stellberger, J. Stier, J. Stiewe, U. Stöβlein, K. Stolze, U. Straumann, W. Struczinski, J.P. Sutton, S. Tapprogge, M. Taševský, V. Tchernyshov, S. Tchetchelnitski, J. Theissen, G. Thompson, P.D. Thompson, N. Tobien, R. Todenhagen, P. Truöl, G. Tsipolitis, J. Turnau, E. Tzamariudaki, P. Uelkes, A. Usik, S. Valkár, A. Valkárová, C. Valĺee, P. Van Esch, P. Van Mechelen, D. Vandenplas, Y. Vazdik, P. Verrecchia, G. Villet, K. Wacker, A. Wagener, M. Wagener, R. Wallny, B. Waugh, G. Weber, M. Weber, D. Wegener, A. Wegner, T. Wengler, M. Werner, L.R. West, S. Wiesand, T. Wilksen, S. Willard, M. Winde, G.-G. Winter, C. Wittek, M. Wobisch, H. Wollatz, E. Wünsch, J. Žáček, D. Zarbock, Z. Zhang, A. Zhokin, P. Zini, F. Zomer, J. Zsembery, M. zurNedden, Laboratoire Leprince-Ringuet (LLR), Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire de l'Accélérateur Linéaire (LAL), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11), Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), H1, Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Levy, Jean-Michel, and H1 Collaboration
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Physics ,Nuclear and High Energy Physics ,Particle physics ,[PHYS.HEXP] Physics [physics]/High Energy Physics - Experiment [hep-ex] ,Proton ,010308 nuclear & particles physics ,Structure function ,FOS: Physical sciences ,HERA ,01 natural sciences ,High Energy Physics - Experiment ,Nuclear physics ,Momentum ,High Energy Physics - Experiment (hep-ex) ,Cross section (physics) ,0103 physical sciences ,[PHYS.HEXP]Physics [physics]/High Energy Physics - Experiment [hep-ex] ,010306 general physics - Abstract
The results of a measurement of the proton structure function F_2(x,Q^2)and the virtual photon-proton cross section are reported for momentum transfers squared Q^2 between 0.35 GeV^2 and 3.5 GeV^2 and for Bjorken-x values down to 6 10^{-6} using data collected by the HERA experiment H1 in 1995. The data represent an increase in kinematic reach to lower x and Q^2 values of about a factor of 5 compared to previous H1 measurements. Including measurements from fixed target experiments the rise of F_2 with decreasing x is found to be less steep for the lowest Q^2 values measured. Phenomenological models at low Q^2 are compared with the data., Comment: 27 pages, 10 Figures
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- 2016
14. Cement technique correlates with tuberosity healing in hemiarthroplasty for proximal humeral fracture
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Edward H. Yian, Mary Chocas, Eric M. Nyberg, Anshuman Singh, Oke A. Anakwenze, Michael A. Padilla, Raffy Mirzayan, and Ronald A. Navarro
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Osteoporosis ,Nonunion ,Dentistry ,Bone healing ,Prosthesis ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,medicine ,Humans ,Orthopedics and Sports Medicine ,Reduction (orthopedic surgery) ,Aged ,Retrospective Studies ,Fracture Healing ,030222 orthopedics ,Shoulder Fracture ,business.industry ,Bone Cements ,Retrospective cohort study ,030229 sport sciences ,General Medicine ,medicine.disease ,Bone cement ,Surgery ,Shoulder Fractures ,Female ,Hemiarthroplasty ,business - Abstract
Background Tuberosity healing correlates with clinical outcomes after hemiarthroplasty for 4-part proximal humeral fractures (4PHFs). We seek to examine variables that affect tuberosity healing. Methods This was a retrospective comparative study. At 1 year postoperatively, patients who underwent hemiarthroplasty for 4PHFs were divided into 2 groups: those with anatomically healed tuberosities and those with tuberosity nonunion. The primary variables included time between injury and surgery, prosthesis fenestration, cement mantle classification, and both vertical and horizontal tuberosity reduction. Secondary demographic factors included age, gender, osteoporosis status, diabetes status, and smoking status. Results There were 84 individuals who met the inclusion criteria: 37 (44%) had anatomically healed tuberosities, and 47 (56%) did not. Individuals with anatomic healing had cement near or under the tuberosities 32% of the time, whereas individuals with nonunion or resorption had cement near the tuberosities 66% of the time ( P = .002). There was no association between tuberosity healing and fenestration of the humeral stem ( P = .84). Anatomic reduction between tuberosities was associated with healing ( P .001), whereas greater tuberosity–to–head height was not ( P = .25). There were no significant differences in age, osteoporosis status, smoking status, diabetes status, or time to surgery between groups. Male patients had nearly double the rate of healing ( P = .03). Discussion and Conclusion The classification and effect of cement technique on tuberosity healing have not previously been described. We suggest limiting cementation to a minimum of 5 mm below the level of the tuberosity fracture. The ideal candidate for hemiarthroplasty for a 4PHF is a male patient with anatomic tuberosity reduction and limited use of cement.
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- 2016
15. Arterial Access/Monitoring (Line Placement)
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Sue M. Nyberg, Daniel J. Bequillard, and Donald G. Vasquez
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medicine.medical_specialty ,Continuous measurement ,business.industry ,Hemodynamics ,Systemic blood pressure ,Arterial cannulation ,medicine.anatomical_structure ,Blood pressure ,Internal medicine ,Cardiology ,Arterial line ,Medicine ,business ,Artery - Abstract
Cannulation of an artery for the purpose of monitoring a patient’s hemodynamic status is a common procedure in the critical care environment (Tiru and McGee, Anesth Clin Res 3(5):1000209, 2012; Mignini et al., Crit Care 10(2):R43, 2006; Cousins and O'Donnell, Aana J 72(4):267-71, 2004; Bowdle, Anesthesiol Clin North America 20(3):571-88, 2002). Continuous measurement of blood pressure through an arterial line is considered to be the most accurate measurement of systemic blood pressure and is the most common form of invasive monitoring (Tiru and McGee, Anesth Clin Res 3(5):1000209, 2012; Bowdle, Anesthesiol Clin North America 20(3):571-88, 2002). Advanced practice clinicians working in the ICU commonly perform arterial cannulation (Nyberg et al., JAAPA 23(1):35-7, 41, 2010) and therefore should have knowledge of indications and contraindications, relevant anatomy, technique, and potential complications from the procedure (Tiru and McGee, Anesth Clin Res 3(5):1000209, 2012; Tegtmeyer et al., N Engl J Med 354(15):e13, 2006).
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- 2016
16. Postoperative Risk of Hepatic Decompensation after Orthopedic Surgery in Patients with Cirrhosis
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Mary Chocas, Anshuman Singh, Susan L. Caparosa, Michael Batech, T. Craig Cheetham, Eric M. Nyberg, and Jose R. Pio
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Orthopedic surgery ,030222 orthopedics ,medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Relative risk ,Diabetes mellitus ,medicine ,Decompensation ,In patient ,Original Article ,business ,030217 neurology & neurosurgery ,Hepatic decompensation ,Kidney disease - Abstract
Background and Aims: Previous studies have shown increased hepatic decompensation in patients with cirrhosis undergoing surgery. However, there are little data available in cirrhotics undergoing orthopedic surgery compared to cirrhotics who did not undergo surgery. The aim of this study was to examine the demographics, comorbid conditions, and clinical factors associated with hepatic decompensation within 90 days in cirrhotics who underwent orthopedic surgery. Methods: This is a retrospective matched cohort study. Inclusion criteria were cirrhosis diagnosis, age > 18 years, ≥ 6 months continuous health plan membership, and a procedure code for orthopedic surgery. Up to five cirrhotic controls without orthopedic surgery were matched on age, gender, and cirrhosis diagnosis date. Data abstraction was performed for demographics, socioeconomics, clinical, and decompensation data. Chart review was performed for validation. Multivariable analysis estimated relative risk of decompensation. Results: Eight hundred fifty-three orthopedic surgery cases in cirrhotics were matched with 4,263 cirrhotic controls. Among the cases and matched controls, the mean age was 60.5 years, and 52.2% were female. Within 90 days after surgery, cases had more decompensation compared to matched controls (12.8% vs 4.9%). Using multivariable analysis, orthopedic surgery, a 0.5 g/dL decrease in serum albumin, and a 1-unit increase in Charlson Comorbidity Index were associated with a significant increase in decompensation within 90 days of surgery. Diabetes, chronic obstructive pulmonary disease, and chronic kidney disease were seen with increased frequency in cases vs. matched controls. Conclusions: Cirrhotics who underwent orthopedic surgery had a significant increase in hepatic decompensation within 90 days of surgery compared to matched controls. An incremental decrease in serum albumin and an incremental increase in the Charlson Comorbidity Index were significantly associated with hepatic decompensation after surgery.
