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This study examined the influence of patient attributes and provider or organizational factors on the decision to apply targeted temperature management (TTM) to resuscitated out-of-hospital cardiac arrest (OHCA) patients.A balanced factorial experiment was conducted among emergency medicine physicians (EMPs). Sixteen OHCA patient scenarios with balanced factors were presented. The balancing factors were dichotomous categories of patient age (45 ± 2 vs. 70 ± 2 years), patient sex (men vs. women), socioeconomic status (SES; higher vs. lower), and guardian attitudes (positive vs. reluctant) regarding TTM. Information on participant and organizational characteristics was collected. The outcome variable was a score (0-100) based on responses to questions that indicated how likely the participants were to apply TTM.Seventy-five EMPs completed the experiment. The median score for the likelihood of TTM application was 85 (interquartile range, 70-95). Scores differed significantly for patient age (90% vs. 80%, p = 0.001), SES (90% vs. 80%, p = 0.001), and guardian attitude regarding TTM (90% vs. 70%, p = 0.001). The likelihood of TTM application was associated with EMP experience with TTM (more or50 times) (90% vs. 80%, p = 0.001). EMPs working in hospitals with commercial TTM devices or operating protocols were more likely to use TTM than those working in hospitals without TTM devices or protocols (88 vs. 80 and 90 vs. 80; p = 0.001, respectively).Patient demographics and provider and organizational factors significantly affected the decision to apply TTM.

Background and purpose The occurrence of stroke in cancer patients is caused by conventional vascular risk factors and cancer-specific mechanisms. However, cryptogenic stroke in patients with cancer was considered to be more related to cancer-specific hypercoagulability. In this study, we investigated the potential of the D-dimer level to serve as a predictor of early neurologic deterioration (END) in cryptogenic stroke patients with active cancer. Methods We recruited 109 cryptogenic stroke patients with active cancer within 72 h of symptom onset. We defined END as an increase of ≥1 point in the motor National Institutes of Health Stroke Scale (NIHSS) score or ≥2 points in the total NIHSS score within 72 h of admission. After adjusting for potential confounding factors in the multivariate analysis, we calculated the odds ratios (ORs) and confidence intervals (CIs) of D-dimer in the prediction of END. Results Among 109 patients, END events were identified in 34 (31%) patients within 72 h. END was significantly associated with systemic metastasis, multiple vascular territory lesions on the initial magnetic resonance imaging (MRI), initial NIHSS score and D-dimer levels. In the multivariate analysis, the D-dimer level (adjusted OR, 1.11; 95% CI, 1.04–1.17; P < 0.01) and initial NIHSS score (adjusted OR, 1.08; 95% CI, 1.01–1.15; P = 0.03) predicted END after adjusting for potential confounding factors. In the subgroup analysis of 72 follow-up MRIs, D-dimer level was also correlated with new territory lesions on the follow-up MRI in a dose-dependent manner. Conclusion Ischemic stroke patients with active cancer and elevated D-dimer levels appear to be at increased risk for END recurrent thromboembolic stroke.

To develop a sildenafil lactate-loaded orally disintegrating tablet with a faster drug effect onset and immediate action of erection, the orally disintegrating tablets were prepared with various amounts of menthol and colloidal silica using the direct compression technique followed by vacuum drying. Their tablet properties such as friability, hardness, wetting time and disintegration time were investigated. The oral bioavailability of sildenafil in the orally disintegrating tablet was then compared with the sildenafil citrate-loaded commercial tablet (Viagra(®)) in rabbits. Sildenafil lactate was a new salt form with more improved solubility and alleviated bitterness compared with commercial salt, sildenafil citrate. As the amount of menthol in the orally disintegrating tablet increased, the friability increased and hardness decreased, resulting in a shorter wetting time and disintegration time. Colloidal silica did the opposite. The sildenafil lactate-loaded orally disintegrating tablet prepared with 45 mg/tab of menthol and 1.5 mg/tab of colloidal silica gave a hardness of 3-4 KP, friability less than 0.5% and disintegration time less than 30 s, suggesting that it was a practical and commercial product with good tablet property and excellent efficacy. Furthermore, it gave higher AUC and C(max), and shorter T(max) values than did the commercial tablet, indicating that it improved the oral bioavailability of sildenafil in rabbits compared with the commercial tablet. Thus, the sildenafil lactate-loaded orally disintegrating tablet might induce a fast onset of action and immediate erection compared with the sildenafil citrate-loaded commercial tablet.

