Practice transition in graduate medical education.

PubMed

Shaffer, Robyn; Piro, Nancy; Katznelson, Laurence; Gephart, Melanie Hayden

2017-10-01

Debt repayment, professional negotiation and practice management skills are vital to a successful medical practice, yet are undervalued and seldom taught in graduate medical education. Medical residents need additional training to confidently transition to independent practice, requiring the development of novel curricula. Medical residents need additional training to confidently transition to independent practice METHODS: We developed a trial practice management curriculum to educate senior residents and fellows through voluntary workshops. Topics discussed in the workshops included debt repayment, billing compliance, medical malpractice, contract negotiations, and lifestyle and financial management. Resident self-confidence was assessed, and feedback was obtained through voluntary survey responses before and after attendance at a workshop, scored using a Likert scale. Twenty-five residents from 20 specialties attended a 1-day session incorporating all lectures; 53 residents from 17 specialties attended a re-designed quarterly session with one or two topics per session. Survey evaluations completed before and after the workshop demonstrated an improvement in residents' self-assessment of confidence in contract negotiations (p < 0.001) and their first year in practice (p < 0.001): after the curriculum, 94 per cent (n = 42) of respondents felt confident participating in contract negotiations, and 93 per cent (n = 38) of respondents felt confident about their first year in practice. One hundred per cent of respondents agreed that the presentation objectives were relevant to their needs as residents. Participant responses indicated a need for structured education in practice management for senior trainees. Senior residents and fellows will benefit most from curricula, but have high familial and professional demands on their schedules. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Seroprevalence and factors associated with equine herpesvirus type 1 and 4 in Spanish Purebred horses in Spain.

PubMed

Cruz, F; Fores, P; Mughini-Gras, L; Ireland, J; Moreno, M A; Newton, J R

2016-04-16

Equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4) have a worldwide distribution and cause respiratory disease, abortion, neonatal death and myeloencephalopathy in susceptible horses. Given the scarcity of serological EHV-1/EHV-4 data in Spain, the objective of this cross-sectional study was to estimate the seroprevalence of EHV-1/EHV-4 and to identify potential horse-level and stud farm-level factors associated with EHV-1/EHV-4 in the breeding Spanish Purebred (SP) horse population in central Spain. Serum samples from 334 SP unvaccinated horses, collected between September 2011 and November 2013 at 30 stud farms, were tested using a commercially available EHV-1/EHV-4 antibody ELISA and seroneutralisation as the World Organisation for Animal Health reference confirmation test. Data on factors putatively associated with seropositivity to EHV-1/EHV-4 were collected via a questionnaire and examined using logistic regression analysis. EHV-1/EHV-4 seroprevalence in the SP breeding population in central Spain, standardised for the sex distribution of the reference horse population, was 53.9 per cent (95 per cent confidence interval 44.0 per cent to 63.8 per cent). Increasing age, southern location of the stud farm, temperate climate during the summer, and a smaller surface area used for breeding activities in the farm were associated with increased odds for EHV-1/EHV-4 seropositivity, whereas EHV-1/EHV-4 vaccination of other resident horses and separation of breeding mares from youngsters were protective factors. British Veterinary Association.

Preliminary report of associated factors in wound infection after major head and neck neoplasm operations--does the duration of prophylactic antibiotic matter?

PubMed

Liu, S-A; Tung, K-C; Shiao, J-Y; Chiu, Y-T

2008-04-01

The aim of this study was to investigate whether an extended course of prophylactic antibiotic could reduce the wound infection rate in a subtropical country. Fifty-three consecutive cases scheduled to receive major head and neck operations were randomised into one-day or three-day prophylactic antibiotic groups. Thirteen cases (24.5 per cent) developed wound infections after operations. The duration of prophylactic antibiotic was not related to the surgical wound infection. However, pre-operative haemoglobulin less than 10.5 g/dl (odds ratio: 7.24, 95 per cent confidence interval: 1.28-41.0) and reconstruction with a free flap or pectoris major myocutaneous flap during the operation (odds ratio: 11.04, 95 per cent confidence interval: 1.17-104.7) were associated factors significantly influencing post-operative wound infection. Therefore, one day of prophylactic antibiotic was effective in major head and neck procedures but should not be substituted for proper aseptic and meticulous surgical techniques.

Suspected side effects of doxycycline use in dogs - a retrospective study of 386 cases.

PubMed

Schulz, B S; Hupfauer, S; Ammer, H; Sauter-Louis, C; Hartmann, K

2011-08-27

This study investigated doxycycline-related side effects in a large population of dogs. Data from 386 dogs that had received doxycycline for the treatment of various infectious diseases were analysed retrospectively. Potential side effects that developed during treatment were documented, and correlations with signalment, dose, duration of treatment, frequency of application, doxycycline preparation and use of additional drugs were investigated. Vomiting was reported in 18.3 per cent of dogs, 7.0 per cent developed diarrhoea and 2.5 per cent developed anorexia. While being treated with doxycycline, 39.4 per cent of dogs showed an increase in alanine aminotransferase (ALT) activity and 36.4 per cent showed an increase in alkaline phosphatase (ALP) activity. There was a dose-related risk of an increase in ALP activity (P=0.011, odds ratio [OR]=1.27, 95 per cent confidence interval [CI] 1.06 to 1.53), and older dogs treated with doxycycline were more likely to develop an increase in ALT activity (P=0.038, OR=1.23, 95 per cent CI 1.01 to 1.50) and vomiting (P=0.017, OR=1.11, 95 per cent CI 1.02 to 1.21).

Kangaroo mother care: a randomized controlled trial on effectiveness of early kangaroo mother care for the low birthweight infants in Addis Ababa, Ethiopia.

PubMed

Worku, Bogale; Kassie, Assaye

2005-04-01

A randomized controlled trial was conducted over a 1-year period (November 2001-November 2002) in Addis Ababa to study the effectiveness of early Kangaroo mother care before stabilization of low birthweight infants as compared with the conventional method of care. There were 259 babies weighing less than 2000 g during the study period and a total of 123 (47.5 per cent) low birthweight infants were included in to the study. Sixty-two infants were enrolled as Kangaroo Mother Care (KMC) and the remaining 61 were Conventional Method of Care (CMC) cases. The demographic and socioeconomic characteristics for both groups were comparable. The mean age at the time of enrollment was 10 and 9.8 h for KMC and CMC, respectively (p>0.05 with 95 per cent confidence interval). The mean birthweight was 1514.8 g (range 1000-1900 g) for KMC and 1471.8 g (range 930-1900 g) for CMC (p>0.05 with 95 per cent CI) and the mean gestational age was 32.42 and 31.59 weeks for KMC and CMC cases, respectively. Fifty-eight per cent of KMC and 52 per cent of CMC cases were on i.v. fluid. Twenty-one of 62 (34 per cent) of KMC and 23/61 (37 per cent) of CMC babies were on oxygen through nasopharyngeal catheter. The mean age at exit from the study was 4.6 days for KMC and 5.4 days for CMC. Ninety-one per cent and 88 per cent of babies in KMC and CMC were discharged from the study in the first 7 days of life, respectively. The study showed that 14/62 (22.5 per cent) of KMC vs. 24/63 (38 per cent) CMC babies died during the study (p<0.05 and CI of 95 per cent.) The majority of deaths occurred during the first 12 h of life. Survival for the preterm low birthweight infants was remarkably better for the early kangaroo mother care group than the babies in the conventional method of care in the first 12 h and there after. More than 95 per cent of mothers reported that they were happy to care for their low birthweight babies using the early Kangaroo mother method. It was recommended to study the feasibility and effectiveness of Kangaroo mother care at the community level.

Peer-teaching of evidence-based medicine.

PubMed

Rees, Eliot; Sinha, Yashashwi; Chitnis, Abhishek; Archer, James; Fotheringham, Victoria; Renwick, Stephen

2014-07-01

Many medical schools teach the principles of evidence-based medicine (EBM) as part of their undergraduate curriculum. Medical students perceive that EBM is valuable to their undergraduate and postgraduate career. Students may experience barriers to applying EBM principles, especially when searching for evidence or identifying high-quality resources. The UK National Institute for Health and Care Excellence (NICE) Evidence Search is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal. Evidence-based medicine workshops were organised and delivered by fourth-year medical students, having first received training from NICE to become NICE student champions. The workshops covered the basic principles of EBM and focused on retrieving EBM resources for study through the NICE Evidence Search portal. The scheme was evaluated using a pre-workshop survey and an 8-12 week post-workshop survey. Self-reported confidence in searching for evidence-based resources increased from 29 per cent before the workshop to 87 per cent after the workshop. Only 1 per cent of students rated evidence-based resources as their first preference pre-workshop, compared with 31 per cent post-workshop. The results show that although many students were aware of evidence-based resources, they tended not to use them as their preferred resource. Despite appreciating the value of evidence-based resources, few students were confident in accessing and using such resources for pre-clinical study. A peer-taught workshop in EBM improved students' confidence with, and use of, evidence-based resources. © 2014 John Wiley & Sons Ltd.

Challenges in the treatment of lactational mastitis for general practitioners.

PubMed

Topić, Zeljka; Amir, Lisa H; Zakarija-Grković, Irena

2015-11-01

To determine how GPs manage breastfeeding women with mastitis and how confident they are in treating women with breast conditions that occur during lactation. A cross-sectional survey conducted among all Croatian GPs. Sixty-four per cent of the total number of respondents (171/268) had seen a patient with lactational mastitis (LM) in the previous 12 months. Among respondents who recommended medication for the treatment of LM, 93% prescribed an antibiotic (122/131). Fifteen per cent of respondents who gave advice on infant feeding advised alternative feeding methods. Approximately half (47%) felt completely confident when treating LM while more than half (57%) felt partially confident when treating other breast conditions that can occur during lactation. The management of LM among Croatian GPs is not in full compliance with current recommendations. FUTURE IMPLICATIONS: There is a need for further training of Croatian GPs in the management of mastitis.

Chandra survey in the AKARI North Ecliptic Pole Deep Field - I. X-ray data, point-like source catalogue, sensitivity maps, and number counts

NASA Astrophysics Data System (ADS)

Krumpe, M.; Miyaji, T.; Brunner, H.; Hanami, H.; Ishigaki, T.; Takagi, T.; Markowitz, A. G.; Goto, T.; Malkan, M. A.; Matsuhara, H.; Pearson, C.; Ueda, Y.; Wada, T.

2015-01-01

We present data products from the 300 ks Chandra survey in the AKARI North Ecliptic Pole Deep Field. This field has a unique set of nine-band infrared photometry covering 2-24 μm from the AKARI Infrared Camera, including mid-infrared (MIR) bands not covered by Spitzer. The survey is one of the deepest ever achieved at ˜15 μm, and is by far the widest among those with similar depths in the MIR. This makes this field unique for the MIR-selection of AGN at z ˜ 1. We design a source detection procedure, which performs joint maximum likelihood PSF (point spread function) fits on all of our 15 mosaicked Chandra pointings covering an area of 0.34 deg2. The procedure has been highly optimized and tested by simulations. We provide a point source catalogue with photometry and Bayesian-based 90 per cent confidence upper limits in the 0.5-7, 0.5-2, 2-7, 2-4, and 4-7 keV bands. The catalogue contains 457 X-ray sources and the spurious fraction is estimated to be ˜1.7 per cent. Sensitivity and 90 per cent confidence upper flux limits maps in all bands are provided as well. We search for optical-MIR counterparts in the central 0.25 deg2, where deep Subaru Suprime-Cam multiband images exist. Among the 377 X-ray sources detected there, ˜80 per cent have optical counterparts and ˜60 per cent also have AKARI MIR counterparts. We cross-match our X-ray sources with MIR-selected AGN from Hanami et al. Around 30 per cent of all AGN that have MIR SEDs purely explainable by AGN activity are strong Compton-thick AGN candidates.

Cas A and the Crab were not stellar binaries at death

NASA Astrophysics Data System (ADS)

Kochanek, C. S.

2018-01-01

The majority of massive stars are in binaries, which implies that many core collapse supernovae should be binaries at the time of the explosion. Here we show that the three most recent, local (visual) SNe (the Crab, Cas A and SN 1987A) were not stellar binaries at death, with limits on the initial mass ratios of q = M2/M1 ≲ 0.1. No quantitative limits have previously been set for Cas A and the Crab, while for SN 1987A we merely updated existing limits in view of new estimates of the dust content. The lack of stellar companions to these three ccSNe implies a 90 per cent confidence upper limit on the q ≳ 0.1 binary fraction at death of fb < 44 per cent. In a passively evolving binary model (meaning no binary interactions), with a flat mass ratio distribution and a Salpeter IMF, the resulting 90 per cent confidence upper limit on the initial binary fraction of F < 63 per cent is in tension with observed massive binary statistics. Allowing a significant fraction fM ≃ 25 per cent of stellar binaries to merge reduces the tension, with F < 63({1-f}M)^{-1}{ per cent} ˜eq 81{ per cent}, but allowing for the significant fraction in higher order systems (triples, etc.) reintroduces the tension. That Cas A was not a stellar binary at death also shows that a surviving massive binary companion at the time of the explosion is not necessary for producing a Type IIb SNe. Much larger surveys for binary companions to Galactic SNe will become feasible with the release of the full Gaia proper motion and parallax catalogues providing a powerful probe of the statistics of such binaries and their role in massive star evolution, neutron star velocity distributions and runaway stars.

Polymorphisms of the matrix metalloproteinase 9 gene and abdominal aortic aneurysm.

PubMed

Smallwood, L; Allcock, R; van Bockxmeer, F; Warrington, N; Palmer, L J; Iacopetta, B; Golledge, J; Norman, P E

2008-10-01

Increased matrix metalloproteinase (MMP) 9 activity has been implicated in the formation of abdominal aortic aneurysm (AAA). The aim was to explore the association between potentially functional variants of the MMP-9 gene and AAA. The -1562C > T and -1811A > T variants of the MMP-9 gene were genotyped in 678 men with an AAA (at least 30 mm in diameter) and 659 control subjects (aortic diameter 19-22 mm) recruited from a population-based trial of screening for AAA. Levels of MMP-9 were measured in a random subset of 300 cases and 84 controls. The association between genetic variants (including haplotypes) and AAA was assessed by multivariable logistic regression. There was no association between the MMP-9-1562C > T (odds ratio (OR) 0.70 (95 per cent confidence interval (c.i.) 0.27 to 1.82)) or -1811A > T (OR 0.71 (95 per cent c.i. 0.28 to 1.85)) genotypes, or the most common haplotype (OR 0.81 (95 per cent c.i. 0.62 to 1.05)) and AAA. The serum MMP-9 concentration was higher in cases than controls, and in minor allele carriers in cases and controls, although the differences were not statistically significant. In this study, the genetic tendency to higher levels of circulating MMP-9 was not associated with AAA.

Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery.

PubMed

2016-08-01

There is currently conflicting evidence surrounding the effects of obesity on postoperative outcomes. Previous studies have found obesity to be associated with adverse events, but others have found no association. The aim of this study was to determine whether increasing body mass index (BMI) is an independent risk factor for development of major postoperative complications. This was a multicentre prospective cohort study across the UK and Republic of Ireland. Consecutive patients undergoing elective or emergency gastrointestinal surgery over a 4-month interval (October-December 2014) were eligible for inclusion. The primary outcome was the 30-day major complication rate (Clavien-Dindo grade III-V). BMI was grouped according to the World Health Organization classification. Multilevel logistic regression models were used to adjust for patient, operative and hospital-level effects, creating odds ratios (ORs) and 95 per cent confidence intervals (c.i.). Of 7965 patients, 2545 (32·0 per cent) were of normal weight, 2673 (33·6 per cent) were overweight and 2747 (34·5 per cent) were obese. Overall, 4925 (61·8 per cent) underwent elective and 3038 (38·1 per cent) emergency operations. The 30-day major complication rate was 11·4 per cent (908 of 7965). In adjusted models, a significant interaction was found between BMI and diagnosis, with an association seen between BMI and major complications for patients with malignancy (overweight: OR 1·59, 95 per cent c.i. 1·12 to 2·29, P = 0·008; obese: OR 1·91, 1·31 to 2·83, P = 0·002; compared with normal weight) but not benign disease (overweight: OR 0·89, 0·71 to 1·12, P = 0·329; obese: OR 0·84, 0·66 to 1·06, P = 0·147). Overweight and obese patients undergoing surgery for gastrointestinal malignancy are at increased risk of major postoperative complications compared with those of normal weight. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management.

PubMed

Guldfred, L-A; Philipsen, B B; Siim, C

2012-06-01

To examine the accuracy of the pre-operative diagnosis of branchial cleft anomalies, and also to describe their occurrence, clinical presentation and management. Retrospective review of the records of patients diagnosed with a branchial cleft anomaly between 1997 and 2006. One hundred and twenty-six patients were included. Pre-operative diagnosis had a positive predictive value of 0.856 (95 per cent confidence interval, 0.771-0.918) and a sensitivity of 0.944 (95 per cent confidence interval, 0.869-0.979). These patients' demographic data, investigations, findings and management are presented, along with a possible strategy for dealing with solitary cystic masses in the neck. As pre-operative diagnosis has a positive predictive value of 86 per cent, cystic lesions in the neck should be presumed to be carcinomatous until proven otherwise. Branchial fistulae and sinuses seem to be a disease of childhood, while branchial cysts occur mainly in adults. Branchial cleft anomalies are equally frequent in men and women, and equally distributed on the left and right side of the neck.

Systematic review of high-intensity focused ultrasound ablation in the treatment of breast cancer.

PubMed

Peek, M C L; Ahmed, M; Napoli, A; ten Haken, B; McWilliams, S; Usiskin, S I; Pinder, S E; van Hemelrijck, M; Douek, M

2015-07-01

A systematic review was undertaken to assess the clinical efficacy of non-invasive high-intensity focused ultrasound (HIFU) ablation in the treatment of breast cancer. MEDLINE/PubMed library databases were used to identify all studies published up to December 2013 that evaluated the role of HIFU ablation in the treatment of breast cancer. Studies were eligible if they were performed on patients with breast cancer and objectively recorded at least one clinical outcome measure of response (imaging, histopathological or cosmetic) to HIFU treatment. Nine studies fulfilled the inclusion criteria. The absence of tumour or residual tumour after treatment was reported for 95·8 per cent of patients (160 of 167). No residual tumour was found in 46·2 per cent (55 of 119; range 17-100 per cent), less than 10 per cent residual tumour in 29·4 per cent (35 of 119; range 0-53 per cent), and between 10 and 90 per cent residual tumour in 22·7 per cent (27 of 119; range 0-60 per cent). The most common complication associated with HIFU ablation was pain (40·1 per cent) and less frequently oedema (16·8 per cent), skin burn (4·2 per cent) and pectoralis major injury (3·6 per cent). MRI showed an absence of contrast enhancement after treatment in 82 per cent of patients (31 of 38; range 50-100 per cent), indicative of coagulative necrosis. Correlation of contrast enhancement on pretreatment and post-treatment MRI successfully predicted the presence of residual disease. HIFU treatment can induce coagulative necrosis in breast cancers. Complete ablation has not been reported consistently on histopathology and no imaging modality has been able confidently to predict the percentage of complete ablation. Consistent tumour and margin necrosis with reliable follow-up imaging are required before HIFU ablation can be evaluated within large, prospective clinical trials. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Wife's level of education and husband's risk of primary cardiac arrest.

PubMed Central

Strogatz, D S; Siscovick, D S; Weiss, N S; Rennert, G

1988-01-01

Data from a case-control study were analyzed to examine wife's education and risk of primary cardiac arrest in the husband. Men whose wives had more than 12 years of education had 80 per cent the rate of men with less educated wives (odds ratio = 0.8, 95% confidence interval = 0.5, 1.3), after adjustment for risk factors. There was no evidence of a status incongruity effect. These data are inconsistent with reports of positive associations between wife's education and coronary heart disease. PMID:3177731

Main-belt comets in the Palomar Transient Factory survey - I. The search for extendedness

NASA Astrophysics Data System (ADS)

Waszczak, A.; Ofek, E. O.; Aharonson, O.; Kulkarni, S. R.; Polishook, D.; Bauer, J. M.; Levitan, D.; Sesar, B.; Laher, R.; Surace, J.; PTF Team

2013-08-01

Cometary activity in main-belt asteroids probes the ice content of these objects and provides clues to the history of volatiles in the inner Solar system. We search the Palomar Transient Factory survey to derive upper limits on the population size of active main-belt comets (MBCs). From data collected from 2009 March through 2012 July, we extracted ˜2 million observations of ˜220 thousand known main-belt objects (40 per cent of the known population, down to ˜1-km diameter) and discovered 626 new objects in multinight linked detections. We formally quantify the `extendedness' of a small-body observation, account for systematic variation in this metric (e.g. due to on-sky motion) and evaluate this method's robustness in identifying cometary activity using observations of 115 comets, including two known candidate MBCs and six newly discovered non-MBCs (two of which were originally designated as asteroids by other surveys). We demonstrate a 66 per cent detection efficiency with respect to the extendedness distribution of the 115 sampled comets, and a 100 per cent detection efficiency with respect to extendedness levels greater than or equal to those we observed in the known candidate MBCs P/2010 R2 (La Sagra) and P/2006 VW139. Using a log-constant prior, we infer 95 per cent confidence upper limits of 33 and 22 active MBCs (per million main-belt asteroids down to ˜1-km diameter), for detection efficiencies of 66 and 100 per cent, respectively. In a follow-up to this morphological search, we will perform a photometric (disc-integrated brightening) search for MBCs.

Prevalence of wet litter and the associated risk factors in broiler flocks in the United Kingdom.

PubMed

Hermans, P G; Fradkin, D; Muchnik, I B; Organ, K L

2006-05-06

A postal questionnaire was sent to the managers of 857 broiler farms in the UK to determine the prevalence and risk factors for wet litter. The response rate was 75 per cent. Wet litter was reported by 75 per cent (95 per cent confidence interval [CI] 71.3 to 78.3) of the respondents in at least one flock during the year 2001 and 56.1 per cent (95 per cent CI 52.0 to 60.0) of them reported that they had an outbreak of wet litter in their most recently reared flock. Wet litter occurred more often during the winter months and farms using side ventilation systems were at an increased risk (odds ratio 1.74; 95 per cent CI 1.09 to 2.76). A multivariable analysis was carried out using two different definitions of wet litter as outcome variables - all cases of wet litter, and cases of wet litter associated with disease. Consistent risk factors for both outcomes were coccidiosis, feed equipment failures and the availability of separate farm clothing for each house. Cases of wet litter associated with disease were reported by 33.7 per cent (95 per cent CI 28.8 to 39.1) of the managers in their last flock and were associated with the use of hand sanitisers and broiler houses with walls made of concrete.

Molecular hydrogen absorption systems in Sloan Digital Sky Survey

NASA Astrophysics Data System (ADS)

Balashev, S. A.; Klimenko, V. V.; Ivanchik, A. V.; Varshalovich, D. A.; Petitjean, P.; Noterdaeme, P.

2014-05-01

We present a systematic search for molecular hydrogen absorption systems at high redshift in quasar spectra from the Sloan Digital Sky Survey (SDSS)-II Data Release 7 and SDSS-III Data Release 9. We have selected candidates using a modified profile fitting technique taking into account that the Lyα forest can effectively mimic H2 absorption systems at the resolution of SDSS data. To estimate the confidence level of the detections, we use two methods: a Monte Carlo sampling and an analysis of control samples. The analysis of control samples allows us to define regions of the spectral quality parameter space where H2 absorption systems can be confidently identified. We find that H2 absorption systems with column densities log NH2 > 19 can be detected in only less than 3 per cent of SDSS quasar spectra. We estimate the upper limit on the detection rate of saturated H2 absorption systems (NH2 > 19) in damped Lyα (DLA) systems to be about 7 per cent. We provide a sample of 23 confident H2 absorption system candidates that would be interesting to follow up with high-resolution spectrographs. There is a 1σ r - i colour excess and non-significant AV extinction excess in quasar spectra with an H2 candidate compared to standard DLA-bearing quasar spectra. The equivalent widths of C II, Si II and Al III (but not Fe II) absorptions associated with H2 candidate DLAs are larger compared to standard DLAs. This is probably related to a larger spread in velocity of the absorption lines in the H2-bearing sample.

Serosurvey of selected zoonotic agents in polar bears (Ursus maritimus)

USGS Publications Warehouse

Rah, H.; Chomel, B.B.; Follmann, Erich H.; Kasten, R.W.; Hew, C.H.; Farver, T.B.; Garner, G.W.; Amstrup, Steven C.

2005-01-01

Between 1982 and 1999 blood samples were collected from 500 polar bears (Ursus maritimus) captured in the Beaufort and Chukchi seas, to determine the seroprevalence of Brucella species, Toxoplasma gondii, and Trichinella species infections. The bears were classified into four age groups, cubs, yearlings, subadults and adults. Brucella and Toxoplasma antibodies were detected by agglutination (a buffered acidified card antigen and rapid automated presumptive test for brucellosis and a commercial latex agglutination test for toxoplasmosis); an ELISA was used to detect Thichinella antibodies. The overall seroprevalence of Brucella species was 5 per cent, and subadults and yearlings were 2.62 times (95 per cent confidence interval 1-02 to 6-82) more likely to be seropositive for Brucella species than adults and their cubs. The antibody prevalence for Toxoplasma gondii was 6 per cent, and for Trichinella species 55.6 per cent. The prevalence of antibodies to Trichinella species increased with age (P<0.001).

VizieR Online Data Catalog: X-ray sources in the AKARI NEP deep field (Krumpe+, 2015)

NASA Astrophysics Data System (ADS)

Krumpe, M.; Miyaji, T.; Brunner, H.; Hanami, H.; Ishigaki, T.; Takagi, T.; Markowitz, A. G.; Goto, T.; Malkan, M. A.; Matsuhara, H.; Pearson, C.; Ueda, Y.; Wada, T.

2015-06-01

The fits images labelled SeMap* are the sensitivity maps in which we give the minimum flux that would have caused a detection at each position. This flux depends on the maximum likelihood threshold chosen in the source detection run, the point spread function, and the background level at the chosen position. We create sensitivity maps in different energy bands (0.5-2, 0.5-7, 2-4, 2-7, and 4-7keV) by searching for the flux to reject the null-hypothesis that the flux at a given position is only caused by a background fluctuation. In a chosen energy band, we determine for each position in the survey the flux required to obtain a certain Poisson probability above the background counts. Since ML=-ln(P), we know from our ML=12 threshold the probability we are aiming for. In practice, we search for a value of -ln P_total that falls within Delta ML=+/-0.2 of our targeted ML threshold. This tolerance range corresponds to having one spurious source more or less in the whole survey. Note, that outside the deep Subaru/Suprime-Cam imaging the sensitivity maps should be used with caution since we assume for their generation a ML=12 over the whole area covered by Chandra. More details on the procedure of producing the sensitivity maps, including the PSF-summed background map and PSF-weighted averaged exposure maps are given in the paper, section 5.3. The fits images labelled u90* are the upper limit maps, where the upper 90 per cent confidence flux limit is given at each position. We take a Bayesian approach following Kraft, Burrows & Nousek, 1991ApJ...374..344K. Consequently, we obtain the upper 90~per cent confidence flux limit by searching for the flux such that given the observed counts the Bayesian probability of having this flux or larger is 10~per cent. More details on the procedure of producing the upper 90 per cent flux limit maps are given in the paper, section 5.4. (6 data files).

Associations between informal care, disease, and risk factors: A Spanish country-wide population-based study.

PubMed

González-de Paz, Luís; Real, Jordi; Borrás-Santos, Alicia; Martínez-Sánchez, José M; Rodrigo-Baños, Virginia; Dolores Navarro-Rubio, María

2016-05-01

This population-based study using 2011-2012 Spanish National Health Survey data aimed to measure the impact of disease, health-related habits, and risk factors associated with informal caregiving. We included and matched self-reported informal caregivers [ICs] with controls (1:4) from the same survey. For each outcome, we analyzed associations between ICs and controls using linear regression or logistic regression models. ICs had 3.4 per cent more depression (OR: 1.33, 95 per cent confidence intervals [CI]:1.06, 1.68). ICs had lower social support (95 per cent CI: 1.64, 3.28), they did more housework alone (OR:3.6, 95 per cent CI:2.65, 4.89), and had greater stress (95 per cent CI:0.13, 0.83). Women ICs caring alone had more anxiety than other groups. We found no statistical association between caregivers and worse health-related habits or increased risk factors (less physical activity, smoking, drinking, and cholesterol). Our results provide evidence that health-care professionals and organizations should recognize the importance of caring for those who care.

A closer look at the relationships between panic attacks, emergency department visits and non-cardiac chest pain.

PubMed

Foldes-Busque, Guillaume; Denis, Isabelle; Poitras, Julien; Fleet, Richard P; Archambault, Patrick; Dionne, Clermont E

2017-01-01

This study examined the prevalence of emergency department visits prompted by panic attacks in patients with non-cardiac chest pain. A validated structured telephone interview was used to assess panic attacks and their association with the emergency department consultation in 1327 emergency department patients with non-cardiac chest pain. Patients reported at least one panic attack in the past 6 months in 34.5 per cent (95% confidence interval: 32.0%-37.1%) of cases, and 77.1 per cent (95% confidence interval: 73.0%-80.7%) of patients who reported panic attacks had visited the emergency department with non-cardiac chest pain following a panic attack. These results indicate that panic attacks may explain a significant proportion of emergency department visits for non-cardiac chest pain.

Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India

PubMed Central

Murhekar, Manoj V.; Kamaraj, P.; Kanagasabai, K.; Elavarasu, G.; Rajasekar, T. Daniel; Boopathi, K.; Mehendale, Sanjay

2017-01-01

Background & objectives: District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. Methods: Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers’ recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. Results: A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. Interpretation & conclusions: The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing primary vaccination. Efforts to increase vaccination coverage in the State need to focus on educating vaccinators about the need to adhere to the national vaccination schedule and strengthening supervision to ensure that children are vaccinated appropriately. PMID:28749402

Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India.

PubMed

Murhekar, Manoj V; Kamaraj, P; Kanagasabai, K; Elavarasu, G; Rajasekar, T Daniel; Boopathi, K; Mehendale, Sanjay

2017-03-01

District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers' recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing primary vaccination. Efforts to increase vaccination coverage in the State need to focus on educating vaccinators about the need to adhere to the national vaccination schedule and strengthening supervision to ensure that children are vaccinated appropriately.

Reasons for non-participation in population-based abdominal aortic aneurysm screening.

PubMed

Linne, A; Leander, K; Lindström, D; Törnberg, S; Hultgren, R

2014-04-01

A population-based screening programme for abdominal aortic aneurysm (AAA) started in 2010 in Stockholm County, Sweden. This present study used individual data from Sweden's extensive healthcare registries to identify the reasons for non-participation in the AAA screening programme. All 65-year-old men in Stockholm are invited to screening for AAA; this study included all men invited from July 2010 to July 2012. Participants and non-participants were compared for socioeconomic factors, travel distance to the examination centre and healthcare use. The influence of these factors on participation was analysed using univariable and multivariable logistic regression models. The participation rate for AAA screening was 77·6 per cent (18 876 of 24 319 men invited). The prevalence of AAA (aortic diameter more than 2·9 cm) among participants was 1·4 per cent. The most important reasons for non-participation in the multivariable regression analyses were: recent immigration (within 5 years) (odds ratio (OR) 3·25, 95 per cent confidence interval 1·94 to 5·47), low income (OR 2·76, 2·46 to 3·10), marital status single or divorced (OR 2·23, 2·08 to 2·39), low level of education (OR 1·28, 1·16 to 1·40) and long travel distance (OR 1·23, 1·10 to 1·37). Non-participants had a higher incidence of stroke (4·5 versus 2·8 per cent; P < 0·001) and chronic pulmonary disease (2·9 versus 1·3 per cent; P < 0·001). Daily smoking was more common in residential areas where the participation rate for AAA screening was low. Efforts to improve participation in AAA screening should target the groups with low income, a low level of education and immigrants. The higher morbidity in the non-participant group, together with a higher rate of smoking, make it probable that this group also has a high risk of AAA. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

The search for failed supernovae with the Large Binocular Telescope: constraints from 7 yr of data

NASA Astrophysics Data System (ADS)

Adams, S. M.; Kochanek, C. S.; Gerke, J. R.; Stanek, K. Z.

2017-08-01

We report updated results for the first 7 yr of our programme to monitor 27 galaxies within 10 Mpc using the Large Binocular Telescope to search for failed supernovae (SNe) - core collapses of massive stars that form black holes without luminous SNe. In the new data, we identify no new compelling candidates and confirm the existing candidate. Given the six successful core-collapse SNe in the sample and one likely failed SN, the implied fraction of core collapses that result in failed SNe is f=0.14^{+0.33}_{-0.10} at 90 per cent confidence. If the current candidate is a failed SN, the fraction of failed SN naturally explains the missing high-mass red supergiants SN progenitors and the black hole mass function. If the current candidate is ultimately rejected, the data imply a 90 per cent confidence upper limit on the failed SN fraction of f < 0.35.

Negative self-perception of smile associated with malocclusions among Brazilian adolescents.

PubMed

Moura, Cristiano; Cavalcanti, Alessandro Leite; Gusmão, Estela Santos; Soares, Renata de Souza Coelho; Moura, Fabiana Torres Cavalcante; Santillo, Patrícia Morgana Hordonho

2013-08-01

This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.

Thirteen-week dose-intensifying simultaneous combination chemotherapy protocol for malignant lymphoma in dogs.

PubMed

Zenker, I; Meichner, K; Steinle, K; Kessler, M; Hirschberger, J

2010-11-06

This prospective study aimed to record the toxicity profile of a dose-intensifying simultaneous chemotherapy (DISC) protocol for lymphoma in dogs. Remission rates and the duration of the protocol were also evaluated. Twenty-one dogs were studied. Diagnosis was based on cytological or histological assessments. The DISC protocol is a 13-week maintenance-free protocol. L-Asparaginase (400 iu/kg) was administered subcutaneously on day 1, followed by weekly simultaneous intravenous administration of vincristine (0.7 mg/m(2) = 100 per cent), cyclophosphamide (200 mg/m(2) = 100 per cent) and doxorubicin (30 mg/m(2) = 100 per cent) at a starting dose level of 33 per cent. Dose levels were given twice and then increased by 5 to 7 per cent if grade 0 or I toxicities were seen, to a maximum dose level of 60 per cent. Two dogs experienced a grade IV toxicity (asymptomatic neutropenia in one dog and sepsis in the other). Two episodes of asymptomatic grade III thrombocytopenia and one episode of neutropenia were recorded. Other toxic events were infrequent and mild. Only one dog required hospitalisation for less than 72 hours. Seventeen dogs (80.9 per cent) achieved complete remission, one (4.8 per cent) achieved partial remission, two (9.5 per cent) had stable disease and in one (4.8 per cent) disease progressed.

Freedom from equine infectious anaemia virus infection in Spanish Purebred horses

PubMed Central

Cruz, Fatima; Fores, Paloma; Ireland, Joanne; Moreno, Miguel A.; Newton, Richard

2015-01-01

Introduction No cases of equine infectious anaemia (EIA) have been reported in Spain since 1983. Factors that could increase the risk of reintroducing equine infectious anaemia virus (EIAV) into Spain include the recent occurrence of the disease in Europe and the absence of compulsory serological testing before importation into Spain. Aims and objectives Given the importance of the Spanish Purebred (SP) horse breeding industry in Spain, the aim of this cross-sectional study was to provide evidence of freedom from EIAV in SP stud farms in Central Spain. Materials and methods Serum samples from 555 SP horses, collected between September 2011 and November 2013, were tested using a commercially available EIAV ELISA with a published sensitivity of 100 per cent. Results All 555 samples were negative for antibody to EIAV, providing evidence of a true EIAV seroprevalence between 0 per cent and 0.53 per cent (95% CIs of the sensitivity and specificity of the ELISA technique used Q10 were 100 per cent and 99.3 per cent, respectively) among the SP breeding population in Central Spain. Conclusions These findings should serve to increase confidence when exporting SP horses to other countries. PMID:26392894

Association between socioeconomic status, surgical treatment and mortality in patients with colorectal cancer.