- Published
- 2015
17. Kansas Physician Assistants’ Attitudes and Beliefs Regarding Spirituality and Religiosity in Patient Care
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Jennifer L. Norman, Ginny Budke, Robin E. Crowe, Felecia A. Lee, Sue M. Nyberg, Gina M. Berg, and Valerie M. Swick
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Health knowledge ,Religiosity ,Nursing ,Spirituality ,Humans ,Medicine ,In patient ,Physician assistants ,General Nursing ,business.industry ,Public health ,Religion and Medicine ,Religious studies ,General Medicine ,Kansas ,Middle Aged ,Patient Acuity ,Physician Assistants ,Family medicine ,Female ,Patient Care ,business ,Healthcare providers - Abstract
Research indicates patients want to discuss spirituality/religious (S/R) beliefs with their healthcare provider. This was a cross-sectional study of Kansas physician assistants (PA) regarding S/R in patient care. Surveys included questions about personal S/R beliefs and attitudes about S/R in patient care. Self-reported religious respondents agreed (92%) they should be aware of patient S/R; 82% agreed they should address it. Agreement with incorporating S/R increased significantly based on patient acuity. This research indicates Kansas PAs' personal S/R beliefs influence their attitudes toward awareness and addressing patient S/R.
- Published
- 2011
18. Oral Repeat Dose and Reproductive Toxicity of the Chlorinated Flame Retardant Dechlorane Plus
- Author
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William J. Brock, Janice M. Nyberg, Christy A. McKnight, Raymond E. Schroeder, and Jan L. VanSteenhouse
- Subjects
Male ,medicine.medical_specialty ,No-observed-adverse-effect level ,Administration, Oral ,Poison control ,Physiology ,Toxicology ,Rats, Sprague-Dawley ,Random Allocation ,chemistry.chemical_compound ,Pregnancy ,Lactation ,Hydrocarbons, Chlorinated ,medicine ,Animals ,Polycyclic Compounds ,Flame Retardants ,No-Observed-Adverse-Effect Level ,Dose-Response Relationship, Drug ,business.industry ,Reproduction ,Dechlorane plus ,medicine.disease ,Rats ,Surgery ,Dose–response relationship ,Teratogens ,medicine.anatomical_structure ,chemistry ,Maternal Exposure ,Prenatal Exposure Delayed Effects ,Paternal Exposure ,Gestation ,Female ,Neurotoxicity Syndromes ,Reproductive toxicity ,business - Abstract
This study consisted of a 28-day oral repeat dose (repeat dose toxicity [RDT]) phase and a developmental and reproductive (developmental and reproductive toxicity [DART]) phase with rats. Rats were treated with Dechlorane Plus at doses of 0, 750, 1500, or 5000 mg/kg by gavage. For the RDT phase, no effects were observed on in-life parameters or clinical or anatomic pathology. In the DART phase, no effects were observed on reproductive or fertility indices, or fetal development through lactation day (LD) 4. No effects were noted on gestation day (GD) 20 implantation data, fetal indices, or external and visceral examinations. Mortalities occurred across all dose groups, although these were gavage-related errors and not compound related. Microscopic evidence of gavage-related errors included adhesions, inflammation, and fibrosis in the thoracic and pleural cavities. These findings were not test article related as they were observed only in animals with evidence of gavage injury. The no-observable-effect level (NOEL) in both phases of study was 5000 mg/kg.
- Published
- 2010
19. Near-Infrared Spectroscopy Measurement of Sacral Tissue Oxygen Saturation in Healthy Volunteers Immobilized on Rigid Spine Boards
- Author
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Paul B. Harrison, Jessica Baumchen, Emily Hennes, Erin Gurss, Gina M. Berg, and Sue M. Nyberg
- Subjects
Adult ,Male ,Restraint, Physical ,medicine.medical_specialty ,Prolonged immobilization ,Emergency Nursing ,Oxygen Consumption ,Healthy volunteers ,medicine ,Humans ,Tissue oxygen ,Buttocks ,Pressure Ulcer ,Spectroscopy, Near-Infrared ,Sacrococcygeal Region ,business.industry ,Rigid spine ,Surgery ,Tissue oxygenation ,medicine.anatomical_structure ,Connective Tissue ,Connective tissue metabolism ,Emergency Medicine ,Tissue necrosis ,Female ,business ,Biomedical engineering - Abstract
Immobilization of patients utilizing rigid spine boards (RSBs) is standard practice in the management of trauma patients. Pressure ulcers have been associated with prolonged immobilization, and the possibility exists that formation may begin when the patient is initially immobilized on the RSB. The effects may not be fully recognized because of limited research on the direct tissue effects of prolonged immobilization. Near-infrared spectroscopy is an emerging tool to measure peripheral tissue oxygen saturation (StO(2)). The purpose of this research was to study the effects of prolonged spinal immobilization on an RSB on sacral tissue oxygenation of healthy volunteers.This experimental study measured StO(2) in healthy volunteers at baseline and again after 30 minutes of immobilization on an RSB at two sites: the sacral area (intervention) and 8-10 cm above the buttocks (control). Tissue oxygenation was measured with the InSpectra Tissue Oxygenation Monitor (Hutchinson Technology, Hutchinson, MN) by placing the probe at the measurement site and waiting for 15 seconds for equilibration prior to recording StO(2). Data were analyzed utilizing mixed-model and within-subjects analysis of variance (ANOVA), chi-square, and t-tests.Seventy-three participants were included in the analysis. A slight majority of participants were female (55%), the average age was 38 years, the average height was 170 cm, and the average weight was 82 kg. There was a significant increase in the StO(2) percentage at the sacral (intervention) area following immobilization, p0.001, point biserial correlation (r(pb)) = 0.48. Significant changes in oxygenation were not noted at the control site.An increase in sacral tissue oxygenation following immobilization was a finding consistent with other research. This is likely a result of initial, rapid tissue reperfusion at the time of pressure release. Rapid reperfusion indicates that a period of previous hypoperfusion has occurred. This research indicates that there are detrimental effects of spine board immobilization in healthy volunteers, which suggests that pressure ulcer formation may begin prior to hospital admission with immobilization on an RSB.
- Published
- 2010
20. Tu1459 - Healthcare Resource Utilization, Demographics, and Comorbidities in Non-Alcoholic Fatty Liver Disease (NAFLD)/Non-Alcoholic Steatohepatitis (NASH) and Progressive Stages in a Large, Integrated Healthcare Delivery System
- Author
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Lisa M. Nyberg, Su-Jau Yang, Anders Nyberg, Susan L. Caparosa, Heather Patton, Julie Stern, and Kevin M. Chiang
- Subjects
medicine.medical_specialty ,Hepatology ,Demographics ,business.industry ,Fatty liver ,Gastroenterology ,Non alcoholic ,Disease ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Healthcare delivery ,Health care ,medicine ,030211 gastroenterology & hepatology ,030212 general & internal medicine ,Steatohepatitis ,business ,Intensive care medicine ,Resource utilization - Published
- 2018
21. Effect of Amitriptyline on Symptoms in Treatment Naïve Patients With Interstitial Cystitis/Painful Bladder Syndrome
- Author
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Liyi Cen, Philip M. Hanno, Leroy M. Nyberg, Kathleen J. Propert, Toby C. Chai, Christopher K. Payne, John W. Kusek, Wei Yang, Mary P. FitzGerald, Claire C. Yang, David Burks, J. Curtis Nickel, Kenneth M. Peters, Robert D. Mayer, Emily S. Lukacz, Karl J. Kreder, Harris E. Foster, and J. Richard Landis
- Subjects
Adult ,Male ,Amitriptyline ,Urology ,Cystitis, Interstitial ,Pain ,Placebo ,Article ,Statistics, Nonparametric ,law.invention ,Placebos ,Double-Blind Method ,Randomized controlled trial ,law ,medicine ,Humans ,Adverse effect ,Pain Measurement ,Urinary bladder ,Intention-to-treat analysis ,business.industry ,Urinary Bladder Diseases ,Interstitial cystitis ,Syndrome ,Analgesics, Non-Narcotic ,medicine.disease ,Clinical trial ,Treatment Outcome ,medicine.anatomical_structure ,Anesthesia ,Female ,business ,medicine.drug - Abstract
Purpose Amitriptyline is frequently used to treat patients with interstitial cystitis/painful bladder syndrome. The evidence to support this practice is derived mainly from a small, single site clinical trial and case reports. Materials and methods We conducted a multicenter, randomized, double-blind, placebo controlled clinical trial of amitriptyline in subjects with interstitial cystitis/painful bladder syndrome who were naive to therapy. Study participants in both treatment arms received a standardized education and behavioral modification program. The drug dose was increased during a 6-week period from 10 up to 75 mg once daily. The primary outcome was a patient reported global response assessment of symptom improvement evaluated after 12 weeks of treatment. Results A total of 271 subjects were randomized and 231 (85%) provided a global response assessment at 12 weeks of followup. Study participants were primarily women (83%) and white (74%), with a median age of 38 years. In an intent to treat analysis (271) the rate of response of subjects reporting moderate or marked improvement from baseline in the amitriptyline and placebo groups was 55% and 45%, respectively (p = 0.12). Of the subgroup of subjects (207) who achieved a drug dose of at least 50 mg, a significantly higher response rate was observed in the amitriptyline group (66%) compared to placebo (47%) (p = 0.01). Conclusions When all randomized subjects were considered, amitriptyline plus an education and behavioral modification program did not significantly improve symptoms in treatment naive patients with interstitial cystitis/painful bladder syndrome. However, amitriptyline may be beneficial in persons who can achieve a daily dose of 50 mg or greater, although this subgroup comparison was not specified in advance.