− To develop a sildenafil lactate-loaded solid self-emulsifying drug delivery system (SEDDS) with a fast onsetof action and immediate action of erection, sildenafil lactate (0.3 g), which was prepared using a spray dryer, was dissolvedin 4.7 g of the mixture of glyceryl monooleate/Transcutol/ Tween 20 (3/0.5/1, g). Its emulsion droplet size and phar-macokinetics in rabbits were evaluated compared with sildenafil citrate-loaded commercial tablet. The sildenafil lactate-loaded SEDDS showed an emulsion droplet size of about 300 nm. In pharmacokinetics study, it gave significantly fasterT max than did the commercial tablet. Thus, the sildenafil lactate-loaded SEDDS at the one-third drug dose compared to silde-nafil citrate-loaded conventional tablet might induce a fast onset of action and immediate erection without enhanced bio-availability compared with the sildenafil citrate-loaded commercial tablet.Key words − Sildenafil lactate, SEDDS, Immediate erection, Pharmacokinetics Sildenafil (1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine) is used to treat male erectile dysfunction. Itis a selective inhibitor of cyclic guanosine monophosphate(cGMP)-specific phosphodiesterase type 5 (PDE5) (Boolell etal., 1996). However, this drug has low aqueous solubility andhigh membrane permeability, and is included in class 2 of theBiopharmaceutical Drug Classification system (Amidon et al.,1995). Its bioavailability is relatively low after oral admin-istration since it is practically insoluble in water (Elshafeey etal., 2009; Wang et al., 2008). Thus, a commercial product hasbeen developed with a salt form such as sildenafil citrate,which improves the drug's solubility. This commercial product(Viagra

To develop sildenafil lactate, a salt form of sildenafil with improved solubility and bioavailability of poorly water-soluble sildenafil base, this salt form was prepared using a spray dryer. Its solubility and pharmacokinetics in rabbits were evaluated compared with sildenafil base and sildenafil citrate. Sildenafil lactate improved the solubility of sildenafil in various solvents including distilled water compared with sildenafil citrate. It provided higher AUC and C(max) and, shorter t(1/2) values than did the other materials, indicating that it improved the oral bioavailability of sildenafil in rabbits. Our results suggest that sildenafil lactate would be useful to deliver sildenafil in a pattern that allows fast absorption and late metabolism. Furthermore, the plasma concentration at 0.25 h in sildenafil lactate was similar to the C(max) value at T(max) (0.5 h) in sildenafil citrate. Thus, sildenafil lactate might provide a faster onset of action and immediate erection compared with sildenafil citrate, the conventional drug.

Five slab specimens with predefined cracks arc examined to evaluate the corrosion behavior of cpoxy-coated bars in chloride contaminated concrete, using linear polarization mcthod. The test specimens were subjected to alternating weekly cycles or ponding in a salt solution and drying for 48 weeks. Test results show that the current density of the specimen ofnormal steel bars becomes 0.715u_A/cm' indicating that the steel bars arc in moderate or high corrosion condition. However, the corrosion rates of the specimens with_ damagced epoxy-coated bars are significantly below 0.1 uA/cm' and the bars appears to be in passive condition. The damaged epoxy-coated bars with a corrosion inhibitor or calcium nitrite showed a corrosion rate 01'0.110 um/ycar or 56 percents of the corrosion rate of damaged epoxy-coated specimen without such an inhibitor, 0.195 urn/year. However, the corrosion rates of specimens containing the other two corrosion inhibitors, a combination of amines and esters or mixtures of organic alkenyl dicarboxyl acid salts are quite equivalent to the control specimen. The research technique of linear polarization resistance method has proven itself to be useful in measuring corrosion rates ofreinforcement in concrete.

The present paper introduces a new lateral vibration damper using leaf springs and oil. This damper, named as a leaf spring damper (LSD), has several beneficial rotordynamic advantages. The leaf spring vibration damper, unlike the well-known squeeze film damper, is simple and easy enough to design the required stiffness and damping coefficients. Furthermore, the damper can be designed as a unit product joined with a rolling element bearing. A theoretical modeling procedure for leaf spring damper is presented in detail. Prototypes of the leaf spring damper are manufactured to test the dynamic characteristics of the damper. Experiments are performed to measure the stiffness and the damping coefficients of the damper.