PubMed

Dik, V K; Aarts, M J; Van Grevenstein, W M U; Koopman, M; Van Oijen, M G H; Lemmens, V E; Siersema, P D

2014-08-01

High socioeconomic status is associated with better survival in colorectal cancer (CRC). This study investigated whether socioeconomic status is associated with differences in surgical treatment and mortality in patients with CRC. Patients diagnosed with stage I-III CRC between 2005 and 2010 in the Eindhoven Cancer Registry area in the Netherlands were included. Socioeconomic status was determined at a neighbourhood level by combining the mean household income and the mean value of the housing. Some 4422 patients with colonic cancer and 2314 with rectal cancer were included. Patients with colonic cancer and high socioeconomic status were operated on with laparotomy (70·7 versus 77·6 per cent; P = 0·017), had laparoscopy converted to laparotomy (15·7 versus 29·5 per cent; P = 0·008) and developed anastomotic leakage or abscess (9·6 versus 12·6 per cent; P = 0·049) less frequently than patients with low socioeconomic status. These differences remained significant after adjustment for patient and tumour characteristics. In rectal cancer, patients with high socioeconomic status were more likely to undergo resection (96·3 versus 93·7 per cent; P = 0·083), but this was not significant in multivariable analysis (odds ratio (OR) 1·44, 95 per cent confidence interval 0·84 to 2·46). The difference in 30-day postoperative mortality in patients with colonic cancer and high and low socioeconomic status (3·6 versus 6·8 per cent; P < 0·001) was not significant after adjusting for age, co-morbidities, emergency surgery, and anastomotic leakage or abscess formation (OR 0·90, 0·51 to 1·57). Patients with CRC and high socioeconomic status have more favourable surgical treatment characteristics than patients with low socioeconomic status. The lower 30-day postoperative mortality found in patients with colonic cancer and high socioeconomic status is largely explained by patient and surgical factors. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Improved Bayesian Infrasonic Source Localization for regional infrasound

DOE PAGES

Blom, Philip S.; Marcillo, Omar; Arrowsmith, Stephen J.

2015-10-20

The Bayesian Infrasonic Source Localization (BISL) methodology is examined and simplified providing a generalized method of estimating the source location and time for an infrasonic event and the mathematical framework is used therein. The likelihood function describing an infrasonic detection used in BISL has been redefined to include the von Mises distribution developed in directional statistics and propagation-based, physically derived celerity-range and azimuth deviation models. Frameworks for constructing propagation-based celerity-range and azimuth deviation statistics are presented to demonstrate how stochastic propagation modelling methods can be used to improve the precision and accuracy of the posterior probability density function describing themore » source localization. Infrasonic signals recorded at a number of arrays in the western United States produced by rocket motor detonations at the Utah Test and Training Range are used to demonstrate the application of the new mathematical framework and to quantify the improvement obtained by using the stochastic propagation modelling methods. Moreover, using propagation-based priors, the spatial and temporal confidence bounds of the source decreased by more than 40 per cent in all cases and by as much as 80 per cent in one case. Further, the accuracy of the estimates remained high, keeping the ground truth within the 99 per cent confidence bounds for all cases.« less

Tree stands, not guns, are the midwestern hunter's most dangerous weapon.

PubMed

Crockett, Andrew; Stawicki, Stanislaw P; Thomas, Yalaunda M; Jarvis, Amy M; Wang, Cecily F; Beery, Paul R; Whitmill, Melissa L; Lindsey, David E; Steinberg, Steven M; Cook, Charles H

2010-09-01

Although the prevailing stereotype is that most hunting injuries are gunshot wounds inflicted by intoxicated hunting buddies, our experience led us to hypothesize that falls comprise a significant proportion of hunting related injuries. Trauma databases of two Level I trauma centers in central Ohio were queried for all hunting related injuries during a 10-year period. One hundred and thirty patients were identified (90% male, mean age 41.0 years, range 17-76). Fifty per cent of injuries resulted from falls, whereas gunshot wounds accounted for 29 per cent. Most hunters were hunting deer and 92 per cent of falls were from tree stands. Alcohol was involved in only 2.3 per cent, and drugs of abuse in 4.6 per cent. Of gunshots, 58 per cent were self-inflicted, and 42 per cent were shot by another hunter. Tree stand falls were highly morbid, with 59 per cent of fall victims suffering spinal fractures, 47 per cent lower extremity fractures, 18 per cent upper extremity fractures, and 18 per cent closed head injuries. Surgery was required for 81 per cent of fall-related injuries, and 8.2 per cent of fall victims had permanent neurological deficits. In contrast to prevailing beliefs, in our geographic area tree-stand falls are the most common mechanism of hunting related injury requiring admission to a Level 1 trauma center.

Minimal geological methane emissions during the Younger Dryas-Preboreal abrupt warming event.

PubMed

Petrenko, Vasilii V; Smith, Andrew M; Schaefer, Hinrich; Riedel, Katja; Brook, Edward; Baggenstos, Daniel; Harth, Christina; Hua, Quan; Buizert, Christo; Schilt, Adrian; Fain, Xavier; Mitchell, Logan; Bauska, Thomas; Orsi, Anais; Weiss, Ray F; Severinghaus, Jeffrey P

2017-08-23

Methane (CH 4 ) is a powerful greenhouse gas and plays a key part in global atmospheric chemistry. Natural geological emissions (fossil methane vented naturally from marine and terrestrial seeps and mud volcanoes) are thought to contribute around 52 teragrams of methane per year to the global methane source, about 10 per cent of the total, but both bottom-up methods (measuring emissions) and top-down approaches (measuring atmospheric mole fractions and isotopes) for constraining these geological emissions have been associated with large uncertainties. Here we use ice core measurements to quantify the absolute amount of radiocarbon-containing methane ( 14 CH 4 ) in the past atmosphere and show that geological methane emissions were no higher than 15.4 teragrams per year (95 per cent confidence), averaged over the abrupt warming event that occurred between the Younger Dryas and Preboreal intervals, approximately 11,600 years ago. Assuming that past geological methane emissions were no lower than today, our results indicate that current estimates of today's natural geological methane emissions (about 52 teragrams per year) are too high and, by extension, that current estimates of anthropogenic fossil methane emissions are too low. Our results also improve on and confirm earlier findings that the rapid increase of about 50 per cent in mole fraction of atmospheric methane at the Younger Dryas-Preboreal event was driven by contemporaneous methane from sources such as wetlands; our findings constrain the contribution from old carbon reservoirs (marine methane hydrates, permafrost and methane trapped under ice) to 19 per cent or less (95 per cent confidence). To the extent that the characteristics of the most recent deglaciation and the Younger Dryas-Preboreal warming are comparable to those of the current anthropogenic warming, our measurements suggest that large future atmospheric releases of methane from old carbon sources are unlikely to occur.

Minimal geological methane emissions during the Younger Dryas-Preboreal abrupt warming event

NASA Astrophysics Data System (ADS)

Petrenko, Vasilii V.; Smith, Andrew M.; Schaefer, Hinrich; Riedel, Katja; Brook, Edward; Baggenstos, Daniel; Harth, Christina; Hua, Quan; Buizert, Christo; Schilt, Adrian; Fain, Xavier; Mitchell, Logan; Bauska, Thomas; Orsi, Anais; Weiss, Ray F.; Severinghaus, Jeffrey P.

2017-08-01

Methane (CH4) is a powerful greenhouse gas and plays a key part in global atmospheric chemistry. Natural geological emissions (fossil methane vented naturally from marine and terrestrial seeps and mud volcanoes) are thought to contribute around 52 teragrams of methane per year to the global methane source, about 10 per cent of the total, but both bottom-up methods (measuring emissions) and top-down approaches (measuring atmospheric mole fractions and isotopes) for constraining these geological emissions have been associated with large uncertainties. Here we use ice core measurements to quantify the absolute amount of radiocarbon-containing methane (14CH4) in the past atmosphere and show that geological methane emissions were no higher than 15.4 teragrams per year (95 per cent confidence), averaged over the abrupt warming event that occurred between the Younger Dryas and Preboreal intervals, approximately 11,600 years ago. Assuming that past geological methane emissions were no lower than today, our results indicate that current estimates of today’s natural geological methane emissions (about 52 teragrams per year) are too high and, by extension, that current estimates of anthropogenic fossil methane emissions are too low. Our results also improve on and confirm earlier findings that the rapid increase of about 50 per cent in mole fraction of atmospheric methane at the Younger Dryas-Preboreal event was driven by contemporaneous methane from sources such as wetlands; our findings constrain the contribution from old carbon reservoirs (marine methane hydrates, permafrost and methane trapped under ice) to 19 per cent or less (95 per cent confidence). To the extent that the characteristics of the most recent deglaciation and the Younger Dryas-Preboreal warming are comparable to those of the current anthropogenic warming, our measurements suggest that large future atmospheric releases of methane from old carbon sources are unlikely to occur.

Meta-analysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ.

PubMed

Clayton, E S J; Connor, S; Alexakis, N; Leandros, E

2006-10-01

There is no clear consensus on the better therapeutic approach (endoscopic versus surgical) to choledocholithiasis. This study is a meta-analysis of the available evidence. A search of the Medline and ISI databases identified 12 studies that met the inclusion criteria for data extraction. The analysis was performed using a random-effects model. The outcome was calculated as an odds ratio (OR) or relative risk (RR) with 95 per cent confidence intervals (c.i.). Outcomes of 1357 patients were studied. There was no significant difference in successful duct clearance (OR 0.85 (95 per cent c.i. 0.64 to 1.12); P = 0.250), mortality (RR 1.79 (95 per cent c.i. 0.66 to 4.83); P = 0.250), total morbidity (RR 0.89 (95 per cent 0.71 c.i. to 1.13); P = 0.350), major morbidity (RR 1.34 (95 per cent c.i. 0.92 to 1.97); P = 0.130) or need for additional procedures (OR 1.37 (95 per cent c.i. 0.82 to 2.29); P = 0.230) between the endoscopic and surgical groups. There was also no significant difference between the endoscopic and laparoscopic surgery groups. Both approaches have similar outcomes, and treatment should be determined by local resources and expertise.

Epidemiology of canine parvovirus and coronavirus in dogs presented with severe diarrhoea to PDSA PetAid hospitals.

PubMed

Godsall, S A; Clegg, S R; Stavisky, J H; Radford, A D; Pinchbeck, G

2010-08-07

Canine parvovirus (CPV) and canine enteric coronavirus (CECoV) are often cited as causes of diarrhoea in dogs. This study aimed to determine the prevalence of CPV and CECoV in dogs presenting with severe diarrhoea to PDSA PetAid hospitals throughout the UK. A total of 355 samples were collected from the PDSA between 2006 and 2008. All samples were tested for CPV using a long range PCR and for CECoV using RT-PCR. The prevalence of CPV was 58 per cent (95 per cent confidence interval [CI] 52 to 63 per cent), with some evidence for regional variation. The prevalence of CECoV was 7.9 per cent (95 per cent CI 5.1 to 10.7 per cent). Analysis showed that animals with no history of vaccination were more likely to be CPV positive, with greatest effect in younger animals. CPV-positive animals were more likely to present with depression/lethargy than CPV-negative cases. The volume of diarrhoea and the presence of haemorrhage did not appear to be associated with the likelihood of detecting CPV. This study shows that CPV is a common finding in dogs presenting to PDSA hospitals with severe diarrhoea, and that CECoV is a less common but still potentially important pathogen. It also confirms that young and unvaccinated animals appear to be more at risk of presenting with CPV.

Breastfeeding at 6 weeks and predictive factors.

PubMed

Chye, J K; Zain, Z; Lim, W L; Lim, C T

1997-10-01

Despite the numerous changes made in accordance with the Baby Friendly Hospital Initiative at the University Hospital, Kuala Lumpur, the low rates of breastfeeding have persisted. This study aims to examine the current trend in infant feeding, and the influences of some perinatal and sociodemographic factors on breastfeeding. Five-hundred mothers with singleton pregnancies and healthy infants were interviewed at 6 weeks post-partum. Only 124 (25 per cent) mothers were practising exclusive breastfeeding (EBF), and 132 (26 per cent) mothers were using exclusive infant formula feeding (EIF). On logistic regression analyses, mothers who followed EBF were more likely to have had antenatal plans to breastfeed (Odds ratio 2.44, 95 per cent confidence interval 1.75-3.45), not in paid employment post-natally (OR 1.76, 95 per cent CI 1.31-2.36), of older age group (> 27 years) (OR 1.48, 95 per cent CI 1.13-1.93), had female infants (OR 1.38, 95 per cent CI 1.05-1.80) and of Indian ethnicity (compared to Chinese) (OR 3.87, 95 per cent CI 2.16-6.89). Breastfeeding difficulties were associated with decreased odds of EBF (OR 0.21, 95 per cent CI 0.13-0.34). Parental education, fathers' ages and incomes, primigravida status, Caesarean section, present of episiotomy, late first breastfeed, phototherapy, and length of hospital stay were not significant predictors of failure of EBF. In comparison, predictive factors for increased use of EIF were mothers who have had breastfeeding difficulties, < or = 9 years of schooling, and of Chinese descent. In conclusions, the overall rate of EBF by 6 weeks of age in infants born in this urban hospital had remained poor. The adverse factors for EBF identified in this study warrant further in-depth studies to determine effective ways of improving EBF rates.

One year study of bacterial and fungal nosocomial infections among patients in pediatric intensive care unit (PICU) in Alexandria.

PubMed

El-Nawawy, Ahmed Ahmed; Abd El-Fattah, Mohamed Mohamed; Metwally, Hala Abd El-Raouf; Barakat, Shahira Salah El Din; Hassan, Ihab Abdel Rehim

2006-06-01

A 1-year prospective and observational study included all admissions (n=216) until 48 h after discharge to Alexandria PICU between first of May 2003 and end of April 2004. Cultures for bacteria and fungi and antibiotic sensitivity tests (19 antibiotic using Bauer-Kirby disc diffusion method) were obtained (blood, stool, urine and cerebrospinal fluid, if needed) and repeated on suspicion of NIs. All cannulae, endotracheal tube (ET) aspirates and tips, nasogastric tubes and different catheters were cultured. All PICU health care workers (HCWs) were subjected to throat and under-finger nails cultures as well as inanimate objects, both on bimonthly basis. The referral place (ward or emergency), PRISM III score, length of stay (LOS) and fate were recorded. Amongst those patients whose age ranged from 1 to 23 months, 23 per cent had NIs with infection rates of 40/1000 days. Significantly high rates of mortality, LOS and PRISM III score were encountered among patients with NIs (52 per cent vs 30 per cent; 9.4+/-4.8 vs 5.4+/-2.2 days; 14.4+/-7 vs 11.8+/-6 respectively). The descending order of frequency of NIs was blood stream infection (BSI) (47 per cent), urinary tract infection (UTI) (28 per cent), ventilator-associated pneumonia (VAP) (16 per cent) and meningitis (9 per cent). Gr-ve bacilli accounted for 76.7 per cent; Gr+ve cocci 13.3 per cent (with satisfactory sensitivity to cefepime, imipenem and meropenem) and Candida albicans 10 per cent of all NIs. The rate of NIs/1000 device days were: 18.7 per cent for BSI, 10.9 per cent for VAP and 25.5 per cent for UTI. Vulnerable age groups were >6 m for VAP and <6 m for meningitis. Multiple logistic regression analysis identified LOS, PRISM III score and referral from wards a predictors of NI acquisition (odd ratio and 95 per cent confidence interval: 1.537, 1.423-1.659; 1.073, 1.041-1.105 and 0.269, 0.178-0.406 respectively). Bimonthly cultures for HCWs isolated coagulase-ve Staphylococci, while inanimate objects isolated diphtheroids and Candida albicans. NIs rate was high (23 per cent) mainly due to severity of condition on admission as shown by high PRISM III score value, the high PRISM III score, LOS and referral from wards were predictors of acquisition of NIs and there is a high incidence of Candida albicans infection (10 per cent of NIs).

Vascular surgical society of great britain and ireland: immunoglobulin A antibodies against chlamydia pneumoniae are associated with expansion of small abdominal aortic aneurysms and declining ankle blood pressure

PubMed

Lindholt; Vammen; Henneberg; Fasting

1999-05-01

BACKGROUND: The potential correlation between chronic infection with Chlamydia pneumoniae and the progression of small abdominal aortic aneurysms (AAAs) and lower limb atherosclerosis was studied. METHODS: Mass screening for AAA was carried out in outdoor clinics at all hospitals in the county. Some 139 men (aged 65-73 years) with a 3.0-4.9-cm AAA were followed prospectively for 1-3 (mean 2.7) years. Initially, an interview and examination was performed, and blood samples were taken. RESULTS: Some 62 per cent (53-71 per cent) had an immunoglobulin (Ig) A level of 40 or more, or an IgG level of 64 or above. Some 83 per cent (74-93 per cent) had an IgA level of 20 or more, or an IgG level of 32 or more. Men with an IgA level of 20 or more had 51 per cent greater AAA expansion and men with an IgA level of 40 or above had 24 per cent more expansion. An IgA level of 20 or more, or IgA of 40 or greater, were significant independent predictors of AAA expansion adjusted for age, smoking, initial AAA size, steroid treatment, diastolic blood pressure, pulmonary function and other plasma factors. The ankle blood pressure index (ABI) of the IgA-seropositive men decreased 11 per cent, while the ABI decreased by 5 per cent among IgA-seronegative men (P < 0.05). The significant difference persisted after adjusting for age, smoking, initial systolic ankle blood pressure, initial brachial systolic or diastolic blood pressure, but disappeared after adjusting for low-density lipoprotein (LDL) levels. CONCLUSION: A high proportion of men with a small AAA have signs of chronic C. pneumoniae infection. The progression of AAAs and lower limb atherosclerosis seems to be correlated to chronic infection with C. pneumoniae.

Surgical delay is a critical determinant of survival in perforated peptic ulcer.

PubMed

Buck, D L; Vester-Andersen, M; Møller, M H

2013-07-01

Morbidity and mortality following perforated peptic ulcer (PPU) remain substantial. Surgical delay is a well established negative prognostic factor, but evidence derives from studies with a high risk of bias. The aim of the present nationwide cohort study was to evaluate the adjusted effect of hourly surgical delay on survival after PPU. This was a cohort study including all Danish patients treated surgically for PPU between 1 February 2003 and 31 August 2009. Medically treated patients and those with a malignant ulcer were excluded. The associations between surgical delay and 30-day survival are presented as crude and adjusted relative risks (RRs) with 95 per cent confidence intervals (c.i.). A total of 2668 patients were included. Their median age was 70·9 (range 16·2-104·2) years and 55·4 per cent (1478 of 2668) were female. Some 67·5 per cent of the patients (1800 of 2668) had at least one of six co-morbid diseases and 45·6 per cent had an American Society of Anesthesiologists fitness grade of III or more. A total of 708 patients (26·5 per cent) died within 30 days of surgery. Every hour of delay from admission to surgery was associated with an adjusted 2·4 per cent decreased probability of survival compared with the previous hour (adjusted RR 1·024, 95 per cent c.i. 1·011 to 1·037). Limiting surgical delay in patients with PPU seems of paramount importance. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

PubMed Central

Naidoo, Mergan

2016-01-01

Background Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM). Methods An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa. Results Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05). Conclusion The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot. PMID:28155315

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa.

PubMed

Goie, Thea T; Naidoo, Mergan

2016-11-17

Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM). An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa. Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2-4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8-11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p < 0.05). The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

Simulating the effect of non-linear mode coupling in cosmological parameter estimation

NASA Astrophysics Data System (ADS)

Kiessling, A.; Taylor, A. N.; Heavens, A. F.

2011-09-01

Fisher Information Matrix methods are commonly used in cosmology to estimate the accuracy that cosmological parameters can be measured with a given experiment and to optimize the design of experiments. However, the standard approach usually assumes both data and parameter estimates are Gaussian-distributed. Further, for survey forecasts and optimization it is usually assumed that the power-spectrum covariance matrix is diagonal in Fourier space. However, in the low-redshift Universe, non-linear mode coupling will tend to correlate small-scale power, moving information from lower to higher order moments of the field. This movement of information will change the predictions of cosmological parameter accuracy. In this paper we quantify this loss of information by comparing naïve Gaussian Fisher matrix forecasts with a maximum likelihood parameter estimation analysis of a suite of mock weak lensing catalogues derived from N-body simulations, based on the SUNGLASS pipeline, for a 2D and tomographic shear analysis of a Euclid-like survey. In both cases, we find that the 68 per cent confidence area of the Ωm-σ8 plane increases by a factor of 5. However, the marginal errors increase by just 20-40 per cent. We propose a new method to model the effects of non-linear shear-power mode coupling in the Fisher matrix by approximating the shear-power distribution as a multivariate Gaussian with a covariance matrix derived from the mock weak lensing survey. We find that this approximation can reproduce the 68 per cent confidence regions of the full maximum likelihood analysis in the Ωm-σ8 plane to high accuracy for both 2D and tomographic weak lensing surveys. Finally, we perform a multiparameter analysis of Ωm, σ8, h, ns, w0 and wa to compare the Gaussian and non-linear mode-coupled Fisher matrix contours. The 6D volume of the 1σ error contours for the non-linear Fisher analysis is a factor of 3 larger than for the Gaussian case, and the shape of the 68 per cent confidence volume is modified. We propose that future Fisher matrix estimates of cosmological parameter accuracies should include mode-coupling effects.

A pilot programme of clinical practice improvement for future consultant doctors.

PubMed

Oates, Kim; Vinters, Cathy; Cass-Verco, John; Fletcher, Mandy; Kaur, Narinder; Mherekumombe, Martha; Tang, Alice

2017-04-01

To provide junior doctors with tools to improve patient care in their workplace, a partnership was developed between the Clinical Excellence Commission (CEC) and the Royal Australasian College of Physicians (RACP) to help trainee consultants carry out clinical practice improvement (CPI) projects during clinical work. Based on a patient-care problem they wished to resolve, trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods, describe their proposals and refine them using CPI methodology. They were provided with continuing supervision, participated in a mid-point review and were responsible for driving their projects. Trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods RESULTS: Examples of five projects are: reducing mislabelled specimens leaving an emergency department, from 82 in the baseline period to 18 following the intervention; creating a multidisciplinary team to reduce hypoglycaemic episodes on a diabetic ward, from 23 episodes at baseline to three episodes over the same time period after the intervention; establishing an acute paediatric review clinic that reduced avoidable admissions of pneumonia by 74 per cent; providing 100 per cent of patients in a palliative care unit with an effective pain-management plan; developing an education package to increase staff confidence in recognising and responding to anaphylaxis in children, producing an increase in confidence from 51 per cent at baseline to 100 per cent after the intervention. Involving a learned college such as the RACP in patient-care improvement, with educational input from a partner organisation, shows how junior staff can become effective leaders in improving patient care. © 2016 John Wiley & Sons Ltd.

The occurrence of planets and other substellar bodies around white dwarfs using K2

NASA Astrophysics Data System (ADS)

van Sluijs, L.; Van Eylen, V.

2018-03-01

The majority of stars both host planetary systems and evolve into a white dwarf (WD). To understand their post-main-sequence planetary system evolution, we present a search for transiting/eclipsing planets and other substellar bodies (SBs) around WDs using a sample of 1148 WDs observed by K2. Using transit injections, we estimate the completeness of our search. We place constraints on the occurrence of planets and SBs around WDs as a function of planet radius and orbital period. For short-period (P < 40 d) small objects, from asteroid-sized to 1.5 R⊕, these are the strongest constraints known to date. We further constrain the occurrence of hot Jupiters ( < 1.5 per cent), habitable zone Earth-sized planets ( < 28 per cent), and disintegrating short-period planets ( ˜ 12 per cent). We blindly recovered all previously known eclipsing objects, providing confidence in our analysis, and make all light curves publicly available.

On the frequency of close binary systems among very low-mass stars and brown dwarfs

NASA Astrophysics Data System (ADS)

Maxted, P. F. L.; Jeffries, R. D.

2005-09-01

We have used Monte Carlo simulation techniques and published radial velocity surveys to constrain the frequency of very low-mass star (VLMS) and brown dwarf (BD) binary systems and their separation (a) distribution. Gaussian models for the separation distribution with a peak at a= 4au and 0.6 <=σlog(a/au)<= 1.0, correctly predict the number of observed binaries, yielding a close (a < 2.6au) binary frequency of 17-30 per cent and an overall VLMS/BD binary frequency of 32-45 per cent. We find that the available N-body models of VLMS/BD formation from dynamically decaying protostellar multiple systems are excluded at >99 per cent confidence because they predict too few close binary VLMS/BDs. The large number of close binaries and high overall binary frequency are also very inconsistent with recent smoothed particle hydrodynamical modelling and argue against a dynamical origin for VLMS/BDs.

Applying Emax model and bivariate thin plate splines to assess drug interactions.

PubMed

Kong, Maiying; Lee, J Jack

2010-01-01

We review the semiparametric approach previously proposed by Kong and Lee and extend it to a case in which the dose-effect curves follow the Emax model instead of the median effect equation. When the maximum effects for the investigated drugs are different, we provide a procedure to obtain the additive effect based on the Loewe additivity model. Then, we apply a bivariate thin plate spline approach to estimate the effect beyond additivity along with its 95 per cent point-wise confidence interval as well as its 95 per cent simultaneous confidence interval for any combination dose. Thus, synergy, additivity, and antagonism can be identified. The advantages of the method are that it provides an overall assessment of the combination effect on the entire two-dimensional dose space spanned by the experimental doses, and it enables us to identify complex patterns of drug interaction in combination studies. In addition, this approach is robust to outliers. To illustrate this procedure, we analyzed data from two case studies.

Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy.

PubMed

Zierler, S; Rothman, K J

1985-08-08

To clarify the association of Bendectin and other drugs used in early pregnancy with the occurrence of congenital heart disease, we interviewed 298 mothers of children with congenital heart disease and 738 mothers of healthy controls. Differential recall of drug use by mothers of affected children and mothers of controls was evaluated by comparison of information collected by interview with that recorded in the prenatal record. Data derived from maternal interviews were generally consistent with the record data. Reported Bendectin use was minimally associated with congenital heart disease (prevalence odds ratio, 1.1; 90 per cent confidence interval, 0.8 to 1.5). The data from this study were consistent with previously reported associations of other drugs with congenital heart disease. In particular, aspirin use in early pregnancy was associated with about a twofold increase in the frequency of defects in septation of the truncus arteriosus (prevalence odds ratio, 2.1; 90 per cent confidence interval, 1.1 to 3.9).

Maximal compression of the redshift-space galaxy power spectrum and bispectrum

NASA Astrophysics Data System (ADS)

Gualdi, Davide; Manera, Marc; Joachimi, Benjamin; Lahav, Ofer

2018-05-01

We explore two methods of compressing the redshift-space galaxy power spectrum and bispectrum with respect to a chosen set of cosmological parameters. Both methods involve reducing the dimension of the original data vector (e.g. 1000 elements) to the number of cosmological parameters considered (e.g. seven ) using the Karhunen-Loève algorithm. In the first case, we run MCMC sampling on the compressed data vector in order to recover the 1D and 2D posterior distributions. The second option, approximately 2000 times faster, works by orthogonalizing the parameter space through diagonalization of the Fisher information matrix before the compression, obtaining the posterior distributions without the need of MCMC sampling. Using these methods for future spectroscopic redshift surveys like DESI, Euclid, and PFS would drastically reduce the number of simulations needed to compute accurate covariance matrices with minimal loss of constraining power. We consider a redshift bin of a DESI-like experiment. Using the power spectrum combined with the bispectrum as a data vector, both compression methods on average recover the 68 {per cent} credible regions to within 0.7 {per cent} and 2 {per cent} of those resulting from standard MCMC sampling, respectively. These confidence intervals are also smaller than the ones obtained using only the power spectrum by 81 per cent, 80 per cent, and 82 per cent respectively, for the bias parameter b1, the growth rate f, and the scalar amplitude parameter As.

Barriers to glaucoma case finding as perceived by optometrists in Ireland.

PubMed

Barrett, Catriona; O'Brien, Colm; Butler, John S; Loughman, James

2018-01-01

This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95 per cent CI 1.3-8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ 2 [1] = 13.52, p < 0.001). Multiple linear regression showed that optometrists with less experience, charging lower fees, and working in large multiples or franchised practices have the shortest appointment times. The strong link found between postgraduate education and the confidence of optometrists in detecting glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest. The responses also indicate a lack of funding for the level of diagnostic testing required for accurate glaucoma diagnosis. Recent increases in the state's eye examination fees look likely to address the identified time and financial barriers to glaucoma detection in Ireland. Future work should look to analyse the effects of increased funding on optometric case finding for glaucoma. © 2017 Optometry Australia.

Influence of body mass index on mortality after surgery for perforated peptic ulcer.

PubMed

Buck, D L; Møller, M H

2014-07-01

Body mass index (BMI) is a strong predictor of mortality in the general population. In spite of the medical hazards of obesity, a protective effect on mortality has been suggested in surgical patients: the obesity paradox. The aim of the present nationwide cohort study was to examine the association between BMI and mortality in patients treated surgically for perforated peptic ulcer (PPU). This was a national prospective cohort study of all Danish patients treated surgically for PPU between 1 February 2003 and 31 August 2009, for whom BMI was registered. Non-surgically treated patients and those with malignant ulcers were excluded. The primary outcome measure was 90-day mortality. The association between BMI and mortality was calculated as crude and adjusted relative risks (RRs) with 95 per cent confidence intervals (c.i.). Of 2668 patients who underwent surgical treatment for PPU, 1699 (63.7 per cent) had BMI recorded. Median age was 69.4 (range 17.6-100.9) years and 53.7 per cent of the patients were women. Some 1126 patients (66.3 per cent) had at least one of six co-morbid diseases; 728 (42.8 per cent) had an American Society of Anesthesiologists grade of III or more. A total of 471 patients (27.7 per cent) died within 90 days of surgery. Being underweight was associated with a more than twofold increased risk of death following surgery for PPU (adjusted RR 2.26, 95 per cent c.i. 1.37 to 3.71). No statistically significant association was found between obesity and mortality. Being underweight was associated with increased mortality in patients with PPU, whereas being overweight or obese was neither protective nor an adverse prognostic factor. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

PubMed

Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

2002-04-01

Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

Costs of polio immunization days in China: implications for mass immunization campaign strategies.

PubMed

Zhang, J; Yu, J J; Zhang, R Z; Zhang, X L; Zhou, J; Wing, J S; Schnur, A; Wang, K A

1998-01-01

Ten provinces of China were selected to estimate the cost per immunization of the 1994-95 national immunization days (NIDs) at five levels (e.g. province, prefecture, county, township and village). Personnel costs accounted for the largest overall share of costs (39 per cent), followed by publicity and promotion costs (27 per cent), and logistic costs (15 per cent). Without consideration of vaccine costs, the major part of NID expenses were shouldered at the township level, which paid for 47 per cent of all incremental costs, while county and village level covered 28 per cent and 18 per cent respectively. Estimation of average costs per immunization was 2.86 RMB yuan, or $0.34, including vaccine costs, buildings and equipment amortization and salaries at all levels. The factors affecting average cost of NID included the output volume, socio-economic development and geographic features. Various approaches were recommended: to intensify the productivity of time and staff, to employ alternative inexpensive manpower resources, to make the best use of publicity and social promotion, the expansion of the age groups and utilization of multi-intervention strategies. Good planning at township level was a decisive factor to ensure an effective NID conducted in an efficient manner. The average cost of China's NID was the lowest among all mass immunization campaigns ever documented. Much of the reduced average cost was attributable to economies of scale.

Women in Science, Resource Guide.

ERIC Educational Resources Information Center

Michigan Univ., Ann Arbor. School of Dentistry.

Many young women must contend with social and psychological barriers that prevent them from pursuing careers in science and mathematics. Because of lack of confidence, misconceptions, lack of preparation, and discrimination, many women self-select themselves out of as many as 75 per cent of all careers before they reach college age. This series…

Comparison of haemoglobin estimates using direct & indirect cyanmethaemoglobin methods.

PubMed

Bansal, Priyanka Gupta; Toteja, Gurudayal Singh; Bhatia, Neena; Gupta, Sanjeev; Kaur, Manpreet; Adhikari, Tulsi; Garg, Ashok Kumar

2016-10-01

Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions. Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation. Haemoglobin levels were estimated for 888 adolescent girls aged 11-18 yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared. The mean haemoglobin levels for 888 whole blood samples estimated by direct and indirect cyanmethaemoglobin method were 116.1 ± 12.7 and 110.5 ± 12.5 g/l, respectively, with a mean difference of 5.67 g/l (95% confidence interval: 5.45 to 5.90, P<0.001); which is equivalent to 0.567 g%. The prevalence of anaemia was reported as 59.6 and 78.2 per cent by direct and indirect methods, respectively. Sensitivity and specificity of indirect cyanmethaemoglobin method were 99.2 and 56.4 per cent, respectively. Using regression analysis, prediction equation was developed for indirect haemoglobin values. The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods.

Tongue-lip adhesion and tongue repositioning for obstructive sleep apnoea in Pierre Robin sequence: A systematic review and meta-analysis.

PubMed

Camacho, M; Noller, M W; Zaghi, S; Reckley, L K; Fernandez-Salvador, C; Ho, E; Dunn, B; Chan, D K

2017-05-01

To search for studies on tongue-lip adhesion and tongue repositioning used as isolated treatments for obstructive sleep apnoea in children with Pierre Robin sequence. A systematic literature search of PubMed/Medline and three additional databases, from inception through to 8 July 2016, was performed by two authors. Seven studies with 90 patients (59 tongue-lip adhesion and 31 tongue repositioning patients) met the inclusion criteria. Tongue-lip adhesion reduced the mean (± standard deviation) apnoea/hypopnoea index from 30.8 ± 22.3 to 15.4 ± 18.9 events per hour (50 per cent reduction). The apnoea/hypopnoea index mean difference for tongue-lip adhesion was -15.28 events per hour (95 per cent confidence interval = -30.70 to 0.15; p = 0.05). Tongue-lip adhesion improved the lowest oxygen saturation from 75.8 ± 6.8 to 84.4 ± 7.3 per cent. Tongue repositioning reduced the apnoea/hypopnoea index from 46.5 to 17.4 events per hour (62.6 per cent reduction). Tongue repositioning improved the mean oxygen saturation from 90.8 ± 1.2 to 95.0 ± 0.5 per cent. Tongue-lip adhesion and tongue repositioning can improve apnoea/hypopnoea index and oxygenation parameters in children with Pierre Robin sequence and obstructive sleep apnoea.

Community Mothers Programme--seven year follow-up of a randomized controlled trial of non-professional intervention in parenting.

PubMed

Johnson, Z; Molloy, B; Scallan, E; Fitzpatrick, P; Rooney, B; Keegan, T; Byrne, P

2000-09-01

The Community Mothers Programme aims at using experienced volunteer mothers in disadvantaged areas to give support to first-time parents in rearing their children up to 1 year of age. The programme was evaluated by randomized controlled trial in 1990. Seven years later, trial participants were interviewed about child health, nutrition, cognitive stimulation, parenting skills, and maternal self-esteem. The aim of this study was to see whether the demonstrated benefits at 1 year of age of this programme could be sustained at age 8. One-third of the original group (38 intervention, 38 control), were contacted and interviewed. The risk for having an accident requiring a hospital visit was lower in the intervention group: relative risk (RR) 0.59, 95 per cent confidence interval (CI) 0.31-1.11. Intervention children were more likely to visit the library weekly: RR 1.58, 95 per cent CI 1.10-2.26. Intervention mothers were more likely to check homework every night: RR 1.23, 95 per cent CI 1.05-1.43 (p=0.006); and to disagree with the statement 'children should be smacked for persistently bad behaviour': RR 2.11, 95 per cent CI 1.10-4.06. They were more likely to disagree with the statement 'I do not have much to be proud of': RR 1.24, 95 per cent CI 1.04-1.40; and to make a positive statement about motherhood than controls: RR 1.53, 95 per cent CI 1.06-2.20. Subsequent children of intervention mothers were more likely to have completed Haemophilus influenzae b: RR 1.26, 95 per cent CI 1.06-1.51; and polio immunization: RR 1.19, 95 per cent CI 1.02-1.40. The Community Mothers programme had sustained beneficial effects on parenting skills and maternal self-esteem 7 years later with benefit extending to subsequent children.

Meta-analysis of aberrant lymphatic drainage in recurrent breast cancer.

PubMed

Ahmed, M; Baker, R; Rubio, I T

2016-11-01

Sentinel node biopsy (SNB) in recurrent breast cancer offers targeted axillary staging compared with axillary lymph node dissection (ALND) or no treatment. The evidence for lymphatic mapping in recurrent breast cancer is reviewed, focusing on aberrant drainage and its implications for patient management. A meta-analysis of studies evaluating lymphatic mapping in recurrent breast cancer was performed. Outcomes included sentinel node identification, aberrant lymphatic pathways and metastatic node rates in aberrant drainage and ipsilateral axilla. Pooled odds ratios (ORs) and 95 per cent confidence intervals (c.i.) were estimated using fixed-effect analyses, or random-effects analyses in the event of statistically significant heterogeneity. Seven studies reported data on lymphatic mapping in 1053 patients with recurrent breast cancer. The intraoperative sentinel node identification rate was 59·6 (95 per cent c.i. 56·7 to 62·6) per cent, and significantly greater when the original axillary surgery was SNB compared with ALND (OR 2·97, 95 per cent c.i. 1·66 to 5·32). The rate of aberrant lymphatic drainage identification was 25·7 (23·0 to 28·3) per cent, and significantly greater when the original axillary surgery was ALND (OR 0·27, 0·19 to 0·38). The metastatic sentinel node rate was 10·4 (8·6 to 12·3) per cent, and a significantly greater metastatic nodal burden was identified in the ipsilateral axilla (OR 6·31, 1·03 to 38·79). Lymphatic mapping is feasible in recurrent breast cancer. It avoids ALND in over 50 per cent of patients who have undergone SNB, and allows the 4 per cent of patients with metastatically involved aberrant nodes to receive targeted surgical and adjuvant therapies. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Views and practices of Australian optometrists regarding driving for patients with central visual impairment.