- Published
- 2010
22. Development, Validation and Testing of an Epidemiological Case Definition of Interstitial Cystitis/Painful Bladder Syndrome
- Author
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Michael A. Stoto, Karin Liu, J. Quentin Clemens, Chau Pham, Marika J. Suttorp, Sandra H. Berry, Leroy M. Nyberg, and Laura M. Bogart
- Subjects
medicine.medical_specialty ,Vulvodynia ,Urology ,Urinary system ,Cystitis, Interstitial ,Endometriosis ,Pain ,urologic and male genital diseases ,Sensitivity and Specificity ,Article ,Diagnosis, Differential ,Interviews as Topic ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,Urinary bladder ,Urinary Bladder, Overactive ,business.industry ,Urinary Bladder Diseases ,Interstitial cystitis ,Syndrome ,medicine.disease ,Dermatology ,United States ,Surgery ,medicine.anatomical_structure ,Overactive bladder ,Female ,Differential diagnosis ,business ,Urinary bladder disease - Abstract
No standard case definition exists for interstitial cystitis/painful bladder syndrome for patient screening or epidemiological studies. As part of the RAND Interstitial Cystitis Epidemiology study, we developed a case definition for interstitial cystitis/painful bladder syndrome with known sensitivity and specificity. We compared this definition with others used in interstitial cystitis/painful bladder syndrome epidemiological studies.We reviewed the literature and performed a structured, expert panel process to arrive at an interstitial cystitis/painful bladder syndrome case definition. We developed a questionnaire to assess interstitial cystitis/painful bladder syndrome symptoms using this case definition and others used in the literature. We administered the questionnaire to 599 women with interstitial cystitis/painful bladder syndrome, overactive bladder, endometriosis or vulvodynia. The sensitivity and specificity of each definition was calculated using physician assigned diagnoses as the reference standard.No single epidemiological definition had high sensitivity and high specificity. Thus, 2 definitions were developed. One had high sensitivity (81%) and low specificity (54%), and the other had the converse (48% sensitivity and 83% specificity). These values were comparable or superior to those of other epidemiological definitions used in interstitial cystitis/painful bladder syndrome prevalence studies.No single case definition of interstitial cystitis/painful bladder syndrome provides high sensitivity and high specificity to identify the condition. For prevalence studies of interstitial cystitis/painful bladder syndrome the best approach may be to use 2 definitions that would yield a prevalence range. The RAND Interstitial Cystitis Epidemiology interstitial cystitis/painful bladder syndrome case definitions, developed through structured consensus and validation, can be used for this purpose.
- Published
- 2010
23. A national survey: Acceptance of physician assistants and nurse practitioners in trauma centers
- Author
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Angela D. Johnston, Kayla R. Keuter, Amy M Helton, Sue M. Nyberg, and Gina M. Berg
- Subjects
medicine.medical_specialty ,business.industry ,Cross-sectional study ,Nurse practitioners ,education ,MEDLINE ,Specialty ,Subspecialty ,Nurse Assisting ,Nursing ,Family medicine ,Workforce ,Medicine ,Professional association ,business ,Trauma surgery - Abstract
Objective: Census data published by professional organizations indicate an upward trend in the number of physician assistants (PAs) working in many specialty fields, including the subspecialty of trauma surgery. As the role of hospitalbased PAs and nurse practitioners (NPs) continues to evol
- Published
- 2010
24. Bladder pain syndrome international consultation on incontinence
- Author
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Arndt van Ophoven, Leroy M. Nyberg, Tomohiro Ueda, Alan J. Wein, Jörgen Nordling, Alex T.L. Lin, and Philip M. Hanno
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Urinalysis ,business.industry ,Urology ,Chronic pain ,Interstitial cystitis ,Physical examination ,Evidence-based medicine ,Cystoscopy ,medicine.disease ,Bladder Disorder ,Physical therapy ,Medicine ,Neurology (clinical) ,business ,Bladder Pain - Abstract
Aims of Study The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature, taxonomy, epidemiology, etiology, pathology, diagnosis, symptom scales, outcome assessment, principles of management, specific therapies, and future directions in research. Study Design, Materials, Methods The emphasis was on new information developed since the last consultation 4 years previously. Where possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results The consultation decided to refer to the condition as “bladder pain syndrome” (BPS) because the designation is more descriptive of the clinical condition and better fits standard classification taxonomy. Reasonable definitions of BPS include the definition of the ESSIC European group and a slight modification made at a SUFU sponsored Miami meeting in early 2008. Males or females with pain, pressure, or discomfort that they perceive to be related to the bladder with at least one urinary symptom, such as frequency not obviously related to high fluid intake, or a persistent urge to void should be evaluated for possible BPS. The initial assessment consists of a frequency/volume chart, focused physical examination, urinalysis, and urine culture. Urine cytology and cystoscopy are recommended if clinically indicated. Treatment progresses from conservative management through various oral and intravesical therapies, with most surgical therapies reserved for unresponsive cases. Pain management is critical throughout the treatment process. The consultation believes that the disorder is best viewed as one of a group of chronic pain syndromes, rather than as primarily an inflammatory bladder disorder. Recommendations for future research pathways are suggested. Neurourol. Urodynam. 29: 191–198, 2010. © 2009 Wiley-Liss, Inc.
- Published
- 2010
25. Redesigning a large-scale clinical trial in response to negative external trial results: the CAMUS study of Phytotherapy for Benign Prostatic Hyperplasia
- Author
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Michael J. Naslund, Harris E. Foster, Steven Kaplan, J. Curtis Nickel, Karl J. Kreder, Andrew McCullough, Michael J. Barry, E. David Crawford, Andrew L. Avins, Gerald L. Andriole, O. Dale Williams, Sreelatha Meleth, Leroy M. Nyberg, Kevin T. McVary, Claus G. Roehrborn, John W. Kusek, and Jeannette Y. Lee
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Prostatic Hyperplasia ,Urology ,Article ,Serenoa ,Saw palmetto ,Lower urinary tract symptoms ,Prostate ,Humans ,Multicenter Studies as Topic ,Medicine ,Adrenergic alpha-Antagonists ,Randomized Controlled Trials as Topic ,Transurethral resection of the prostate ,Pharmacology ,Gynecology ,Dose-Response Relationship, Drug ,biology ,Plant Extracts ,business.industry ,Serenoa repens ,General Medicine ,Middle Aged ,Pygeum ,Hyperplasia ,medicine.disease ,biology.organism_classification ,Prunus africana ,medicine.anatomical_structure ,Research Design ,Fruit ,Plant Bark ,business ,Phytotherapy - Abstract
Background Benign prostatic hyperplasia (BPH), a common condition among older men, confers its morbidity through potentially bothersome lower urinary tract symptoms. Treatments for BPH include drugs such as alpha-adrenergic receptor blockers and 5-alpha reductase inhibitors, minimally invasive therapies that use heat to damage or destroy prostate tissue, and surgery including transurethral resection of the prostate. Complementary and alternative medicines are gaining popularity in the US. Two phytotherapies commonly used for BPH are extracts of the fruit of Serenoa repens, the Saw palmetto dwarf palm that grows in the Southeastern US, and extracts of the bark of Pygeum africanum, the African plum tree. Purpose The objective of the Complementary and Alternative Medicines for Urological Symptoms (CAMUS) clinical trial is to determine if phytotherapy is superior to placebo in the treatment of BPH. Methods CAMUS was originally designed as a 3300-participant, four-arm trial of S. repens, P. africanum, an alpha-adrenergic blocking drug, and placebo with time to clinical progression of BPH, a measure of long-term efficacy, as the primary endpoint. Before enrollment started, a randomized, double-blind, placebo-controlled, single institution clinical trial showed that S. repens at the usual dose did not demonstrate any benefit over placebo with respect to symptom relief at 1 year. Consequently, the focus of CAMUS shifted from evaluating long-term efficacy to determining if any short-term (6—18 months) symptom relief could be achieved with increasing doses of S. repens, the phytotherapy most commonly used in the US for BPH. Results Results are anticipated in 2011. Conclusions Trial design occurs in an environment of continually evolving information. In this case, emerging results from another trial suggested that a study of long-term efficacy was premature, and that an effective dose and preparation of S. repens had to be established before proceeding to a long-term clinical trial. Clinical Trials 2009; 6: 628—636. http://ctj.sagepub.com
- Published
- 2009
26. Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for the Treatment of Urological Chronic Pelvic Pain Syndromes
- Author
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Liyi Cen, Anna Sanfield, Rodney U. Anderson, Suzanne A. Badillo, J. Quentin Clemens, Lisa Odabachian, John W. Kusek, Cynthia E. Neville, Rhonda Kotarinos, Leroy M. Nyberg, Christopher K. Payne, Betsy O'Dougherty, J. Richard Landis, Annamarie Cosby, Laura Fraser, Kenneth M. Peters, Mary P. FitzGerald, Carole Fortman, Rick Halle-Podell, Jeannette M. Potts, and Shannon Chuai
- Subjects
Pelvic pain syndrome ,medicine.medical_specialty ,business.industry ,Urology ,Pelvic pain ,Article ,law.invention ,Randomized controlled trial ,law ,Therapeutic Massage ,medicine ,Physical therapy ,medicine.symptom ,Manual therapy ,business - Abstract
Objectives To determine the feasibility of conducting a randomized clinical trial designed to compare two methods of manual therapy (myofascial physical therapy (MPT) and global therapeutic massage (GTM)) among patients with urologic chronic pelvic pain syndromes.
