The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, Jan 4, 2017
To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among ... more To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC). Prospective multicenter longitudinal study (2011-2015). 9 EDs across the United States. Adults aged 65 years and older who presented to an ED after MVC without severe injuries. PTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised. Of 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), pred...
Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults... more Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain. We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a…
Transforming growth factor a (TGF-a) is produced by many trans formed cells, but little is known ... more Transforming growth factor a (TGF-a) is produced by many trans formed cells, but little is known about the regulation of its expression. We examined TGF-a mRNA levels in a set of cloned neoplastic cell lines derived by chemical transformation of a normal rat liver epithelial cell. The untransformed parental cell line, WB-344, did not express a detect able level of
Motor vehicle crashes are the second most common form of trauma among older adults. We seek to de... more Motor vehicle crashes are the second most common form of trauma among older adults. We seek to describe the incidence, risk factors, and consequences of persistent pain among older adults evaluated in the emergency department (ED) after a motor vehicle crash. We conducted a prospective longitudinal study of patients aged 65 years or older who presented to one of 8 EDs after motor vehicle crash between June 2011 and June 2014 and were discharged home after evaluation. ED evaluation was done through in-person interview; follow-up data were obtained through mail-in survey or telephone call. Pain severity (0 to 10 scale) overall and for 15 parts of the body were assessed at each follow-up point. Principal component analysis was used to assess the dimensionality of the locations of pain data. Participants reporting pain severity greater than or equal to 4 attributed to the motor vehicle crash at 6 months were defined as having persistent pain. Of the 161 participants, 72% reported modera...
We examine the performance of high-speed non-directed infrared links using pulse-position modulat... more We examine the performance of high-speed non-directed infrared links using pulse-position modulation (PPM) with trellis-coded modulation (TCM) to mitigate the effects of multipath-induced intersymbol interference (ISI) on such links. Using the measured characteristics of multipath indoor infrared channels, we calculate BER curves and ISI power penalties for maximum-likelihood sequence detection of 8-PPM links using rate-2/3 trellis codes operating at 10
We have previously reported on the performance of Multilevel ML technology on a wide variety of s... more We have previously reported on the performance of Multilevel ML technology on a wide variety of systems including CD-, DVD-, and blue-based systems. ML technology enables increased capacity and performance over traditional binary-modulation systems. Implementing this technology requires the addition of a single integrated circuit or IC core to the standard electronics of current drives, so manufacturers can provide ML
Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment, 2005
The fast liquid–liquid extraction system SISAK with continuous liquid scintillation detection was... more The fast liquid–liquid extraction system SISAK with continuous liquid scintillation detection was coupled to the Berkeley Gas-filled Separator to enable studies of the chemical properties of α-decaying transactinide elements. The preseparated transactinide 257Rf (4.7s), was transported via a He/KCl-jet directly into the scintillation solution. This permitted the first unambiguous detection of transactinide atoms by the means of the α-liquid scintillation
Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder... more Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.
Routine ultrasonography revealed a large, complex renal mass in a 39-year-old pregnant woman. An ... more Routine ultrasonography revealed a large, complex renal mass in a 39-year-old pregnant woman. An MRI confirmed a 14.5 x 12 x 17 cm complex renal mass, and laparoscopic nephrectomy was chosen as the management option. During the mid-second trimester, a right laparoscopic nephrectomy was performed. The pathology report noted clear-cell carcinoma with negative margins. The child, delivered without incident, is now more than 2 years old and is developmentally normal. A review of laparoscopy in pregnancy is also presented.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, Jan 4, 2017
To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among ... more To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC). Prospective multicenter longitudinal study (2011-2015). 9 EDs across the United States. Adults aged 65 years and older who presented to an ED after MVC without severe injuries. PTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised. Of 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), pred...
Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults... more Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain. We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a…
Transforming growth factor a (TGF-a) is produced by many trans formed cells, but little is known ... more Transforming growth factor a (TGF-a) is produced by many trans formed cells, but little is known about the regulation of its expression. We examined TGF-a mRNA levels in a set of cloned neoplastic cell lines derived by chemical transformation of a normal rat liver epithelial cell. The untransformed parental cell line, WB-344, did not express a detect able level of
Motor vehicle crashes are the second most common form of trauma among older adults. We seek to de... more Motor vehicle crashes are the second most common form of trauma among older adults. We seek to describe the incidence, risk factors, and consequences of persistent pain among older adults evaluated in the emergency department (ED) after a motor vehicle crash. We conducted a prospective longitudinal study of patients aged 65 years or older who presented to one of 8 EDs after motor vehicle crash between June 2011 and June 2014 and were discharged home after evaluation. ED evaluation was done through in-person interview; follow-up data were obtained through mail-in survey or telephone call. Pain severity (0 to 10 scale) overall and for 15 parts of the body were assessed at each follow-up point. Principal component analysis was used to assess the dimensionality of the locations of pain data. Participants reporting pain severity greater than or equal to 4 attributed to the motor vehicle crash at 6 months were defined as having persistent pain. Of the 161 participants, 72% reported modera...
We examine the performance of high-speed non-directed infrared links using pulse-position modulat... more We examine the performance of high-speed non-directed infrared links using pulse-position modulation (PPM) with trellis-coded modulation (TCM) to mitigate the effects of multipath-induced intersymbol interference (ISI) on such links. Using the measured characteristics of multipath indoor infrared channels, we calculate BER curves and ISI power penalties for maximum-likelihood sequence detection of 8-PPM links using rate-2/3 trellis codes operating at 10
We have previously reported on the performance of Multilevel ML technology on a wide variety of s... more We have previously reported on the performance of Multilevel ML technology on a wide variety of systems including CD-, DVD-, and blue-based systems. ML technology enables increased capacity and performance over traditional binary-modulation systems. Implementing this technology requires the addition of a single integrated circuit or IC core to the standard electronics of current drives, so manufacturers can provide ML
Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment, 2005
The fast liquid–liquid extraction system SISAK with continuous liquid scintillation detection was... more The fast liquid–liquid extraction system SISAK with continuous liquid scintillation detection was coupled to the Berkeley Gas-filled Separator to enable studies of the chemical properties of α-decaying transactinide elements. The preseparated transactinide 257Rf (4.7s), was transported via a He/KCl-jet directly into the scintillation solution. This permitted the first unambiguous detection of transactinide atoms by the means of the α-liquid scintillation
Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder... more Surgical stapling devices are often used to secure the distal ureter along with a cuff of bladder during laparoscopic nephroureterectomy. As the viability of cells within the stapled tissue would be important in patients with upper urinary-tract transitional-cell carcinoma, we determined the viability of cells within the lines of various commercially available staplers in a porcine model. Four laparoscopic stapling devices were used: two vascular and two tissue designs (US Surgical, Norwalk, CT, and Ethicon, Cincinnati, OH). The devices were deployed across a portion of the bladder, much as they would be during a nephroureterectomy to create a bladder cuff while excising the distal ureter. The animals were sacrificed 6 weeks later, and the stapled sites were harvested for histopathologic examination by an experienced genitourinary pathologist (PH). Grossly, there were no visible staples at harvest of the stapled bladder and the ureterovesical junction, with a completely healed bladder being seen in all four animals. On histologic examination with hematoxylin and eosin staining, there were distinctly viable cells within the staple lines of the ureterovesical junction and the bladder wall, similar to the unstapled control tissue. There were viable cells in all samples of tissues stapled by either vascular or tissue staplers. Deployment of both vascular and tissue staplers resulted in viable cells within the staple lines at the ureterovesical junction and bladder wall in this porcine model. There is a potential risk of tumor recurrence at the stapled site in patients who have the ureter and bladder cuff secured with these devices during laparoscopic nephroureterectomy for upper-tract transitional-cell carcinoma. Despite this concern, to date, over a period of 13 years, clinical experience has not revealed a single case of tumor recurrence within the stapled cuff of bladder. Careful endoscopic evaluation of the stapled bladder-cuff site after laparoscopic nephroureterectomy should minimize the potential for local tumor recurrence.
Routine ultrasonography revealed a large, complex renal mass in a 39-year-old pregnant woman. An ... more Routine ultrasonography revealed a large, complex renal mass in a 39-year-old pregnant woman. An MRI confirmed a 14.5 x 12 x 17 cm complex renal mass, and laparoscopic nephrectomy was chosen as the management option. During the mid-second trimester, a right laparoscopic nephrectomy was performed. The pathology report noted clear-cell carcinoma with negative margins. The child, delivered without incident, is now more than 2 years old and is developmentally normal. A review of laparoscopy in pregnancy is also presented.
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