PubMed

Oberstein, Sharon L; Boon, Mei Ying; Chu, Byoung Sun; Wood, Joanne M

2016-09-01

Eye-care practitioners are often required to make recommendations regarding their patients' visual fitness for driving, including patients with visual impairment. This study aimed to understand the perspectives and management strategies adopted by optometrists regarding driving for their patients with central visual impairment. Optometrists were invited to participate in an online survey (from April to June 2012). Items were designed to explore the views and practices adopted by optometrists regarding driving for patients with central visual impairment (visual acuity [VA] poorer than 6/12, normal visual fields, cognitive and physical health), including conditional driver's licences and bioptic telescopes. Closed- and open-ended questions were used. The response rate was 14 per cent (n = 300 valid responses were received). Most respondents (83 per cent) reported that they advised their patients with visual impairment to 'always' or 'sometimes' stop driving. Most were confident in interpreting the visual licensing standards (78 per cent) and advising on legal responsibilities concerning driving (99 per cent). Respondents were familiar with VA requirements for unconditional licensing (98 per cent); however, the median response VA of 6/15 as the poorest VA suggested for conditional licences differed from international practice and Australian medical guidelines released a month prior to the survey's launch. Few respondents reported prescribing bioptic telescopes (two per cent). While 97 per cent of respondents stated that they discussed conditional licences with their patients with visual impairment, relatively few (28 per cent) reported having completed conditional licence applications for such individuals in the previous year. Those who had completed applications were more experienced in years of practice (p = 0.02) and spent more time practising in rural locations (p = 0.03) than those who had not. The majority of Australian optometrists were receptive to the possibilities of driving options for individuals with central visual impairment, although management approaches varied with respect to conditional licensing. © 2016 Optometry Australia.

Does the virtual refractor patient-simulator improve student competency when refracting in the consulting room?

PubMed

Alhazmi, Mohammed S; Butler, Craig W; Junghans, Barbara M

2018-06-12

The use of patient simulators in ophthalmic education appears limited. This study examines the effects of the addition of the 'Virtual Refractor' patient simulator learning activity into a short unit preparing students to determine the power of the spectacle lenses required by patients in a clinic. Twenty-four year one optometry students were randomly assigned to either the simulator-intervention group (n = 12) or the non-intervention group. All students attended tutorials on refraction and the use of a refractor-head. Simulator-intervention students additionally attended a tutorial on the Virtual Refractor. All answered a questionnaire concerning time spent studying, perceived knowledge and confidence. Twenty-four short-sighted patients were recruited. Two refractions per student were timed and the accuracy compared with that of an experienced optometrist. Ten students from each group completed the study. Students who used the simulator were significantly (p < 0.05) more accurate at a clinical level (within 0.22 ± 0.22 DS, 95 per cent CI 0.12-0.32) than those who did not (within 0.60 ± 0.67 DS, 95 per cent CI 0.29-0.92) and 13 per cent quicker (4.7 minutes, p < 0.05). Students who used the simulator felt more knowledgeable (p < 0.05) and confident (p < 0.05), but had spent more time reading about refraction and practised on the Virtual Refractor at home for 5.7 ± 1.3 hours. The Virtual Refractor has many features of high-fidelity medical simulation known to lead to effective learning and it also offers flexible independent learning without a concomitant increase in the student time-burden. The improved accuracy and speed on first patient encounters found in this study validates the use of this patient simulator as a useful bridge for students early in training to successfully transfer theoretical knowledge prior to entering the consulting room. The translational benefits resulting from compulsory learning activities on a patient simulator can lead to reduced demands on infrastructure and clinical supervision. © 2018 Optometry Australia.

Protein requirements of bobwhite chicks for survival, growth and efficiency of feed utilization

USGS Publications Warehouse

Nestler, R.B.; Bailey, W.W.; McClure, H.E.

1942-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Methods for the investigation of the statistics of the commercial fisheries of the Great Lakes

USGS Publications Warehouse

Hile, Ralph; Duden, William R.

1933-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Using radiotelemetry to monitor cardiac response of free-living tule greater white-fronted geese (Anser albifrons elgasi) to human disturbance

USGS Publications Warehouse

Ackerman, Joshua T.; Takekawa, John Y.; Kruse, K.L.; Orthmeyer, D.L.; Yee, J.L.; Ely, Craig R.; Ward, D.H.; Bollinger, K.S.; Mulcahy, D.M.

2004-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Breast reconstruction in the United Kingdom and Ireland.

PubMed

Callaghan, C J; Couto, E; Kerin, M J; Rainsbury, R M; George, W D; Purushotham, A D

2002-03-01

Although it is becoming more common, previous surveys have identified concerns regarding the safety of immediate reconstruction following mastectomy. The aims of this study were to define current practice of breast reconstruction in the UK and Ireland, and to identify the characteristics of surgeons who use immediate breast reconstruction. : A postal questionnaire survey of 498 consultant breast surgeons in the UK and Ireland was performed in January 2000. There were 376 responses (response rate 76 per cent). Eighty-eight per cent of surgeons 'always' or 'usually' discuss reconstruction with patients due to undergo mastectomy; clinicians with a heavy caseload were significantly more likely to discuss it (odds ratio (OR) 18.45 (95 per cent confidence interval 1.99 to 171.07)). The majority of respondents (57 per cent) preferred delayed to immediate breast reconstruction; 70 per cent believed that immediate reconstruction has disadvantages, most commonly that it interferes with adjuvant therapy (56 per cent). Older surgeons were significantly less likely to perform immediate reconstruction (OR 5.18 (2.21 to 12.11)), and were significantly more likely to believe that immediate breast reconstruction has disadvantages (OR 2.02 (1.01 to 4.05)). Surgeons from Ireland were less likely to discuss and perform breast reconstruction (OR 0.20 (0.10 to 0.43) and 0.27 (0.12 to 0.60) respectively), or to have access to a plastic surgeon (OR 0.22 (0.11 to 0.44)). : Significant variation exists in the delivery of breast reconstruction after mastectomy in the UK and Ireland. The age, workload and personal characteristics of the surgeon are important in determining reconstructive practice.

Helium in the eroding atmosphere of an exoplanet

NASA Astrophysics Data System (ADS)

Spake, J. J.; Sing, D. K.; Evans, T. M.; Oklopčić, A.; Bourrier, V.; Kreidberg, L.; Rackham, B. V.; Irwin, J.; Ehrenreich, D.; Wyttenbach, A.; Wakeford, H. R.; Zhou, Y.; Chubb, K. L.; Nikolov, N.; Goyal, J. M.; Henry, G. W.; Williamson, M. H.; Blumenthal, S.; Anderson, D. R.; Hellier, C.; Charbonneau, D.; Udry, S.; Madhusudhan, N.

2018-05-01

Helium is the second-most abundant element in the Universe after hydrogen and is one of the main constituents of gas-giant planets in our Solar System. Early theoretical models predicted helium to be among the most readily detectable species in the atmospheres of exoplanets, especially in extended and escaping atmospheres1. Searches for helium, however, have hitherto been unsuccessful2. Here we report observations of helium on an exoplanet, at a confidence level of 4.5 standard deviations. We measured the near-infrared transmission spectrum of the warm gas giant3 WASP-107b and identified the narrow absorption feature of excited metastable helium at 10,833 angstroms. The amplitude of the feature, in transit depth, is 0.049 ± 0.011 per cent in a bandpass of 98 angstroms, which is more than five times greater than what could be caused by nominal stellar chromospheric activity. This large absorption signal suggests that WASP-107b has an extended atmosphere that is eroding at a total rate of 1010 to 3 × 1011 grams per second (0.1-4 per cent of its total mass per billion years), and may have a comet-like tail of gas shaped by radiation pressure.

Coagulation Profile Changes Due to Thromboprophylaxis and Platelets in Trauma Patients at High-Risk for Venous Thromboembolism.

PubMed

Allen, Casey J; Murray, Clark R; Meizoso, Jonathan P; Ray, Juliet J; Teisch, Laura F; Ruiz, Xiomara D; Hanna, Mena M; Guarch, Gerardo A; Manning, Ronald J; Livingstone, Alan S; Ginzburg, Enrique; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G

2015-07-01

We hypothesize there are coagulation profile changes associated both with initiation of thromboporphylaxis (TPX) and with change in platelet levels in trauma patients at high-risk for venous thromboembolism (VTE). A total of 1203 trauma intensive care unit patients were screened with a VTE risk assessment profile. In all, 302 high-risk patients (risk assessment profile score ≥ 10) were consented for weekly thromboelastography. TPX was initiated between initial and follow-up thromboelastography. Seventy-four patients were analyzed. Upon admission, 87 per cent were hypercoagulable, and 81 per cent remained hypercoagulable by Day 7 (P = 0.504). TPX was initiated 3.4 ± 1.4 days after admission; 68 per cent received unfractionated heparin and 32 per cent received low-molecular-weight heparin. The VTE rate was 18 per cent, length of stay 38 (25-37) days, and mortality of 17.6 per cent. In all, 76 per cent had a rapid clotting time at admission versus 39 per cent at Day 7 (P < 0.001); correcting from 7.75 (6.45-8.90) minutes to 10.45 (7.90-15.25) minutes (P < 0.001). At admission, 41 per cent had an elevated maximum clot formation (MCF) and 85 per cent had at Day 7 (P < 0.001); increasing from 61(55-65) mm to 75(69-80) mm (P < 0.001). Platelets positively correlated with MCF at admission (r = 0.308, R(2) = 0.095, P = 0.008) and at Day 7 (r = 0.516, R(2) = 0.266, P < 0.001). Change in platelet levels correlated with change in MCF (r = 0.332, R(2) = 0.110, P = 0.005). In conclusion, hypercoagulability persists despite the use of TPX. Although clotting time normalizes, MCF increases in correlation with platelet levels. As platelet function is a dominant contributor to sustained trauma-evoked hypercoagulability, antiplatelet therapy may be indicated in the management of severely injured trauma patients.

Is psychotropic medication use related to organisational and treatment culture in residential care.

PubMed

Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

2015-01-01

The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture may be another avenue to improve prescribing in residential aged care.

The H II galaxy Hubble diagram strongly favours Rh = ct over ΛCDM

NASA Astrophysics Data System (ADS)

Wei, Jun-Jie; Wu, Xue-Feng; Melia, Fulvio

2016-12-01

We continue to build support for the proposal to use H II galaxies (HIIGx) and giant extragalactic H II regions (GEHR) as standard candles to construct the Hubble diagram at redshifts beyond the current reach of Type Ia supernovae. Using a sample of 25 high-redshift HIIGx, 107 local HIIGx, and 24 GEHR, we confirm that the correlation between the emission-line luminosity and ionized-gas velocity dispersion is a viable luminosity indicator, and use it to test and compare the standard model ΛCDM and the Rh = ct universe by optimizing the parameters in each cosmology using a maximization of the likelihood function. For the flat ΛCDM model, the best fit is obtained with Ω _m= 0.40_{-0.09}^{+0.09}. However, statistical tools, such as the Akaike (AIC), Kullback (KIC) and Bayes (BIC) Information Criteria favour Rh = ct over the standard model with a likelihood of ≈94.8-98.8 per cent versus only ≈1.2-5.2 per cent. For wCDM (the version of ΛCDM with a dark-energy equation of state wde ≡ pde/ρde rather than wde = wΛ = -1), a statistically acceptable fit is realized with Ω _m=0.22_{-0.14}^{+0.16} and w_de= -0.51_{-0.25}^{+0.15} which, however, are not fully consistent with their concordance values. In this case, wCDM has two more free parameters than Rh = ct, and is penalized more heavily by these criteria. We find that Rh = ct is strongly favoured over wCDM with a likelihood of ≈92.9-99.6 per cent versus only 0.4-7.1 per cent. The current HIIGx sample is already large enough for the BIC to rule out ΛCDM/wCDM in favour of Rh = ct at a confidence level approaching 3σ.

Survey of quantitative antimicrobial consumption in two different pig finishing systems.

PubMed

Moreno, M A

2012-09-29

The primary objectives of this study were to: (a) collect on-farm antimicrobial use (AMU) data in fattener pigs employing two questionnaire-based surveys; (b) assess different quantitative measures for quantifying AMU in fattener pigs; (c) compare AMU in fattener pigs between two different management systems producing finishers: farrow-to-finish (FtF) farms versus finisher farms. Two questionnaires were designed both containing five groups of questions focused on the responder, the farm and AMU (eg, in-feed, in-drinking water and parenteral); both surveys were carried out by means of personal face-to-face interviews. Both surveys started with a sample size of 108 potentially eligible farms per survey; nevertheless, finally 67 finisher farms and 49 FtF farms were recruited. Overall percentages of animals exposed to antimicrobials (AM) were high (90 per cent in finisher farms and 54 per cent FtF farms); colistin (61 per cent and 33 per cent) and doxycycline (62 per cent and 23 per cent) were the most common AMs, followed by amoxicillin (51 per cent and 19 per cent) and lincomycin (49 per cent), respectively. Questionnaire-based surveys using face-to-face interviews are useful for capturing information regarding AMU at the farm level. Farm-level data per administration route can be used for comparative AMU analysis between farms. Nevertheless, for the analysis of the putative relationships between AMU and AM resistance, measures based on exposed animals or exposure events are needed.

Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery.

PubMed

2014-10-01

Recent evidence has suggested an association between postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and increased operation-specific complications. This study aimed to determine the safety profile following gastrointestinal surgery across a multicentre setting in the UK. This multicentre study was carried out during a 2-week interval in September-October 2013. Consecutive adults undergoing elective or emergency gastrointestinal resection were included. The study was powered to detect a 10 per cent increase in major complications (grade III-V according to the Dindo-Clavien classification). The effect of administration of NSAIDs on the day of surgery or the following 2  days was risk-adjusted using propensity score matching and multivariable logistic regression to produce adjusted odds ratios (ORs). The type of NSAID and the dose were registered. Across 109 centres, early postoperative NSAIDs were administered to 242 (16·1 per cent) of 1503 patients. Complications occurred in 981 patients (65·3 per cent), which were major in 257 (17·1 per cent) and minor (Dindo-Clavien grade I-II) in 724 (48·2 per cent). Propensity score matching created well balanced groups. Treatment with NSAIDs was associated with a reduction in overall complications (OR 0·72, 95 per cent confidence interval 0·52 to 0·99; P  = 0·041). This effect predominantly comprised a reduction in minor complications with high-dose NSAIDs (OR 0·57, 0·39 to 0·89; P = 0·009). Early use of NSAIDs is associated with a reduction in postoperative adverse events following major gastrointestinal surgery. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

General practitioners' knowledge and management of viral hepatitis in the migrant population.

PubMed

Guirgis, M; Yan, K; Bu, Y M; Zekry, A

2012-05-01

Escalating morbidity and mortality associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major health burden in Australia, particularly among migrants from endemic areas who may present late. We evaluated the knowledge and educational needs of general practitioners (GPs) in the St George Division, Sydney which serves a large migrant population. The aims of the study were to identify gaps in knowledge about viral hepatitis that may affect management and referral patterns. GPs completed a survey comprised of 15 questions. They were also invited to comment on barriers to managing viral hepatitis in migrant patients. A 44% response rate was achieved from 280 eligible GPs. Forty-two per cent of GPs lacked confidence in interpreting HCV serology and 20% for HBV serology. Twenty-two per cent of GPs did not recognise HCC as a complication of HBV and 18% for HCV. Twenty per cent of GPs were unaware of treatment for HBV. Forty-seven per cent of GPs were uncertain whether pregnant women could receive HCV treatment. Twenty-three per cent and 21% of respondents believed that all HCV- or HBV-infected mothers, respectively, should not breast-feed. Eighty-nine per cent of GPs identified language difficulties as the main barrier to treatment among the migrant population. There were gaps in the knowledge of GPs particularly concerning natural history, diagnosis, treatment availability and management of pregnant or lactating women with viral hepatitis. Specific educational initiatives targeting these deficits are required as well as increased availability of language resources for managing patients from a non-English-speaking background. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

Web page quality: can we measure it and what do we find? A report of exploratory findings.

PubMed

Abbott, V P

2000-06-01

The aim of this study was to report exploratory findings from an attempt to quantify the quality of a sample of World Wide Web (WWW) pages relating to MMR vaccine that a typical user might locate. Forty pages obtained from a search of the WWW using two search engines and the search expression 'mmr vaccine' were analysed using a standard proforma. The proforma looked at the information the pages contained in terms of three categories: content, authorship and aesthetics. The information from each category was then quantified into a summary statistic, and receiver operating characteristic (ROC) curves were generated using a 'gold standard' of quality derived from the published literature. Optimal cut-off points for each of the three sections were calculated that best discriminated 'good' from 'bad' pages. Pages were also assessed as to whether they were pro- or anti-vaccination. For this sample, the combined contents and authorship score, with a cut-off of five, was a good discriminator, having 88 per cent sensitivity and 92 per cent specificity. Aesthetics was not a good discriminator. In the sample, 32.5 per cent of pages were pro-vaccination; 42.5 per cent were anti-vaccination and 25 per cent were neutral. The relative risk of being of poor quality if anti-vaccination was 3.3 (95 per cent confidence interval 1.8, 6.1). The sample of Web pages did contain some quality information on MMR vaccine. It also contained a great deal of misleading, inaccurate data. The proforma, combined with a knowledge of the literature, may help to distinguish between the two.

[The use of triptan in ambulatory medicine in Midi-Pyrénées Region: clinical and pharmacological contra-indications and drug abuse].

PubMed

Roussel, Henri; Lo Re, Geneviève; Honorat, Christian; Alonso, Michèle; Sciortino, Vincent

2006-01-01

Evaluate triptan prescriptions in ambulatory medicine. Collection of medical data from 301 patients treated with triptans reimbursed by the French National Health Fund in the region of Midi-Pyrenees. Ninety-five per cent of selected patients suffered from migraine condition according to the International Headache Society diagnosis criteria [Confidence interval (CI) 95%: 93-98]. Co-morbidity factors contra-indicating triptan therapy were present in 6% of patients (CI 95%: 3-9). 2% of patients were prescribed other medicinal products contra-indicated with their triptan therapy (CI 95%: 0-4). Twenty-six per cent of patients were taking triptan medicines more than 8 times per month over a period of three months (CI 95%: 21-31) and 8% were taking this treatment more than 12 times per month (CI 95%: 5-1 I). Eleven per cent kept written information of their migraine crises (CI 95%: 7-15). Thirty-nine per cent benefited from dedicated prophylactic treatments (CI 95%: 33-45). In a context of sustained increase in prescriptions of migraine treatments, it appears necessary to remain cautious about clinical and pharmacological contra-indications. Prevention of abuse of medicines is based on a better use of crises agendas and introduction of prophylactic therapies.

Non-linearity of geocentre motion and its impact on the origin of the terrestrial reference frame

NASA Astrophysics Data System (ADS)

Dong, Danan; Qu, Weijing; Fang, Peng; Peng, Dongju

2014-08-01

The terrestrial reference frame is a cornerstone for modern geodesy and its applications for a wide range of Earth sciences. The underlying assumption for establishing a terrestrial reference frame is that the motion of the solid Earth's figure centre relative to the mass centre of the Earth system on a multidecadal timescale is linear. However, past international terrestrial reference frames (ITRFs) showed unexpected accelerated motion in their translation parameters. Based on this underlying assumption, the inconsistency of relative origin motions of the ITRFs has been attributed to data reduction imperfection. We investigated the impact of surface mass loading from atmosphere, ocean, snow, soil moisture, ice sheet, glacier and sea level from 1983 to 2008 on the geocentre variations. The resultant geocentre time-series display notable trend acceleration from 1998 onward, in particular in the z-component. This effect is primarily driven by the hydrological mass redistribution in the continents (soil moisture, snow, ice sheet and glacier). The acceleration is statistically significant at the 99 per cent confidence level as determined using the Mann-Kendall test, and it is highly correlated with the satellite laser ranging determined translation series. Our study, based on independent geophysical and hydrological models, demonstrates that, in addition to systematic errors from analysis procedures, the observed non-linearity of the Earth-system behaviour at interannual timescales is physically driven and is able to explain 42 per cent of the disparity between the origins of ITRF2000 and ITRF2005, as well as the high level of consistency between the ITRF2005 and ITRF2008 origins.

Food insecurity and low income in an English inner city.

PubMed

Tingay, Richard S; Tan, Chuan Jin; Tan, Neil C W; Tang, Stephen; Teoh, Pei Fen; Wong, Rebecca; Gulliford, Martin C

2003-06-01

Low incomes may not provide the minimum requirements for healthy living. We evaluated experiences of food insecurity in relation to income in inner London. Subjects attending 10 general medical practices completed a short self-administered questionnaire, including the short form Household Food Security Scale and a short food frequency questionnaire. Responses were obtained from 431/495 (87 per cent) subjects. Overall 87 (20 per cent) of subjects were classified as food insecure. Food insecurity was negatively associated with household income (p = 0.004). University-educated subjects (8 per cent) were less often food insecure than all others (26 per cent). Subjects who were food insecure were less likely to report eating fruit daily (food secure 48 per cent, food insecure 33 per cent, p = 0.017) or vegetables or salads daily (food secure 56 per cent, food insecure 34 per cent, p = 0.002). Experiences of food insecurity may be common in households with incomes at the level of the UK national minimum wage or lower.

Age, extent and carbon storage of the central Congo Basin peatland complex.

PubMed

Dargie, Greta C; Lewis, Simon L; Lawson, Ian T; Mitchard, Edward T A; Page, Susan E; Bocko, Yannick E; Ifo, Suspense A

2017-02-02

Peatlands are carbon-rich ecosystems that cover just three per cent of Earth's land surface, but store one-third of soil carbon. Peat soils are formed by the build-up of partially decomposed organic matter under waterlogged anoxic conditions. Most peat is found in cool climatic regions where unimpeded decomposition is slower, but deposits are also found under some tropical swamp forests. Here we present field measurements from one of the world's most extensive regions of swamp forest, the Cuvette Centrale depression in the central Congo Basin. We find extensive peat deposits beneath the swamp forest vegetation (peat defined as material with an organic matter content of at least 65 per cent to a depth of at least 0.3 metres). Radiocarbon dates indicate that peat began accumulating from about 10,600 years ago, coincident with the onset of more humid conditions in central Africa at the beginning of the Holocene. The peatlands occupy large interfluvial basins, and seem to be largely rain-fed and ombrotrophic-like (of low nutrient status) systems. Although the peat layer is relatively shallow (with a maximum depth of 5.9 metres and a median depth of 2.0 metres), by combining in situ and remotely sensed data, we estimate the area of peat to be approximately 145,500 square kilometres (95 per cent confidence interval of 131,900-156,400 square kilometres), making the Cuvette Centrale the most extensive peatland complex in the tropics. This area is more than five times the maximum possible area reported for the Congo Basin in a recent synthesis of pantropical peat extent. We estimate that the peatlands store approximately 30.6 petagrams (30.6 × 10 15  grams) of carbon belowground (95 per cent confidence interval of 6.3-46.8 petagrams of carbon)-a quantity that is similar to the above-ground carbon stocks of the tropical forests of the entire Congo Basin. Our result for the Cuvette Centrale increases the best estimate of global tropical peatland carbon stocks by 36 per cent, to 104.7 petagrams of carbon (minimum estimate of 69.6 petagrams of carbon; maximum estimate of 129.8 petagrams of carbon). This stored carbon is vulnerable to land-use change and any future reduction in precipitation.

Anaemia in pet rabbits: causes, severity and reticulocyte response.

PubMed

Dettweiler, Alexandra; Klopfleisch, Robert; Müller, Kerstin

2017-12-16

The objective of the study was to determine the causes and the severity of anaemia in pet rabbits ( Oryctolagus cuniculus ), to classify anaemia and to compare the reticulocyte counts from healthy and anaemic rabbits. Over a time period of 11 years (2000-2011) a retrospective and prospective study of 223 pet rabbits was performed. Based on the clinic's own reference range for healthy pet rabbits (packed cell volume [PCV] levels 0.33-0.45 l/l), animals with a PCV level below 0.33 l/l were considered anaemic. Anaemia was mostly caused by inflammation (65/223, 29 per cent) and bleeding (54/223, 24 per cent). Seven per cent (15/223) of the rabbits suffered from renal diseases and one rabbit got diagnosed with haemolysis caused by liver lobe torsion. In 14 per cent (32/223) of the rabbits more than one underlying pathomechanism, like inflammation and bleeding, was diagnosed as possible cause of anaemia. In 25 per cent (56/223) of the anaemic rabbits no cause was found. Most anaemias were mild (156/223, 70 per cent). Moderate (43/223, 19 per cent) or severe (24/223, 11 per cent) anaemia was diagnosed more rarely. Anaemic rabbits showed similar reticulocyte counts to healthy rabbits with no significant difference. Therefore, a differentiation of regenerative and non-regenerative anaemia was not possible. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Velocity anti-correlation of diametrically opposed galaxy satellites in the low-redshift Universe.

PubMed

Ibata, Neil G; Ibata, Rodrigo A; Famaey, Benoit; Lewis, Geraint F

2014-07-31

Recent work has shown that the Milky Way and the Andromeda galaxies both possess the unexpected property that their dwarf satellite galaxies are aligned in thin and kinematically coherent planar structures. It is interesting to evaluate the incidence of such planar structures in the larger galactic population, because the Local Group may not be a representative environment. Here we report measurements of the velocities of pairs of diametrically opposed satellite galaxies. In the local Universe (redshift z < 0.05), we find that satellite pairs out to a distance of 150 kiloparsecs from the galactic centre are preferentially anti-correlated in their velocities (99.994 per cent confidence level), and that the distribution of galaxies in the larger-scale environment (out to distances of about 2 megaparsecs) is strongly clumped along the axis joining the inner satellite pair (>7σ confidence). This may indicate that planes of co-rotating satellites, similar to those seen around the Andromeda galaxy, are ubiquitous, and their coherent motion suggests that they represent a substantial repository of angular momentum on scales of about 100 kiloparsecs.

Helium in the eroding atmosphere of an exoplanet.

PubMed

Spake, J J; Sing, D K; Evans, T M; Oklopčić, A; Bourrier, V; Kreidberg, L; Rackham, B V; Irwin, J; Ehrenreich, D; Wyttenbach, A; Wakeford, H R; Zhou, Y; Chubb, K L; Nikolov, N; Goyal, J M; Henry, G W; Williamson, M H; Blumenthal, S; Anderson, D R; Hellier, C; Charbonneau, D; Udry, S; Madhusudhan, N

2018-05-01

Helium is the second-most abundant element in the Universe after hydrogen and is one of the main constituents of gas-giant planets in our Solar System. Early theoretical models predicted helium to be among the most readily detectable species in the atmospheres of exoplanets, especially in extended and escaping atmospheres 1 . Searches for helium, however, have hitherto been unsuccessful 2 . Here we report observations of helium on an exoplanet, at a confidence level of 4.5 standard deviations. We measured the near-infrared transmission spectrum of the warm gas giant 3 WASP-107b and identified the narrow absorption feature of excited metastable helium at 10,833 angstroms. The amplitude of the feature, in transit depth, is 0.049 ± 0.011 per cent in a bandpass of 98 angstroms, which is more than five times greater than what could be caused by nominal stellar chromospheric activity. This large absorption signal suggests that WASP-107b has an extended atmosphere that is eroding at a total rate of 10 10 to 3 × 10 11 grams per second (0.1-4 per cent of its total mass per billion years), and may have a comet-like tail of gas shaped by radiation pressure.

Value of lymph node biopsy in the diagnosis of acquired toxoplasmosis.

PubMed

Tuzuner, N; Doğusoy, G; Demirkesen, C; Ozkan, F; Altas, K

1996-04-01

Toxoplasmic lymphadenitis generally involves a solitary lymph node in the head and neck regions, without systemic symptoms. In order to determine the frequency of toxoplasmic lymphadenitis, we reviewed the histological sections of 731 consecutive patients with reactive lymph node hyperplasia. Amongst 731 patients, 112 had histological features supporting a diagnosis of toxoplasmic lymphadenitis (15.3 per cent). In 80 of these patients (71 per cent), either Indirect Haemaglutination test (IHA), in 37 cases, or the Enzyme-Linked Immunosorbent Assay (ELISA) for detecting toxoplasmic IgG or IgM antibodies, in 43 cases, were performed. In 76 out of 80 patients (95 per cent), histological features correlated well with serological studies. The IHA test was positive in 30 patients with a titre of 1/64 or higher. The IgG-ELISA test was positive in 11 whereas the IgM-ELISA test was positive in 28 patients. These results provide further evidence of the distinctive nature of the histological changes in toxoplasmic lymphadenitis, which should enable the clinician to make a confident diagnosis of acute acquired toxoplasmosis.

Emergent constraint on equilibrium climate sensitivity from global temperature variability.

PubMed

Cox, Peter M; Huntingford, Chris; Williamson, Mark S

2018-01-17

Equilibrium climate sensitivity (ECS) remains one of the most important unknowns in climate change science. ECS is defined as the global mean warming that would occur if the atmospheric carbon dioxide (CO 2 ) concentration were instantly doubled and the climate were then brought to equilibrium with that new level of CO 2 . Despite its rather idealized definition, ECS has continuing relevance for international climate change agreements, which are often framed in terms of stabilization of global warming relative to the pre-industrial climate. However, the 'likely' range of ECS as stated by the Intergovernmental Panel on Climate Change (IPCC) has remained at 1.5-4.5 degrees Celsius for more than 25 years. The possibility of a value of ECS towards the upper end of this range reduces the feasibility of avoiding 2 degrees Celsius of global warming, as required by the Paris Agreement. Here we present a new emergent constraint on ECS that yields a central estimate of 2.8 degrees Celsius with 66 per cent confidence limits (equivalent to the IPCC 'likely' range) of 2.2-3.4 degrees Celsius. Our approach is to focus on the variability of temperature about long-term historical warming, rather than on the warming trend itself. We use an ensemble of climate models to define an emergent relationship between ECS and a theoretically informed metric of global temperature variability. This metric of variability can also be calculated from observational records of global warming, which enables tighter constraints to be placed on ECS, reducing the probability of ECS being less than 1.5 degrees Celsius to less than 3 per cent, and the probability of ECS exceeding 4.5 degrees Celsius to less than 1 per cent.

Emergent constraint on equilibrium climate sensitivity from global temperature variability

NASA Astrophysics Data System (ADS)

Cox, Peter M.; Huntingford, Chris; Williamson, Mark S.

2018-01-01

Equilibrium climate sensitivity (ECS) remains one of the most important unknowns in climate change science. ECS is defined as the global mean warming that would occur if the atmospheric carbon dioxide (CO2) concentration were instantly doubled and the climate were then brought to equilibrium with that new level of CO2. Despite its rather idealized definition, ECS has continuing relevance for international climate change agreements, which are often framed in terms of stabilization of global warming relative to the pre-industrial climate. However, the ‘likely’ range of ECS as stated by the Intergovernmental Panel on Climate Change (IPCC) has remained at 1.5-4.5 degrees Celsius for more than 25 years. The possibility of a value of ECS towards the upper end of this range reduces the feasibility of avoiding 2 degrees Celsius of global warming, as required by the Paris Agreement. Here we present a new emergent constraint on ECS that yields a central estimate of 2.8 degrees Celsius with 66 per cent confidence limits (equivalent to the IPCC ‘likely’ range) of 2.2-3.4 degrees Celsius. Our approach is to focus on the variability of temperature about long-term historical warming, rather than on the warming trend itself. We use an ensemble of climate models to define an emergent relationship between ECS and a theoretically informed metric of global temperature variability. This metric of variability can also be calculated from observational records of global warming, which enables tighter constraints to be placed on ECS, reducing the probability of ECS being less than 1.5 degrees Celsius to less than 3 per cent, and the probability of ECS exceeding 4.5 degrees Celsius to less than 1 per cent.

Proactive dairy cattle disease control in the UK: veterinary surgeons' involvement and associated characteristics

PubMed Central

Higgins, H. M.; Huxley, J. N.; Wapenaar, W.; Green, M. J.

2013-01-01

Characteristics of 94 veterinary surgeons associated with delivering preventive herd-level strategies to control mastitis, lameness and Johne's disease were investigated using two multinomial models. The response variables were ‘Gold Standard Monitoring’ (including on-going data analysis, risk assessments and laboratory testing), and a lower level of involvement called ‘Regular Control Advice’. Although the sample was biased towards those who spend the majority of their time with dairy cows, 69 per cent currently had no involvement in Gold Standard Monitoring for lameness, 60 per cent no involvement with Johne's, and 52 per cent no involvement with mastitis. The final model predicted that an assistant without a postgraduate cattle qualification, who had spent no time on dairy cattle continuous professional development (CPD) in the last year, had an 88 per cent chance of having no involvement with Gold Standard Monitoring for any disease, versus <5 per cent chance for a CPD ‘enriched’ partner with a postgraduate cattle qualification; there was <1 per cent chance this assistant would be involved with Gold Standard Monitoring of all three diseases on one or more farms, versus a 58 per cent chance for this partner. CPD and employment status were also associated with markedly different probabilities for delivering Regular Control Advice. Increased postgraduate education may further veterinary involvement of this nature. PMID:23887976

Glutathione and 2,3-diphosphoglycerate in the blood of hypoxic ruminants.

PubMed

O'Dea, J D; Agar, N S

1980-09-01

Two merino sheep and two angora goats were subjected to simulated altitudes of up to 5500 m for about 10 h per day for 38 days. Packed cell volume (PCV), haemoglobin (Hb) concentration and red blood cell (RBC) levels of reduced glutathione (GSH) and 2,3-diphosphoglycerate (2,3-DPG) were measured at regular intervals. Mean PCV increased from 33 per cent to 60 per cent in the sheep and from 33 per cent to 45 per cent in the goats. Mean Hb concentration rose from 11.7 g/dl to 23.1 g/dl in the sheep, and from 11.4 g/dl to 16.0 g/dl in the goats. The level of GSH began to rise in the sheep only after the animals were no longer being subjected to the hypoxic stress, increasing by about 20 mg/dl RBC. In the goats, the levels of GSH rose during, as well as after, the period of hypoxic stress, also by about 20 mg/dl RBC. No change in 2,3-DPG levels was found in either species.

Testing for a Debt-Threshold Effect on Output Growth.

PubMed

Lee, Sokbae; Park, Hyunmin; Seo, Myung Hwan; Shin, Youngki

2017-12-01

Using the Reinhart-Rogoff dataset, we find a debt threshold not around 90 per cent but around 30 per cent, above which the median real gross domestic product (GDP) growth falls abruptly. Our work is the first to formally test for threshold effects in the relationship between public debt and median real GDP growth. The null hypothesis of no threshold effect is rejected at the 5 per cent significance level for most cases. While we find no evidence of a threshold around 90 per cent, our findings from the post-war sample suggest that the debt threshold for economic growth may exist around a relatively small debt-to-GDP ratio of 30 per cent. Furthermore, countries with debt-to-GDP ratios above 30 per cent have GDP growth that is 1 percentage point lower at the median.

Testing for a Debt‐Threshold Effect on Output Growth†

PubMed Central

Lee, Sokbae; Park, Hyunmin; Seo, Myung Hwan; Shin, Youngki

2017-01-01

Abstract Using the Reinhart–Rogoff dataset, we find a debt threshold not around 90 per cent but around 30 per cent, above which the median real gross domestic product (GDP) growth falls abruptly. Our work is the first to formally test for threshold effects in the relationship between public debt and median real GDP growth. The null hypothesis of no threshold effect is rejected at the 5 per cent significance level for most cases. While we find no evidence of a threshold around 90 per cent, our findings from the post‐war sample suggest that the debt threshold for economic growth may exist around a relatively small debt‐to‐GDP ratio of 30 per cent. Furthermore, countries with debt‐to‐GDP ratios above 30 per cent have GDP growth that is 1 percentage point lower at the median. PMID:29263562

Upper limits to the quiet-time solar neutron flux from 10 to 100 MeV

NASA Technical Reports Server (NTRS)

Moon, S.; Simnett, G. M.; White, R. S.