- Published
- 2009
27. Moulds and mycotoxins in rice from the Swedish retail market
- Author
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M. Olsen, Ann Gidlund, M. Nyberg, Elisabeth Fredlund, A.-M. Thim, and S. Brostedt
- Subjects
Ochratoxin A ,Aflatoxin ,Health, Toxicology and Mutagenesis ,Aspergillus flavus ,Toxicology ,chemistry.chemical_compound ,Limit of Detection ,Mycotoxin ,Ochratoxin ,Chromatography, High Pressure Liquid ,Sweden ,biology ,business.industry ,Commerce ,Fungi ,technology, industry, and agriculture ,Public Health, Environmental and Occupational Health ,food and beverages ,Oryza ,General Chemistry ,General Medicine ,Mycotoxins ,biology.organism_classification ,Alternaria ,Biotechnology ,chemistry ,Penicillium ,business ,Food Science ,Cladosporium - Abstract
A survey of moulds and mycotoxins was performed on 99 rice samples taken from the Swedish retail market. The main objective was to study the mould and mycotoxin content in basmati rice and rice with a high content of fibre. Samples of jasmine rice as well as long-grain rice were also included. The samples were analysed for their content of ochratoxin A (high-performance liquid chromatography (HPLC)), aflatoxin B(1), B(2), G(1), and G(2) (HPLC, RIDA(R)QUICK), and mould (traditional cultivation methods in combination with morphological analysis). The majority of samples were sampled according to European Commission Regulation 401/2006. Subsamples were pooled and mixed before milling and both mould and mycotoxin analyses were performed on milled rice. The results showed that the majority of basmati rice (71%) and many jasmine rice samples (20%) contained detectable levels of aflatoxin B(1) (level of quantification = 0.1 microg aflatoxin kg(-1) rice). Two samples of jasmine rice and ten basmati rice samples contained levels over the regulated European maximum limits of 2 microg kg(-1) for aflatoxin B(1) or 4 microg kg(-1) for total aflatoxins. Aspergillus was the most common mould genus isolated, but also Penicillium, Eurotium, Wallemia, Cladosporium, Epicoccum, Alternaria, and Trichotecium were found. The presence of Aspergillus flavus in 21% of the samples indicates that incorrect management of rice during production and storage implies a risk of mould growth and subsequent production of aflatoxin. Rough estimates showed that high rice consumers may have an intake of 2-3 ng aflatoxin kg(-1) bodyweight and day(-1) from rice alone. This survey shows that aflatoxin is a common contaminant in rice imported to Europe.
- Published
- 2009
28. Effect of Intensive Glycemic Control and Diabetes Complications on Lower Urinary Tract Symptoms in Men With Type 1 Diabetes
- Author
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Leroy M. Nyberg, Kevin T. McVary, Stephen K. Van Den Eeden, Brandy N. Rutledge, Patricia A. Cleary, John W. Kusek, Aruna V. Sarma, and Hunter Wessells
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Type 1 diabetes ,business.industry ,Endocrinology, Diabetes and Metabolism ,Urination disorder ,medicine.disease ,Surgery ,Lower urinary tract symptoms ,Internal medicine ,Diabetes mellitus ,Cohort ,Internal Medicine ,medicine ,Urologic disease ,business ,Glycemic ,Cohort study - Abstract
OBJECTIVE Although diabetes is known to result in lower urinary tract symptoms (LUTS) in men, it remains unclear if glycemic control can mitigate urinary symptoms. We studied how diabetic characteristics are related to LUTS in the men who completed the urological assessment component (UroEDIC) of the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study of the Diabetes Control and Complications Trial (DCCT) participants. RESEARCH DESIGN AND METHODS Study participants were men who completed the UroEDIC questionnaire at the year 10 DCCT/EDIC follow-up examination, which included data on genitourinary tract function and the American Urological Association Symptom Index (AUASI). Analyses were conducted to assess how treatment arm and diabetes characteristics were associated with LUTS using logistic regression. RESULTS Of the 591 men who completed the AUASI questions, nearly 20% (n = 115) had AUASI scores in the moderate to severe category for LUTS (AUASI score ≥8). No associations were observed between LUTS and treatment arm, or A1C levels at the DCCT baseline or end-of-study or at the year 10 EDIC (UroEDIC) examination. Of the diabetes complications studied, only erectile dysfunction at the UroEDIC examination was associated with LUTS. CONCLUSIONS These data from the UroEDIC cohort do not support the assumption that intensive glycemic control results in decreased lower urinary tract symptom severity in men with type 1 diabetes. This result may be due to a true lack of effect, or it may be due to other factors, for example, the relatively young age of the cohort.
- Published
- 2009
29. Rationale and Design Issues of the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) Study
- Author
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Russell W. Chesney, H. Gil Rushton, James Hosking, Myra A. Carpenter, Gordon A. McLurie, William A. Primack, Jack Elder, Timothy P. Bukowski, Lawrence A. Greenbaum, Ranjiv Matthews, Caleb P. Nelson, Barbara A. Fivush, Leroy M. Nyberg, Saul P. Greenfield, Tej K. Matoo, Douglas A. Canning, Alejandro Hoberman, Dawn Stewart, Ron Keren, Richard W. Sutherland, Marva Moxey-Mims, Nader Shaikh, and Arlene C. Gerson
- Subjects
Male ,medicine.medical_specialty ,Urinary system ,Unnecessary Procedures ,Kidney ,Placebo ,Vesicoureteral reflux ,Article ,Drug Administration Schedule ,law.invention ,Cicatrix ,Clinical Protocols ,Double-Blind Method ,Randomized controlled trial ,Recurrence ,law ,Internal medicine ,medicine ,Humans ,Child ,Ultrasonography ,Vesico-Ureteral Reflux ,Pyelonephritis ,business.industry ,Sulfamethoxazole ,Reflux ,Infant ,medicine.disease ,Trimethoprim ,Anti-Bacterial Agents ,Surgery ,Clinical trial ,Early Diagnosis ,Research Design ,Child, Preschool ,Urinary Tract Infections ,Pediatrics, Perinatology and Child Health ,Female ,business ,Follow-Up Studies ,medicine.drug - Abstract
ObjectiveOur goal is to determine if antimicrobial prophylaxis with trimethoprim/sulfamethoxazole prevents recurrent urinary tract infections and renal scarring in children who are found to have vesicoureteral reflux after a first or second urinary tract infection.Design, Participants, and MethodsThe Randomized Intervention for Children With Vesi-coureteral Reflux (RIVUR) study is a double-blind, randomized, placebo-controlled trial. Six hundred children aged 2 to 72 months will be recruited from both primary and subspecialty care settings at clinical trial centers throughout North America. Children who are found to have grades I to IV vesicoureteral reflux after the index febrile or symptomatic urinary tract infection will be randomly assigned to receive daily doses of either trimethoprim/sulfamethoxazole or placebo for 2 years. Scheduled follow-up contacts include in-person study visits every 6 months and telephone interviews every 2 months. Biospecimens (urine and blood) and genetic specimens (blood) will be collected for future studies of the genetic and biochemical determinants of vesicoureteral reflux, recurrent urinary tract infection, renal insufficiency, and renal scarring.ResultsThe primary outcome is recurrence of urinary tract infection. Secondary outcomes include time to recurrent urinary tract infection, renal scarring (assessed by dimercaptosuccinic acid scan), treatment failure, renal function, resource utilization, and development of antimicrobial resistance in stool flora.ConclusionsThe RIVUR study will provide useful information to clinicians about the risks and benefits of prophylactic antibiotics for children who are diagnosed with vesicoureteral reflux after a first or second urinary tract infection. The data and specimens collected over the course of the study will allow researchers to better understand the pathophysiology of recurrent urinary tract infection and its sequelae. Pediatrics 2008;122:240-250
- Published
- 2008
30. Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR): Background Commentary of RIVUR Investigators
- Author
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Ron Keren, Tej K. Matoo, Alejandro Hoberman, Russell W. Chesney, Myra A. Carpenter, Leroy M. Nyberg, Saul P. Greenfield, Ron Matthews, and Marva Moxey-Mims
- Subjects
Male ,Research design ,medicine.medical_specialty ,Urinary system ,MEDLINE ,Unnecessary Procedures ,Kidney ,Vesicoureteral reflux ,Article ,Drug Administration Schedule ,Cicatrix ,Double-Blind Method ,Recurrence ,medicine ,Humans ,Multicenter Studies as Topic ,Child ,Intensive care medicine ,Randomized Controlled Trials as Topic ,Vesico-Ureteral Reflux ,Pyelonephritis ,business.industry ,Genitourinary system ,Incidence (epidemiology) ,Disease Management ,Infant ,medicine.disease ,Antimicrobial ,Anti-Bacterial Agents ,Surgery ,Early Diagnosis ,medicine.anatomical_structure ,Research Design ,Child, Preschool ,Urinary Tract Infections ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
Because of the frequency of urinary tract infections in children, off-label use of antimicrobial prophylaxis is often the usual treatment of children with vesicoureteral reflux, and such use is increasingly being called into question; hence, a definitive study to determine the value of antimicrobial prophylaxis with regard to the recurrence of urinary tract infection and the incidence of renal scarring is essential. The currently recommended follow-up procedures (repeated urine cultures, renal and genitourinary imaging, antimicrobial therapy and prophylaxis, as well as other factors including cleanliness, adequate bladder and bowel emptying, and compliance with protocols) are expensive (in terms of time, attention to detail, and cost) and cumbersome. Such recommendations should be evidence-based.