This paper addresses the lubrication analysis of a short squeeze-film damper operating with electrorheological (ER) fluids which have large and reversible changes in yield shear stresses with respect to an applied electric field. The ER fluids are assumed to be modeled as Bingham fluids. The governing lubrication equation for the ER short squeeze-film damper is developed on the basis of a Bingham fluid model, and the equation is subsequently solved in order to investigate the effects of the ER fluids on the damping capability of the damper. It is shown that a substantial increase in both direct and cross-coupled damping is accomplished by increasing the yield shear stress of the ER fluids. This significant improvement of the damping capability suggests that the ER short squeeze-film damper could be very effective for reducing the vibration and controlling the critical speeds of a rotor system.

This study evaluated peroxisome proliferator-activated receptor (PPAR) δ as a potential target for therapeutic intervention in Ang II-induced senescence in human vascular smooth muscle cells (hVSMCs). Activation of PPARδ by GW501516, a specific agonist of PPARδ, significantly inhibited the Ang II-induced premature senescence of hVSMCs. Agonist-activated PPARδ suppressed the generation of Ang II-triggered reactive oxygen species (ROS) with a concomitant reduction in DNA damage. Notably, GW501516 up-regulated the expression of antioxidant genes, such as glutathione peroxidase 1, thioredoxin 1, manganese superoxide dismutase and heme oxygenase 1. siRNA-mediated down-regulation of these antioxidant genes almost completely abolished the effects of GW501516 on ROS production and premature senescence in hVSMCs treated with Ang II. Taken together, the enhanced transcription of antioxidant genes is responsible for the PPARδ-mediated inhibition of premature senescence through sequestration of ROS in hVSMCs treated with Ang II.

The effect of vapor cavitation on the pressure distribution and the force coefficients of a long squeeze film damper executing circular centered orbits is studied in association with the Swift-Stieber cavitation boundary conditions. The existence of vapor cavitation significantly decreases the whole of the pressure distribution. A modified Reynolds equation is solved analytically for a long squeeze film damper to investigate the effect of fluid inertia on cavitated pressure profiles. Increasing fluid inertia lends to extend the region of cavitation to the minimum film gap and to reduce the pressure. The corresponding damping and inertia force coefficients are presented for varying positions of cavitation inception and termination. Experimental comparisons are presented in Part II. Presented at the 45th Annual Meeting in Denver, Colorado May 7–10, 1990

A solution of a cavitated long squeeze film damper executing circular centered orbits, which is obtained from the Swift-Stieber cavitation conditions, is modified considering side leakage of end seals. The cavitated pressure profiles and force coefficients for orbit radii equal to e=0.47 and 0.76 are measured from a squeeze film damper test rig, and compared with the analysis. The Swift-Stieber conditions and leakage factor used can improve the prediction of cavitation effects and end leakage effects on the performance of a squeeze film dampe. Presented at the 45th Annual Meeting in Denver, Colorado May 7–10, 1990

A new class of photodefinable polymer based on di-tert-butyl malonate protecting group was developed. A novel alkyl malonated copolymer was synthesized by copolymerization of di- tert-butyl malonylmethyl styrene (DBMST) with 4-acetoxystyrene (AST), and the subsequent deprotection of acetoxy group. Exposure of the material to deep-UV light followed by postbaking results in significant changes in solubility and polarity due to the formation of carboxylic functions which were produced on the polymer chain through the photogenerated acid catalyst (chemical amplification). This resist resolved 0.24 micrometer line-and-space patterns, formulated from di-tert-butyl malonate-protected polyhydroxystyrene (PHS) and triphenylsulfonium (TPS) triflate, with the aqueous base development using a KrF excimer laser stepper (NA 0.45) with a dose of 44 mJ/cm2.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Carcinoid tumors are peripheral endocrine system, which produce biologic amines and various polypeptides. Primary carcinoid tumors of the ovary are devided into insular, trabecular, strumal types. The primary insular carcinoid should be distinguished from carcinoid metastatic to the ovary, which is nearly always bilateral, is usually associated with the presence of peritoneal metastases. The age incidence of patients with ovarian carcinoids show a wide range but most patients are postmenopausal. Most primary insular carcinoids of the ovary have been components of teratomas, but some have occurred in apparently pure form. We experienced a case of primary insular carcinoid tumor of the ovary and report it with a brief review of concerned literature.