1976-01-01

A large-area solid-angle double-scatter neutron telescope was flown to search for solar neutrons on three balloon flights in 1971 and 1972. The first two flights were launched from Palestine, Texas, and the third from Cape Girardeau, Missouri. The float altitude on each flight was at about 5 g/sq cm residual atmosphere. Neutrons from 10 to 100 MeV were measured. No solar flares occurred during the flights. Upper limits to the quiet-time solar neutron fluxes at the 95-per cent confidence level are 2.8, 4.6, 9.6, and 9.0 x 10 to the -4th power neutron/sq cm/sec in the energy intervals of 10-30, 30-50, 50-100, and 10-100 MeV, respectively.

Functional properties of pasta enriched with variable cereal brans.

PubMed

Kaur, Gurkirat; Sharma, Savita; Nagi, H P S; Dar, Basharat N

2012-08-01

To explore the potentiality of cereal brans for preparation of fiber enriched pasta, various cereal brans (Wheat, Rice, Barley and Oat) were added at 0, 5, 10, 15, 20 and 25 per cent to durum wheat semolina. The effect of cereal bran enrichment on the colour, cooking, sensory quality and shelf life of enriched pasta was assessed at ambient temperature. Pasta prepared with added fiber at 25 per cent level had the highest protein and dietary fiber content as compared to control. Enrichment with variable fiber sources improved the brightness of pasta, as colour of pasta enhanced significantly. Addition of cereal brans resulted an increase in the water absorption and cooking losses of pasta. This effect was dependent on the level and type of cereal brans. Significant correlation (r = 0.80) was obtained between water absorption and volume expansion in all types of bran enriched pasta. At 25 per cent level of supplementation, maximum solids were leached into cooking water. Bran enriched pasta required less cooking time for complete gelatinization of starch. Increasing level of cereal brans had significantly affected the overall acceptability of enriched pasta. Cooking quality of pasta remained constant during storage. Non significant effect of storage was found on water activity, free fatty acids. Enriched pasta (15 per cent level of wheat, rice and oat bran and 10 per cent barley bran) was highly acceptable upto 4 months of storage with respect to quality.

Myocardial infarction in young men. Study of risk factors in nine countries.

PubMed Central

Dolder, M A; Oliver, M F

1975-01-01

In order to determine whether the development of myocardial infarction in different countries is associated with different risk factors, 240 male survivors, aged 40 or less, were studied in nine countries. In the seven centres in developed countries (Auckland, Melbourne, Los Angles/Atlanta, Cape Town, Tel Avic, Heidelberg, and Edinburgh) there was a high procedure of risk factors, particularly of hyperlipidaemia and cigarette smoking. The prevalence of hypertension, obesity, hyperglycaemia, and hyperuricaemia varied from centre to centre. Risk factors were less prevalent in Bombay and Singapore: the most common risks operating in Bombay seemed to be cigarette smoking and hyperglycaemia, while in Singpore cigarette smoking was the commonest. The mean age of the whole group was 35.4 years. Serum cholesterol levels of 7.25 mmol/l (280 mg/dl) or more were present in 25 per cent of all patients, serum triglyceride levels of 2.26 mmol/l )l200 mg/dl) or more in 35 per cent. 80 per cent of the patients were smokers, and 15 per cent were either for hypertension before myocardial infarction or had a raised blood pressure after myocardial infarction. Obesity was found in 19 per cent of all patients and serum uric acid levels over 0.5 mmol/l (8.5 mg/dl) in 17 per cent. 10 per cent of all patients were either treated for diabetes mellitus before myocardial infarction or showed an abnormal glucose tolerance after myocardial infarction. This collaborative study may help, by showing differences in the prevalence of risk factors, to indicate to each centre and to national and to international organizations, the direction for their future studies into the causation and prevention of myocardial infarction in young men. PMID:1137658

The prevalence of refractive errors among adult rural populations in Iran.

PubMed

Hashemi, Hassan; Nabovati, Payam; Yekta, Abbasali; Shokrollahzadeh, Fereshteh; Khabazkhoob, Mehdi

2018-01-01

The aim was to determine the prevalence of myopia and hyperopia and related factors in underserved rural areas in Iran. Under random cluster sampling, two rural regions were randomly selected in the north and southwest of the country, and 3,061 persons over 15 years of age were invited into the study. After selecting samples, all participants had refraction, measurement of uncorrected vision and visual acuity and ocular health examination by slitlamp biomicroscopy. Of the 3,061 invitees, 2,575 participated in the study (response rate: 84.1 per cent). After excluding those who met the exclusion criteria or had missing refractive data, eventually there were 2,518 subjects available for this analysis. The mean age of the participants was 44.3 ± 17.5 years (range: 16 to 93 years) and 1,460 of them (58.0 per cent) were female. The overall prevalence of myopia and hyperopia in this study was 25.2 per cent (95 per cent CI: 23.2 to 27.2) and 22.5 per cent (95 per cent CI: 20.6 to 24.4), respectively. The prevalence of myopia increased from 20.9 per cent in participants 16 to 20 years to 32.9 per cent in the 21 to 30 years age group, declined up to the age of 60 years and increased again afterwards. The lowest prevalence was 6.8 per cent observed in the 16 to 20 years age group and the highest was 45.8 per cent in 61- to 70-year-olds. In the final logistic regression model, myopia significantly associated with age, higher education levels and cataracts, while hyperopia associated with age, lower education levels and male gender. In our study, the prevalence of myopia was lower and the prevalence of hyperopia was higher compared to most previous studies. The findings of this study imply that refractive errors vary by age. © 2017 Optometry Australia.

Prevalence of bovine milk pathogens in Azorean pastures: mobile versus fixed milking machines.

PubMed

Azevedo, C; Pacheco, D; Soares, L; Moitoso, M; Maldonado, J; Guix, R; Simões, J

2016-01-01

The aims of the present study were (1) to evaluate the influence of using mobile (n=47) or fixed (n=45) milking machines in Azorean herds on the apparent prevalence of several milk pathogens in bulk tank milk (BTM) and (2) to determine whether separated subclinical mastitic cows can serve, in real time, as predictors of milk pathogen prevalence for the remaining animals at the herd level. The use of a mobile or fixed milking machine influenced (P≤0.05) the prevalence of Staphylococcus aureus (72.3 per cent; n=34 v 51.1 per cent; n=23, respectively) and Klebsiella species (46.8 per cent; n=22 v 26.7 per cent; n=12, respectively). S aureus (95 per cent CI OR 1.1 to 6.0) and Klebsiella species (95 per cent CI OR 1.0 to 5.8) were 2.5 times more likely to increase in the BTM of herds using mobile milking machines. The prevalence of coagulase-negative staphylococci (100 per cent; n=92), Escherichia coli (75.0 per cent), Corynebacterium bovis (57.6 per cent), Enterococcus species (55.4 per cent), Streptococcus dysgalactiae (51.1 per cent), Streptococcus uberis (41.3 per cent), Actinomyces pyogenes or Peptostreptococcus indolicus (41.3 per cent) and Streptococcus agalactiae (32.6 per cent) in BTM remained similar among the herds. κ coefficients were always <0.70, indicating intra-herd disagreement of the prevalence of milk pathogens between BTM and separated milking cows. Milking hygiene should be improved in pastures, focusing specifically on herds that use a mobile milking machine. The segregated cows at milking time are not good predictors of milk pathogens in BTM.

Time-lapse changes of P- and S-wave velocities and shear wave splitting in the first year after the 2011 Tohoku earthquake, Japan: shallow subsurface

NASA Astrophysics Data System (ADS)

Sawazaki, Kaoru; Snieder, Roel

2013-04-01

We detect time-lapse changes in P- and S-wave velocities (hereafter, VP and VS, respectively) and shear wave splitting parameters associated with the 2011 Tohoku earthquake, Japan, at depths between 0 and 504 m. We estimate not only medium parameters but also the 95 per cent confidence interval of the estimated velocity change by applying a new least squares inversion scheme to the deconvolution analysis of KiK-net vertical array records. Up to 6 per cent VS reduction is observed at more than half of the analysed KiK-net stations in northeastern Japan with over 95 per cent confidence in the first month after the main shock. There is a considerable correlation between the S-wave traveltime delay and the maximum horizontal dynamic strain (MDS) by the main shock motion when the strain exceeds 5 × 10- 4 on the ground surface. This correlation is not clearly observed for MDS at the borehole bottom. On the contrary, VP and shear wave splitting parameters do not show systematic changes after the Tohoku earthquake. These results indicate that the time-lapse change is concentrated near the ground surface, especially in loosely packed soil layers. We conclude that the behaviour of VP, VS and shear wave splitting parameters are explained by the generation of omnidirectional cracks near the ground surface and by the diffusion of water in the porous subsurface. Recovery of VS should be related to healing of the crack which is proportional to the logarithm of the lapse time after the main shock and/or to decompaction after shaking.

Anomalously shallow inclination in middle-northern part of the South China block: palaeomagnetic study of Late Cretaceous red beds from Yichang area

NASA Astrophysics Data System (ADS)

Narumoto, Kazutoshi; Yang, Zhenyu; Takemoto, Kazuhiro; Zaman, Haider; Morinaga, Hayao; Otofuji, Yo-ichiro

2006-02-01

We present new palaeomagnetic results from Late Cretaceous red beds of the Paomagang Formation collected at 42 sites in the Yichang area (30.7°N, 111.7°E), middle-northern part of the South China Block. A high unblocking temperature component around 680°C was isolated from 26 sites by stepwise thermal demagnetization. Fold tests are positive at the 95 per cent confidence limit for 14 and 11 sites of the Paomagang and Wangdian areas, respectively. Normal and reversed polarity sequence found in the Wangdian area passed a reversal test at the 95 per cent confidence limit. The tilt-corrected mean direction for Yichang area is D= 3.8°, I= 23.3° (α95= 5.1°,N= 26), corresponding to a palaeopole at 71.5°N, 280.0°E with A95= 4.3°. Comparison with the expected inclination from the 80 Ma Eurasian APWP pole indicates a inclination flattening of 26.3°+/- 6.4°. Middle Cretaceous to Cenozoic NW-SE extension tectonics within the SCB contributes only 2.0° to the inclination flattening. While the massive samples of the Paomagang Formation show a moderate degree of anisotropy (1.017 < Pj < 1.086) and steeper inclination (I= 29.3°), the laminated samples, which form more than 75 per cent of the studied samples, show a higher degree of anisotropy (1.052 < Pj < 1.227) and shallower inclination value (I= 22.7°). A good correlation between remanence inclination and facies types indicates that depositional processes produced the observed shallow inclination in the Yichang area.

Benchmarking welfare indicators in 73 free-stall dairy farms in north-western Spain

PubMed Central

Trillo, Yolanda; Quintela, Luis Angel; Barrio, Mónica; Becerra, Juan José; Peña, Ana Isabel; Vigo, Marcos; Garcia Herradon, Pedro

2017-01-01

The aim of this study was to describe the status of body condition score (BCS), hock injuries prevalence, locomotion and body hygiene score as animal welfare measures in 73 free-stall dairy cattle farms in Lugo (Spain). A benchmarking process was established across farms: (1) the animal-based indicators were ordered from low to high values; (2) The farms were classified into three categories based on the number of indicators within less than the 25th percentile, 25th to 75th percentile and above the 75th percentile. The median prevalence of unsuitable BCS, hock injuries and clinical lameness was (median (range)) 51.7 per cent (13.3 to 89.5 per cent), 40.0 per cent (7.0per cent to 100 per cent) and 9.0 per cent (0per cent to 60.0 per cent) respectively. The dirtiness of the cow’s coat had a high prevalence (73.0 per cent (37.5per cent to 100 per cent)). Most farms did not display consistently good or poor animal-based indicators and each farm had its own set of strong and weak points. Moreover, facilities design and management practices were described to understand source of the observations made of the cows. The incidence of overstocking was 31.5 per cent for stalls and 26.0 per cent for headlocks. The front lunge space was reduced (<90 cm) on most dairies (90.4 per cent). Signs of poor natural ventilation (cobwebs or humidity on the roof) and ammonia odour were observed on 32.8 per cent and 85.0 per cent of the barns totally closed or with a side openingless than 50 per cent of the wall height. The milking parlour was designed with two or more turns more than 90° (9.3 per cent), and failed to allow cows to see the parlour before entering (45.2 per cent). On 52.0 per cent of dairies, more than 15 per cent of the cows had to be forcefully moved into the milking parlour. In conclusion, there was a big variation in the animal welfare levels within and across farms and they could benefit from others by changing management practices related to facilities and herds. PMID:29018530

Cost of delivering secondary-level health care services through public sector district hospitals in India.

PubMed

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Contribution of surgical specialization to improved colorectal cancer survival.

PubMed

Oliphant, R; Nicholson, G A; Horgan, P G; Molloy, R G; McMillan, D C; Morrison, D S

2013-09-01

Reorganization of colorectal cancer services has led to surgery being increasingly, but not exclusively, delivered by specialist surgeons. Outcomes from colorectal cancer surgery have improved, but the exact determinants remain unclear. This study explored the determinants of outcome after colorectal cancer surgery over time. Postoperative mortality (within 30 days of surgery) and 5-year relative survival rates for patients in the West of Scotland undergoing surgery for colorectal cancer between 1991 and 1994 were compared with rates for those having surgery between 2001 and 2004. The 1823 patients who had surgery in 2001-2004 were more likely to have had stage I or III tumours, and to have undergone surgery with curative intent than the 1715 patients operated on in 1991-1994. The proportion of patients presenting electively who received surgery by a specialist surgeon increased over time (from 14·9 to 72·8 per cent; P < 0·001). Postoperative mortality increased among patients treated by non-specialists over time (from 7·4 to 10·3 per cent; P = 0·026). Non-specialist surgery was associated with an increased risk of postoperative death (adjusted odds ratio 1·72, 95 per cent confidence interval (c.i.) 1·17 to 2·55; P = 0·006) compared with specialist surgery. The 5-year relative survival rate increased over time and was higher among those treated by specialist compared with non-specialist surgeons (62·1 versus 53·0 per cent; P < 0·001). Compared with the earlier period, the adjusted relative excess risk ratio for the later period was 0·69 (95 per cent c.i. 0·61 to 0·79; P < 0·001). Increased surgical specialization accounted for 18·9 per cent of the observed survival improvement. Increased surgical specialization contributed significantly to the observed improvement in longer-term survival following colorectal cancer surgery. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

Impact of deprivation on short- and long-term outcomes after colorectal cancer surgery.

PubMed

Bharathan, B; Welfare, M; Borowski, D W; Mills, S J; Steen, I N; Kelly, S B

2011-06-01

The aim of the study was to determine the association between short- and long-term outcomes and deprivation for patients undergoing operative treatment for colorectal cancer in the Northern Region of England. This was a retrospective analytical study based on the Northern Region Colorectal Cancer Audit Group database for the period 1998-2002. The Index of Multiple Deprivation 2004, an area-based measure, was recalibrated and used to quantify deprivation. Patients were ranked based on their postcode of residence and grouped into five categories. Of 8159 patients in total, 7352 (90·1 per cent) had surgery; 6953 (94·6 per cent) of the 7352 patients underwent tumour resection and 4935 (67·7 per cent) of 7294 had a margin-negative (R0) resection. Deprivation was not associated with age, sex, tumour site, stage or other tumour-related factors. Compared with the most affluent group, the most deprived patients had fewer elective operations (72·9 versus 76·4 per cent; P = 0·014), more adverse co-morbidity (P < 0·001) and fewer curative resections (65·5 versus 71·2 per cent; P < 0·001). In multivariable analysis, deprivation was not an independent predictor of postoperative death (odds ratio (OR) 0·72, 95 per cent confidence interval 0·48 to 1·06; P = 0·101) but it was a predictor of curative resection (OR 1·24, 1·01 to 1·52; P = 0·042), overall survival (HR 0·83, 0·73 to 0·95; P = 0·006) and relative survival (HR 0·74, 0·58 to 0·95; P = 0·023). Deprivation, both independently and by influencing other surgical predictors, impacts on short- and long-term outcomes of patients with colorectal cancer. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy.

PubMed

Jang, J-Y; Chang, Y R; Kim, S-W; Choi, S H; Park, S J; Lee, S E; Lim, C-S; Kang, M J; Lee, H; Heo, J S

2016-05-01

There is no consensus on the best method of preventing postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). This multicentre, parallel group, randomized equivalence trial investigated the effect of two ways of pancreatic stenting after PD on the rate of POPF. Patients undergoing elective PD or pylorus-preserving PD with duct-to-mucosa pancreaticojejunostomy were enrolled from four tertiary referral hospitals. Randomization was stratified according to surgeon with a 1 : 1 allocation ratio to avoid any related technical factors. The primary endpoint was clinically relevant POPF rate. Secondary endpoints were nutritional index, remnant pancreatic volume, long-term complications and quality of life 2 years after PD. A total of 328 patients were randomized to the external (164 patients) or internal (164) stent group between August 2010 and January 2014. The rates of clinically relevant POPF were 24·4 per cent in the external and 18·9 per cent in the internal stent group (risk difference 5·5 per cent). As the 90 per cent confidence interval (-2·0 to 13·0 per cent) did not fall within the predefined equivalence limits (-10 to 10 per cent), the clinically relevant POPF rates in the two groups were not equivalent. Similar results were observed for patients with soft pancreatic texture and high fistula risk score. Other postoperative outcomes were comparable between the two groups. Five stent-related complications occurred in the external stent group. Multivariable analysis revealed that soft pancreatic texture, non-pancreatic disease and high body mass index (23·3 kg/m 2 or above) predicted clinically relevant POPF. External stenting after PD was associated with a higher rate of clinically relevant POPF than internal stenting. Registration number: NCT01023594 (https://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Reporting quality of N-of-1 trials published between 1985 and 2013: a systematic review.

PubMed

Li, Jiang; Gao, Wei; Punja, Salima; Ma, Bin; Vohra, Sunita; Duan, Naihua; Gabler, Nicole; Yang, Kehu; Kravitz, Richard L

2016-08-01

To evaluate the quality of reporting of single-patient (N-of-1) trials published in the medical literature based on the CONSORT Extension for N-of-1 Trials (CENT) statement and to examine factors that influence reporting quality in these trials. Through a search of 10 electronic databases, we identified N-of-1 trials in clinical medicine published between January 1, 1985, and December 31, 2013. Two reviewers screened articles for eligibility and independently extracted data. Quality assessment was performed using the CENT statement. Discrepancies were resolved by consensus. We identified 112 eligible N-of-1 trials published in 87 journals and involving a total of 2,278 patients. Overall, kappa agreement between the two evaluators for compliance with CENT criteria was 0.80 (95% confidence interval: 0.79, 0.82). Trials assessed pharmacology and therapeutics (87%), behavior (11%), or diagnosis (2%). Although 87% of articles described the trial design (including the planned number of subjects and length of treatment period), the median percentage of specific CENT elements reported in the Methods was 41% (range, 16-87%), and the median percentage in the Results was 38% (range, 32-93%). First authors were predominantly from North America (46%), Europe (29%), and Australia (17%). Quality of reporting was higher in articles published in journals with relatively high-impact factors (P = 0.004). The quality of reporting of published N-of-1 trials is variable and in need of improvement. Because the CENT guidelines were not published until near the end of the period of this review, these results represent a baseline from which improvement may be expected in the future. Copyright © 2016 Elsevier Inc. All rights reserved.

The working hours of general practitioners 2000-2008.

PubMed

Aasland, Olaf G; Rosta, Judith

2011-06-03

There is little reliable information available on the working hours of general practitioners (GPs). The purpose of our study is to describe the development of weekly working hours of Norwegian general practitioners in the period from 2000 to 2008, as well as the length of their patient lists and their perceived workload. General practitioners in the reference panel of the Research Institute of the Norwegian Medical Association have reported their weekly working hours for 2000, 2002, 2004, 2006 and 2008, and the length of their patient lists for 2002 and 2008. We used non-overlapping 95 per cent confidence intervals for testing inter-group differences in interval variables and proportions. From 227 to 316 general practitioners responded to each survey round. Average weekly working hours constituted 45.1 hours (95 per cent CI: 43.6-46.5 hours) in 2000 and 46.4 hours (95 per cent CI: 45.2-47.6 hours) in 2008. The number of hours increased for women GPs, while the number of hours remained basically unchanged for men from 2000 to 2008. Average length of the patient lists in 2002 and 2008 constituted 1,325 and 1,278 for men, and 1,155 and 1,144 for women GPs respectively. The proportion of GPs who responded that they perceived their workload as unacceptable decreased significantly, from 38.1 per cent in 2000 to 25.5 per cent in 2008. Average weekly working hours for GPs increased by approximately one hour from 2000 to 2008, and this increase is found mainly among women GPs. We believe that the reduction in the proportion reporting to have an unacceptable workload can be explained by the introduction of the list-patient system, which has given the doctors better control of their own workload.

Amniotic fluid-AFP in Down syndrome and other chromosome abnormalities.

PubMed

Crandall, B F; Matsumoto, M; Perdue, S

1988-05-01

80.2 Per cent of 111 Down syndrome pregnancies had anmiotic fluid (AF) alpha fetoprotein (AFP) levels on or below the median and 10.8 per cent at or below 0.5 MoM compared with 41.9 and 1.4 per cent of controls. These differences were even more striking when the gestational age was less than 18 weeks compared with greater than or equal to 18 weeks. No such association was seen for other chromosome abnormalities including trisomy 18,45,X and mosaics, 47,XXY,47,XXX, and other structural abnormalities and triploidy, even when high levels due to defects such as omphalocele and cystic hygroma were excluded. All cases of trisomy 13 and 80 per cent with 47,XYY had AF-AFP levels above the median. Selection of cases for karyotyping by a low level of AF-AFP would clearly fail to detect aneuploidies other than Down syndrome and is not recommended. A possible weak association between low maternal serum (MS) and AF-AFPs in Down syndrome was most evident at less than 18 weeks, suggesting that MS screening between 16 and 18 weeks may be the most informative time.

Authorship characteristics of orthodontic randomized controlled trials, systematic reviews, and meta-analyses in non-orthodontic journals with impact factor.

PubMed

Alqaydi, Ahlam R; Kanavakis, Georgios; Naser-Ud-Din, Shazia; Athanasiou, Athanasios E

2017-12-08

This study was conducted to explore authorship characteristics and publication trends of all orthodontic randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses (MAs) published in non-orthodontic journals with impact factor (IF). Appropriate research strategies were developed to search for all articles published until December 2015, without restrictions regarding language or publication status. The initial search generated 4524 results, but after application of the inclusion criteria, the final number of articles was reduced to 274 (SRs: 152; MAs: 36; and RCTs: 86). Various authorship characteristics were recorded for each article. Frequency distributions for all parameters were explored with Pearson chi-square for independence at the 0.05 level of significance. More than half of the included publications were SRs (55.5 per cent), followed by RCTs (31.4 per cent) and MAs (13.1 per cent); one hundred seventy-eight (65 per cent) appeared in dental journals and 96 (35 per cent) were published in non-dental journals. The last decade was significantly more productive than the period before 2006, with 236 (86.1 per cent) articles published between 2006 and 2015. European countries produced 51.5 per cent of the total number of publications, followed by Asia (18.6 per cent) and North America (USA and Canada; 16.8 per cent). Studies published in journals without IF were not included. Level-1 evidence orthodontic literature published in non-orthodontic journals has significantly increased during 2006-15. This indicates a larger interest of other specialty journals in orthodontic related studies and a trend for orthodontic authors to publish their work in journals with impact in broader fields of dentistry and medicine. © The Author(s) 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

British university students' attitudes towards noise-induced hearing loss caused by nightclub attendance.

PubMed

Johnson, O; Andrew, B; Walker, D; Morgan, S; Aldren, A

2014-01-01

Over the past 30 years, the prevalence of noise-induced hearing loss among adolescents and young adults has increased. This study aimed to address the current dearth of literature implicating excessive nightclub sound levels (more than 85 dB) as a direct cause of auditory symptoms related to noise-induced hearing loss. A questionnaire was completed by 325 students to gauge the frequency of auditory symptoms after nightclub attendance, and to explore knowledge and opinions about noise levels in nightclubs. The findings showed that 88.3 per cent of students experienced tinnitus after leaving a nightclub and 66.2 per cent suffered impaired hearing the following morning. In terms of behaviour, 73.2 per cent of students said that the risk of hearing damage would not affect their nightclub attendance, but most students (70.2 per cent) felt that noise levels in nightclubs should be limited to safe volumes. A high proportion of students reported experiencing symptoms related to noise-induced hearing loss after attending a nightclub. These findings are relevant to policy makers.

[Use of flour from sunflower oil cake in the biosynthesis of antigungal antibiotics].

PubMed

Sukharevich, V M; Shvetsova, N N; Prodan, S I; Malkov, M A

1977-04-01

The possibility of replacing soybean meal and corn-steep liquor by food wastes of the oilpress industry and the meal of the sunflower oil cake in particular is discussed as applied to the fermentation media for production of antifungal antibiotics, such as levorin, mycoheptin, amphotericin. The studies showed that replacement of soybean meal by sunflower oil cake meal with simultaneous increasing of the amount of carbohydrates in the medium increased the levorin levels by 60--70 per cent as compared to the media used at present. When soybean meal and corn-steep liquor were simultaneously replaced by sunflower oil cake meal in amounts of 3--4 per cent the levels of mycoheptin in the fermentation broth increased by 30--65 per cent respectively. Replacement of soybean meal and corn-steep liquor by 3 per cent of sunflow oil cake meal in the medium used presently increased the amphotericin levels by 27 percent as compared to the control. Therefore, sunflower oil cake meal is a substitute of full value for soybean meal and corn-steep liquor in the fermentation media for production of antifungal antibiotics.

Intraoperative fluorescence-based enhanced reality laparoscopic real-time imaging to assess bowel perfusion at the anastomotic site in an experimental model.

PubMed

Diana, M; Agnus, V; Halvax, P; Liu, Y-Y; Dallemagne, B; Schlagowski, A-I; Geny, B; Diemunsch, P; Lindner, V; Marescaux, J

2015-01-01

Fluorescence videography is a promising technique for assessing bowel perfusion. Fluorescence-based enhanced reality (FLER) is a novel concept, in which a dynamic perfusion cartogram, generated by computer analysis, is superimposed on to real-time laparoscopic images. The aim of this experimental study was to assess the accuracy of FLER in detecting differences in perfusion in a small bowel resection-anastomosis model. A small bowel ischaemic segment was created laparoscopically in 13 pigs. Animals were allocated to having anastomoses performed at either low perfusion (25 per cent; n = 7) or high perfusion (75 per cent; n = 6), as determined by FLER analysis. Capillary lactate levels were measured in blood samples obtained by serosal puncturing in the ischaemic area, resection lines and vascularized areas. Pathological inflammation scoring of the anastomosis was carried out. Lactate levels in the ischaemic area (mean(s.d.) 5·6(2·8) mmol/l) were higher than those in resection lines at 25 per cent perfusion (3·7(1·7) mmol/l; P = 0·010) and 75 per cent perfusion (2·9(1·3) mmol/l; P < 0·001), and higher than levels in vascular zones (2·5(1·0) mmol/l; P < 0·001). Lactate levels in resection lines with 75 per cent perfusion were lower than those in lines with 25 per cent perfusion (P < 0·001), and similar to those in vascular zones (P = 0·188). Levels at resection lines with 25 per cent perfusion were higher than those in vascular zones (P = 0·001). Mean(s.d.) global inflammation scores were higher in the 25 per cent perfusion group compared with the 75 per cent perfusion group for mucosa/submucosa (2·1(0·4) versus 1·2(0·4); P = 0·003) and serosa (1·8(0·4) versus 0·8(0·8); P = 0·014). A ratio of preanastomotic lactate levels in the ischaemic area relative to the resection lines of 2 or less was predictive of a more severe inflammation score. In an experimental model, FLER appeared accurate in discriminating bowel perfusion levels. Surgical relevance Clinical assessment has limited accuracy in evaluating bowel perfusion before anastomosis. Fluorescence videography estimates intestinal perfusion based on the fluorescence intensity of injected fluorophores, which is proportional to bowel vascularization. However, evaluation of fluorescence intensity remains a static and subjective measure. Fluorescence-based enhanced reality (FLER) is a dynamic fluorescence videography technique integrating near-infrared endoscopy and specific software. The software generates a virtual perfusion cartogram based on time to peak fluorescence, which can be superimposed on to real-time laparoscopic images. This experimental study demonstrates the accuracy of FLER in detecting differences in bowel perfusion in a survival model of laparoscopic small bowel resection-anastomosis, based on biochemical and histopathological data. It is concluded that real-time imaging of bowel perfusion is easy to use and accurate, and should be translated into clinical use. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood.

PubMed

Goudet, Sophie; Griffths, Paula; Bogin, Barry A

2011-10-01

Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Risk factors for infection with highly pathogenic influenza A virus (H5N1) in commercial chickens in Bangladesh.

PubMed

Biswas, P K; Christensen, J P; Ahmed, S S U; Barua, H; Das, A; Rahman, M H; Giasuddin, M; Hannan, A S M A; Habib, A M; Debnath, N C

2009-06-13

A matched case-control study was carried out to identify risk factors for highly pathogenic avian influenza A virus (subtype H5N1) infection in commercial chickens in Bangladesh. A total of 33 commercial farms diagnosed with H5N1 before September 9, 2007, were enrolled as cases, and 99 geographically matched unaffected farms were enrolled as control farms. Farm data were collected using a pretested questionnaire, and analysed by matched-pair analysis and multivariate conditional logistic regression. Two factors independently and positively associated with H5N1 infection remained in the final model. They were 'farm accessible to feral and wild animals' (odds ratio [OR] 5.71, 95 per cent confidence interval [CI] 1.81 to 18.0, P=0.003) and 'footbath at entry to farm/shed' (OR 4.93, 95 per cent CI 1.61 to 15.1, P=0.005). The use of a designated vehicle for sending eggs to a vendor or market appeared to be a protective factor (OR 0.14, 95 per cent CI 0.02 to 0.88, P=0.036).

Testing the existence of optical linear polarization in young brown dwarfs

NASA Astrophysics Data System (ADS)

Manjavacas, E.; Miles-Páez, P. A.; Zapatero-Osorio, M. R.; Goldman, B.; Buenzli, E.; Henning, T.; Pallé, E.; Fang, M.

2017-07-01

Linear polarization can be used as a probe of the existence of atmospheric condensates in ultracool dwarfs. Models predict that the observed linear polarization increases with the degree of oblateness, which is inversely proportional to the surface gravity. We aimed to test the existence of optical linear polarization in a sample of bright young brown dwarfs, with spectral types between M6 and L2, observable from the Calar Alto Observatory, and cataloged previously as low gravity objects using spectroscopy. Linear polarimetric images were collected in I and R band using CAFOS at the 2.2-m telescope in Calar Alto Observatory (Spain). The flux ratio method was employed to determine the linear polarization degrees. With a confidence of 3σ, our data indicate that all targets have a linear polarimetry degree in average below 0.69 per cent in the I band, and below 1.0 per cent in the R band, at the time they were observed. We detected significant (I.e. P/σ ≥ 3) linear polarization for the young M6 dwarf 2MASS J04221413+1530525 in the R band, with a degree of p* = 0.81 ± 0.17 per cent.

Giving Change When Payment Is Made with a Dime: The Difficulty of Tens and Ones

ERIC Educational Resources Information Center

Chandler, Cynthia C.; Kamii, Constance

2009-01-01

The purpose of this study was to investigate children's construction of 10s out of the 1s they have already constructed. It was found that, for many younger children, a dime was something different from 10 pennies even though they could say with confidence that a dime was worth 10 cents. As the children grew older, their performance improved.…

Precision timing measurements of PSR J1012+5307

NASA Astrophysics Data System (ADS)

Lange, Ch.; Camilo, F.; Wex, N.; Kramer, M.; Backer, D. C.; Lyne, A. G.; Doroshenko, O.

2001-09-01

We present results and applications of high-precision timing measurements of the binary millisecond pulsar J1012+5307. Combining our radio timing measurements with results based on optical observations, we derive complete 3D velocity information for this system. Correcting for Doppler effects, we derive the intrinsic spin parameters of this pulsar and a characteristic age of 8.6+/-1.9Gyr. Our upper limit for the orbital eccentricity of only 8×10-7 (68 per cent confidence level) is the smallest ever measured for a binary system. We demonstrate that this makes the pulsar an ideal laboratory in which to test certain aspects of alternative theories of gravitation. Our precision measurements suggest deviations from a simple pulsar spin-down timing model, which are consistent with timing noise and the extrapolation of the known behaviour of slowly rotating pulsars.

Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases.

PubMed

2016-11-01

The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals.

PubMed

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-09-20

The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals.

Comparative use of CO₂ laser, diode laser and monopolar electrocautery for resection of the soft palate in dogs with brachycephalic airway obstructive syndrome.

PubMed

Dunié-Mérigot, A; Bouvy, B; Poncet, C

2010-10-30

Clinical results, complications and the outcome of using either a carbon dioxide (CO₂) laser, diode laser or electrocautery (ELEC) for resection of the soft palate with an extended palatoplasty technique in brachycephalic dogs with upper airway obstructive syndrome were compared. Dogs were randomly allocated into three groups (n=20 in each group): ELEC, diode and CO₂ groups. The palatoplasty was made at the rostral aspect of the tonsils. A respiratory clinical score, ranging from 0 (normal) to 4 (cyanosis), was attributed to each dog before surgery and at 0 hours, 24 hours, two weeks and six months after surgery. A favourable outcome was defined as a one point or greater decrease in score 24 hours after surgery. The proportion of dogs with a favourable outcome was significantly higher in the CO₂ (n=15) and ELEC groups (n=15) in comparison with the diode group (n=7) (OR=5.6, 95 per cent confidence interval 1.4 to 21.9). Surgical time was significantly shorter (P<0.001; mean [sd] 510 [178] seconds), and bleeding was less common (P<0.001; 30 per cent of cases) in the CO₂ group. Complications were most frequent with the diode group (two cases of death and two cases of tracheostomy). The final outcome for all groups (n=57) was considered excellent in 79 per cent of cases and was considered good in 21 per cent.

Impact of surgeon volume and specialization on short-term outcomes in colorectal cancer surgery.

PubMed

Borowski, D W; Kelly, S B; Bradburn, D M; Wilson, R G; Gunn, A; Ratcliffe, A A

2007-07-01

Several studies have shown a relationship between surgeon volume and outcomes in colorectal cancer surgery. The aim of this study was to determine the impact of surgeon volume and specialization on primary tumour resection rate, restoration of bowel continuity following rectal cancer resection, anastomotic leakage and perioperative mortality. The Northern Region Colorectal Cancer Audit Group conducts a population-based audit of patients with colorectal cancer managed by surgeons. This study examined 8219 patients treated between 1998 and 2002. Outcomes were modelled using multivariate logistic regression analysis. Tumour resection was performed in 6949 (93.8 per cent) of 7411 patients. High-volume surgeons with an annual caseload of at least 18.5 (odds ratio (OR) 1.53 (95 per cent confidence interval (c.i.) 1.10 to 2.12); P = 0.012) and colorectal specialists (OR 1.42 (95 per cent c.i. 1.06 to 1.90); P = 0.018) were more likely to perform elective sphincter-saving rectal surgery. In elective surgery, the risk of perioperative death was lower for high-volume surgeons (OR 0.58 (95 per cent c.i. 0.44 to 0.76); P < 0.001), but this was not the case in emergency surgery. High-volume surgeons had lower perioperative mortality rates for elective surgery, and were more likely to use restorative rectal procedures. Copyright (c) 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Serological responses of adult dogs to revaccination against distemper, parvovirus and rabies.

PubMed

Ottiger, H-P; Neimeier-Förster, M; Stärk, K D C; Duchow, K; Bruckner, L

2006-07-01

Serum antibody titres to canine distemper virus (CDV), canine parvovirus (CPV) and rabies were measured in dogs that had not been revaccinated annually and compared with the titres in a control group of regularly vaccinated animals; 83 per cent (171 of 207) of the dogs vaccinated against CDV one or more years earlier had serum neutralising antibody titres equal to or greater than 16; 64 per cent (136 of 213) of the dogs vaccinated against CPV one or more years earlier had haemagglutination inhibiting titres equal to or greater than 80; and 59 per cent (46 of 78) of the dogs vaccinated against rabies two or more years earlier had serum neutralising antibody titres equal to or greater than 0.5 iu/ml. Three weeks after a single booster vaccination the dogs' antibody titres against CDV had increased above the threshold level in 94 per cent of the dogs, against CPV in 68 per cent, and against rabies in 100 per cent.

Short-term X-ray spectral variability of the quasar PDS 456 observed in a low-flux state

NASA Astrophysics Data System (ADS)

Matzeu, G. A.; Reeves, J. N.; Nardini, E.; Braito, V.; Costa, M. T.; Tombesi, F.; Gofford, J.