- Published
- 2008
31. Challenges of conducting multi-center, multi-disciplinary urinary incontinence clinical trials: Experience of the urinary incontinence Treatment Network
- Author
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Toby C. Chai, William D. Steers, John W. Kusek, Holly E. Richter, Leroy M. Nyberg, Kimberly J. Dandreo, Stephen R. Kraus, and Linda Brubaker
- Subjects
Research design ,medicine.medical_specialty ,Pelvic floor ,Multi disciplinary ,business.industry ,Urology ,Behavioral therapy ,Urinary incontinence ,Urologic Surgical Procedure ,Clinical trial ,medicine.anatomical_structure ,medicine ,Physical therapy ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Aims The Urinary Incontinence Treatment Network (UITN) was established in 2000 as a multi-disciplinary, multi-institutional network by the National Institute for Diabetes, Digestive, and Kidney Diseases (NIDDK) to investigate treatments for urinary incontinence in women.
- Published
- 2008
32. Long-Term Treatment With Finasteride Results in a Clinically Significant Reduction in Total Prostate Volume Compared to Placebo Over the Full Range of Baseline Prostate Sizes in Men Enrolled in the MTOPS Trial
- Author
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John W. Kusek, Steven A. Kaplan, Shailaja Surynawanshi, Leroy M. Nyberg, Claus G. Roehrborn, Jeannette Y. Lee, Alan G. Meehan, Jennifer Rotonda, and John D. McConnell
- Subjects
medicine.medical_specialty ,Intention-to-treat analysis ,medicine.drug_class ,business.industry ,Urology ,medicine.disease ,Antiandrogen ,Placebo ,Surgery ,law.invention ,chemistry.chemical_compound ,medicine.anatomical_structure ,Randomized controlled trial ,chemistry ,Prostate ,Lower urinary tract symptoms ,law ,medicine ,Doxazosin ,Finasteride ,business ,medicine.drug - Abstract
Purpose: In the present analysis we examined data from the MTOPS (Medical Therapy of Prostatic Symptoms) trial to determine the effect of long-term finasteride treatment, either alone or in combination with doxazosin, on total prostate volume across the full range of baseline total prostate volume values in men enrolled in this study.Materials and Methods: In this trial a total of 3,047 patients with lower urinary tract symptoms were randomized to placebo, doxazosin (4 to 8 mg), finasteride (5 mg) or the combination of doxazosin and finasteride (average length of treatment 4.5 years). Total prostate volume was measured by transrectal ultrasound in all patients at baseline, yearly and at study end or at termination of participation.Results: Long-term treatment with finasteride led to a consistent reduction of approximately 25% in total prostate volume compared to placebo in men with a relatively small prostate (less than 25 to 30 ml), as well as in those with a moderate size (30 to less than 40 ml) or enla...
- Published
- 2008
33. Systemic to Pulmonary Venous Shunt
- Author
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Robert C, Gilkeson, Eric M, Nyberg, Peter B, Sachs, Amanda M, Wiant, Amanda M, Want, Kenneth G, Zahka, Ernest S, Siwik, and Ernest S, Siwit
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Thorax ,medicine.medical_specialty ,Adolescent ,Heart Diseases ,Gadolinium ,Young Adult ,Paradoxical embolus ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Child ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Multislice computed tomography ,Middle Aged ,Magnetic Resonance Imaging ,Venous Obstruction ,Pulmonary Veins ,Child, Preschool ,Cardiology ,Venous shunt ,Female ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Multislice computed tomography technology has enabled sophisticated insights into the evaluation of collateral venous pathways in the thorax. A small but well-established body of literature has described the multiple venous pathways in patients with central venous obstruction. In unusual circumstances, however, physiologically maladaptive pathways have been described involving systemic to pulmonary venous shunts. This paper describes 21 patients with systemic to pulmonary venous shunts having a wide spectrum of etiologies. Clinical presentations typically include cardiopulmonary symptomatology and paradoxical emboli. Ultrafast magnetic resonance and multislice computed tomography established the diagnosis of this uncommon but important entity.
- Published
- 2008
34. Followup of Patients With Interstitial Cystitis Responsive to Treatment With Intravesical Bacillus Calmette-Guerin or Placebo
- Author
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Harris E. Foster, Robert J. Mayer, David Burks, Christopher K. Payne, J. Curtis Nickel, Kathleen J. Propert, Valerie Teal, John W. Kusek, Kenneth M. Peters, and Leroy M. Nyberg
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,Time Factors ,Urology ,Urinary system ,Cystitis, Interstitial ,Placebo ,Article ,Adjuvants, Immunologic ,Double-Blind Method ,Quality of life ,Internal medicine ,medicine ,Humans ,Urinary bladder ,business.industry ,Interstitial cystitis ,medicine.disease ,Surgery ,Clinical trial ,Administration, Intravesical ,Treatment Outcome ,medicine.anatomical_structure ,BCG Vaccine ,Female ,business ,BCG vaccine ,Follow-Up Studies - Abstract
We evaluated the longer term response in patients with interstitial cystitis who initially responded to intravesical bacillus Calmette-Guerin or placebo in a randomized clinical trial.Patients with interstitial cystitis who responded positively to treatment with bacillus Calmette-Guerin or placebo after 34 weeks of followup in a double-blind clinical trial were followed for an additional 34 weeks in an observational study to assess response durability. Outcomes at 68 weeks included a patient reported global response assessment, 24-hour voiding diary, and pain, urgency and validated interstitial cystitis symptom indexes.Of responders to bacillus Calmette-Guerin or placebo in the clinical trial 38 continued extended followup in the observational study. A total of 12 (75%) responders who received placebo and 19 (86%) who received bacillus Calmette-Guerin considered themselves to remain moderately or markedly improved at week 68. Improved symptom outcomes were also generally maintained during followup in the 2 groups.Most patients who respond to therapy with intravesical bacillus Calmette-Guerin or placebo maintain improved symptoms for up to 68 weeks after the initiation of therapy. However, initial response rates are low and placebo responders demonstrated essentially the same durability of response as bacillus Calmette-Guerin responders. These results argue against the routine use of bacillus Calmette-Guerin in this patient group.
- Published
- 2008
35. Prospective evaluation of candidate urine and cell markers in patients with interstitial cystitis enrolled in a randomized clinical trial of Bacillus Calmette Guerin (BCG)
- Author
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Christopher K. Payne, Kathleen J. Propert, Jay E. Reeder, Lee M. Nyberg, John W. Kusek, Kenneth M. Peters, David Grkovic, Yawei Zhang, Chen-Ou Zhang, Kristopher R. Koch, and Susan Keay
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Urology ,Urinary Bladder ,Cystitis, Interstitial ,Urine ,Placebo ,Gastroenterology ,law.invention ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Multicenter trial ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,business.industry ,Interstitial cystitis ,Epithelial Cells ,Middle Aged ,medicine.disease ,Mycobacterium bovis ,Administration, Intravesical ,Immunology ,Biomarker (medicine) ,Female ,business ,Biomarkers - Abstract
We measured candidate urine biomarkers and bladder cell DNA cytometry in interstitial cystitis (IC) patients randomized to receive intravesical Bacillus Calmette Guerin (BCG) or placebo in a multicenter trial. Participants received 6 weekly instillations and were followed for 34 weeks. Urine was collected at baseline, prior to fourth treatment, and at study end. Antiproliferative factor (APF) activity was determined by 3H-thymidine incorporation assay; heparin-binding epidermal growth factor-like growth factor (HB-EGF) and epidermal growth factor-like growth factor (EGF) levels were determined by ELISA. Cellular DNA content was measured by image analysis to determine the mean hyperdiploid fraction (HDF) of the urine cell pellet. Associations between marker levels, and treatment or symptoms, were examined. Baseline APF positivity rate and mean levels of the other biomarkers were similar to previous smaller studies. During the week 34 follow-up, mean HDF decreased (P = 0.0003) and HB-EGF increased (P < 0.0001); both correlated weakly with decreased urgency. There was no difference in any biomarker between symptom responders and non-responders, but the percentage of responders was low and not significantly different for BCG versus placebo. APF positivity, decreased HB-EGF, increased EGF, and increased HDF were confirmed at baseline in IC patients. Changes in HDF and HB-EGF levels correlated weakly with changes in urgency, but the low BCG response rate prevented identification of additional associations between biomarker changes and treatment or symptoms.