2016-05-01

We present a detailed analysis of a recent, 2013 Suzaku campaign on the nearby (z = 0.184) luminous (Lbol ˜ 1047 erg s-1) quasar PDS 456. This consisted of three observations, covering a total duration of ˜1 Ms and a net exposure of 455 ks. During these observations, the X-ray flux was unusually low, suppressed by a factor of >10 in the soft X-ray band when compared to previous observations. We investigated the broad-band continuum by constructing a spectral energy distribution (SED), making use of the optical/UV photometry and hard X-ray spectra from the later simultaneous XMM-Newton and NuSTAR campaign in 2014. The high-energy part of this low-flux SED cannot be accounted for by physically self-consistent accretion disc and corona models without attenuation by absorbing gas, which partially covers a substantial fraction of the line of sight towards the X-ray continuum. At least two layers of absorbing gas are required, of column density log (NH,low/cm-2) = 22.3 ± 0.1 and log (NH,high/cm-2) = 23.2 ± 0.1, with average line-of-sight covering factors of ˜80 per cent (with typical ˜5 per cent variations) and 60 per cent (±10-15 per cent), respectively. During these observations PDS 456 displays significant short-term X-ray spectral variability, on time-scales of ˜100 ks, which can be accounted for by variable covering of the absorbing gas along the line of sight. The partial covering absorber prefers an outflow velocity of v_pc = 0.25^{+0.01}_{-0.05} c at the >99.9 per cent confidence level over the case where vpc = 0. This is consistent with the velocity of the highly ionized outflow responsible for the blueshifted iron K absorption profile. We therefore suggest that the partial covering clouds could be the denser, or clumpy part of an inhomogeneous accretion disc wind. Finally estimates are placed upon the size-scale of the X-ray emission region from the source variability. The radial extent of the X-ray emitter is found to be of the order ˜15-20Rg, although the hard X-ray (>2 keV) emission may originate from a more compact or patchy corona of hot electrons, which is typically ˜6-8Rg in size.

Prevalence of diagnostic characteristics indicating canine autoimmune lymphocytic thyroiditis in giant schnauzer and hovawart dogs.

PubMed

Ferm, K; Björnerfeldt, S; Karlsson, A; Andersson, G; Nachreiner, R; Hedhammar, A

2009-04-01

To investigate prevalence of autoantibodies to thyroglobulin (TgAA) and/or elevated levels of thyroid stimulating hormone (TSH), indicating canine autoimmune lymphocytic thyroiditis (CLT) and/or hypothyroidism, in two high-risk dog breeds. A cohort study was conducted in two birth cohorts of giant schnauzer and hovawart dogs. The cohorts were three to four and six to seven years of age at the time of blood sampling and screening for TgAA and TSH levels. Blood sampling was accompanied by one initial and one follow-up questionnaire to the dog owners. A total number of 236 giant schnauzers and 95 hovawarts were included in the study. Seventeen (7.2 per cent) giant schnauzers and three (3.2 per cent) hovawarts had been diagnosed as hypothyroid at the time of sampling. Out of the remaining dogs, 22 giant schnauzers (10.0 per cent) and nine hovawarts (10.1 per cent) had elevated TgAA and/or TSH levels. Prevalence of elevated TgAA and TSH levels varied with age. The high prevalence of diagnostic characteristics indicating CLT/hypothyroidism in these two breeds suggests a strong genetic predisposition. It would be advisable to screen potential breeding stock for TSH and TgAA as a basis for genetic health programmes to reduce prevalence of CLT in these breeds.

Prevalence of refractive errors among schoolchildren in rural central Ethiopia.

PubMed

Mehari, Zelalem Addisu; Yimer, Abdirahman Wollie

2013-01-01

The aim of the present study was to assess the prevalence of refractive errors and visual impairment among schoolchildren in rural central Ethiopia. A cross-sectional study was conducted from November 2010 to January 2011 among 5,470 schoolchildren from 14 schools, of whom 4,238 (aged 7-18 years) were screened for refractive errors. In all participants, uncorrected vision and best corrected visual acuity were determined and those with a visual acuity of 6/12 or worse, underwent a complete ophthalmic examination to determine the cause of visual impairment. Myopia was defined as a spherical equivalent of -0.50 dioptre (D) or greater in one or both eyes and hyperopia as a spherical equivalent of +2.00 D or greater. A cylindrical power of -0.50 DC (D cylinder) or greater was considered as astigmatism. Chi-square was used to test differences in proportions. Differences were considered to be statistically significant at the five per cent level. Of the 4,238 children, 405 (9.5 per cent) were visually impaired and of these 267 children were diagnosed as having refractive errors, with an overall prevalence of 6.3 per cent, comprised of 6.1 per cent in boys and 6.6 per cent in girls. Myopia is the most prevalent refractive error; accounting for 6.0 per cent, followed by compound myopic astigmatism 1.2 per cent, then simple myopic astigmatism 0.5 per cent, mixed astigmatism 0.26 per cent and finally hyperopia 0.33 per cent. Reasons for visual acuity of 6/12 or worse in the better eye were found to be refractive error (65.9 per cent), corneal problems (12.8 per cent) and amblyopia (9.6 per cent). The prevalence of manifest strabismus in the study group was 1.1 per cent (n = 45). The study concluded that uncorrected refractive error is a common cause of visual impairment among schoolchildren in rural central Ethiopia. This indicates the need for regular school-screening programs that provide glasses at low cost or free of charge for those who have refractive errors. © 2012 The Authors; Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

Multi-level obstruction in obstructive sleep apnoea: prevalence, severity and predictive factors.

PubMed

Phua, C Q; Yeo, W X; Su, C; Mok, P K H

2017-11-01

To characterise multi-level obstruction in terms of prevalence, obstructive sleep apnoea severity and predictive factors, and to collect epidemiological data on upper airway morphology in obstructive sleep apnoea patients. Retrospective review of 250 obstructive sleep apnoea patients. On clinical examination, 171 patients (68.4 per cent) had multi-level obstruction, 49 (19.6 per cent) had single-level obstruction and 30 (12 per cent) showed no obstruction. Within each category of obstructive sleep apnoea severity, multi-level obstruction was more prevalent. Multi-level obstruction was associated with severe obstructive sleep apnoea (more than 30 events per hour) (p = 0.001). Obstructive sleep apnoea severity increased with the number of obstruction sites (correlation coefficient = 0.303, p < 0.001). Multi-level obstruction was more likely in younger (p = 0.042), male (p = 0.045) patients, with high body mass index (more than 30 kg/m2) (p < 0.001). Palatal (p = 0.004), tongue (p = 0.026) and lateral pharyngeal wall obstructions (p = 0.006) were associated with severe obstructive sleep apnoea. Multi-level obstruction is more prevalent in obstructive sleep apnoea and is associated with increased severity. Obstruction at certain anatomical levels contributes more towards obstructive sleep apnoea severity.

Near-peer medical student simulation training.

PubMed

Cash, Thomas; Brand, Eleanor; Wong, Emma; Richardson, Jay; Athorn, Sam; Chowdhury, Faiza

2017-06-01

There is growing concern that medical students are inadequately prepared for life as a junior doctor. A lack of confidence managing acutely unwell patients is often cited as a barrier to good clinical care. With medical schools investing heavily in simulation equipment, we set out to explore if near-peer simulation training is an effective teaching format. Medical students in their third year of study and above were invited to attend a 90-minute simulation teaching session. The sessions were designed and delivered by final-year medical students using clinical scenarios mapped to the Sheffield MBChB curriculum. Candidates were required to assess, investigate and manage an acutely unwell simulated patient. Pre- and post-simulation training Likert scale questionnaires were completed relating to self-reported confidence levels. There is growing concern that medical students are inadequately prepared for life as a junior doctor RESULTS: Questionnaires were completed by 25 students (100% response rate); 52 per cent of students had no prior simulation experience. There were statistically significant improvements in self-reported confidence levels in each of the six areas assessed (p < 0.005). Thematic analysis of free-text comments indicated that candidates enjoyed the practical format of the sessions and found the experience useful. Our results suggest that near-peer medical student simulation training benefits both teacher and learner and that this simplistic model could easily be replicated at other medical schools. As the most junior members of the team, medical students are often confined to observer status. Simulation empowers students to practise independently in a safe and protected environment. Furthermore, it may help to alleviate anxiety about starting work as a junior doctor and improve future patient care. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Dose-expanded study in the reinforcement of efficacy of simvastatin.

PubMed

Vichayanrat, Apichati

2002-04-01

Two hundred and twenty two hyperlipidemic patients were recruited for a 12-week prospective, multicenter, open-label, titrate-to-goal study to evaluate the efficacy and safety of 20 to 40 mg per day of simvastatin in a Thai population. The efficacy on lipid lowering was evaluated at 4 weeks and 8 weeks after medication. Based on NCEP ATP II guideline and ADA position statement, subjects were categorized into three groups according to LDL-C goals; group I: patients without CHD and with < 2 CHD risk factors, group II: patients without CHD and with > or = 2 CHD risk factors and group III: CHD patients or diabetic patients with > or = 1 risk factors. Significant changes of all lipid parameters from baselines were noted at 4 weeks after medication except for HDL-C levels. Reduction of serum LDL-C, TC and TG by 40 per cent, 29 per cent and 16 per cent respectively and increase of serum HDL-C by 5 per cent were observed at 8 weeks of therapy (p<0.05). At 4 weeks after taking simvastatin 20 mg/day, 78.9 per cent of patients in group I, 67.4 per cent in group II and 40.9 per cent in group III achieved LDL-C goals. Seventeen per cent of the patients who were evaluated at 8 weeks increased the simvastatin dosage to 40 mg per day in the second month of treatment. At 8 weeks of therapy with simvastatin 20-40 mg/day, 90.1 per cent of patients in group I, 77.4 per cent in group II and 66.7 per cent in group III achieved LDL-C goals. Adverse symptoms during therapy, mostly mild, developed in 6.3 per cent of the 222 patients. Simvastatin 20-40 mg/day was effective and well tolerated in managing lipid parameters in Thai patients similar to other ethnic populations.

Gasoline tax as a corrective tax: Estimates for the United States, 1970-1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haughton, J.; Sarkar, S.

1996-12-01

The debate over the appropriate level of gasoline taxes in the United States (US) surfaces every few years. For every gallon of gasoline tax collected 14.1 cents was for the federal government and 17.6 cents on average for state governments, far less than $2.30 per gallon collected in Western Europe. The author offers estimates of benefits gained by taxing at various levels. 42 refs., 4 tabs.

Upper limits to the interstellar radiation field between 775 and 1050 A

NASA Technical Reports Server (NTRS)

Paresce, F.; Bowyer, S.

1976-01-01

A 40-A resolution extreme-ultraviolet spectrometer, sensitive to radiation in the 775-1050 A band, was flown on a Black Brant VC rocket to measure the night sky brightness in this region of the electromagnetic spectrum. A weak signal above background was recorded in most channels as the spectrometer's field of view scanned the sky in the vicinity of the galactic plane from Monoceros to Andromeda. Because the earth's upper atmosphere may produce some radiation in this wavelength region, the possibility cannot be excluded that some or all of the observed signal is terrestrial in origin. However, observational upper limits can be established at the 95-per cent confidence level for the intensity of an extraterrestrial extreme ultraviolet background which ranges from 6 millionths erg/sq cm/s/sr/A at 1050 A to 4 ten-millionths erg/sq cm/s/sr/A at 775 A. These results are consistent with existing theoretical predictions.

Gravitational redshift of galaxies in clusters as predicted by general relativity.

PubMed

Wojtak, Radosław; Hansen, Steen H; Hjorth, Jens

2011-09-28

The theoretical framework of cosmology is mainly defined by gravity, of which general relativity is the current model. Recent tests of general relativity within the Lambda Cold Dark Matter (ΛCDM) model have found a concordance between predictions and the observations of the growth rate and clustering of the cosmic web. General relativity has not hitherto been tested on cosmological scales independently of the assumptions of the ΛCDM model. Here we report an observation of the gravitational redshift of light coming from galaxies in clusters at the 99 per cent confidence level, based on archival data. Our measurement agrees with the predictions of general relativity and its modification created to explain cosmic acceleration without the need for dark energy (the f(R) theory), but is inconsistent with alternative models designed to avoid the presence of dark matter. © 2011 Macmillan Publishers Limited. All rights reserved

Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia.

PubMed

Edafe, O; Antakia, R; Laskar, N; Uttley, L; Balasubramanian, S P

2014-03-01

Hypocalcaemia is common after thyroidectomy. Accurate prediction and appropriate management may help reduce morbidity and hospital stay. The aim of this study was to perform a systematic literature review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia. A systematic search of PubMed, EMBASE and the Cochrane Library databases was undertaken, and the quality of manuscripts assessed using a modified Newcastle-Ottawa Scale. Some 115 observational studies were included. The median (i.q.r.) incidence of transient and permanent hypocalcaemia was 27 (19-38) and 1 (0-3) per cent respectively. Independent predictors of transient hypocalcaemia included levels of preoperative calcium, perioperative parathyroid hormone (PTH), preoperative 25-hydroxyvitamin D and postoperative magnesium. Clinical predictors included surgery for recurrent goitre and reoperation for bleeding. A calcium level lower than 1·88 mmol/l at 24 h after surgery, identification of fewer than two parathyroid glands (PTGs) at surgery, reoperation for bleeding, Graves' disease and heavier thyroid specimens were identified as independent predictors of permanent hypocalcaemia in multivariable analysis. Factors associated with transient hypocalcaemia in meta-analyses were inadvertent PTG excision (odds ratio (OR) 1·90, 95 per cent confidence interval 1·31 to 2·74), PTG autotransplantation (OR 2·03, 1·44 to 2·86), Graves' disease (OR 1·75, 1·34 to 2·28) and female sex (OR 2·28, 1·53 to 3·40). Perioperative PTH, preoperative vitamin D and postoperative changes in calcium are biochemical predictors of post-thyroidectomy hypocalcaemia. Clinical predictors include female sex, Graves' disease, need for parathyroid autotransplantation and inadvertent excision of PTGs. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Effect of a blood transfusion protocol and low dose steroid regime on renal transplant survival.

PubMed

Notghi, A; Anderton, J L; Chisholm, G D; Hamer-Hodges, D; Wilkinson, S; Smith, G; Galloway, N T; Yap, P L; Winney, R J

1986-04-01

The effects of introduction of a low steroid regime and pre-transplant blood transfusion were evaluated. The kidney and patient survival rates for the period before such a policy was adopted were compared with the period after this policy. There has been a highly significant rise in patient survival rates to the present level of 95 per cent at three years. There was a similar rise in three year graft survival rates from less than 40 per cent to 66 per cent.

Parasitic disease control in a residential facility for the mentally retarded.

PubMed Central

Thacker, S B; Simpson, S; Gordon, T J; Wolfe, M; Kimball, A M

1979-01-01

Asymptomatic infection with either Entameba histolytica or Giardia lamblia was found in 61 per cent of the residents of a dormitory in an institution for the mentally retarded; two other dormitories had rates of 20 per cent and 22 per cent. Drug therapy was successfully undertaken in all three dormitories, and environmental improvements were introduced in the heavily infected dormitory. A one-year follow-up showed a reduction in parasitic disease in two dormitories but, in the most heavily infected dormitory, infection had returned to pretreatment levels. PMID:389070

Fit for work? Evaluation of a workshop for rheumatology teams.

PubMed

Cohen, D; Khan, S; Marfell, N

2016-06-01

People with rheumatoid arthritis (RA) may rapidly cease work prematurely due to ill-health. A recent survey noted that a quarter of respondents with RA experienced job loss within a year of diagnosis and 50% stopped work within 6 years. To develop and pilot workshops to increase the knowledge, skills and confidence of rheumatology team members to support work-related issues in outpatient clinics. A 3-h interactive workshop, informed by rheumatology experts and the Royal College of General Practitioners (RCGP) National Education Programme (NEP) about work and health, was developed to address both knowledge and skills in the management of health and work consultations in an outpatient setting. Questionnaires were developed for use pre- and immediately post-workshop, with questions that focused on the confidence of delegates in managing these discussions and the importance they placed upon them. Ninety-nine participants attended five workshops throughout the UK between 2013 and 2104. Seventy-three per cent (72) completed the post-workshop questionnaire. Eighty-nine per cent found the workshop useful or very useful, 88% found it relevant or very relevant and 79% responded that it had an impact or a considerable impact on their practice. Wilcoxon matched pairs signed rank tests were carried out that showed an overall increase in confidence after training. The results suggest that the workshop was both relevant and useful to participants and had an impact on their practice. This was true for all specialities. The workshops also highlighted participants' desire to understand how to use the 'fit note' to enhance their patient management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Kuiper belt analogues in nearby M-type planet-host systems

NASA Astrophysics Data System (ADS)

Kennedy, G. M.; Bryden, G.; Ardila, D.; Eiroa, C.; Lestrade, J.-F.; Marshall, J. P.; Matthews, B. C.; Moro-Martin, A.; Wyatt, M. C.

2018-06-01

We present the results of a Herschel survey of 21 late-type stars that host planets discovered by the radial velocity technique. The aims were to discover new discs in these systems and to search for any correlation between planet presence and disc properties. In addition to the known disc around GJ 581, we report the discovery of two new discs, in the GJ 433 and GJ 649 systems. Our sample therefore yields a disc detection rate of 14 per cent, higher than the detection rate of 1.2 per cent among our control sample of DEBRIS M-type stars with 98 per cent confidence. Further analysis however shows that the disc sensitivity in the control sample is about a factor of two lower in fractional luminosity than for our survey, lowering the significance of any correlation between planet presence and disc brightness below 98 per cent. In terms of their specific architectures, the disc around GJ 433 lies at a radius somewhere between 1 and 30 au. The disc around GJ 649 lies somewhere between 6 and 30 au, but is marginally resolved and appears more consistent with an edge-on inclination. In both cases the discs probably lie well beyond where the known planets reside (0.06-1.1 au), but the lack of radial velocity sensitivity at larger separations allows for unseen Saturn-mass planets to orbit out to ˜5 au, and more massive planets beyond 5 au. The layout of these M-type systems appears similar to Sun-like star + disc systems with low-mass planets.

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer.

PubMed

Søreide, K; Thorsen, K; Søreide, J A

2014-01-01

Perforated peptic ulcer (PPU) is a common surgical emergency that carries high mortality and morbidity rates. Globally, one-quarter of a million people die from peptic ulcer disease each year. Strategies to improve outcomes are needed. PubMed was searched for evidence related to the surgical treatment of patients with PPU. The clinical registries of trials were examined for other available or ongoing studies. Randomized clinical trials (RCTs), systematic reviews and meta-analyses were preferred. Deaths from peptic ulcer disease eclipse those of several other common emergencies. The reported incidence of PPU is 3.8-14 per 100,000 and the mortality rate is 10-25 per cent. The possibility of non-operative management has been assessed in one small RCT of 83 patients, with success in 29 (73 per cent) of 40, and only in patients aged less than 70 years. Adherence to a perioperative sepsis protocol decreased mortality in a cohort study, with a relative risk (RR) reduction of 0.63 (95 per cent confidence interval (c.i.) 0.41 to 0.97). Based on meta-analysis of three RCTs (315 patients), laparoscopic and open surgery for PPU are equivalent, but patient selection remains a challenge. Eradication of Helicobacter pylori after surgical repair of PPI reduces both the short-term (RR 2.97, 95 per cent c.i. 1.06 to 8.29) and 1-year (RR 1.49, 1.10 to 2.03) risk of ulcer recurrence. Mortality and morbidity from PPU can be reduced by adherence to perioperative strategies. © 2013 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993-2015.

PubMed

Li, Yingfang; Fang, Wenjie; Jiang, Weiwei; Hagen, Ferry; Liu, Jia; Zhang, Lei; Hong, Nan; Zhu, Yu; Xu, Xiaoguang; Lei, Xia; Deng, Danqi; Xu, Jianping; Liao, Wanqing; Boekhout, Teun; Chen, Min; Pan, Weihua

2017-11-01

Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51.5, 60.6), and 93% of the patients were older than 40 years. Sixty-two per cent of the patients experienced untreated or poorly controlled blood glucose before infection. Multilocus sequence typing analysis categorised all cultured strains as Cryptococcus neoformans and sequence type 5. Sixty-nine per cent of pulmonary cryptococcosis patients experienced misdiagnoses and treatment delays. Sixty per cent of cryptococcal meningitis patients received substandard antifungal therapy. The overall death rate was 33%. Considering the large population size of DM II patients in China, improved attention should be paid to the high prevalence of cryptococcosis as revealed by us. We also emphasised the importance of blood glucose control for infection prevention, especially among the elderly. © 2017 Blackwell Verlag GmbH.

The role for peer-assisted ultrasound teaching in medical school.

PubMed

Dickerson, Jonathan; Paul, Katie; Vila, Pierre; Whiticar, Rebecca

2017-06-01

Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure. Although countless hours are devoted to plain radiograph and electrocardiogram (ECG) interpretation, ultrasound is frequently glossed over. Yet this imaging modality could enhance students' understanding of anatomy, physiology and pathology, and may increase their integration into hospital teams. We aimed to investigate whether a peer-assisted ultrasound course has a place within the undergraduate medical curriculum. We describe the implementation of a course and discuss its acceptability and utility in student education. Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure METHODS: Following consultation with the medical school, an improved ultrasonography course was developed with expert guidance from an ultrasonographer and with new equipment. Sessions involved peer-tutors teaching ultrasonography techniques to medical students during emergency medicine placements. Tutees completed questionnaires to assess the quality and perceived benefits of the course and of learning ultrasonography. Both quantitative and thematic analyses of the responses were conducted by the authors. Over a period of 8 months, 105 medical students received teaching across four sessions. A total of 103 students (98%) returned questionnaires on their evaluation of the course and tutors, and on their confidence in using ultrasound. Ninety-eight per cent felt that the teaching was well delivered, 100 per cent felt that their knowledge of ultrasound had improved and 100 per cent would recommend the course. The peer-assisted ultrasound course described here enabled the majority of students to feel confident gaining elementary ultrasound views, and performing abdominal aneurysm screening and trauma assessments: techniques that they could hopefully put to use during their placements. The peer-assisted model has an acceptable role in teaching emerging clinical skills to medical students. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

A study on existing knowledge about AIDS among undergraduates of a Nigerian University.

PubMed

Gugnani, A; Ukeje, M A

1993-06-01

This study, carried out during August-October, 1991, involved 236 respondents to a questionnaire designed to determine awareness and attitudes to AIDS and the consequent effect of such awareness on their sexual behaviour. Almost all the medical students were aware of the existence of the disease, while a few (3.8 per cent) of the non-medicos believed that it had not yet reached Nigeria. Most students i.e. 98 per cent and 97 per cent of these respective groups were aware of carrier state of the disease. Only a small percentage of students, mostly medics knew about the exact signs and symptoms of clinical AIDS. The level of knowledge about the modes of transmission of AIDS was found to be adequate. With regard to the effect of this awareness on their behaviour, it was known that a good number of medics (30.37) per cent and non-medics (28.88) per cent had started using condoms. About 40 per cent medicos, and 45 per cent non-medicos revealed an aversion to sit near a person with AIDS thus emphasizing the stigma associated with the disease. Regarding control of AIDS, many felt there should be strict isolation of HIV positive individuals along with a ban on prostitution and homosexuality.

Implications of PSR J0737-3039B for the Galactic NS-NS binary merger rate

NASA Astrophysics Data System (ADS)

Kim, Chunglee; Perera, Benetge Bhakthi Pranama; McLaughlin, Maura A.

2015-03-01

The Double Pulsar (PSR J0737-3039) is the only neutron star-neutron star (NS-NS) binary in which both NSs have been detectable as radio pulsars. The Double Pulsar has been assumed to dominate the Galactic NS-NS binary merger rate R_g among all known systems, solely based on the properties of the first-born, recycled pulsar (PSR J0737-3039A, or A) with an assumption for the beaming correction factor of 6. In this work, we carefully correct observational biases for the second-born, non-recycled pulsar (PSR J0737-0737B, or B) and estimate the contribution from the Double Pulsar on R_g using constraints available from both A and B. Observational constraints from the B pulsar favour a small beaming correction factor for A (˜2), which is consistent with a bipolar model. Considering known NS-NS binaries with the best observational constraints, including both A and B, we obtain R_g=21_{-14}^{+28} Myr-1 at 95 per cent confidence from our reference model. We expect the detection rate of gravitational waves from NS-NS inspirals for the advanced ground-based gravitational-wave detectors is to be 8^{+10}_{-5} yr-1 at 95 per cent confidence. Within several years, gravitational-wave detections relevant to NS-NS inspirals will provide us useful information to improve pulsar population models.

Status of sea lamprey control

USGS Publications Warehouse

Moffett, James W.

1956-01-01

Four experiments involving 873 bob-white quail (Colinus virginianus) chicks were conducted at the Patuxent Research Refuge, Laurel, Maryland. A comparison was made of calcium: phosphorus ratios of 1:1, 15:1, 1%: 1, 2:1, 2+:1,and 2%: 1in diets with phosphorus levels of 0.52, 0.75, 1.00, and 1.25 percent. The results indicate that the optimum level of phosphorus for growth is in the neighborhood of 0.75 per cent, and that of calcium is about 1.00 per cent, making a ratio of 1 1/3: 1....Although the greatest efficiency of feed utilization occurred on the phosphorus level of 0.52 per cent, the liveweight and bone-ash of the birds at the end of ten weeks were significantly lower than they were on the levels of 0.75 and 1.00 per cent, phosphorus. Bone-ash of birds on a Ca: P ratio of 1:1was significantly lower than that on any of the other five ratios, regardless of phosphorus level....There was a significant reverse correlation between the Ca: P ratio of the diet and the storage of vitamin A in the liver. Storage was especially low on the ratio of 2 2/3: 1....The low and high levels of calcium and phosphorus considered in these studies are abnormal, the low level especially being hard to obtain with common feedstuffs, if the protein requirements of the birds are met. Nevertheless, even on such levels, results were not disastrous. The growth of quail in the wild happens during a season when the birds have access to the minerals of the soil and in the abundant animal matter (mostly insects), as well as to minerals in plant material. Therefore, seemingly, calcium and phosphorus need not be critical nutrients for growing quail in the wild.

Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

PubMed

Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

2013-04-01

Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Cardiac rehabilitation after percutaneous coronary intervention: Results from a nationwide survey.

PubMed

Olsen, Siv Js; Schirmer, Henrik; Bønaa, Kaare H; Hanssen, Tove A

2018-03-01

The purpose of this study was to estimate the proportion of Norwegian coronary heart disease patients participating in cardiac rehabilitation programmes after percutaneous coronary intervention, and to determine predictors of cardiac rehabilitation participation. Participants were patients enrolled in the Norwegian Coronary Stent Trial. We assessed cardiac rehabilitation participation in 9013 of these patients who had undergone their first percutaneous coronary intervention during 2008-2011. Of these, 7068 patients (82%) completed a self-administered questionnaire on cardiac rehabilitation participation within three years after their percutaneous coronary intervention. Twenty-eight per cent of the participants reported engaging in cardiac rehabilitation. Participation rate differed among the four regional health authorities in Norway, varying from 20%-31%. Patients undergoing percutaneous coronary intervention for an acute coronary syndrome were more likely to participate in cardiac rehabilitation than patients with stable angina (odds ratio 3.2; 95% confidence interval 2.74-3.76). A multivariate statistical model revealed that men had a 28% lower probability ( p<0.001) of participating in cardiac rehabilitation, and the odds of attending cardiac rehabilitation decreased with increasing age ( p<0.001). Contributors to higher odds of cardiac rehabilitation participation were educational level >12 years (odds ratio 1.50; 95% confidence interval 1.32-1.71) and body mass index>25 (odds ratio 1.19; 95% confidence interval 1.05-1.36). Prior coronary artery bypass graft was associated with lower odds of cardiac rehabilitation participation (odds ratio 0.47; 95% confidence interval 0.32-0.70) Conclusion: The estimated cardiac rehabilitation participation rate among patients undergoing first-time percutaneous coronary intervention is low in Norway. The typical participant is young, overweight, well-educated, and had an acute coronary event. These results varied by geographical region.

First measurement of the bulk flow of nearby galaxies using the cosmic microwave background

NASA Astrophysics Data System (ADS)

Lavaux, Guilhem; Afshordi, Niayesh; Hudson, Michael J.

2013-04-01

Peculiar velocities in the nearby Universe can be measured via the kinetic Sunyaev-Zel'dovich (kSZ) effect. Using a statistical method based on an optimized cross-correlation with nearby galaxies, we extract the kSZ signal generated by plasma halo of galaxies from the cosmic microwave background (CMB) temperature anisotropies observed by the Wilkinson Microwave Anisotropy Probe (WMAP). Marginalizing over the thermal Sunyaev-Zel'dovich contribution from clusters of galaxies, possible unresolved point source contamination, and Galactic foregrounds, we find a kSZ bulk flow signal present at the ˜90 per cent confidence level in the seven-year WMAP data. When only galaxies within 50 h-1 Mpc are included in the kSZ template, we find a bulk flow in the CMB frame of |V| = 533 ± 263 km s-1, in the direction l = 324 ± 27, b = -7 ± 17, consistent with bulk flow measurements on a similar scale using classical distance indicators. We show how this comparison constrains, for the first time, the (ionized) baryonic budget in the local universe. On very large (˜500 h-1 Mpc) scales, we find a 95 per cent upper limit of 470 km s-1, inconsistent with some analyses of bulk flow of clusters from the kSZ. We estimate that the significance of the bulk flow signal may increase to 3σ-5σ using data from the Planck probe.

A magnified young galaxy from about 500 million years after the Big Bang.

PubMed

Zheng, Wei; Postman, Marc; Zitrin, Adi; Moustakas, John; Shu, Xinwen; Jouvel, Stephanie; Høst, Ole; Molino, Alberto; Bradley, Larry; Coe, Dan; Moustakas, Leonidas A; Carrasco, Mauricio; Ford, Holland; Benítez, Narciso; Lauer, Tod R; Seitz, Stella; Bouwens, Rychard; Koekemoer, Anton; Medezinski, Elinor; Bartelmann, Matthias; Broadhurst, Tom; Donahue, Megan; Grillo, Claudio; Infante, Leopoldo; Jha, Saurabh W; Kelson, Daniel D; Lahav, Ofer; Lemze, Doron; Melchior, Peter; Meneghetti, Massimo; Merten, Julian; Nonino, Mario; Ogaz, Sara; Rosati, Piero; Umetsu, Keiichi; van der Wel, Arjen

2012-09-20

Re-ionization of the intergalactic medium occurred in the early Universe at redshift z ≈ 6-11, following the formation of the first generation of stars. Those young galaxies (where the bulk of stars formed) at a cosmic age of less than about 500 million years (z ≲ 10) remain largely unexplored because they are at or beyond the sensitivity limits of existing large telescopes. Understanding the properties of these galaxies is critical to identifying the source of the radiation that re-ionized the intergalactic medium. Gravitational lensing by galaxy clusters allows the detection of high-redshift galaxies fainter than what otherwise could be found in the deepest images of the sky. Here we report multiband observations of the cluster MACS J1149+2223 that have revealed (with high probability) a gravitationally magnified galaxy from the early Universe, at a redshift of z = 9.6 ± 0.2 (that is, a cosmic age of 490 ± 15 million years, or 3.6 per cent of the age of the Universe). We estimate that it formed less than 200 million years after the Big Bang (at the 95 per cent confidence level), implying a formation redshift of ≲14. Given the small sky area that our observations cover, faint galaxies seem to be abundant at such a young cosmic age, suggesting that they may be the dominant source for the early re-ionization of the intergalactic medium.

Gravitational detection of a low-mass dark satellite galaxy at cosmological distance.

PubMed

Vegetti, S; Lagattuta, D J; McKean, J P; Auger, M W; Fassnacht, C D; Koopmans, L V E

2012-01-18

The mass function of dwarf satellite galaxies that are observed around Local Group galaxies differs substantially from simulations based on cold dark matter: the simulations predict many more dwarf galaxies than are seen. The Local Group, however, may be anomalous in this regard. A massive dark satellite in an early-type lens galaxy at a redshift of 0.222 was recently found using a method based on gravitational lensing, suggesting that the mass fraction contained in substructure could be higher than is predicted from simulations. The lack of very low-mass detections, however, prohibited any constraint on their mass function. Here we report the presence of a (1.9 ± 0.1) × 10(8) M dark satellite galaxy in the Einstein ring system JVAS B1938+666 (ref. 11) at a redshift of 0.881, where M denotes the solar mass. This satellite galaxy has a mass similar to that of the Sagittarius galaxy, which is a satellite of the Milky Way. We determine the logarithmic slope of the mass function for substructure beyond the local Universe to be 1.1(+0.6)(-0.4), with an average mass fraction of 3.3(+3.6)(-1.8) per cent, by combining data on both of these recently discovered galaxies. Our results are consistent with the predictions from cold dark matter simulations at the 95 per cent confidence level, and therefore agree with the view that galaxies formed hierarchically in a Universe composed of cold dark matter.

Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.

PubMed

Albutt, Katherine; Kelly, Jocelyn; Kabanga, Justin; VanRooyen, Michael

2017-04-01

Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

A nurse-led 'stop smoking' initiative.

PubMed

McGowan, E; MacAuley, D; Anderson, U

A one-week smoking awareness initiative and subsequent audit in a general practice are described. All patients attending morning surgery during the study period were offered the opportunity to discuss smoking habits at a smoking awareness clinic: 84 smokers attended. They were interviewed by the practice preventive care nurse who took a smoking history, monitored carbon monoxide (CO Hb) levels and offered a follow-up appointment. CO Hb provided immediate feedback on the effect of smoking and patients who smoked 20 or more cigarettes per day had an average CO Hb of 16.1 per cent. Fifteen per cent of smokers made a commitment to stop smoking and agreed to attend follow-up clinics. A random sample (50) of attenders at the initial Smoking Awareness Clinic (84) were followed up by questionnaire six months later. There were 29 replies (58 per cent); 19 patients (65 per cent) found the visit to the clinic helpful, 14 (48 per cent) reduced the number of cigarettes they smoked, and 11 (38 per cent) altered some other aspect of their lifestyle, of whom four modified their diet and four increased exercise. Five patients claimed they had given up smoking.

Study on the management of diarrhea in young children at community level in Thailand.

PubMed

Wongsaroj, T; Thavornnunth, J; Charanasri, U

1997-03-01

An evaluating study was carried out among 15,466 children from households randomized from 30 clusters from twelve provinces of twelve regions of Thailand. Results of this study revealed 5.13 per cent of incidence-rate of diarrhea among young children aged under five years with an average of annual prevalence of 1.3 per child. The overall mortality-rate and diarrhea associated death were 51.7 per 100,000 and 6.5 per 100,000 respectively. The utilization of ORS was 25.6 per cent while the using-rate of sugar salt solution (SSS) and the use of recommended home fluids were 2.8 and 33.8 per cent respectively. As for treatment, the intravenous therapy was 6.2 per cent and the use of different types of drugs varied from 18.0 to 21.3 per cent. Only 23.7 per cent of parents could correctly prepare the ORS. The authors have made recommendations for the strengthening of community health education aiming at better promotion of ORS and other home care practices for diarrhea as important measures for lowering mortality together with relating preventive interventions.

Cost of delivering secondary-level health care services through public sector district hospitals in India

PubMed Central

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals

PubMed Central

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-01-01

Background The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size – the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals. PMID:16987416

The Tennessee child restraint law in its third year.

PubMed Central

Williams, A F; Wells, J K

1981-01-01

Observations of child travel were made in Knoxville and Nashville, Tennessee, and Lexington and Louisville, Kentucky about two and one-half years after the Tennessee child restraint law went into force. Use of child restraints anchored by seat belts increased in Tennessee from 8 per cent prior to the law to 29 per cent, compared to a change from 11 to 14 per cent in Kentucky, which does not have a child restraint law. Travel in arms, a hazardous practice permitted by the law, was at the same level in Tennessee and Kentucky as prior to passage of the law. PMID:7457685

Compliance and hygiene behaviour among soft contact lens wearers in the Maldives.

PubMed

Gyawali, Rajendra; Nestha Mohamed, Fathimath; Bist, Jeewanand; Kandel, Himal; Marasini, Sanjay; Khadka, Jyoti

2014-01-01

Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behaviour of soft contact lens wearers in the Maldives. Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behaviour (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices. Out of 107 participants, 79 (74.8 per cent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 ± 4.4 years. Mean duration of lens wear was 28.04 ± 8.36 months. Most of them were using spherical lenses (86.9 per cent) on a daily wear basis (96.3 per cent). Major reported forms of non-compliance were poor hand hygiene (60.7 per cent), lack of aftercare awareness (39.3 per cent), water exposure (35.5 per cent) and over-use of lenses (24.3 per cent). While females were more likely to overuse their lenses than males (p < 0.005), other socio-demographic factors were not associated with reported non-compliance. Although around 90 per cent of the participants considered themselves average or good contact lens wearers, most exhibited some form of non-compliant and poor hygienic behaviour. A significant number of Maldivian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

Do doctors need statistics? Doctors' use of and attitudes to probability and statistics.