- Published
- 2007
36. Isotonic saline in elderly men: an open-labelled controlled infusion study of electrolyte balance, urine flow and kidney function
- Author
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Claes R. Nyman, J. Rosvall, Robert G. Hahn, M. Nyberg Isacson, and Tim Fagerström
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Bicarbonate ,Sodium ,Renal function ,chemistry.chemical_element ,Sodium Chloride ,Kidney ,Kidney Function Tests ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,030202 anesthesiology ,medicine ,Humans ,Infusions, Intravenous ,Saline ,Aged ,Aged, 80 and over ,Creatinine ,Cross-Over Studies ,business.industry ,030208 emergency & critical care medicine ,Metabolic acidosis ,Water-Electrolyte Balance ,medicine.disease ,Crossover study ,Surgery ,Anesthesiology and Pain Medicine ,chemistry ,Anesthesia ,Isotonic Solutions ,business - Abstract
Isotonic saline is a widely-used infusion fluid, although the associated chloride load may cause metabolic acidosis and impair kidney function in young, healthy volunteers. We wished to examine whether these effects also occurred in the elderly, and conducted a crossover study in 13 men with a mean age of 73 years (range 66-84), who each received intravenous infusions of 1.5 l of Ringer's acetate and of isotonic saline. Isotonic saline induced mild changes in plasma sodium (mean +1.5 mmol.l(-1) ), plasma chloride (+3 mmol.l(-1) ) and standard bicarbonate (-2 mmol.l(-1) ). Three hours after starting the infusions, 68% of the Ringer's acetate and 30% of the infused saline had been excreted (p0.01). The glomerular filtration rate increased in response to both fluids, but more after the Ringer's acetate (p0.03). Pre-infusion fluid retention, as evidenced by high urinary osmolality (700 mOsmol.kg(-1) ) and/or creatinine (7 mmol.l(-1) ), was a strong factor governing the responses to both fluid loads.
- Published
- 2015
37. EERC Center for Biomass Utilization 2008-2010. Phases I-III
- Author
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Paul Pansegrau, Bruce C. Folkedahl, Josua R. Strege, John P. Hurley, Michael L. Swanson, Ted R. Auich, Carolyn M. Nyberg, Edwin S. Olson, Christopher J. Zygarlicke, Nikhil Patel, Christopher Martin, Chad A. Wocken, Benjamin Oster, and Joshua Stanislowski
- Subjects
Engineering ,Energy development ,Waste management ,business.industry ,Biofuel ,Alternative energy ,Environmental impact of the energy industry ,Energy statistics ,Renewable fuels ,business ,Efficient energy use ,Renewable energy - Abstract
The U.S. Department of Energy (DOE) Energy Information Administration (EIA) projects nonhydro renewable electric energy increases of 140% and liquid transportation biofuels growing by 32,200 barrels a day between 2012 and 2040 (U.S. Energy Information Administration, 2014). This is the EIA base case scenario, and this outlook could be a low estimate depending on the many assumptions involved in making such projections, not the least of which are climate change and the resultant legislation. The climate change postulate is based on increasing levels of CO2 being introduced into the atmosphere through anthropogenic activity such as fossil fuel combustion for energy use. Renewable energy, and biomass conversion to energy in particular, is a net-zero CO2 emission generator. When biomass is converted to energy, it emits CO2; however, this CO2 is balanced in a cycle where the production of biomass removes CO2 from the atmosphere for growth and then releases it back into the atmosphere to be taken up by new growth of biomass feedstocks for energy. In comparison, fossil fuels are examples of CO2 that has been removed from the atmosphere and sequestered and which, when converted to energy, is a new addition to the atmospheric levels of CO2, which has more » been linked to climate change. While recent advances in technology used for extracting oil and gas from tight formations have increased the availability of fossil fuels for energy, the end game needs to focus on providing sustainable energy sources for the United States as well as the world. If, in the future, legislation is enacted that places a fee on atmospheric CO2 emissions, this may make the use of biomass for energy more economically attractive, increasing its use. Research that focuses on the future sustainability of energy production is part of the answer to bringing about game-changing technologies that can provide energy in a timely, reliable, sustainable fashion. « less
- Published
- 2015
38. Performance Improvement
- Author
-
Gina M. Berg and Sue M. Nyberg
- Published
- 2015
39. Catastrophizing and Pain-Contingent Rest Predict Patient Adjustment in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome
- Author
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Mark S. Litwin, Dean A. Tripp, Richard B. Alexander, J. Curtis Nickel, Leroy M. Nyberg, Mary McNaughton-Collins, Michel A. Pontari, Yanlin Wang, Michael P. O'Leary, Jackson E. Fowler, John W. Kusek, Anthony J. Schaeffer, and J. Richard Landis
- Subjects
Adult ,Male ,Biopsychosocial model ,Canada ,medicine.medical_specialty ,Rest ,Prostatitis ,Learned helplessness ,Anger ,Pelvic Pain ,Cohort Studies ,Disability Evaluation ,Social support ,Chronic prostatitis/chronic pelvic pain syndrome ,Surveys and Questionnaires ,Adaptation, Psychological ,medicine ,Humans ,Depression (differential diagnoses) ,Depressive Disorder ,Physician-Patient Relations ,business.industry ,Chronic pain ,Social Support ,Middle Aged ,Urination Disorders ,medicine.disease ,United States ,Anesthesiology and Pain Medicine ,Neurology ,Chronic Disease ,Quality of Life ,Physical therapy ,Pain catastrophizing ,Neurology (clinical) ,business ,Stress, Psychological - Abstract
Cognitive/behavioral and environmental variables are significant predictors of patient adjustment in chronic pain. Using a biopsychosocial template and selecting several pain-relevant constructs from physical, cognitive/behavioral, and environmental predictors, outcomes of pain and disability in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were explored. Men (n = 253) from a North American multi-institutional NIH-funded Chronic Prostatitis Cohort Study in 6 US and 1 Canadian centers participated in a survey examining pain and disability. Measures included demographics, urinary symptoms, depression, pain, disability, catastrophizing, control over pain, pain-contingent rest, social support, and solicitous responses from a significant other. Regressions showed that urinary symptoms (beta = .20), depression (beta = .24), and helplessness catastrophizing (beta = .29) predicted overall pain. Further, affective pain was predicted by depression (beta = .39) and helplessness catastrophizing (beta = .44), whereas sensory pain was predicted by urinary symptoms (beta = .25) and helplessness catastrophizing (beta = .37). With regard to disability, urinary symptoms (beta = .17), pain (beta = .21), and pain-contingent rest (beta = .33) were the predictors. These results suggest cognitive/behavioral variables (ie, catastrophizing, pain-contingent rest) may have significant impact on patient adjustment in CP/CPPS. Findings support the need for greater research of such pain-related variables in CP/CPPS.This article explores predictors of patient adjustment in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Cognitive/behavioral variables of catastrophizing and pain-contingent rest respectively predicted greater pain and disability. Catastrophic helplessness was a prominent pain predictor. These findings inform clinicians and researchers on several new variables in CP/CPPS outcomes and suggest future research.
- Published
- 2006
40. Prevalence and Risk Factors for Urinary Incontinence in Women With Type 2 Diabetes and Impaired Fasting Glucose
- Author
-
Feng Lin, John W. Kusek, Leroy M. Nyberg, Alka M. Kanaya, Eric Vittinghoff, and Jeanette S. Brown
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Stress incontinence ,National Health and Nutrition Examination Survey ,business.industry ,Endocrinology, Diabetes and Metabolism ,Urinary incontinence ,Type 2 diabetes ,medicine.disease ,Impaired fasting glucose ,Surgery ,Impaired glucose tolerance ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,medicine.symptom ,Risk factor ,business - Abstract
OBJECTIVE—Diabetes is associated with increased risk of urinary incontinence. It is unknown whether women with pre-diabetes, or impaired fasting glucose (IFG), have increased prevalence of incontinence. We determined the prevalence of, and risk factors for, incontinence among U.S. women with diabetes and IFG. RESEARCH DESIGN AND METHODS—The 2001–2002 National Health and Nutrition Examination Survey measured fasting plasma glucose and obtained information about diabetes and urinary incontinence among 1,461 nonpregnant adult women. Self-reported weekly or more frequent incontinence, both overall and by type (urge and stress), was our outcome. RESULTS—Of the 1,461 women, 17% had diabetes and 11% met criteria for IFG. Prevalence of weekly incontinence was similar among women in these two groups (35.4 and 33.4%, respectively) and significantly higher than among women with normal fasting glucose (16.8%); both urge and stress incontinence were increased. In addition to well-recognized risk factors including age, weight, and oral estrogen use, two microvascular complications caused by diabetes, specifically macroalbuminuria and peripheral neuropathic pain, were associated with incontinence. CONCLUSIONS—Physicians should be alert for incontinence, an often unrecognized and therefore undertreated disorder, among women with diabetes and IFG, in particular those with microvascular complications. The additional prospect of improvements in their incontinence may help motivate some high-risk women to undertake difficult lifestyle changes to reduce their more serious risk of diabetes and its sequelae.