PubMed

Swift, Louise; Miles, Susan; Price, Gill M; Shepstone, Lee; Leinster, Sam J

2009-07-10

There is little published evidence on what doctors do in their work that requires probability and statistics, yet the General Medical Council (GMC) requires new doctors to have these skills. This study investigated doctors' use of and attitudes to probability and statistics with a view to informing undergraduate teaching.An email questionnaire was sent to 473 clinicians with an affiliation to the University of East Anglia's Medical School.Of 130 respondents approximately 90 per cent of doctors who performed each of the following activities found probability and statistics useful for that activity: accessing clinical guidelines and evidence summaries, explaining levels of risk to patients, assessing medical marketing and advertising material, interpreting the results of a screening test, reading research publications for general professional interest, and using research publications to explore non-standard treatment and management options.Seventy-nine per cent (103/130, 95 per cent CI 71 per cent, 86 per cent) of participants considered probability and statistics important in their work. Sixty-three per cent (78/124, 95 per cent CI 54 per cent, 71 per cent) said that there were activities that they could do better or start doing if they had an improved understanding of these areas and 74 of these participants elaborated on this. Themes highlighted by participants included: being better able to critically evaluate other people's research; becoming more research-active, having a better understanding of risk; and being better able to explain things to, or teach, other people.Our results can be used to inform how probability and statistics should be taught to medical undergraduates and should encourage today's medical students of the subjects' relevance to their future careers. Copyright 2009 John Wiley & Sons, Ltd.

High-resolution estimates of Southwest Indian Ridge plate motions, 20 Ma to present

NASA Astrophysics Data System (ADS)

DeMets, C.; Merkouriev, S.; Sauter, D.

2015-12-01

We present the first estimates of Southwest Indian Ridge (SWIR) plate motions at high temporal resolution during the Quaternary and Neogene based on nearly 5000 crossings of 21 magnetic reversals out to C6no (19.72 Ma) and the digitized traces of 17 fracture zones and transform faults. Our reconstructions of this slow-spreading mid-ocean ridge reveal several unexpected results with notable implications for regional and global plate reconstructions since 20 Ma. Extrapolations of seafloor opening distances to zero-age seafloor based on reconstructions of reversals C1n (0.78 Ma) through C3n.4 (5.2 Ma) reveal evidence for surprisingly large outward displacement of 5 ± 1 km west of 32°E, where motion between the Nubia and Antarctic plates occurs, but 2 ± 1 km east of 32°E, more typical of most mid-ocean ridges. Newly estimated SWIR seafloor spreading rates are up to 15 per cent slower everywhere along the ridge than previous estimates. Reconstructions of the numerous observations for times back to 11 Ma confirm the existence of the hypothesized Lwandle plate at high confidence level and indicate that the Lwandle plate's western and eastern boundaries respectively intersect the ridge near the Andrew Bain transform fault complex at 32°E and between ˜45°E and 52°E, in accord with previous results. The Nubia-Antarctic, Lwandle-Antarctic and Somalia-Antarctic rotation sequences that best fit many magnetic reversal, fracture zone and transform fault crossings define previously unknown changes in the Neogene motions of all three plate pairs, consisting of ˜20 per cent slowdowns in their spreading rates at 7.2^{+0.9 }_{ -1.4} Ma if we enforce a simultaneous change in motion everywhere along the SWIR and gradual 3°-7° anticlockwise rotations of the relative slip directions. We apply trans-dimensional Bayesian analysis to our noisy, best-fitting rotation sequences in order to estimate less-noisy rotation sequences suitable for use in future global plate reconstructions and geodynamic studies. Notably, our new Nubia-Antarctic reconstruction of C5n.2 (11.0 Ma) predicts 20 per cent less opening than do two previous estimates, with important implications for motion that is estimated between the Nubia and Somalia plates. A Nubia-Somalia rotation determined from our Nubia-Antarctic and Somalia-Antarctic plate rotations for C5n.2 (11.0 Ma) predicts cumulative opening of 45 ± 4 km (95 per cent uncertainty) across the northernmost East Africa rift since 11.0 Ma, 70 per cent less than a recent 129 ± 62 km opening estimate based on a now-superseded interpretation of Anomaly 5 along the western portion of the SWIR.

Spectrochemical determination of thorium in monazite by the powder-d.c. arc technique

USGS Publications Warehouse

Dutra, C.V.; Murata, K.J.

1954-01-01

Thorium in monazite is determined by a d.c. carbon-arc technique using zirconium as the internal standard. The analytical curve for Th II 2870.413 A??/Zr II 2844-579 A?? is established by means of synthetic standards containing graduated amounts of thoria and 0.500 per cent zirconia in pegmatite base (60 parts quartz, 40 parts microchne, and 1 part ferric oxide). Monazite samples are diluted 14-fold with pegmatite base that contains 0.538 per cent ZrO2, so that the zirconia content of the resulting mixture is also 0.500 per cent. In addition, both the standards and the diluted monazites are mixed with one-half their weight of powdered graphite. Approximately 25 mg of the prepared samples are arced to completion at 15.5 to 17.5 amperes. With the 14-fold dilution employed, the accurate range of the method is 3 to 20 per cent thoria in the original monazite. The coefficient of variation for a single determination is 4 per cent at the 7 per cent thoria level. Tests with synthetic unknowns and chemically analyzed monazites show a maximum error of ??10 per cent of the thoria content. If niobium is substituted for zirconium as the internal standard, there is a loss of precision. Platinum as the internal standard gives results of good precision but introduces a marked sensitivity to matrix effects. ?? 1954.

Second-hand smoke levels in UK pubs and bars: do the English Public Health White Paper proposals go far enough?

PubMed

Gee, I L; Watson, A F R; Carrington, J; Edwards, P R; van Tongeren, M; McElduff, P; Edwards, R E

2006-03-01

The English Public Health White Paper proposes introducing smoke-free workplaces except in pubs and bars that do not prepare and serve food. The bar area will be non-smoking in exempted pubs. To explore the likely impact of these proposals in UK pubs and bars. A total of 59 pubs and bars within Greater Manchester in 2001 were chosen. Thirteen were mechanically ventilated, 12 were naturally ventilated and 34 had extractor fans; 23 provided non-smoking areas. We measured time-weighted average concentrations of respirable suspended particles (RSP), solanesol tobacco-specific particles and vapour-phase nicotine (VPN) over a 4-h sampling period on a Tuesday or Saturday night. Second-hand smoke (SHS) levels in smoking areas were high (mean RSP 114.5 microg/m3, VPN 88.2 microg/m3, solanesol 101.7 microg/m3). There were only small (5-13 per cent) reductions in bar areas. Mean levels were lower in non-smoking areas: by 33 per cent for RSPs, 52 per cent for solanesol particles and 69 per cent for VPN. Compared with other settings (homes and other workplaces) with unrestricted smoking, mean SHS levels were high throughout all areas of the pubs regardless of ventilation strategy. Partial measures, like those in the English Public Health White Paper, will leave bar staff in exempted pubs unprotected from the occupational hazard of SHS.

Risk factor profile for non-communicable diseases among Mishing tribes in Assam, India: results from a WHO STEPs survey.

PubMed

Misra, Palash Jyoti; Mini, G K; Thankappan, K R

2014-09-01

A comprehensive risk factor profile of non-communicable diseases (NCDs) as suggested by the World Health Organization (WHO) has not been reported from tribal population in India. This survey was carried out to assess the prevalence of NCD risk factors among Mishing tribes in Assam using the WHO STEPs approach. A total of 332 individuals of the Mishing tribe (men 54%) aged 25-64 yr were selected from Tinsukia district by multistage cluster sampling. Using the WHO STEPs approach information was collected on demographics, STEP 1 variables (tobacco, alcohol, physical activity, diet) and measured STEP 2 variables (weight, height, waist circumference and blood pressure). Multivariate analysis was used to find the relation between STEP 1 and STEP 2 variables. Overall, tobacco use was 84 per cent (men 94%; women 73%, p0 <0.001) and alcohol use was 67 per cent (men 82%; women 50%, p0 <0.05); 86 per cent reported vigorous physical activity, (men 91%, women 82%; p0 < 0.05). Sixty eight per cent reported to consume unhealthy diet (less than five servings of fruits and vegetables/day), 11 per cent had abdominal obesity, 16 per cent were overweight and 26 per cent had hypertension. Non users of tobacco and those who consumed more fruits and vegetables had higher prevalence of overweight ( p0 <0.05). Among the hypertensives, 24 per cent were aware, 17 per cent treated and 2.4 per cent controlled their hypertension. Older individuals had higher hypertension prevalence ( p0 <0.05) compared to younger individuals. Tobacco use, alcohol use and unhealthy diet habits were high among men and women in this population and were major NCD risk factors. An integrated approach of culturally appropriate population level and high risk strategies are warranted to reduce these risk factors and to enhance adequate control of hypertension.

Risk factor profile for non-communicable diseases among Mishing tribes in Assam, India: Results from a WHO STEPs survey

PubMed Central

Misra, Palash Jyoti; Mini, G.K.; Thankappan, K.R.

2014-01-01

Background & objectives: A comprehensive risk factor profile of non-communicable diseases (NCDs) as suggested by the World Health Organization (WHO) has not been reported from tribal population in India. This survey was carried out to assess the prevalence of NCD risk factors among Mishing tribes in Assam using the WHO STEPs approach. Methods: A total of 332 individuals of the Mishing tribe (men 54%) aged 25-64 yr were selected from Tinsukia district by multistage cluster sampling. Using the WHO STEPs approach information was collected on demographics, STEP 1 variables (tobacco, alcohol, physical activity, diet) and measured STEP 2 variables (weight, height, waist circumference and blood pressure). Multivariate analysis was used to find the relation between STEP 1 and STEP 2 variables. Results: Overall, tobacco use was 84 per cent (men 94%; women 73%, P<0.001) and alcohol use was 67 per cent (men 82%; women 50%, P<0.05); 86 per cent reported vigorous physical activity, (men 91%, women 82%; P < 0.05). Sixty eight per cent reported to consume unhealthy diet (less than five servings of fruits and vegetables/day), 11 per cent had abdominal obesity, 16 per cent were overweight and 26 per cent had hypertension. Non users of tobacco and those who consumed more fruits and vegetables had higher prevalence of overweight (P<0.05). Among the hypertensives, 24 per cent were aware, 17 per cent treated and 2.4 per cent controlled their hypertension. Older individuals had higher hypertension prevalence (P<0.05) compared to younger individuals. Interpretation & conclusions: Tobacco use, alcohol use and unhealthy diet habits were high among men and women in this population and were major NCD risk factors. An integrated approach of culturally appropriate population level and high risk strategies are warranted to reduce these risk factors and to enhance adequate control of hypertension. PMID:25366204

Cost-effectiveness of screening for abdominal aortic aneurysm in the Netherlands and Norway.

PubMed

Spronk, S; van Kempen, B J H; Boll, A P M; Jørgensen, J J; Hunink, M G M; Kristiansen, I S

2011-11-01

The aim of this study was to determine the cost-effectiveness of ultrasound screening for abdominal aortic aneurysm (AAA) in men aged 65 years, for both the Netherlands and Norway. A Markov model was developed to simulate life expectancy, quality-adjusted life-years, net health benefits, lifetime costs and incremental cost-effectiveness ratios for both screening and no screening for AAA. The best available evidence was retrieved from the literature and combined with primary data from the two countries separately, and analysed from a national perspective. A threshold willingness-to-pay (WTP) of €20,000 and €62,500 was used for data from the Netherlands and Norway respectively. The additional costs of the screening strategy compared with no screening were €421 (95 per cent confidence interval 33 to 806) per person in the Netherlands, and the additional life-years were 0·097 (-0·180 to 0·365), representing €4340 per life-year. For Norway, the values were €562 (59 to 1078), 0·057 (-0·135 to 0·253) life-years and €9860 per life-year respectively. In Norway the results were sensitive to a decrease in the prevalence of AAA in 65-year-old men to 1 per cent, or lower. Probabilistic sensitivity analyses indicated that AAA screening has a 70 per cent probability of being cost-effective in the Netherlands with a WTP threshold of €20,000, and 70 per cent in Norway with a threshold of €62,500. Using this model, screening for AAA in 65-year-old men would be highly cost-effective in both the Netherlands and Norway. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Clinical effects of pre-adjusted edgewise orthodontic brackets: a systematic review and meta-analysis.

PubMed

Papageorgiou, Spyridon N; Konstantinidis, Ioannis; Papadopoulou, Konstantina; Jäger, Andreas; Bourauel, Christoph

2014-06-01

Fixed-appliance treatment is a major part of orthodontic treatment, but clinical evidence remains scarce. Objective of this systematic review was to investigate how the therapeutic effects and side-effects of brackets used during the fixed-appliance orthodontic treatment are affected by their characteristics. SEARCH METHODS AND SELECTION CRITERIA: We searched MEDLINE and 18 other databases through April 2012 without restrictions for randomized controlled trials and quasi-randomized controlled trials investigating any bracket characteristic. After duplicate selection and extraction procedures, risk of bias was assessed also in duplicate according to Cochrane guidelines and quality of evidence according to the Grades of Recommendation. Assessment, Development and Evaluation approach. Random-effects meta-analyses, subgroup analyses, and sensitivity analyses were performed with the corresponding 95 per cent confidence intervals (CI) and 95 per cent prediction intervals (PI). We included 25 trials on 1321 patients, with most comparing self-ligated (SL) and conventional brackets. Based on the meta-analyses, the duration of orthodontic treatment was on average 2.01 months longer among patients with SL brackets (95 per cent CI: 0.45 to 3.57). The 95 per cent PIs for a future trial indicated that the difference could be considerable (-1.46 to 5.47 months). Treatment characteristics, outcomes, and side-effects were clinically similar between SL and conventional brackets. For most bracket characteristics, evidence is insufficient. Some meta-analyses included trials with high risk of bias, but sensitivity analyses indicated robustness. Based on existing evidence, no clinical recommendation can be made regarding the bracket material or different ligation modules. For SL brackets, no conclusive benefits could be proven, while their use was associated with longer treatment durations.

Observational constraints on the physical nature of submillimetre source multiplicity: chance projections are common

NASA Astrophysics Data System (ADS)

Hayward, Christopher C.; Chapman, Scott C.; Steidel, Charles C.; Golob, Anneya; Casey, Caitlin M.; Smith, Daniel J. B.; Zitrin, Adi; Blain, Andrew W.; Bremer, Malcolm N.; Chen, Chian-Chou; Coppin, Kristen E. K.; Farrah, Duncan; Ibar, Eduardo; Michałowski, Michał J.; Sawicki, Marcin; Scott, Douglas; van der Werf, Paul; Fazio, Giovanni G.; Geach, James E.; Gurwell, Mark; Petitpas, Glen; Wilner, David J.

2018-05-01

Interferometric observations have demonstrated that a significant fraction of single-dish submillimetre (submm) sources are blends of multiple submm galaxies (SMGs), but the nature of this multiplicity, i.e. whether the galaxies are physically associated or chance projections, has not been determined. We performed spectroscopy of 11 SMGs in six multicomponent submm sources, obtaining spectroscopic redshifts for nine of them. For an additional two component SMGs, we detected continuum emission but no obvious features. We supplement our observed sources with four single-dish submm sources from the literature. This sample allows us to statistically constrain the physical nature of single-dish submm source multiplicity for the first time. In three (3/7, { or} 43^{+39 }_{ -33} {per cent at 95 {per cent} confidence}) of the single-dish sources for which the nature of the blending is unambiguous, the components for which spectroscopic redshifts are available are physically associated, whereas 4/7 (57^{+33 }_{ -39} per cent) have at least one unassociated component. When components whose spectra exhibit continuum but no features and for which the photometric redshift is significantly different from the spectroscopic redshift of the other component are also considered, 6/9 (67^{+26 }_{ -37} per cent) of the single-dish sources are comprised of at least one unassociated component SMG. The nature of the multiplicity of one single-dish source is ambiguous. We conclude that physically associated systems and chance projections both contribute to the multicomponent single-dish submm source population. This result contradicts the conventional wisdom that bright submm sources are solely a result of merger-induced starbursts, as blending of unassociated galaxies is also important.

Prospects for detection of intermediate-mass black holes in globular clusters using integrated-light spectroscopy

NASA Astrophysics Data System (ADS)

de Vita, R.; Trenti, M.; Bianchini, P.; Askar, A.; Giersz, M.; van de Ven, G.

2017-06-01

The detection of intermediate-mass black holes (IMBHs) in Galactic globular clusters (GCs) has so far been controversial. In order to characterize the effectiveness of integrated-light spectroscopy through integral field units, we analyse realistic mock data generated from state-of-the-art Monte Carlo simulations of GCs with a central IMBH, considering different setups and conditions varying IMBH mass, cluster distance and accuracy in determination of the centre. The mock observations are modelled with isotropic Jeans models to assess the success rate in identifying the IMBH presence, which we find to be primarily dependent on IMBH mass. However, even for an IMBH of considerable mass (3 per cent of the total GC mass), the analysis does not yield conclusive results in one out of five cases, because of shot noise due to bright stars close to the IMBH line of sight. This stochastic variability in the modelling outcome grows with decreasing BH mass, with approximately three failures out of four for IMBHs with 0.1 per cent of total GC mass. Finally, we find that our analysis is generally unable to exclude at 68 per cent confidence an IMBH with mass of 103 M⊙ in snapshots without a central BH. Interestingly, our results are not sensitive to GC distance within 5-20 kpc, nor to misidentification of the GC centre by less than 2 arcsec (<20 per cent of the core radius). These findings highlight the value of ground-based integral field spectroscopy for large GC surveys, where systematic failures can be accounted for, but stress the importance of discrete kinematic measurements that are less affected by stochasticity induced by bright stars.

Night emergency cover for ENT in England: a national survey.

PubMed

Biswas, D; Rafferty, A; Jassar, P

2009-08-01

To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England. We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England. One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration. Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

Quantitative analysis of antibiotic usage in British sheep flocks.

PubMed

Davies, Peers; Remnant, John G; Green, Martin J; Gascoigne, Emily; Gibbon, Nick; Hyde, Robert; Porteous, Jack R; Schubert, Kiera; Lovatt, Fiona; Corbishley, Alexander

2017-11-11

The aim of this study was to examine the variation in antibiotic usage between 207 commercial sheep flocks using their veterinary practice prescribing records. Mean and median prescribed mass per population corrected unit (mg/PCU) was 11.38 and 5.95, respectively and closely correlated with animal defined daily dose (ADDD) 1.47 (mean), 0.74 (median) (R 2 =0.84, P<0.001). This is low in comparison with the suggested target (an average across all the UK livestock sectors) of 50 mg/PCU. In total, 80 per cent of all antibiotic usage occurred in the 39 per cent of flocks where per animal usage was greater than 9.0 mg/PCU. Parenteral antibiotics, principally oxytetracycline, represented 82 per cent of the total prescribed mass, 65.5 per cent of antibiotics (mg/PCU) were prescribed for the treatment of lameness. Oral antibiotics were prescribed to 49 per cent of flocks, 64 per cent of predicted lamb crop/farm. Lowland flocks were prescribed significantly more antibiotics than hill flocks. Variance partitioning apportioned 79 per cent of variation in total antibiotic usage (mg/PCU) to the farm level and 21 per cent to the veterinary practice indicating that veterinary practices have a substantial impact on overall antimicrobial usage. Reducing antibiotic usage in the sheep sector should be possible with better understanding of the drivers of high usage in individual flocks and of veterinary prescribing practices. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Towards Inclusive Education: A Case Study of IGNOU

ERIC Educational Resources Information Center

Chaudhury, S. V. S.; Khare, Pankaj; Gupta, Sanjay; Garg, Suresh

2016-01-01

Towards the end of the Eleventh Five Year Plan (2007 -2012), India catered to about 20 per cent of those in the age group 17 to 24 years. However, to achieve the threshold level of about 30 per cent by 2020, and address concerns that perpetuate inequalities in opportunities to higher education, the Government of India (GoI) formulated positive…

What Per Cent Cruise?

Treesearch

George M. Furnival

1953-01-01

Cruising timber is ordinarily a job of sampling, in which the quantity of timber on a tract is estimated from the quantity on a part of the tract. The difficulty is to determine what part (per cent) of the tract should be sampled to attain a given level of accuracy. This article gives a rule-ofthumb that can be applied with fair reliability to most Southern forests....

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey.

PubMed

Dennis, T; Start, R D; Cross, S S

2005-03-01

To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

Impacting the problem of inner-city youth violence: "Educating Kids About Gun Violence" program.

PubMed

Hayward, Thomas Z; Simons, Clark J; St John, Wendy; Waymire, Michelle; Stucky, Thomas D

2011-04-01

The Educating Kids Against Gun Violence (EKG) program was developed in response to high levels of gun violence in an urban inner-city county through a partnership between the county prosecutor's office, local law enforcement, and a Level 1 trauma center. This program incorporates short video clips and interactive presentations, which address legal and medical consequences of gun violence. The program was presented to youths varying in age and degree of prior contact with the criminal justice system. Pre and post surveys were used to evaluate the short-term impact of the EKG program on the legal and medical knowledge and attitudes of youth participants. There were 130 pre and post surveys that could be exactly matched. Sixty-three per cent of participants had been arrested and 35 per cent had been convicted of a crime. On the post survey, 79 per cent stated that "the program will help keep me out of trouble" and 69 per cent stated that "in the future because of this program I will be less likely to carry a gun". The EKG program seemed to have positive short-term impacts on youth knowledge of legal and medical consequences and attitudes regarding gun violence.

Coxiella burnetii seroprevalence and risk factors on commercial sheep farms in The Netherlands.

PubMed

Schimmer, B; de Lange, M M A; Hautvast, J L A; Vellema, P; van Duynhoven, Y T H P

2014-07-05

Coxiella burnetii seroprevalence was assessed on Dutch dairy and non-dairy sheep farms using ELISA. Risk factors for seropositivity on non-dairy sheep farms were identified at farm and sheep level by univariate and multivariate multilevel analyses. Based on 953 dairy and 5671 non-dairy serum samples, sheep seroprevalences were 18.7 per cent and 2.0 per cent, respectively, and 78.6 per cent and 30.5 per cent at farm level. Significant risk factors for non-dairy sheep farms were farm location in the south of the country, sheep kept on marginal grounds, one or several supply addresses for ewes during 2007-2009 and wearing farm boots and/or outfit by professional visitors. On sheep level, risk factors included among others farm location in the south of the country, lamb breeding as main farm purpose, goat density within 10 km farm radius, use of windbreak curtain or windshields, and presence of ≥6 stillborn lambs in 2009. Farm location in the south of the country and goat density suggests that infected goats have played a role in the transmission to non-dairy sheep. Other risk factors suggest introduction of the bacterium through sheep supply and professional visitors. Biosecurity measures should be strengthened, including avoiding infection during handling of stillborn lambs and birth products in the lambing period. British Veterinary Association.

Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners.

PubMed

Routly, J E; Taylor, I R; Turner, R; McKernan, E J; Dobson, H

2002-02-09

Postal surveys or personal interviews of 76 recent veterinary graduates and their 49 employers were undertaken to establish their perceptions of good practice when integrating a new graduate into a business and their preferred methods of assessment and development. Practice type and location were the main influences on graduates looking for their first job. Interviews were mostly informal. Employers expected basic veterinary competence and candidates expected good quality support. Most graduates (93 per cent) had their own consultations on the first day. During early consultations 2 per cent of senior vets accompanied the new graduate, 95 per cent of practices provided senior back-up either in person or by telephone but in 3 per cent no back-up was available. Most new graduates (90 per cent) were satisfied with their workload. Three-fifths were on-call within the first week, and 95 per cent within a month. Graduates received calls directly in 45 per cent of practices, in 9 per cent seniors screened the calls, and the remainder used a third party. Assistance from experienced lay staff varied greatly. Discussion of problems was mainly informal. There was little spontaneous feedback and problems resulted from inadequate communication. One in three new graduates left their first job within two years, and one in six identified lack of support, heavy workload, stress or clashes with staff as a primary reason. This high turnover was a problem for employers. From the new graduates' perspectives, initial problems included: being on call (59 per cent), financial aspects (47 per cent) and surgery (43 per cent). Communicating with clients and learning to prioritise jobs were also difficult. New graduates took longer over procedures (79 per cent of employers commented) and required extra back-up (91 per cent) both of which reduced income (59 per cent). Nearly all the seniors felt that their current new graduates had coped 'quite well', although it was claimed that new graduates lacked the ability to talk to clients at the appropriate level, wanted to bring all their scientific knowledge to bear on every case, and often failed to consider the obvious or to appreciate clients' needs. Only 18 per cent of practices had formal and regular review procedures but all monitored the response of clients and watched the new graduate perform. Feedback to their new colleague was considered 'adequate' by 85 per cent of seniors, although 45 per cent of graduates felt they had not received enough. Eighty-three per cent of new graduates felt 'moderately prepared' by their undergraduate course, and 76 per cent of senior vets were 'generally satisfied' Both wanted improvements in extramural studies and increased exposure to routine cases. Senior partners sought greater commitment in the undergraduate curriculum to financial/legal issues and communication skills. Over a third of employers (38 per cent) had a 'great influence' on the choice of continuing professional development courses for their recent graduates. New graduates chose courses to deal with a perceived weakness, or to specialise, and welcomed opportunities to meet other new graduates and share early experiences. It was concluded that turnover and staff problems would be reduced if practices became more effective in coping with new arrivals, especially by supporting their development.

[Experiment to study some suspension media for the lyophilization of actinomycetes].

PubMed

Semenov, S M

1975-09-01

Viability and cultural properties of 59 actinomycetes and 17 bacteria lyophilized in polyvinylpyrrolidone (PVP), sodium glutamate, their combinations and horse serum were studied after storage for 2 years at a temperature of 4-10 degrees. A 5 per cent solution of sodium glutamate had a high protective effect on viability of the above organisms. The solution containing 3 per cent of sodium glutamate and 3 per cent of PVP was somewhat less effective. The cultures lyophilized in 5 per cent solution of sodium glutamate had the same viability levels as those lyophilized in horse serum, while the latter had better growth rates on their plating out on nutrient media. A 5 per cent solution of PVP had no advantages over sodium glutamate or horse serum with respect to preservation of the organism viability. No significant differences in the cultural properties: colour of the aerial and substrate mycelium and pigment production were noted in the actinomycetes lyophilized in various protective media and the analogous control cultures maintained by means of passages on fresh nutrient media.

Resident perceptions of the impact of paging on intraoperative education.

PubMed

Rose, Joel S; Waibel, Brett H; Schenarts, Paul J

2012-06-01

Our purpose was to evaluate the impact of paging on perceptions of intraoperative learning. Intraoperative logs of pager interruptions were kept by surgical residents at a university hospital over a 30-day period. The postgraduate year, number of pages, category of caller, reason for call, and level of urgency were recorded during each operation. At the conclusion of each operation, residents also completed a two-item survey with responses on a 5-point scale (1 = strongly disagree to 5 = strongly agree), querying if interruptions negatively impacted the intraoperative experience and if a message taken by a third party was effective in limiting interruptions. Logs were completed for 124 of 204 operations. Fifty-five per cent of operations were interrupted at least once with 49 per cent interrupted two to five times and 6 per cent were interrupted six or more times. Junior residents had 69 per cent of their operations interrupted compared with 39 per cent of senior residents (P = 0.001). Ninety-two per cent of pages were nonurgent. Residents did not perceive pager interruptions negatively impacted their educational experience (mean 2.3) but were neutral with respect if messages taken by a third party decreased interruptions (mean 3.8). Although our hypothesis was that pager interruptions were frequent and disrupt resident education, our data demonstrate the opposite.

Effect of central compartment neck dissection on hypocalcaemia incidence after total thyroidectomy for carcinoma.

PubMed

Mitra, I; Nichani, J R; Yap, B; Homer, J J

2011-05-01

Central compartment neck dissection is increasingly performed as part of surgical management of differentiated thyroid carcinoma. However, elective central neck dissection remains controversial due to complications and lack of evidence of survival benefit. To investigate and compare rates of transient and permanent hypocalcaemia following total thyroidectomy alone, compared with total thyroidectomy with central neck dissection, for differentiated thyroid carcinoma. Retrospective study of 127 consecutive patients referred with differentiated thyroid carcinoma, 2004-2006; 78 patients had undergone total thyroidectomy (group one) and 49 total thyroidectomy with central compartment node dissection (group two). Surgery was performed in various hospitals by both otolaryngologists and endocrine surgeons. In groups one and two, the incidence of transient hypocalcaemia was 18 per cent (14/78) and 51 per cent (25/49) (p < 0.001), and the incidence of permanent hypocalcaemia 1 per cent (one of 77) and 12 per cent (six of 49) (p < 0.01), respectively. Most patients undergoing central neck dissection had evidence of pathological level six lymphadenopathy (29/49). Total thyroidectomy combined with central neck dissection for the treatment of differentiated thyroid carcinoma is more likely to result in transient (51 per cent) and permanent (12 per cent) hypocalcaemia. Elective neck dissection should be performed selectively, with a high expectation of post-operative hypocalcaemia.

The accuracy of age—sex registers, practice medical records and family practitioner committee registers

PubMed Central

Fraser, Robin C.; Clayton, David G.

1981-01-01

This paper presents the results of a point prevalent evaluation of the comparative reliability and validity of age-sex registers, practice medical records and family practitioner committee (FPC) registers from five teaching practices. They all exhibited similar levels of acceptable accuracy for patient names, sex and age, but the distribution of wrong addresses varied greatly: practice medical records 3·9 per cent, age-sex registers 8·2 per cent and FPC registers 17·1 per cent. The presence of a patient entry in all three registers was associated with a high degree of probability (95·3 per cent) that this individual would be a bona fide practice patient. The register population inflation rates were FPC records 5·5 per cent, practice records 9·8 per cent and age-sex registers 10·6 per cent, but there were large variations between individual practices. A statistically significant contribution to inflation rates came from the age groups 0 to 1 and 21 to 40 (p<0·0005). The register population deflation rates were minimal. The significance of these findings is discussed and the need for practices to determine the accuracy of their individual age-sex registers is stressed. A convenient and economic method for so doing is suggested. We also suggest ways of making it easier to construct and use age-sex registers, since they can be a most versatile and useful aid to research in general practice. ImagesFigure 1. PMID:7320986

Educational priorities and current involvement in genetic practice: a survey of midwives in the Netherlands, UK and Sweden.

PubMed

Benjamin, Caroline M; Anionwu, Elizabeth N; Kristoffersson, Ulf; ten Kate, Leo P; Plass, Anne Marie C; Nippert, Irmgard; Julian-Reynier, Claire; Harris, Hilary J; Schmidtke, Joerg; Challen, Kirsty; Calefato, Jean Marc; Waterman, Christine; Powell, Eileen; Harris, Rodney

2009-10-01

to investigate whether practising midwives are adequately prepared to integrate genetic information into their practice. a cross-sectional, postal, structured questionnaire survey was sent to practising midwives. practising midwives from the Netherlands (NL), Sweden (SE) and the United Kingdom (UK). 1021 replies were received, achieving a response rate of 62%. 79% (799/1015) of midwives reported attending courses with some 'genetic content' during their initial training. Sixty-eight per cent (533/784) judged this to have been useful for clinical practice. Variation was seen between countries in the amount of genetic content in post-registration training (SE 87%, NL 44%, UK 17%) and most was considered useful. Questions assessing clinical activity identified a current need for genetic knowledge. Midwives described low levels of self-reported confidence both in overtly genetic procedures and in everyday tasks that were underpinned by genetic knowledge. For eight of the 12 procedures, fewer than 20% of midwives considered themselves to be confident. Differences were apparent between countries. Midwives identified psychosocial, screening and risk assessment aspects of genetic education as being important to them, rather than technical aspects or genetic science. given the low reported confidence with genetic issues in clinical practice, it is essential that this is addressed in terms of the amount, content and targeting of genetic education. This is especially important to ensure the success of national antenatal and baby screening programmes. The results of this study suggest that midwives would welcome further training in genetics, addressing genetic topics most relevant to their clinical practice.

Calcium and phosphorus requirements of bobwhite quail chicks

USGS Publications Warehouse

Nestler, R.B.; DeWitt, J.B.; Derby, J.V.; Moschler, M.

1948-01-01

Four experiments involving 873 bob-white quail (Colinus virginianus) chicks were conducted at the Patuxent Research Refuge, Laurel, Maryland. A comparison was made of calcium: phosphorus ratios of 1:1, 15:1, 1%: 1, 2:1, 2+:1,and 2%: 1in diets with phosphorus levels of 0.52, 0.75, 1.00, and 1.25 percent. The results indicate that the optimum level of phosphorus for growth is in the neighborhood of 0.75 per cent, and that of calcium is about 1.00 per cent, making a ratio of 1 1/3: 1....Although the greatest efficiency of feed utilization occurred on the phosphorus level of 0.52 per cent, the liveweight and bone-ash of the birds at the end of ten weeks were significantly lower than they were on the levels of 0.75 and 1.00 per cent, phosphorus. Bone-ash of birds on a Ca: P ratio of 1:1was significantly lower than that on any of the other five ratios, regardless of phosphorus level....There was a significant reverse correlation between the Ca: P ratio of the diet and the storage of vitamin A in the liver. Storage was especially low on the ratio of 2 2/3: 1....The low and high levels of calcium and phosphorus considered in these studies are abnormal, the low level especially being hard to obtain with common feedstuffs, if the protein requirements of the birds are met. Nevertheless, even on such levels, results were not disastrous. The growth of quail in the wild happens during a season when the birds have access to the minerals of the soil and in the abundant animal matter (mostly insects), as well as to minerals in plant material. Therefore, seemingly, calcium and phosphorus need not be critical nutrients for growing quail in the wild.

Accuracy of vision technicians in screening ocular pathology at rural vision centres of southern India.

PubMed

Suram, Vasantha; Addepalli, Uday Kumar; Krishnaiah, Sannapaneni; Kovai, Vilas; Khanna, Rohit C

2016-03-01

There is paucity of data on the inter-observer agreement and diagnostic accuracy between a primary-care technician (vision technician) and an ophthalmologist. Hence, the current study was conducted to assess the accuracy of vision technicians, to screen potentially sight-threatening ocular conditions at rural vision centres of southern India and their agreement with an ophthalmologist. In July to August 2010, patients presenting to seven vision centres in Adilabad district (Andhra Pradesh) were selected and screened in a masked manner by seven vision technicians followed by an examination by a consultant ophthalmologist. Agreement was assessed between vision technicians and the ophthalmologist for screening of potential sight-threatening ocular conditions and decisions for referral. The ophthalmologist's findings were considered as the reference standard. Two hundred and seventy-nine patients were enrolled at seven vision centres with a mean age of 32.9 ± 21.8 years. Agreement for screening of ocular pathology was 0.82 (95 per cent CI, 0.8-0.83). There was excellent agreement for cataract (0.97; 95 per cent CI, 0.93-1), refractive error (0.98; 95 per cent CI, 0.96-1), corneal pathology (1.0; 95 per cent CI, 1.0-1.0) and other anterior segment pathology (0.95; 95 per cent CI, 0.9-1); the agreement was moderate to fair for detection of glaucoma suspects (0.43; 95 per cent CI, 0.28-0.60) and retinal pathology (0.39; 95 per cent CI, 0.14-0.63). Sensitivity for screening of anterior segment pathology was 94.6-100 per cent. There was a fair to moderate sensitivity for glaucoma suspect; 35.6 per cent (95 per cent CI, 21.9-51.2) and retinal pathology 26.3 per cent (95 per cent CI, 9.2-51.2). Specificity for screening of ocular pathology was 98.2 to 100 per cent. The kappa (κ) agreement for referral for any pathology was 0.82 (0.8-0.83) CONCLUSION: As there is good agreement between the vision technicians and the ophthalmologist for screening and referral of anterior segment pathology but moderate to fair for glaucoma suspects and retinal pathology, vision technicians would be a good resource at the primary level to screen for anterior segment pathology; however, they may need further training to detect posterior segment pathology. © 2016 Optometry Australia.

The Singaporean response to the SARS outbreak: knowledge sufficiency versus public trust.

PubMed

Deurenberg-Yap, M; Foo, L L; Low, Y Y; Chan, S P; Vijaya, K; Lee, M

2005-12-01

During the outbreak of severe acute respiratory syndrome (SARS) in Singapore from 1 March to 11 May 2003, various national prevention and control measures were undertaken to control and eliminate the transmission of the infection. During the initial period of the epidemic, public communication was effected through press releases and media coverage of the epidemic. About a month into the epidemic, a public education campaign was mounted to educate Singaporeans on SARS and adoption of appropriate behaviours to prevent the spread of the disease. A survey was conducted in late April 2003 to assess Singaporeans' knowledge about SARS and infection control measures, and their concerns and anxiety in relation to the outbreak. The survey also sought to assess their confidence in the ability of various institutions to deal with SARS and their opinion on the seemingly tough measures enforced. The study involved 853 adults selected from a telephone-sampling frame. Stratified sampling was used to ensure adequate representation from major ethnic groups and age groups. The study showed that the overall knowledge about SARS and control measures undertaken was low (mean per cent score of 24.5 +/- 8.9%). While 82% of respondents expressed confidence in measures undertaken by Tan Tock Seng Hospital (the hospital designated to manage SARS), only 36% had confidence in nursing homes. However, >80% of the public agreed that the preventive and control measures instituted were appropriate. Despite the low knowledge score, the overall mean satisfaction score of the government's response to SARS was 4.47 (out of possible highest score of 5.00), with >93% of adult Singaporeans indicating that they were satisfied or very satisfied with the government's response to SARS. Generally, Singaporeans had a high level of public trust (satisfaction with government, confidence in institutions, deeming government measures appropriate), scoring 11.4 out of possible maximum of 14. The disparity between low knowledge on the one hand and high confidence and trust in the actions of the government on the other suggests that Singaporeans do not require high knowledge sufficiency to be confident in measures undertaken by the government to control the SARS crisis.

Prevalence of dental fluorosis & dental caries in association with high levels of drinking water fluoride content in a district of Gujarat, India.

PubMed

Kotecha, P V; Patel, S V; Bhalani, K D; Shah, D; Shah, V S; Mehta, K G

2012-06-01

Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem in India. This study was carried out to measure and compare the prevalence of dental fluorosis and dental caries in the population residing in high and normal level of fluoride in their drinking water in Vadodara district, Gujarat, India. A cross-sectional study was conducted in Vadodara district, six of the 261 villages with high fluoride level and five of 1490 with normal fluoride level in drinking water were selected. The data collection was made by house-to-house visits twice during the study period. The dental fluorosis prevalence in high fluoride area was 59.31 per cent while in normal fluoride area it was 39.21 per cent. The prevalence of dental caries in high fluoride area was 39.53 per cent and in normal fluoride area was 48.21 per cent with CI 6.16 to 11.18. Dental fluorosis prevalence was more among males as compared to females. Highest prevalence of dental fluorosis was seen in 12-24 yr age group. The risk of dental fluorosis was higher in the areas showing more fluoride content in drinking water and to a lesser degree of dental caries in the same area. High fluoride content is a risk factor for dental fluorosis and problem of dental fluorosis increased with passage of time suggesting that the fluoride content in the water has perhaps increased over time. Longitudinal studies should be conducted to confirm the findings.

Serum CEA levels in patients with gastric carcinoma correlate with the tumorigenicity of their xenografts in nude mice.

PubMed

Kiyama, T; Onda, M; Tokunaga, A; Okuda, T; Mizutani, T; Yoshiyuki, T; Shimizu, Y; Nishi, K; Matsukura, N; Tanaka, N

1991-01-01

We examined the correlation among preoperative serum carcinoembryonic antigen (CEA) levels, staining properties of the tumors by CEA immunohistochemistry and the tumorigenicity of their xenografts in nude mice, in 28 patients with gastric cancer. Eleven (40 per cent) of them were positive for serum CEA (greater than or equal to 2.5 ng/ml) and seven (25 per cent) of the xenografts were tumorigenic in nude mice. All the tumorigenic cases were positive for serum CEA (p less than 0.001) and the mean value of the serum CEA level in the patients with tumorigenic neoplasms was 20.8 ng/ml, being significantly higher than that (1.4 ng/ml) in the patients with non-tumorigenic neoplasms (p less than 0.001). Twenty-five of the 28 carcinomas (89 per cent) were positive for CEA staining in their cancer cells by the ABC method and CEA localization correlated with tumorigenicity (p less than 0.05). These results suggest that the serum CEA level in patients is correlated with the tumorigenicity of their gastric carcinoma xenografts in nude mice and may account for the poor prognosis of patients with high serum CEA.

Modelling the line-of-sight contribution in substructure lensing

NASA Astrophysics Data System (ADS)

Despali, Giulia; Vegetti, Simona; White, Simon D. M.; Giocoli, Carlo; van den Bosch, Frank C.

2018-04-01

We investigate how Einstein rings and magnified arcs are affected by small-mass dark-matter haloes placed along the line of sight to gravitational lens systems. By comparing the gravitational signature of line-of-sight haloes with that of substructures within the lensing galaxy, we derive a mass-redshift relation that allows us to rescale the detection threshold (i.e. lowest detectable mass) for substructures to a detection threshold for line-of-sight haloes at any redshift. We then quantify the line-of-sight contribution to the total number density of low-mass objects that can be detected through strong gravitational lensing. Finally, we assess the degeneracy between substructures and line-of-sight haloes of different mass and redshift to provide a statistical interpretation of current and future detections, with the aim of distinguishing between cold dark matter and warm dark matter. We find that line-of-sight haloes statistically dominate with respect to substructures, by an amount that strongly depends on the source and lens redshifts, and on the chosen dark-matter model. Substructures represent about 30 percent of the total number of perturbers for low lens and source redshifts (as for the SLACS lenses), but less than 10 per cent for high-redshift systems. We also find that for data with high enough signal-to-noise ratio and angular resolution, the non-linear effects arising from a double-lens-plane configuration are such that one is able to observationally recover the line-of-sight halo redshift with an absolute error precision of 0.15 at the 68 per cent confidence level.

The redshift evolution of major merger triggering of luminous AGNs: a slight enhancement at z ˜ 2

NASA Astrophysics Data System (ADS)

Hewlett, Timothy; Villforth, Carolin; Wild, Vivienne; Mendez-Abreu, Jairo; Pawlik, Milena; Rowlands, Kate

2017-09-01

Active galactic nuclei (AGNs), particularly the most luminous AGNs, are commonly assumed to be triggered through major mergers; however, observational evidence for this scenario is mixed. To investigate any influence of galaxy mergers on AGN triggering and luminosities through cosmic time, we present a sample of 106 luminous X-ray-selected type 1 AGNs from the COSMOS survey. These AGNs occupy a large redshift range (0.5 < z < 2.2) and two orders of magnitude in X-ray luminosity (˜1043-1045 erg s-1). AGN hosts are carefully mass and redshift matched to 486 control galaxies. A novel technique for identifying and quantifying merger features in galaxies is developed, subtracting galfit galaxy models and quantifying the residuals. Comparison to visual classification confirms this measure reliably picks out disturbance features in galaxies. No enhancement of merger features with increasing AGN luminosity is found with this metric, or by visual inspection. We analyse the redshift evolution of AGNs associated with galaxy mergers and find no merger enhancement in lower redshift bins. Contrarily, in the highest redshift bin (z ˜ 2) AGNs are ˜4 times more likely to be in galaxies exhibiting evidence of morphological disturbance compared to control galaxies, at 99 per cent confidence level (˜2.4σ) from visual inspection. Since only ˜15 per cent of these AGNs are found to be in morphologically disturbed galaxies, it is implied that major mergers at high redshift make a noticeable but subdominant contribution to AGN fuelling. At low redshifts, other processes dominate and mergers become a less significant triggering mechanism.

The noise properties of 42 millisecond pulsars from the European Pulsar Timing Array and their impact on gravitational-wave searches

NASA Astrophysics Data System (ADS)

Caballero, R. N.; Lee, K. J.; Lentati, L.; Desvignes, G.; Champion, D. J.; Verbiest, J. P. W.; Janssen, G. H.; Stappers, B. W.; Kramer, M.; Lazarus, P.; Possenti, A.; Tiburzi, C.; Perrodin, D.; Osłowski, S.; Babak, S.; Bassa, C. G.; Brem, P.; Burgay, M.; Cognard, I.; Gair, J. R.; Graikou, E.; Guillemot, L.; Hessels, J. W. T.; Karuppusamy, R.; Lassus, A.; Liu, K.; McKee, J.; Mingarelli, C. M. F.; Petiteau, A.; Purver, M. B.; Rosado, P. A.; Sanidas, S.; Sesana, A.; Shaifullah, G.; Smits, R.; Taylor, S. R.; Theureau, G.; van Haasteren, R.; Vecchio, A.

2016-04-01

The sensitivity of Pulsar Timing Arrays to gravitational waves (GWs) depends on the noise present in the individual pulsar timing data. Noise may be either intrinsic or extrinsic to the pulsar. Intrinsic sources of noise will include rotational instabilities, for example. Extrinsic sources of noise include contributions from physical processes which are not sufficiently well modelled, for example, dispersion and scattering effects, analysis errors and instrumental instabilities. We present the results from a noise analysis for 42 millisecond pulsars (MSPs) observed with the European Pulsar Timing Array. For characterizing the low-frequency, stochastic and achromatic noise component, or `timing noise', we employ two methods, based on Bayesian and frequentist statistics. For 25 MSPs, we achieve statistically significant measurements of their timing noise parameters and find that the two methods give consistent results. For the remaining 17 MSPs, we place upper limits on the timing noise amplitude at the 95 per cent confidence level. We additionally place an upper limit on the contribution to the pulsar noise budget from errors in the reference terrestrial time standards (below 1 per cent), and we find evidence for a noise component which is present only in the data of one of the four used telescopes. Finally, we estimate that the timing noise of individual pulsars reduces the sensitivity of this data set to an isotropic, stochastic GW background by a factor of >9.1 and by a factor of >2.3 for continuous GWs from resolvable, inspiralling supermassive black hole binaries with circular orbits.

Pre-operative serum alkaline phosphatase as a predictive indicator of post-operative hypocalcaemia in patients undergoing total thyroidectomy.

PubMed

Miah, M S; Mahendran, S; Mak, C; Leese, G; Smith, D

2015-11-01

This study aimed to evaluate whether a pre-operative elevated serum alkaline phosphatase level is a potential predictor of post-operative hypocalcaemia after total thyroidectomy. Data was retrospectively collected from the case notes of patients who had undergone total thyroidectomy. Patients were divided into Graves' disease and non-Graves' groups. Pre-operative and post-operative biochemical markers, including serum calcium, alkaline phosphatase and parathyroid hormone levels, were reviewed. A total of 225 patients met the inclusion criteria. Graves' disease was the most common indication (n = 134; 59.5 per cent) for thyroidectomy. Post-operative hypocalcaemia developed in 48 patients (21.3 per cent) and raised pre-operative serum alkaline phosphatase was noted in 94 patients (41.8 per cent). Raised pre-operative serum alkaline phosphatase was significantly associated with post-operative hypocalcaemia, particularly in Graves' disease patients (p < 0.05). Pre-operative serum alkaline phosphatase measurements help to predict post-thyroidectomy hypocalcaemia, especially in patients who do not develop hypoparathyroidism. Ascertaining the pre-operative serum alkaline phosphatase level in patients undergoing total thyroidectomy may help surgeons to identify at-risk patients.

Does Hofstetter's equation predict the real amplitude of accommodation in children?

PubMed

Hashemi, Hassan; Nabovati, Payam; Khabazkhoob, Mehdi; Yekta, Abbasali; Emamian, Mohammad Hassan; Fotouhi, Akbar

2018-01-01

The aim was to determine the distribution and associated factors of accommodative amplitude (AA) in six- to 12-year-old children and compare the results with those calculated using Hofstetter's formula. In a cross-sectional study in 2015, random sampling was done from urban and rural populations of Shahroud, northern Iran. Participating schoolchildren were examined for manifest, cycloplegic and subjective refraction, as well as uncorrected vision and visual acuity. The AA was measured with Donders' push-up method using a ruler. The near point of convergence (NPC) was also measured. Of the 6,624 selected children, 5,620 participated in the study and after applying the exclusion criteria, the final analyses were done on data from 5,444 schoolchildren. The mean age of the final sample was 9.24 ± 1.71 years (from six to 12 years) and 53.6 per cent (n = 2,919) were boys. Mean measured AA was 14.44 D (95 per cent confidence interval [CI]: 14.33-14.55). In all age groups, the mean measured AA was less than the predicted mean value calculated with the Hofstetter's equation. Mean measured AA was 14.44 D (95 per cent CI: 14.28-14.59) and 14.45 D (95 per cent CI: 14.29-14.6) in boys and girls, respectively (p = 0.926). AA significantly declined with age (coefficient: -0.18, 95 per cent CI: -0.23 to -0.12, p < 0.001). Mean AA in emmetropic, myopic and hyperopic children was 14.31 D, 17.30 D and 14.87 D, respectively. Older age (coefficient = -0.18), living in rural areas (coefficient = -0.48) and NPC (coefficient = 0.47) inversely related with AA and higher AA was associated with a shift of the spherical equivalent refraction toward myopia (coefficient = -0.41). The differences among groups with different types of refractive error and high AA in children with myopia are important findings of this study. The results of the present study suggest that Hofstetter's formula provides inaccurate AA estimates in children and thus, the interpretation of this index requires further population-based studies in different racial and ethnic groups. © 2017 Optometry Australia.

Quantifying cosmic variance

NASA Astrophysics Data System (ADS)

Driver, Simon P.; Robotham, Aaron S. G.

2010-10-01

We determine an expression for the cosmic variance of any `normal' galaxy survey based on examination of M* +/- 1 mag galaxies in the Sloan Digital Sky Survey (SDSS) Data Release 7 (DR7) data cube. We find that cosmic variance will depend on a number of factors principally: total survey volume, survey aspect ratio and whether the area surveyed is contiguous or comprising independent sightlines. As a rule of thumb cosmic variance falls below 10 per cent once a volume of 107h-30.7Mpc3 is surveyed for a single contiguous region with a 1:1 aspect ratio. Cosmic variance will be lower for higher aspect ratios and/or non-contiguous surveys. Extrapolating outside our test region we infer that cosmic variance in the entire SDSS DR7 main survey region is ~7 per cent to z < 0.1. The equation obtained from the SDSS DR7 region can be generalized to estimate the cosmic variance for any density measurement determined from normal galaxies (e.g. luminosity densities, stellar mass densities and cosmic star formation rates) within the volume range 103-107h-30.7Mpc3. We apply our equation to show that two sightlines are required to ensure that cosmic variance is <10 per cent in any ASKAP galaxy survey (divided into Δ z ~ 0.1 intervals, i.e. ~1Gyr intervals for z < 0.5). Likewise 10 MeerKAT sightlines will be required to meet the same conditions. GAMA, VVDS and zCOSMOS all suffer less than 10 per cent cosmic variance (~3-8 per cent) in Δ z intervals of 0.1, 0.25 and 0.5, respectively. Finally we show that cosmic variance is potentially at the 50-70 per cent level, or greater, in the Hubble Space Telescope (HST) Ultra Deep Field depending on assumptions as to the evolution of clustering. 100 or 10 independent sightlines will be required to reduce cosmic variance to a manageable level (<10 per cent) for HST ACS or HST WFC3 surveys, respectively (in Δ z ~ 1 intervals). Cosmic variance is therefore a significant factor in the z > 6 HST studies currently underway.

Search for high-energy neutrinos from bright GRBs with ANTARES

NASA Astrophysics Data System (ADS)

Albert, A.; André, M.; Anghinolfi, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Avgitas, T.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bormuth, R.; Bourret, S.; Bouwhuis, M. C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Celli, S.; Chiarusi, T.; Circella, M.; Coelho, J. A. B.; Coleiro, A.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Deschamps, A.; De Bonis, G.; Distefano, C.; di Palma, I.; Donzaud, C.; Dornic, D.; Drouhin, D.; Eberl, T.; El Bojaddaini, I.; Elsässer, D.; Enzenhöfer, A.; Felis, I.; Fusco, L. A.; Galatà, S.; Gay, P.; Geißelsöder, S.; Geyer, K.; Giordano, V.; Gleixner, A.; Glotin, H.; Gregoire, T.; Gracia-Ruiz, R.; Graf, K.; Hallmann, S.; van Haren, H.; Heijboer, A. J.; Hello, Y.; Hernández-Rey, J. J.; Hößl, J.; Hofestädt, J.; Hugon, C.; Illuminati, G.; James, C. W.; de Jong, M.; Jongen, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kouchner, A.; Kreter, M.; Kreykenbohm, I.; Kulikovskiy, V.; Lachaud, C.; Lahmann, R.; Lefèvre, D.; Leonora, E.; Lotze, M.; Loucatos, S.; Marcelin, M.; Margiotta, A.; Marinelli, A.; Martínez-Mora, J. A.; Mathieu, A.; Mele, R.; Melis, K.; Michael, T.; Migliozzi, P.; Moussa, A.; Mueller, C.; Nezri, E.; Păvălaş, G. E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Quinn, L.; Racca, C.; Riccobene, G.; Roensch, K.; Sánchez-Losa, A.; Saldaña, M.; Salvadori, I.; Samtleben, D. F. E.; Sanguineti, M.; Sapienza, P.; Schnabel, J.; Schüssler, F.; Seitz, T.; Sieger, C.; Spurio, M.; Stolarczyk, Th.; Taiuti, M.; Tayalati, Y.; Trovato, A.; Tselengidou, M.; Turpin, D.; Tönnis, C.; Vallage, B.; Vallée, C.; Van Elewyck, V.; Vivolo, D.; Vizzocca, A.; Wagner, S.; Wilms, J.; Zornoza, J. D.; Zúñiga, J.

2017-07-01

Gamma-ray bursts are thought to be sites of hadronic acceleration, thus neutrinos are expected from the decay of charged particles, produced in pγ interactions. The methods and results of a search for muon neutrinos in the data of the ANTARES neutrino telescope from four bright GRBs (GRB 080916C, GRB 110918A, GRB 130427A and GRB 130505A) observed between 2008 and 2013 are presented. Two scenarios of the fireball model have been investigated: the internal shock scenario, leading to the production of neutrinos with energies mainly above 100 TeV, and the photospheric scenario, characterized by a low-energy component in neutrino spectra due to the assumption of neutrino production closer to the central engine. Since no neutrino events have been detected in temporal and spatial coincidence with these bursts, upper limits at 90 per cent confidence level on the expected neutrino fluxes are derived. The non-detection allows for directly constraining the bulk Lorentz factor of the jet Γ and the baryon loading fp.

Indebtedness of dental school graduates in Canada: mortgaged futures.

PubMed

McDermott, R E; Fuglerud, K P

1996-03-01

The debt level of graduating dental students is increasing annually. Six of Canada's 10 dental schools responded to a survey designed to ascertain the level of student debt on entering and graduating from dental school. For the academic year 1993-94, the average starting debt for students was $2,013.89 and the average graduating debt was $25,671.30. On average, dental students accumulated more than $23,600 in debt while pursuing their dental education. Of those students who completed the survey, 57.89 per cent relied on their parents for assistance, and 76.69 per cent received student/government loans. The level of student debt was independent of age, gender and parents' income.

Workplace-based clinical leadership training increases willingness to lead.

PubMed

MacPhail, Aleece; Young, Carmel; Ibrahim, Joseph Elias

2015-01-01

The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.

Provision of surgical voice restoration in England: questionnaire survey of speech and language therapists.

PubMed

Bradley, P J; Counter, P; Hurren, A; Cocks, H C

2013-08-01

To conduct a questionnaire survey of speech and language therapists providing and managing surgical voice restoration in England. National Health Service Trusts registering more than 10 new laryngeal cancer patients during any one year, from November 2009 to October 2010, were identified, and a list of speech and language therapists compiled. A questionnaire was developed, peer reviewed and revised. The final questionnaire was e-mailed with a covering letter to 82 units. Eighty-two questionnaires were distributed and 72 were returned and analysed, giving a response rate of 87.8 per cent. Forty-four per cent (38/59) of the units performed more than 10 laryngectomies per year. An in-hours surgical voice restoration service was provided by speech and language therapists in 45.8 per cent (33/72) and assisted by nurses in 34.7 per cent (25/72). An out of hours service was provided directly by ENT staff in 35.5 per cent (21/59). Eighty-eight per cent (63/72) of units reported less than 10 (emergency) out of hours calls per month. Surgical voice restoration service provision varies within and between cancer networks. There is a need for a national management and care protocol, an educational programme for out of hours service providers, and a review of current speech and language therapist staffing levels in England.

Foreign body aspiration and language spoken at home: 10-year review.

PubMed

Choroomi, S; Curotta, J

2011-07-01

To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home. Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed. At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence. Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

PubMed Central

Dennis, T; Start, R D; Cross, S S

2005-01-01

Aims: To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. Methods: A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. Results: There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. Conclusions: There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings. PMID:15735155

Dental caries prevalence in the permanent teeth in Greek schoolchildren related to age, sex, urbanization and social status.

PubMed

Megas, B F; Athanassouli, T N

1989-06-01

An epidemiological study of caries experience in permanent teeth of 1739 schoolchildren aged 6-17 years was conducted in Epirus, a northwestern region of Greece. Dental caries was found to be prevalent in the population examined and to increase with age. The mean DMFT values at the ages of 6, 12 and 17 years were 0.53 +/- 1.13, 4.93 +/- 4.04 and 8.88 +/- 6.19 respectively, while the average DMFT value for the total population examined was 4.96 +/- 4.83. The percentages of the children with caries-free permanent dentitions were 80 per cent at the age of 6 years, 24 per cent at 12 years and 7 per cent at 17 years. The total percentage of caries-free children was 20 per cent. Girls were found to have a higher caries prevalence than boys in all age groups. Small differences in the caries prevalence were found between rural and urban children population. Children of lower socioeconomic levels exhibited slightly higher caries prevalence than children of higher levels. The results of this baseline study indicate that dental caries is a major problem in this region of Greece and therefore an active and effective programme of dental care is necessary for the child population.

Endectocide activity of a pour-on formulation containing 1.5 per cent ivermectin +0.5 per cent abamectin in cattle.

PubMed

Silva, Heloisa Cristina; Prette, Nancy; Lopes, Welber Daniel Zanetti; Sakamoto, Cláudio Alessandro M; Buzzulini, Carolina; Dos Santos, Thais Rabelo; Cruz, Breno Cayeiro; Teixeira, Weslen F Pires; Felippelli, Gustavo; Carvalho, Rafael Silveira; Maciel, Willian Giquelin; Soares, Vando Edésio; da Costa, Alvimar José

2015-01-01

The present work aimed to evaluate, through ten different studies, the therapeutic efficacy of a new pour-on formulation, containing 1.5 per cent ivermectin +0.5 per cent abamectin, against parasites of cattle. Results obtained on trials against Rhipicephalus (Boophilus) microplus showed that the pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained superior efficacy indexes against this ectoparasite, when compared with formulations containing 0.5 per cent ivermectin, 1 per cent ivermectin and the combination of 1 per cent abamectin +20 per cent levamisole. The results of efficacy of the ivermectin+abamectin and the 0.5 per cent ivermectin against Haematobia irritans were similar. Against Cochliomyia hominivorax larvae, all pour-on formulations tested (1.5 per cent ivermectin +0.5 per cent abamectin, 0.5 per cent ivermectin and 0.5 per cent abamectin), as well as 1 per cent doramectin administered subcutaneously, were considered ineffective. Cattle medicated with 1.5 per cent ivermectin +0.5 per cent abamectin, pour-on, remained free from parasitism by Dermatobia hominis larvae during 42 days (96 per cent efficacy), while values superior to 90 per cent were obtained by 0.5 per cent ivermectin (92 per cent) and 0.5 per cent abamectin (93 per cent) until the 42nd and 35th days post treatment, respectively. Against Haemonchus placei and Oesophagostomum radiatum, the pour-on of ivermectin+abamectin showed better efficacy than the 0.5 per cent ivermectin and 0.5 per cent abamectin. As to Cooperia punctata, there was no difference regarding efficacy results obtained by the avermectins combination and abamectin. The pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained high efficacy against R. (B.) microplus, D. hominis and some species of cattle gastrointestinal helminths when compared with formulations of 0.5 per cent ivermectin and 0.5 per cent abamectin administered through the same route.

The value of chest X-ray in the Scottish Referral Guidelines for suspected head and neck cancer in 2144 patients.

PubMed

Fingland, P; Carswell, V; Tikka, T; Douglas, C M; Montgomery, J

2018-04-30

In Scotland, patients with suspected head and neck cancer are referred on the basis of the Scottish Referral Guidelines for Suspected Cancer, rather than the National Institute for Health and Care Excellence guidelines. A chest X-ray should be requested by the general practitioner at the same time as referral for persistent hoarseness. The evidence for this is level 4. This audit identified adherence to this recommendation and X-ray results. All 'urgent suspicion of cancer' referrals to the ENT department in the National Health Service Greater Glasgow and Clyde for 2015-2016 were audited. Persistent hoarseness for more than 3 weeks instigated referral in 318 patients (15.7 per cent). Chest X-ray was performed in 120 patients (38 per cent), which showed: no abnormality in 116 (96.7 per cent), features of infection in 2 (1.7 per cent) and something else in 2 patients (1.7 per cent). No chest X-ray altered the management of a patient. Performance of chest X-ray does not alter management and its removal from the Scottish Referral Guidelines for Suspected Cancer is recommended.

Determination of the rate constant for the NH2(X2B1) + NH2(X2B1) recombination reaction with collision partners He, Ne, Ar, and N2 at low pressures and 296 K. Part 1.

PubMed

Altinay, Gokhan; Macdonald, R Glen

2012-02-09

The recombination rate constant for the NH(2)(X(2)B(1)) + NH(2)(X(2)B(1)) → N(2)H(4)(X(1)A(1)) reaction in He, Ne, Ar, and N(2) was measured over the pressure range 1-20 Torr at a temperature of 296 K. The NH(2) radical was produced by 193 nm laser photolysis of NH(3) dilute in the third-body gas. The production of NH(2) and the loss of NH(3) were monitored by high-resolution continuous-wave absorption spectroscopy: NH(2) on the (1)2(21) ← (1)3(31) rotational transition of the (0,7,0)A(2)A(1) ← (0,0,0) X(2)B(1) vibronic band and NH(3) on either inversion doublet of the (q)Q(3)(3) rotational transition of the ν(1) fundamental. Both species were detected simultaneously following the photolysis laser pulse. The broader Doppler width of the NH(2) spectral transition allowed temporal concentration measurements to be extended up to 20 Torr before pressure broadening effects became significant. Fall-off behavior was identified and the bimolecular rate constants for each collision partner were fit to a simple Troe form defined by the parameters, k(0), k(inf), and F(cent). This work is the first part of a two part series in which part 2 will discuss the measurements with more efficient energy transfer collision partners CH(4), C(2)H(6), CO(2), CF(4), and SF(6). The pressure range was too limited to extract any new information on k(inf), and k(inf) was taken from the theoretical calculations of Klippenstein et al. (J. Phys. Chem A 2009, 113, 10241) as k(inf) = 7.9 × 10(-11) cm(3) molecule(-1) s(-1) at 296 K. The individual Troe parameters were: He, k(0) = 2.8 × 10(-29) and F(cent) = 0.47; Ne, k(0) = 2.7 × 10(-29) and F(cent) = 0.34; Ar, k(0) = 4.4 × 10(-29) and F(cent) = 0.41; N(2), k(0) = 5.7 × 10(-29) and F(cent) = 0.61, with units cm(6) molecule(-2) s(-1) for k(0). In the case of N(2) as the third body, it was possible to measure the recombination rate constant for the NH(2) + H reaction near 20 Torr total pressure. The pure three-body recombination rate constant was (2.3 ± 0.55) × 10(-30) cm(6) molecule(-2) s(-1), where the uncertainty is the total experimental uncertainty including systematic errors at the 2σ level of confidence.

Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

PubMed

Langellier, Brent A; Lê-Scherban, Félice; Purtle, Jonathan

2017-09-01

Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. Philadelphia, Pennsylvania, USA. Philadelphia children and adolescents aged 4-18 years. A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

International practice survey on the management of brain metastases: Third International Consensus Workshop on Palliative Radiotherapy and Symptom Control.

PubMed

Tsao, M N; Rades, D; Wirth, A; Lo, S S; Danielson, B L; Vichare, A; Hahn, C; Chang, E L

2012-08-01

To evaluate international patterns of practice for the management of metastatic disease to the brain. An online international practice survey was conducted from April to June 2010. Most of the survey questions were based on common management issues for which optimal management using level 1 evidence was lacking. The survey consisted of three sections: respondent demographics, 13 general questions regarding surgery, whole brain radiotherapy (WBRT) and radiosurgery and 13 questions related to specific scenarios. In total, 445 individuals responded to the survey over a 3 month period. Ninety per cent of respondents worked in a hospital-based setting. Ninety-three per cent of respondents were radiation oncologists. Thirty-seven per cent worked in an academic setting. Only three of 26 survey questions generated at least 70% agreement for a favoured response. Eighty-eight per cent of respondents chose comfort measures only for patients with multiple brain metastases who have been previously treated with WBRT and who now present 6 months later with two to four brain metastases (all less than 4 cm in size) with uncontrolled extracranial disease and bedridden state. Seventy-eight per cent of respondents would use WBRT alone for initial treatment in patients with two to four brain metastases (all less than 4 cm in size), with active, uncontrolled extracranial disease and a Karnofsky performance status of 70. Seventy-eight per cent of respondents chose surgical resection for an enlarging single brain metastasis that has been previously treated with radiosurgery. The enlarging single brain metastasis is in a surgically accessible site and is now symptomatic. The patient has controlled extracranial disease, good performance status and magnetic resonance spectroscopy was not diagnostic. There is a lack of uniform agreement for many common management issues (not well answered by level 1 evidence) in patients with metastatic disease to the brain. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Smoking and the eye: what Québec teenagers know and fear.

PubMed

Brûlé, Julie; Tousignant, Benoît; Marcotte, Stéphanie; Moreau, Marie-Christelle

2018-01-01

Although most people associate smoking with lung cancer and heart disease, few are aware of the impact of smoking on ocular health. Studies have suggested a better knowledge of this association might promote higher quit rates, particularly in teenagers. The purpose of our study was to determine the knowledge of teenagers about the effects of smoking on ocular health and the fear associated with several tobacco-related health conditions. A self-administered questionnaire was distributed to 180 high school students aged 14 to 17 years. Measured variables included socio-economic demographics, smoking status, knowledge of the effects of smoking on general and ocular health, and level of fear as well as level of motivation to quit smoking associated with the following tobacco-related conditions: lung cancer, cardiovascular disease, heart attack, blindness and deafness. Response rate was 100 per cent. Eleven per cent of responders were smokers. The proportion of smokers who thought smoking could cause blindness was 64.3 per cent while it was 13.5 per cent for non-smokers. The proportion of smokers fearing blindness was 30 per cent, as opposed to 69.8 per cent for non-smokers. The proportion of respondents who thought the presented conditions were 'extremely' or 'very good' reasons to quit were similarly high for all smoking-associated conditions. These findings suggest teenagers are unaware of the impact smoking can have on ocular health. Smokers did not seem more concerned about vision loss compared to other tobacco-related diseases, as opposed to non-smokers. Our findings suggest vision loss would be a strong motivator to prevent initiation, but not very effective regarding cessation in this group. However, optometrists should be aware teenagers seem receptive to the message that 'smoking can cause blindness' and use this strategy in order to prevent smoking initiation. © 2017 Optometry Australia.

Complementary therapy support in cancer survivorship: a survey of complementary and alternative medicine practitioners' provision and perception of skills.

PubMed

Samuel, C A; Faithfull, S

2014-03-01

This study reviewed the confidence and perceived skills of complementary and alternative medicine (CAM) practitioners in providing care and symptom management for clients post cancer. An e-survey was mailed to approximately 21, 000 CAM practitioners, targeted at those working with clients who were experiencing consequences of cancer and its treatments. Questions were asked about the main symptoms and concerns of clients, the confidence and current skill levels of practitioners and additional training requirements. Six hundred and twelve practitioners responded to the survey, 507 of whom were working with individuals experiencing the consequences of cancer and its treatments. Forty-five per cent (n = 134) had undertaken training in cancer prior to working with cancer patients, 61% (n = 182) had undertaken courses or study days relative to cancer care in the past two years. The most often treated symptoms or concerns of patients were those of a psychosocial nature, pain management and lymphoedema. CAM practitioners with limited knowledge and training are providing support to cancer survivors, particularly in services where the National Health Service has limited provision. CAM practitioners may fulfil a future role in providing long-term support for cancer survivors; however, in order to properly safeguard patients they are in need of further training and development. © 2013 John Wiley & Sons Ltd.

Interferon-γ-inducible protein-10 in chronic hepatitis C: Correlations with insulin resistance, histological features & sustained virological response.

PubMed

Crisan, Dana; Grigorescu, Mircea Dan; Radu, Corina; Suciu, Alina; Grigorescu, Mircea

2017-04-01

One of the multiple factors contributing to virological response in chronic hepatitis C (CHC) is interferon-gamma-inducible protein-10 (IP-10). Its level reflects the status of interferon-stimulated genes, which in turn is associated with virological response to antiviral therapy. The aim of this study was to evaluate the role of serum IP-10 levels on sustained virological response (SVR) and the association of this parameter with insulin resistance (IR) and liver histology. Two hundred and three consecutive biopsy proven CHC patients were included in the study. Serum levels of IP-10 were determined using ELISA method. IR was evaluated by homeostasis model assessment-IR (HOMA-IR). Histological features were assessed invasively by liver biopsy and noninvasively using FibroTest, ActiTest and SteatoTest. Predictive factors for SVR and their interrelations were assessed. A cut-off value for IP-10 of 392 pg/ml was obtained to discriminate between responders and non-responders. SVR was obtained in 107 patients (52.70%). Area under the receiver operating characteristic curve for SVR was 0.875 with a sensitivity of 91.6 per cent, specificity 74.7 per cent, positive predictive value 80.3 per cent and negative predictive value 88.7 per cent. Higher values of IP-10 were associated with increasing stages of fibrosis (P<0.01) and higher grades of inflammation (P=0.02, P=0.07) assessed morphologically and noninvasively through FibroTest and ActiTest. Significant steatosis and IR were also associated with increased levels of IP-10 (P=0.01 and P=0.02). In multivariate analysis, IP-10 levels and fibrosis stages were independently associated with SVR. Our findings showed that the assessment of serum IP-10 level could be a predictive factor for SVR and it was associated with fibrosis, necroinflammatory activity, significant steatosis and IR in patients with chronic HCV infection.

Evaluation of the effects of the North Carolina Improved Pregnancy Outcome Project: implications for state-level decision-making.

PubMed Central

Peoples, M D; Grimson, R C; Daughtry, G L

1984-01-01

This study was designed to assess the effects of the North Carolina Improved Pregnancy Outcome (IPO) Project on use of prenatal care and incidence of low birthweight among its primarily Black registrants . Weighted least squares and stratified analysis procedures were used to scrutinize vital statistics data for subpopulation effects. IPO services were received by 51.7 per cent of Black women in the counties served by the project. For all Black registrants , the risk of receiving less than adequate prenatal care was 55.1 per cent of that of the comparison group. For Black teenage registrants , the risk was even less: 37.2 per cent of that of the comparison group. Nevertheless, no corresponding effects on the incidence of low birthweight could be detected. The evaluation methods used in this study can be applied to programs for mothers and infants in other locales to generate useful and practical information for state-level decision-making. PMID:6721010

Prevalence of dental fluorosis & dental caries in association with high levels of drinking water fluoride content in a district of Gujarat, India

PubMed Central

Kotecha, P.V.; Patel, S.V.; Bhalani, K.D.; Shah, D.; Shah, V.S.; Mehta, K.G.

2012-01-01

Background & objectives: Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem in India. This study was carried out to measure and compare the prevalence of dental fluorosis and dental caries in the population residing in high and normal level of fluoride in their drinking water in Vadodara district, Gujarat, India. Methods: A cross-sectional study was conducted in Vadodara district, six of the 261 villages with high fluoride level and five of 1490 with normal fluoride level in drinking water were selected. The data collection was made by house-to-house visits twice during the study period. Results: The dental fluorosis prevalence in high fluoride area was 59.31 per cent while in normal fluoride area it was 39.21 per cent. The prevalence of dental caries in high fluoride area was 39.53 per cent and in normal fluoride area was 48.21 per cent with CI 6.16 to 11.18. Dental fluorosis prevalence was more among males as compared to females. Highest prevalence of dental fluorosis was seen in 12-24 yr age group. Interpretation & conclusions: The risk of dental fluorosis was higher in the areas showing more fluoride content in drinking water and to a lesser degree of dental caries in the same area. High fluoride content is a risk factor for dental fluorosis and problem of dental fluorosis increased with passage of time suggesting that the fluoride content in the water has perhaps increased over time. Longitudinal studies should be conducted to confirm the findings. PMID:22825606

Radiographic identification of the equine ventral conchal bulla.