- Published
- 2006
41. Bonding in metal–carbonyls: A comparison with experiment and calculations on adsorbed CO
- Author
-
Alexander Föhlisch, M. Nyberg, L. Triguero, Lars G. M. Pettersson, Anders Nilsson, and Arianna Bassan
- Subjects
Ligand field theory ,Chemistry ,Molecular orbital diagram ,Molecular orbital theory ,Condensed Matter Physics ,Biochemistry ,Chemical bond ,Non-bonding orbital ,Computational chemistry ,Chemical physics ,Molecular orbital ,Valence bond theory ,Physical and Theoretical Chemistry ,Natural bond orbital - Abstract
The general aspects of CO bonding in carbonyls and on metal surfaces are discussed in terms of a molecular orbital description, based on calculations and direct experimental measurements. In particular, the excellent agreement between experiment and theory for CO adsorbed on Ni(100) is the starting point to derive in the same theoretical approach the orbital-based electronic structure of the carbonyls Ni(CO) 4 , Fe(CO) 5 , Cr(CO) 6 and CO coordinated to the heme group. A frontier orbital interaction scheme involving only the 2π* and the 5σ orbitals is shown to be inadequate for the description of the electronic structure; all orbitals change due to the interaction. Instead, we demonstrate how the formation of an allylic configuration in the π-system, involving both the 1π and 2π* orbitals, gives a more complete description of the π electronic structure. The rearrangement of the σ orbitals involves mainly mixing of occupied CO and metal orbitals resulting in Pauli repulsion. The latter is minimized by polarization of charge away from the CO–Me bond. The bonding picture for CO in organometallic systems is very similar to the surface adsorption case; the main idea of repulsive σ and bonding π interactions seems generally valid when CO interacts with metals.
- Published
- 2006
42. Lifestyle Intervention Is Associated With Lower Prevalence of Urinary Incontinence
- Author
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Yong Ma, Eric Vittinghoff, Leroy M. Nyberg, J S. Brown, Trevor J. Orchard, John W. Kusek, Alka M. Kanaya, Rena R. Wing, and Elizabeth Barrett-Connor
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Stress incontinence ,business.industry ,Endocrinology, Diabetes and Metabolism ,Urinary incontinence ,Overweight ,medicine.disease ,Placebo ,Surgery ,law.invention ,Randomized controlled trial ,law ,Weight loss ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Lifestyle Therapy ,medicine.symptom ,business - Abstract
OBJECTIVE—Diabetes is associated with increased urinary incontinence risk. Weight loss improves incontinence, but exercise may worsen this condition. We examined whether an intensive lifestyle intervention or metformin therapy among overweight pre-diabetic women was associated with a lower prevalence of incontinence. RESEARCH DESIGN AND METHODS—We analyzed data from the Diabetes Prevention Program, a randomized controlled trial in 27 U.S. centers. Of the 1,957 women included in this analysis, 660 (34%) were randomized to intensive lifestyle therapy, 636 (32%) to metformin, and 661 (34%) to placebo with standard lifestyle advice. The main outcome measure was incontinence symptoms by frequency and type by a validated questionnaire completed at the end-of-trial visit (mean 2.9 years). RESULTS—The prevalence of total (stress or urge) weekly incontinence was lower among women in the intensive lifestyle group (38.3%) than those randomized to metformin (48.1%) or placebo (45.7%). This difference was most apparent among women with stress incontinence (31.3% for intensive lifestyle group vs. 39.7% for metformin vs. 36.7% for placebo, P = 0.006). Changes in weight accounted for most of the protective effect of the intensive lifestyle intervention on stress incontinence. CONCLUSIONS—Less-frequent urinary incontinence may be a powerful motivator for women to choose lifestyle modification to prevent diabetes.
- Published
- 2006
43. A RANDOMIZED CONTROLLED TRIAL OF INTRAVESICAL BACILLUS CALMETTE-GUERIN FOR TREATMENT REFRACTORY INTERSTITIAL CYSTITIS
- Author
-
J. Richard Landis, Edward M. Messing, John W. Kusek, John B. Warren, Leroy M. Nyberg, Ananias C. Diokno, Alan J. Wein, Rosemary Madigan, Christopher K. Payne, Harris E. Foster, J. Curtis Nickel, Robert J. Mayer, Kathleen J. Propert, David Burks, Philip M. Hanno, Yawei Zhang, Grannum R. Sant, Kenneth M. Peters, and Daniel J. Culkin
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,Urology ,Urinary Bladder ,Cystitis, Interstitial ,Pain ,Urination ,Placebo ,law.invention ,Placebos ,Double-Blind Method ,Randomized controlled trial ,Refractory ,law ,Internal medicine ,Humans ,Medicine ,Urinary bladder ,business.industry ,Remission Induction ,Interstitial cystitis ,Middle Aged ,medicine.disease ,Surgery ,Clinical trial ,Administration, Intravesical ,Treatment Outcome ,medicine.anatomical_structure ,Chronic Disease ,BCG Vaccine ,Female ,Safety ,business ,BCG vaccine ,Follow-Up Studies - Abstract
We compared intravesical bacillus Calmette-Guerin (BCG) to placebo instillations in patients with treatment refractory interstitial cystitis (IC).Subjects who met the National Institutes of Health-National Institute for Diabetes and Digestive and Kidney Diseases criteria for IC, and reported at least moderate pain and frequency for a minimum of 6 months before study entry, were randomized to 6 weekly double-blinded intravesical instillations of either BCG or placebo, and then followed for a total of 34 weeks. The primary outcome was a patient reported global response assessment at week 34, supplemented with medications for IC during weeks 31 to 34. Secondary outcomes included a 24-hour voiding diary, pain, urgency, validated IC symptom indexes and adverse events. The target sample size was 260 participants, designed to detect a difference in response rates between placebo and BCG of 30% and 50%, respectively.A total of 265 participants were randomized and 17 (6%) patients withdrew from study. The response rates for the primary outcome were 12% for placebo and 21% for BCG (p = 0.062). Small improvements were observed for all secondary outcomes, some more so with BCG, but these differences were of borderline statistical significance. Although a large number of adverse events were reported in the BCG arm, there was no statistically significant difference between the treatment arms in overall adverse event rates.Although the BCG safety profile was acceptable, the response rate for the primary outcome was low. Effective medical treatment for patients with moderate to severe interstitial cystitis remains elusive.
- Published
- 2005
44. Nickel and Sulfur Speciation of Residual Oil Fly Ashes from Two Electric Utility Steam-Generating Units
- Author
-
Richard L. Schulz, Frank E. Huggins, Kevin C. Galbreath, Edward J. Zillioux, Donald L. Toman, Carolyn M. Nyberg, and Gerald P. Huffman
- Subjects
Analytical chemistry ,Residual oil ,chemistry.chemical_element ,Management, Monitoring, Policy and Law ,Coal Ash ,Risk Assessment ,Electricity ,Nickel ,Air Pollution ,Neoplasms ,Humans ,Spectroscopy ,Waste Management and Disposal ,Inhalation Exposure ,Waste management ,Extraction (chemistry) ,Sulfur ,Carbon ,X-ray absorption fine structure ,chemistry ,Fly ash ,Irritants ,Particulate Matter ,Heat of combustion ,Environmental Monitoring - Abstract
Representative duplicate fly ash samples were obtained from the stacks of 400- and 385-MW utility boilers (Unit A and Unit B, respectively) using a modified U.S. Environmental Protection Agency (EPA) Method 17 sampling train assembly as they burned 0.9 and 0.3 wt % S residual (No. 6 fuel) oils, respectively, during routine power plant operations. Residual oil fly ash (ROFA) samples were analyzed for Ni concentrations and speciation using inductively coupled plasma-atomic emission spectroscopy, X-ray absorption fine structure (XAFS) spectroscopy, and X-ray diffraction (XRD). ROFA deionized H2O extraction residues were also analyzed for Ni speciation using XAFS and XRD. Total Ni concentrations in the ROFAs were similar, ranging from 1.3-1.5 wt%; however, stack gas Ni concentrations in the Unit A were 0.990 microg/Nm3 compared with 0.620 microg/Nm3 for Unit B because of the greater residual oil feed rates employed at Unit A to attain higher 400-MW load conditions with a lower heating value oil. Ni speciation analysis results indicated that ROFAs from Unit A contain approximately 3 wt % NiSO4 x xH2O (where x is assumed to be 6 for calculation purposes) and appoximately 4.5 wt% of a Ni-containing spinel compound, similar in composition to (Mg,Ni)(Al,Fe)2O4. ROFAs from Unit B contain on average 2 wt% NiSO4 x 6 H20 and 1.1 wt% NiO. XAFS and XRD analyses did not detect any nickel sulfide compounds, including carcinogenic nickel subsulfide (Ni3S2) (XAFS detection limit is 5% of the total Ni concentration). In addition, XAFS measurements indicated that inorganic sulfate and organic thiophene species accounted for97% of the total S in the ROFAs. Unit A ROFAs contained much lower thiophene proportions because cyclone-separated ROFA reinjection is employed on this unit to collect and reburn the larger carbonaceous particles.
- Published
- 2005
45. Surface structure of thin ice films
- Author
-
Hirohito Ogasawara, Anders Nilsson, Dennis Nordlund, Lars G. M. Pettersson, M. Nyberg, Michael Odelius, and Ph. Wernet
- Subjects
Surface (mathematics) ,Materials science ,Absorption spectroscopy ,Analytical chemistry ,General Physics and Astronomy ,Surface structure ,Physical and Theoretical Chemistry - Abstract
An angular dependent X-ray absorption spectroscopy study of the surface of thin ice films grown on Pt(1 1 1) is presented. Using different probing depths together with spectral calculations based o ...
- Published
- 2004
46. Ethylene on Cu( 110 ) and Ni( 110 ): electronic structure and bonding derived from X-ray spectroscopy and theory
- Author
-
Henrik Öström, M. Nyberg, Lars G. M. Pettersson, Anders Nilsson, Alexander Föhlisch, Martin Weinelt, and Clemens Heske
- Subjects
Valence (chemistry) ,Chemistry ,Surfaces and Interfaces ,Electronic structure ,Condensed Matter Physics ,Surfaces, Coatings and Films ,Crystallography ,Atomic orbital ,Excited state ,Materials Chemistry ,Density of states ,Density functional theory ,Atomic physics ,Triplet state ,Surface states - Abstract
The bonding of ethylene to Cu(1 1 0) and Ni(1 1 0) is analyzed in detail using symmetry-resolved X-ray absorption (XAS) and emission (XES) spectroscopies in conjunction with density functional theory (DFT) calculations of geometric structure and spectra. XES, which probes the occupied valence states, reveals the formation of bonding and non-bonding orbitals of π-3d as well as π ∗ -3d character. Additional mixing of σ and π states indicates rehybridization upon adsorption. The anti-bonding π-3d and π ∗ -3d combinations are unoccupied and seen in XAS. A lower intensity of the π ∗ transition for Ni is evidence of larger π ∗ occupancy upon bonding. The position of the σ ∗ shape-resonance indicates a 0.02 A longer C–C bond on Ni than on Cu, in good agreement with the DFT structure optimizations. The XE spectra are well-reproduced both by specific spectrum calculations based on cluster models and by the carbon p-density of states calculated using periodic boundary conditions. The contribution of both π and π ∗ levels to the new, surface-induced occupied states close to the Fermi-level lends support to the traditional Dewar–Chatt–Duncanson picture of the bonding. Theoretical charge-density difference plots support an alternative view of ethylene bonding in terms of the specific involvement of the excited molecular triplet state. Based on the variation in XE intensities the main difference between ethylene bonding to Cu and Ni is found to be an about two times larger occupancy of the π ∗ orbital upon chemisorption on the transition metal, which comes along with C–C bond elongation and stronger σ–π rehybridization.
- Published
- 2004
47. Hydrodesulfurization reaction pathways on MoS2 nanoclusters revealed by scanning tunneling microscopy
- Author
-
Jeppe V. Lauritsen, H. Topsøe, Clausen Bjerne Steffen, Erik Lægsgaard, Jens K. Nørskov, M. Nyberg, and Flemming Besenbacher
- Subjects
Steric effects ,Chemistry ,Stacking ,Catalysis ,Nanoclusters ,law.invention ,chemistry.chemical_compound ,Crystallography ,law ,Thiophene ,Organic chemistry ,Molecule ,Physical and Theoretical Chemistry ,Scanning tunneling microscope ,Hydrodesulfurization - Abstract
Single-layer MoS2 nanoclusters were synthesized on a Au substrate as a model system for the hydrotreating catalyst and studied by atomically resolved scanning tunneling microscopy (STM) in order to achieve atomic-scale insight into the interactions with hydrogen and thiophene (C4H4S). Surprisingly, STM images show that thiophene molecules can adsorb and react on the fully sulfided edges of triangular single-layer MoS2 nanoclusters. We associate this unusual behavior with the presence of special brim sites exhibiting a metallic character. The STM images reveal that these sites exist only at the regions immediately adjacent to the edges of the MoS2 nanoclusters, and from density-functional theory such sites are found to be associated with one-dimensional electronic edge states. The fully sulfur-saturated sites are from STM images found to be capable of adsorbing thiophene, and when thiophene and hydrogen reactants are coadsorbed here, a reaction path is revealed which leads to partial hydrogenation of the thiophene followed by CS bond activation and ring opening of thiophene molecules. This may be regarded as important first steps in the hydrodesulfurization of thiophene. The metallic brim sites are suggested to be important for other hydrotreating reactions over MoS2-based catalysts, and the properties of the brim sites directly explain why hydrogenation reactions of aromatics are not severely inhibited by H2S. The presence of brim sites in MoS2 nanoclusters also explains previous structure–activity relations and observations regarding steric effects and the influence of stacking of MoS2 on the reactivity and selectivity.
- Published
- 2004
48. The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia
- Author
-
Michael M. Lieber, John W. Kusek, Douglas F. Milam, Kevin M. Slawin, Karl J. Kreder, Ananias C. Diokno, Steven A. Kaplan, Oliver Bautista, E. David Crawford, Joe W. Ramsdell, Herbert Lepor, M. Scott Lucia, Mani Menon, Harris E. Foster, John D. McConnell, Gerald L. Andriole, Stephen C. Jacobs, Joseph A. Smith, Harry Clarke, Leroy M. Nyberg, Kevin T. McVary, Christopher M. Dixon, Claus G. Roehrborn, John P. Foley, Noah S. Schenkman, and Gary J. Miller
- Subjects
Male ,medicine.medical_specialty ,Combination therapy ,medicine.drug_class ,Prostatic Hyperplasia ,Urology ,Antiandrogen ,Severity of Illness Index ,chemistry.chemical_compound ,5-alpha Reductase Inhibitors ,Double-Blind Method ,American Urological Association Symptom Score ,medicine ,Doxazosin ,Humans ,Enzyme Inhibitors ,Alfuzosin ,Adrenergic alpha-Antagonists ,Analysis of Variance ,business.industry ,Urinary retention ,Finasteride ,General Medicine ,Middle Aged ,Dutasteride ,Surgery ,chemistry ,Disease Progression ,Drug Therapy, Combination ,medicine.symptom ,business ,medicine.drug - Abstract
background Benign prostatic hyperplasia is commonly treated with alpha-adrenergic–receptor antagonists (alpha-blockers) or 5 a -reductase inhibitors. The long-term effect of these drugs, singly or combined, on the risk of clinical progression is unknown. methods We conducted a long-term, double-blind trial (mean follow-up, 4.5 years) involving 3047 men to compare the effects of placebo, doxazosin, finasteride, and combination therapy on measures of the clinical progression of benign prostatic hyperplasia. results The risk of overall clinical progression — defined as an increase above base line of at least 4 points in the American Urological Association symptom score, acute urinary retention, urinary incontinence, renal insufficiency, or recurrent urinary tract infection — was significantly reduced by doxazosin (39 percent risk reduction, P
- Published
- 2003
49. Hydrogen bonding between adsorbed deprotonated glycine molecules on Cu(110)
- Author
-
Lars G. M. Pettersson, M. Nyberg, Anders Nilsson, and Michael Odelius
- Subjects
Crystallography ,Deprotonation ,Chemical bond ,Absorption spectroscopy ,Hydrogen ,Hydrogen bond ,Chemistry ,Intermolecular force ,General Physics and Astronomy ,Molecule ,chemistry.chemical_element ,Physical and Theoretical Chemistry ,Spectroscopy - Abstract
We present new theoretical results indicating the formation of intermolecular hydrogen bonds (H-bonds) between deprotonated glycine molecules (glycinate) on a Cu(110) surface. It is shown that these hydrogen bonds can be probed through the use of x-ray absorption spectroscopy, with surprisingly large effects in the electronic structure. We propose that the (3×2)pg LEED pattern observed for the most stable species of glycinate on the surface is explained by the formation of more than one hydrogen bond per molecule.
- Published
- 2003
50. Ochratoxin A in raisins and currants: basic extraction procedure used in two small marketing surveys of the occurrence and control of the heterogeneity of the toxins in samples
- Author
-
M. Nyberg and T. E. Möller
- Subjects
Ochratoxin A ,European community ,Health, Toxicology and Mutagenesis ,Extraction (chemistry) ,Public Health, Environmental and Occupational Health ,Food Contamination ,General Chemistry ,Mycotoxins ,Toxicology ,Ochratoxins ,chemistry.chemical_compound ,chemistry ,Chemistry (miscellaneous) ,Carcinogens ,Vitis ,Marketing ,Mycotoxin ,Ochratoxin ,Chromatography, High Pressure Liquid ,Food Science ,Mathematics - Abstract
A basic extraction procedure for analysis of ochratoxin A (OTA) in currants and raisins is described, as well as the occurrence of OTA and a control of heterogeneity of the toxin in samples bought for two small marketing surveys 1999/2000 and 2001/02. Most samples in the surveys were divided into two subsamples that were individually prepared as slurries and analysed separately. The limit of quantification for the method was estimated as 0.1 microg kg(-1) and recoveries of 85, 90 and 115% were achieved in recovery experiments at 10, 5 and 0.1 microg kg(-1), respectively. Of all 118 subsamples analysed in the surveys, 96 (84%) contained ochratoxin A at levels above the quantification level and five samples (4%) contained more than the European Community legislation of 10 microg kg(-1). The OTA concentrations found in the first survey were in the range0.1-19.0 microg kg(-1) with a median concentration of 0.9 microg kg(-1). In the 2001/02 study, the range was0.1-34.6 microg kg(-1) with a median of 0.2 microg kg(-1). Big differences were often achieved between individual subsamples of the original sample, which indicate a wide heterogeneous distribution of the toxin. Data from the repeatability test as well as recovery experiments from the same slurries showed that preparation of slurries as described here seemed to give a homogeneous and representative sample. The extraction with the basic sodium bicarbonate-methanol mixture used in the surveys gave similar or somewhat higher OTA values on some samples tested in a comparison with a weak phosphoric acid water-methanol extraction mixture.
- Published
- 2003
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