PubMed

Finnegan, C M; Townsend, N B; Barnett, T P; Barakzai, S Z

Involvement of the ventral conchal sinus (VCS) is an important diagnostic and prognostic feature in cases of the equine sinus disease. The authors aimed to ascertain if the caudo-dorsal extension of the VCS, the ventral conchal bulla (VCB) is identifiable on plain radiographs of cadaver skulls without sinus disease. Bilateral frontonasal sinus flaps were made in 10 equine cadaver skulls. Plain lateral, lateral oblique and dorso-ventral radiographs were then obtained followed by the same views taken with stainless steel wire outlining the caudal border of the VCB. Plain radiographs were randomised and blindly evaluated by two observers who marked where they believed the VCB to be positioned. This was then correlated with the true position of the VCB using radiographs with wires in place. The ease of identification of the VCB was classified as 'easy' or 'difficult'. The VCB was correctly identified in 70 per cent of lateral radiographs, but only 45 per cent of lateral oblique radiographs and 17 per cent of dorso-ventral radiographs. If a clinician was confident that he or she could identify the VCB, they were usually correct. Conversely if the clinician judged VCB identification as 'difficult', they usually identified it incorrectly. In the authors' clinical experience, the VCB of horses with sinusitis involving this compartment is more radiologically evident than in clinically normal horses. Knowledge of the normal radiographic anatomy of this structure should aid clinicians in identifying horses with sinusitis affecting the VCS.

Fast radio bursts: the observational case for a Galactic origin

NASA Astrophysics Data System (ADS)

Maoz, Dan; Loeb, Abraham; Shvartzvald, Yossi; Sitek, Monika; Engel, Michael; Kiefer, Flavien; Kiraga, Marcin; Levi, Amir; Mazeh, Tsevi; Pawlak, Michał; Rich, R. Michael; Tal-Or, Lev; Wyrzykowski, Lukasz

2015-12-01

There are by now ten published detections of fast radio bursts (FRBs) - single bright GHz-band millisecond pulses of unknown origin. Proposed explanations cover a broad range from exotic processes at cosmological distances to atmospheric and terrestrial sources. Loeb, Maoz, and Shvartzvald have previously suggested that FRB sources could be nearby flare stars, and pointed out the presence of a W-UMa-type contact binary within the beam of one out of three FRB fields that they examined. To further test the flare-star hypothesis, we use time-domain optical photometry and spectroscopy, and now find possible flare stars in additional FRB fields, with one to three such cases among all eight FRB fields studied. We evaluate the chance probabilities of these possible associations to be in the range ˜0.1 per cent to 9 per cent, depending on the input assumptions. Further, we re-analyse the probability that two FRBs recently discovered three years apart within the same radio beam are unrelated. Contrary to other claims, we conclude with 99 per cent confidence that the two events are from the same repeating source. The different dispersion measures between the two bursts then rule out a cosmological intergalactic-medium origin for the dispersion measure, but are consistent with the flare-star scenario with a varying plasma blanket between bursts. Finally, we review some theoretical objections that have been raised against a local flare-star FRB origin, and show that they are incorrect.

Flame burns involving kerosene pressure stoves in India.

PubMed

Sawhney, C P

1989-12-01

The author has analysed 339 patients with extensive burns admitted to a teaching hospital and found them to be most common in poor socioeconomic groups with low incomes, poor housing and illiteracy. Thermal injuries afflicted 89 per cent of the patients and were generally accidental and occurred in homes with floor-level cooking: chemical and electrical burns (the remaining 11 per cent) were uncommon. Kerosene pressure stove accidents were a common cause of thermal burns and occurred in 65 per cent of the patients. These were reported in both sexes but were 3.5 times more common in females. Mishandling of kerosene pressure stoves was the commonest cause and occurred in 65.7 per cent of the patients and the next most common cause was wearing loose garments. Kerosene pressure stove accidents occurred commonly in the age group 16-35 years and were rare in other age groups. These burns were relatively more extensive, deep and carried a high mortality.

Injury rates during the 1988 US Olympic Team Trials for taekwondo.

PubMed Central

Zemper, E D; Pieter, W

1989-01-01

Injury rates were recorded during the 1988 US Olympic Team Trials for taekwondo involving 48 men and 48 women. The injury rate for men (12.74/100 athlete-exposures) was about 40 per cent higher than the rate for women (9.01/100 athlete-exposures). The foot and the head were the most frequently injured body parts. Contusions were the predominant type of injury, and concussions were recorded for both men and women. A large proportion (41 per cent) of the men's injuries were the result of receiving a blow from an unblocked attack. For the women the most common injury situation (40 per cent) was while attacking with a kick. For both men and women, 15 per cent of the reported injuries were time-loss injuries. The head injuries found in this study are discussed with reference to the high impact velocities and momentum levels generated during taekwondo kicking. Recommendations are made with regard to protective equipment testing and rule changes to reduce the possibility of cerebral injury. PMID:2620229

[Socio-hygienic aspects of the contingents of adult patients with pulmonary tuberculosis].

PubMed

Shefer, L B; Nabokova, I P

1989-01-01

The pattern of tuberculous patients was analyzed by groups of dispensary registration and types of the disease. A higher proportion of the patients with advanced tuberculosis from rural areas was revealed. Composition of the patients was studied by the social groups, educational level, marital status and housing conditions. It was shown that 38.7 per cent of the patients had concomitant diseases. Among them 17.2 per cent suffered from chronic alcoholism. On the whole, the number of heavy alcohol drinkers amounted to 37.8 per cent. Interrelation between the above social and hygienic factors and severity of tuberculosis was demonstrated. The patients were followed up for 3 years and marked improvement was observed in 69.4 per cent of them. The disease outcomes depended on the sex, age, social factors, bad habits and concomitant diseases, Economic losses from 1 tuberculous patient were calculated. A model of changes in the patient contingents and economic losses from the patients in regard to the treatment was constructed.

Tubal infertility and the intrauterine device.

PubMed

Cramer, D W; Schiff, I; Schoenbaum, S C; Gibson, M; Belisle, S; Albrecht, B; Stillman, R J; Berger, M J; Wilson, E; Stadel, B V

1985-04-11

To study the association between intrauterine devices (IUDs) and pelvic inflammatory disease, we compared contraceptive histories in 4185 while women--283 nulliparous women with primary tubal infertility, 69 women with secondary tubal infertility, and 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with IUD use was calculated by means of multivariate logistic regression to control for confounding factors, including region, year of menarche, religion, education, smoking, and reported number of sexual partners. The adjusted risk of primary tubal infertility associated with any IUD use before a first live birth was 2.0 (95 per cent confidence limits, 1.5 to 2.6) relative to nonuse. Users of the Dalkon Shield had an adjusted risk of 3.3 (1.7 to 6.1), users of the Lippes Loop or Saf-T-Coil had a risk of 2.9 (1.7 to 5.2), and users of copper IUDs had a risk of 1.6 (1.1 to 2.4). Women who reported having only one sexual partner had no increased risk of primary tubal infertility associated with IUD use. The adjusted risk of secondary tubal infertility associated with use of a copper IUD after a first live birth was not statistically significant (1.5; 95 per cent confidence limits, 0.8 to 3.0), whereas the risk from similar use of noncopper devices was significant (2.8; 1.3 to 5.9). We conclude that tubal infertility is associated with IUD use, but less so with copper IUDs.

Noise induced hearing loss in dance music disc jockeys and an examination of sound levels in nightclubs.

PubMed

Bray, Adam; Szymański, Marcin; Mills, Robert

2004-02-01

Noise exposure, hearing loss and associated otological symptoms have been studied in a group of 23 disc jockeys using a questionnaire and pure tone audiometry. The level of noise exposure in the venues where they work has also been studied using Ametek Mk-3 audio dosimeters. Three members of the study group showed clear evidence of noise-induced hearing loss on audiometry, 70 per cent reported temporary threshold shift after sessions and 74 per cent reported tinnitus. Sound levels of up to 108 dB(A) were recorded in the nightclubs. The average level for a typical session was 96 dB(A) which is above the level at which the provision of ear protection is mandatory for employers in industry. It can be concluded that DJs are at substantial risk of developing noise-induced hearing loss and noise exposure in nightclubs frequently exceeds safe levels.

The size distribution of inhabited planets

NASA Astrophysics Data System (ADS)

Simpson, Fergus

2016-02-01

Earth-like planets are expected to provide the greatest opportunity for the detection of life beyond the Solar system. However, our planet cannot be considered a fair sample, especially if intelligent life exists elsewhere. Just as a person's country of origin is a biased sample among countries, so too their planet of origin may be a biased sample among planets. The magnitude of this effect can be substantial: over 98 per cent of the world's population live in a country larger than the median. In the context of a simple model where the mean population density is invariant to planet size, we infer that a given inhabited planet (such as our nearest neighbour) has a radius r < 1.2r⊕ (95 per cent confidence bound). We show that this result is likely to hold not only for planets hosting advanced life, but also for those which harbour primitive life forms. Further, inferences may be drawn for any variable which influences population size. For example, since population density is widely observed to decline with increasing body mass, we conclude that most intelligent species are expected to exceed 300 kg.

Outbreak of scrub typhus in Puducherry & Tamil Nadu during cooler months

PubMed Central

Stephen, Selvaraj; Sangeetha, Balakrishnan; Ambroise, Stanley; Sarangapani, Kengamuthu; Gunasekaran, Dhandapany; Hanifah, Mohamed; Somasundaram, Subramanian

2015-01-01

Background & objectives: The southern part of India has witnessed an increase in scrub typhus (ST) during the past ten years. ST outbreaks occurred during winter months but at intervals of one to three years. With only a few reports of ST in Puducherry, this study was undertaken to look for the persistence of ST cases in Puducherry and Tamil Nadu in the winter months. Methods: During relatively cooler months of September, 2012 to March, 2013, a total of 45 patients with fever and clinical suspicion of ST and who provided both acute and convalescent blood samples were included. Total WBC, platelet counts, serum creatinine, liver enzymes levels and a rapid immunochromatographic test (RICT) for ST were first done. Paired serum samples were analysed by two specific tests - ST IgM and IgG ELISA- and a non-specific, but widely used Weil-Felix (WF) test. Results: Of the 45 patients, 21 adults and seven children were confirmed as ST based on clinical and laboratory findings, and positivity in specific serological test(s). Setting ST IgM and IgG ELISA as reference, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for RICT were 91.67, 85.71 per cent; 90.48, 100 per cent; 91.67, 100 per cent and 90.48, 80.95 per cent, respectively. Similarly, for WF the values were 83.33, 75 per cent; 95.24, 100 per cent; 95.24, 100 per cent and 83.33, 70.83 per cent, respectively. Interpretation & conclusions: ST continues to persist in the cooler months in Puducherry and neighbouring Tamil Nadu with fever and myalgia as prominent features. None of the tests evaluated in this study was found to be ideal, but ST IgM/IgG ELISA was useful for batch testing and the non-specific WF test can be used in resource poor settings. PMID:26658595

Health information technology adoption in New Zealand optometric practices.

PubMed

Heidarian, Ahmadali; Mason, David

2013-11-01

Health information technology (HIT) has the potential to fundamentally change the practice of optometry and the relationship between optometrists and patients and to improve clinical outcomes. This paper aims to provide data on how health information technology is currently being used in New Zealand optometric practices. Also this paper aims to explore the potential benefits and barriers to the future adoption of health information technology in New Zealand. One hundred and six New Zealand optometrists were surveyed about their current use of health information technology and about potential benefits and barriers. In addition, 12 semi-structured interviews were carried out with leaders of health information technology in New Zealand optometry. The areas of interest were the current and intended use of HIT, the potential benefits of and barriers to using HIT in optometric offices and the level of investment in health information technology. Nearly all optometrists (98.7 per cent) in New Zealand use computers in their practices and 93.4 per cent of them use a computer in their consulting room. The most commonly used clinical assessment technology in optometric practices in New Zealand was automated perimeter (97.1 per cent), followed by a digital fundus/retinal camera (82.6 per cent) and automated lensometer (62.9 per cent). The pachymeter is the technology that most respondents intended to purchase in the next one to five years (42.6 per cent), followed by a scanning laser ophthalmoscope (36.8 per cent) and corneal topographer (32.9 per cent). The main benefits of using health information technology in optometric practices were improving patient perceptions of ‘state of the art’ practice and providing patients with information and digital images to explain the results of assessment. Barriers to the adoption of HIT included the need for frequent technology upgrades, cost, lack of time for implementation, and training. New Zealand optometrists are using HIT broadly in their practices and expect HIT use to increase over time.

Tooth wear in children with Down syndrome.

PubMed

Bell, E J; Kaidonis, J; Townsend, G C

2002-03-01

Several studies have described the impact that dental caries and periodontitis may have on the dentitions of individuals with Down syndrome, but there are few reports about the effects of tooth wear. This investigation aimed to compare the aetiology, prevalence and severity of tooth wear in 49 cytogenetically confirmed Down syndrome children with 49 non-Down syndrome controls. This study involved three aspects: an oral examination, including obtaining dental impressions; a dietary analysis spanning three days; and a questionnaire seeking information about habits, medical problems and medications. Tooth wear severity was scored on a 4-grade scale (none-to-little; moderate; severe; very severe), while aetiology was classified as being due to attrition mainly, erosion mainly, or a combination of both. Double determinations established scoring method reliability and chi-square tests assessed associations between samples. Tooth wear was significantly more frequent (p<0.01) in the Down syndrome than the non-Down syndrome sample (67.4 per cent cf 34.7 per cent), with more of the Down syndrome children showing severe to very severe wear (59.2 per cent cf 8.2 per cent). Significantly more Down syndrome children (p<0.05) displayed a multifactorial aetiology of tooth wear, i.e., both attrition and erosion (46.7 per cent cf 28.6 per cent), although no particular dietary link was established. Gastric reflux and vomiting were reported in over 20 per cent of the Down syndrome sample. Given the potential consequences of high levels of tooth wear, associated with tooth grinding and an acidic oral environment in Down syndrome children, educational programmes aimed at increasing awareness of carers and health professionals are needed urgently.

Synergistic Effect of Combined Hollow Viscus Injuries on Intra-Abdominal Abscess Formation.

PubMed

Paulus, Elena M; Croce, Martin A; Shahan, Charles P; Zarzaur, Ben L; Sharpe, John P; Dileepan, Amirtha; Boyd, Brandon S; Fabian, Timothy C

2015-07-01

The strong association between penetrating colon injuries and intra-abdominal abscess (IAA) formation is well established and attributed to high colon bacterial counts. Since trauma patients are rarely fasting at injury, stomach and small bowel colony counts are also elevated. We hypothesized that there is a synergistic effect of increased IAA formation with concomitant stomach and/or colon injuries when compared to small bowel injuries alone. Consecutive patients at a level one trauma center with penetrating small bowel (SB), stomach (S), and/or colon (C) injuries from 1996 to 2012 were reviewed. Logistic regression determined associations with IAA, adjusting for age, gender, Injury Severity Score (ISS), admission Glasgow Coma Score, transfusions, and concurrent pancreas or liver injury. A total of 1518 patients (91% male, ISS = 15.9 ± 8.4) were identified: 496 (33%) SB, 231 (15%) S, 288 (19%) C, 40 (3%) S + SB, 69 (5%) S + C, 338 (22%) C + SB, and 56 (4%) S + C + SB. 148 (10%) patients developed IAA: 4 per cent SB, 9 per cent S, 10 per cent C, 5 per cent S + SB, 22 per cent S + C, 13 per cent C + SB, and 25 per cent S + C + SB. Multiple logistic regression demonstrated that ISS, 24 hour blood transfusions, and concomitant pancreatic or liver injuries were associated with IAA. Compared with reference SB, S or S + SB injuries were no more likely to develop IAA. However, S + C, SB + C, and S + C + SB injuries were significantly more likely to have IAA. In conclusion, combined stomach + colon, small bowel + colon, and stomach, colon, + small bowel injuries have a synergistic effect leading to increased IAA formation after penetrating injuries. Heightened clinical suspicion for IAA formation is necessary in these combined hollow viscus injury patients.

Intractable diarrhoea of infancy and its management: modified cost effective treatment.

PubMed

Thapa, B R

1994-06-01

One-hundred-twenty infants under 1 year of age suffering from intractable diarrhoea were studied. They had received prior treatment in the form of antimicrobials (100 per cent), stool binding substance (50 percent), antimotility agents (50 per cent), and intravenous (IV) fluids (33 per cent). One-third of them had been hospitalised in peripheral hospitals. All of them had diarrhoea of more than 2 weeks' duration, protein energy malnutrition and were very ill. In addition vomiting, dehydration, fever, paralytic ileus, perianal excoriation and rectal prolapse were present in 44, 23, 33, 9, 47, and 3 per cent of the infants, respectively. Anaemia, multiple vitamin deficiencies, and pedal oedema were seen in 70, 10, and 3 per cent of infants, respectively. The infections documented were septicaemia (22 per cent), bronchopneumonia (6 per cent), meningitis (4 per cent), urinary tract infection (3 per cent) and acute supporative otitis media in 2 per cent of infants. Fifty-three per cent of infants had secondary lactose intolerance. Intolerance to milk protein, milk protein and soyabean and milk protein, as well as soyabean and chicken was seen in 4, 2, and 1 per cent cases, respectively. Aetiological agents isolated from stool culture were E. coli, (18 per cent), Klebsiella species (9 per cent), Shigella species (6 per cent), Salmonella typhimurium (2 per cent), Cholera mitschikom (1 per cent), Giardia lamblia (6 per cent), cryptosporidium (1 per cent), and E. histolytica (1 per cent). Candida albicans was grown in 18 per cent of infants. Pseudomembranous colitis was documented in 2 per cent cases.(ABSTRACT TRUNCATED AT 250 WORDS)

A clinical investigation of force delivery systems for orthodontic space closure.

PubMed

Nightingale, C; Jones, S P

2003-09-01

To investigate the force retention, and rates of space closure achieved by elastomeric chain and nickel titanium coil springs. Randomized clinical trial. Eastman Dental Hospital, London and Queen Mary's University Hospital, Roehampton, 1998-2000. Twenty-two orthodontic patients, wearing the pre-adjusted edgewise appliance undergoing space closure in opposing quadrants, using sliding mechanics on 0.019 x 0.025-inch posted stainless steel archwires. Medium-spaced elastomeric chain [Durachain, OrthoCare (UK) Ltd., Bradford, UK] and 9-mm nickel titanium coil springs [OrthoCare (UK) Ltd.] were placed in opposing quadrants for 15 patients. Elastomeric chain only was used in a further seven patients. The initial forces on placement and residual forces at the subsequent visit were measured with a dial push-pull gauge [Orthocare (UK) Ltd]. Study models of eight patients were taken before and after space closure, from which measurements were made to establish mean space closure. The forces were measured in grammes and space closure in millimetres. Fifty-nine per cent (31/53) of the elastomeric sample maintained at least 50 per cent of the initial force over a time period of 1-15 weeks. No sample lost all its force, and the mean loss was 47 per cent (range: 0-76 per cent). Nickel titanium coil springs lost force rapidly over 6 weeks, following that force levels plateaued. Forty-six per cent (12/26) maintained at least 50 per cent of their initial force over a time period of 1-22 weeks, and mean force loss was 48 per cent (range: 12-68 per cent). The rate of mean weekly space closure for elastomeric chain was 0.21 mm and for nickel titanium coil springs 0.26 mm. There was no relationship between the initial force applied and rate of space closure. None of the sample failed during the study period giving a 100 per cent response rate. In clinical use, the force retention of elastomeric chain was better than previously concluded. High initial forces resulted in high force decay. Nickel titanium coil springs and elastomeric chain closed spaces at a similar rate.

Mortality, crime and access to basic needs before and after the Haiti earthquake: a random survey of Port-au-Prince households.

PubMed

Kolbe, Athena R; Hutson, Royce A; Shannon, Harry; Trzcinski, Eileen; Miles, Bart; Levitz, Naomi; Puccio, Marie; James, Leah; Noel, Jean Roger; Muggah, Robert

2010-01-01

On 12 January 2010 an earthquake measuring 7.0 on the Richter Scale struck Haiti, causing unprecedented death, injury and destruction for an event of this magnitude. Our aim was to generate a rapid assessment of the primary consequences for the population of the metropolitan area of Port-au-Prince, the national capital. During the summer of 2009 we conducted a survey of 1,800 households in metropolitan Port-au-Prince. Six weeks after the earthquake, we attempted to trace these households in order to re-interview them. The questionnaire examined mortality and injuries generated by the natural disaster, as well as the character of victimization, food security and living arrangements following the quake. Data analysis incorporated sampling weights and adjusted for clustering within households. The original 2009 survey featured a 90 per cent response rate; in 2010 we re-interviewed 93 per cent of these households. We estimate that 158,679 people in Port-au-Prince (95 per cent CI 136,813-180,545) died during the quake or in the six-week period afterwards owing to injuries or illness. Children were at particular risk for death. In the six weeks after the earthquake, 10,813 people (95 per cent CI 6,726-14,900) were sexually assaulted, the vast majority of whom were female. In the same period 4,645 individuals (95 per cent CI 1,943-7,347) were physically assaulted. Of all households, 18.6 per cent (95 per cent CI 16.6-20.8) were experiencing severe food insecurity six weeks after the earthquake. 24.4 per cent (95 per cent CI 22.1-26.9) of respondents' homes were completely destroyed. Many residents of Port-au-Prince died during or as a result of the earthquake, albeit fewer than were widely reported. More than half of the capital's population experienced moderate to severe food insecurity, though remittances are a major protective factor in promoting food security. Survivors continue to experience high levels of sexual assault and limited access to durable shelter.

Wide-field SCUBA-2 observations of NGC 2264: submillimetre clumps and filaments

NASA Astrophysics Data System (ADS)

Buckle, J. V.; Richer, J. S.

2015-10-01

We present wide-field observations of the NGC 2264 molecular cloud in the dust continuum at 850 and 450 μm using SCUBA-2 on the James Clerk Maxwell Telescope. Using 12CO 3 → 2 molecular line data, we determine that emission from CO contaminates the 850 μm emission at levels ˜30 per cent in localized regions associated with high-velocity molecular outflows. Much higher contamination levels of 60 per cent are seen in shocked regions near the massive star S Mon. If not removed, the levels of CO contamination would contribute an extra 13 per cent to the dust mass in NGC 2264. We use the FELLWALKER routine to decompose the dust into clumpy structures, and a Hessian-based routine to decompose the dust into filamentary structures. The filaments can be described as a hub-filament structure, with lower column density filaments radiating from the NGC 2264 C protocluster hub. Above mean filament column densities of 2.4 × 1022 cm-2, star formation proceeds with the formation of two or more protostars. Below these column densities, filaments are starless, or contain only a single protostar.

Relationship between the levels of antibodies to bovine viral diarrhoea virus in bulk tank milk and the prevalence of cows exposed to the virus.

PubMed

Niskanen, R

1993-10-02

A positive relationship was found between the prevalence of cows in a herd which were antibody-positive for bovine viral diarrhoea virus (BVDV) and the level of antibodies to the virus in bulk tank milk as determined by an indirect enzyme-linked immunosorbent assay (ELISA). In herds with an ELISA absorbance value of up to 0.20 there were very few or no antibody-positive cows, whereas in herds with an ELISA absorbance value of at least 0.81, 87 to 100 per cent of the lactating cows were antibody-positive to BVDV. An analysis of the level of antibodies to BVDV in milk samples from Sweden and Finland showed that of 123 Swedish herds, 83.7 per cent had detectable antibodies to BVDV in their bulk milk whereas only 3.1 per cent of the 291 Finnish samples were antibody-positive. The incidence of BVDV infection in 105 herds in one area of Sweden was determined by analysing two samples of bulk tank milk taken one year apart. The infection had apparently occurred recently in five of these dairy herds.

Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database.

PubMed

Zafar, S N; Nabeel Zafar, S; Rushing, A; Haut, E R; Kisat, M T; Villegas, C V; Chi, A; Stevens, K; Efron, D T; Zafar, H; Haider, A H

2012-01-01

The aim of this study was to investigate trends in the practice of selective non-operative management (SNOM) for penetrating abdominal injury (PAI) and to determine factors associated with its failure. The National Trauma Data Bank for 2002-2008 was reviewed. Patients with PAI were categorized as those who underwent successful SNOM (operative management not required) and those who failed SNOM (surgery required more than 4 h after admission). Yearly rates of SNOM versus non-therapeutic laparotomy (NTL) were plotted. Multivariable regression analysis was performed to identify factors associated with failed SNOM and mortality. A total of 12 707 patients with abdominal gunshot and 13 030 with stab wounds were identified. Rates of SNOM were 22.2 per cent for gunshot and 33.9 per cent for stab wounds, and increased with time (P < 0.001). There was a strong correlation between the rise in SNOM and the decline in NTL (r = - 0.70). SNOM failed in 20.8 and 15.2 per cent of patients with gunshot and stab wounds respectively. Factors predicting failure included the need for blood transfusion (odds ratio (OR) 1.96, 95 per cent confidence interval 1.11 to 3.46) and a higher injury score. Failed SNOM was independently associated with mortality in both the gunshot (OR 4.48, 2.07 to 9.70) and stab (OR 9.83, 3.44 to 28.00) wound groups. The practice of SNOM is increasing, with an associated decrease in the rate of NTL for PAI. In most instances SNOM is successful; however, its failure is associated with increased mortality. Careful patient selection and adherence to protocols designed to decrease the failure rate of SNOM are recommended. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

The influence of performance-based payment on childhood immunisation coverage.

PubMed

Merilind, Eero; Salupere, Rauno; Västra, Katrin; Kalda, Ruth

2015-06-01

Pay-for-performance, also called the quality system (QS) in Estonia, was implemented in 2006 and one indicator for achievement is the childhood immunisation coverage rate. The WHO vaccination coverage in Europe for diphtheria, tetanus and pertussis, and measles in children aged around one year old should meet or exceed 90 per cent. The study was conducted using a database from the Estonian Health Insurance Fund. The study compared childhood immunisation coverage rates of all Estonian family physicians in two groups, joined and not joined to the quality system during the observation period 2006-2012. Immunisation coverage was calculated as the percentage of persons in the target age group who received a vaccine dose by a given age. The target level of immunisations in Estonia is set at 90 per cent and higher. Immunisation coverage rates of family doctors (FD) in Estonia showed significant differences between two groups of doctors: joined to the quality system and not joined. Doctors joined to the quality system met the 90 per cent vaccination criterion more frequently compared to doctors not joined to the quality system. Doctors not joined to the quality system were below the 90 per cent vaccination criterion in all vaccinations listed in the Estonian State Immunisation Schedule. Pay-for-performance as a financial incentive encourages higher levels of childhood immunisations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation

PubMed Central

Herr, Hugh M.; Grabowski, Alena M.

2012-01-01

Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passive-elastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75–1.75 m s−1 and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation. PMID:21752817

A county-level cross-sectional analysis of positive deviance to assess multiple population health outcomes in Indiana.

PubMed

Hendryx, Michael; Guerra-Reyes, Lucia; Holland, Benjamin D; McGinnis, Michael Dean; Meanwell, Emily; Middlestadt, Susan E; Yoder, Karen M

2017-10-11

To test a positive deviance method to identify counties that are performing better than statistical expectations on a set of population health indicators. Quantitative, cross-sectional county-level secondary analysis of risk variables and outcomes in Indiana. Data are analysed using multiple linear regression to identify counties performing better or worse than expected given traditional risk indicators, with a focus on 'positive deviants' or counties performing better than expected. Counties in Indiana (n=92) constitute the unit of analysis. Per cent adult obesity, per cent fair/poor health, low birth weight per cent, per cent with diabetes, years of potential life lost, colorectal cancer incidence rate and circulatory disease mortality rate. County performance that outperforms expectations is for the most part outcome specific. But there are a few counties that performed particularly well across most measures. The positive deviance approach provides a means for state and local public health departments to identify places that show better health outcomes despite demographic, social, economic or behavioural disadvantage. These places may serve as case studies or models for subsequent investigations to uncover best practices in the face of adversity and generalise effective approaches to other areas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cytotoxic drug use in treatment of dogs and cats with cancer by UK veterinary practices (2003 to 2004).

PubMed

Cave, T A; Norman, P; Mellor, D

2007-07-01

To describe the range and frequency of cytotoxic drugs prescribed within UK veterinary practices to treat dogs and cats with cancer, determine the effect of practice demographic variables on this practice and determine the frequency with which intravenous catheters were used during administration of parenteral cytotoxic drugs. A postal survey of 1838 veterinary practices providing care for dogs and cats within the UK. Prescription of cytotoxic drugs to treat dogs and cats with cancer during the preceding 12 months was reported by 70.8 per cent practices. The most widely prescribed agents were cyclophosphamide (65.4 per cent) and vincristine (63.5 per cent). Twenty-three per cent of responding practices had prescribed an antitumour antibiotic and 8.3 per cent had prescribed a platinum agent. The median frequency of prescription was between once a month and once every three months. Increasing frequency and range of cytotoxic drug prescription were associated with practice employment of higher numbers of veterinary surgeons and increased levels of pet insurance among practice clients. Almost a quarter of practices administering vesicant parenteral cytotoxic drugs failed to always use intravenous catheters to do so. Prescription of cytotoxic drugs, and therefore the potential for occupational exposure of staff, was widespread among UK veterinary practices providing care for dogs and cats.

Epidemiological, clinical, haematological and biochemical characteristics of canine hypothyroidism.

PubMed

Dixon, R M; Reid, S W; Mooney, C T

1999-10-23

Hypothyroidism was diagnosed in 50 dogs and excluded in 86 dogs suspected of hypothyroidism, on the basis of the results of bovine thyrotropin response tests. Breed, pedigree, sex or neutering status did not significantly influence the likelihood of the dogs being hypothyroid. The hypothyroid dogs were significantly older than the non-hypothyroid dogs referred to the University of Glasgow during the same period. However, when dogs under two years of age were excluded from the statistical analyses there was no significant difference in age between the two groups. The most common clinical characteristics associated with hypothyroidism were metabolic signs (84 per cent of cases), particularly lethargy (76 per cent), obesity or weight gain (44 per cent), and exercise intolerance (24 per cent); and dermatological abnormalities (80 per cent), including alopecia (56 per cent), poor coat quality (30 per cent) and hyperpigmentation (20 per cent). When compared with the laboratory reference limits the most common biochemical and haematological abnormalities were increased concentrations of triglycerides (88 per cent), cholesterol (78 per cent), glucose (49 per cent), and fructosamine (43 per cent), and increased activities of creatine kinase (35 per cent), and decreased concentrations of inorganic phosphate (63 per cent), and a low red blood cell count (40 per cent). When compared with reference limits derived from the euthyroid dogs the most common abnormalities were increased concentrations of gamma-glutamyltransferase (21 per cent), cholesterol (18 per cent), and aspartate aminotransferase (15 per cent) and a decreased red blood cell count (29 per cent), and decreased neutrophils (18 per cent) and decreased activity of creatine kinase (15 per cent). Assessment of cholesterol, creatine kinase, aspartate aminotransferase, gamma-glutamyltransferase, and red blood cell and neutrophil counts may be particularly useful in distinguishing hypothyroid dogs from euthyroid animals with similar clinical signs.

A 3.5-million Solar Masses Black Hole in the Centre of the Ultracompact Dwarf Galaxy Fornax UCD3

NASA Astrophysics Data System (ADS)

Afanasiev, Anton V.; Chilingarian, Igor V.; Mieske, Steffen; Voggel, Karina T.; Picotti, Arianna; Hilker, Michael; Seth, Anil; Neumayer, Nadine; Frank, Matthias; Romanowsky, Aaron J.; Hau, George; Baumgardt, Holger; Ahn, Christopher; Strader, Jay; den Brok, Mark; McDermid, Richard; Spitler, Lee; Brodie, Jean; Walsh, Jonelle L.

2018-04-01

The origin of ultracompact dwarfs (UCDs), a class of compact stellar systems discovered two decades ago, still remains a matter of debate. Recent discoveries of central supermassive black holes in UCDs likely inherited from their massive progenitor galaxies provide support for the tidal stripping hypothesis. At the same time, on statistical grounds, some massive UCDs might be representatives of the high luminosity tail of the globular cluster luminosity function. Here we present a detection of a 3.3^{+1.4}_{-1.2}× 10^6 M_{⊙} black hole (1σ uncertainty) in the centre of the UCD3 galaxy in the Fornax cluster, that corresponds to 4 per cent of its stellar mass. We performed isotropic Jeans dynamical modelling of UCD3 using internal kinematics derived from adaptive optics assisted observations with the SINFONI spectrograph and seeing limited data collected with the FLAMES spectrograph at the ESO VLT. We rule out the zero black hole mass at the 3σ confidence level when adopting a mass-to-light ratio inferred from stellar populations. This is the fourth supermassive black hole found in a UCD and the first one in the Fornax cluster. Similarly to other known UCDs that harbour black holes, UCD3 hosts metal rich stars enhanced in α-elements that supports the tidal stripping of a massive progenitor as its likely formation scenario. We estimate that up to 80 per cent of luminous UCDs in galaxy clusters host central black holes. This fraction should be lower for UCDs in groups, because their progenitors are more likely to be dwarf galaxies, which do not tend to host central black holes.

Simultaneous optical/X-ray study of GS 1354-64 (=BW Cir) during hard outburst: evidence for optical cyclo-synchrotron emission from the hot accretion flow

NASA Astrophysics Data System (ADS)

Pahari, Mayukh; Gandhi, Poshak; Charles, Philip A.; Kotze, Marissa M.; Altamirano, Diego; Misra, Ranjeev

2017-07-01

We present results from simultaneous optical [South African Large Telescope (SALT)] and X-ray (Swift and INTEGRAL) observations of GS 1354-64/BW Cir during the 2015 hard state outburst. During the rising phase, optical/X-ray time series shows a strong anti-correlation with X-ray photons lagging optical. Optical and X-ray power spectra show quasi-periodic oscillations (QPOs) at a frequency of ˜18 mHz with a confidence level of at least 99 per cent. Simultaneous fitting of Swift/XRT and INTEGRAL spectra in the range 0.5-1000.0 keV shows non-thermal, power-law-dominated (>90 per cent) spectra with a hard power-law index of 1.48 ± 0.03, inner disc temperature of 0.12 ± 0.01 keV and an inner disc radius of ˜3000 km. All evidence is consistent with cyclo-synchrotron radiation in a non-thermal, hot electron cloud extending to ˜100 Schwarzschild radii being a major physical process for the origin of optical photons. At outburst peak about one month later, when the X-ray flux rises and the optical drops, the apparent features in the optical/X-ray correlation vanish and the optical auto correlation widens. Although ˜0.19 Hz QPO is observed from the X-ray power spectra, the optical variability is dominated by the broad-band noise, and the inner disc temperature increases. These results support a change in the dominant optical emission source between outburst rise and peak, consistent with a weakening of hot flow as the disc moves in.

A 3.5 million Solar masses black hole in the centre of the ultracompact dwarf galaxy fornax UCD3

NASA Astrophysics Data System (ADS)

Afanasiev, Anton V.; Chilingarian, Igor V.; Mieske, Steffen; Voggel, Karina T.; Picotti, Arianna; Hilker, Michael; Seth, Anil; Neumayer, Nadine; Frank, Matthias; Romanowsky, Aaron J.; Hau, George; Baumgardt, Holger; Ahn, Christopher; Strader, Jay; den Brok, Mark; McDermid, Richard; Spitler, Lee; Brodie, Jean; Walsh, Jonelle L.

2018-07-01

The origin of ultracompact dwarfs (UCDs), a class of compact stellar systems discovered two decades ago, still remains a matter of debate. Recent discoveries of central supermassive black holes in UCDs likely inherited from their massive progenitor galaxies provide support for the tidal stripping hypothesis. At the same time, on statistical grounds, some massive UCDs might be representatives of the high luminosity tail of the globular cluster luminosity function. Here we present a detection of a 3.3^{+1.4}_{-1.2}× 10^6 M_{⊙} black hole (1σ uncertainty) in the centre of the UCD3 galaxy in the Fornax cluster, which corresponds to 4 per cent of its stellar mass. We performed isotropic Jeans dynamical modelling of UCD3 using internal kinematics derived from adaptive optics-assisted observations with the SINFONI spectrograph and seeing limited data collected with the FLAMES spectrograph at the ESO VLT. We rule out the zero black hole mass at the 3σ confidence level when adopting a mass-to-light ratio inferred from stellar populations. This is the fourth supermassive black hole found in a UCD and the first one in the Fornax cluster. Similarly to other known UCDs that harbour black holes, UCD3 hosts metal rich stars enhanced in α-elements that support the tidal stripping of a massive progenitor as its likely formation scenario. We estimate that up to 80 per cent of luminous UCDs in galaxy clusters host central black holes. This fraction should be lower for UCDs in groups, because their progenitors are more likely to be dwarf galaxies, which do not usually host black holes massive enough to be detected.

Observation of the black widow B1957+20 millisecond pulsar binary system with the MAGIC telescopes

NASA Astrophysics Data System (ADS)

Ahnen, M. L.; Ansoldi, S.; Antonelli, L. A.; Arcaro, C.; Babić, A.; Banerjee, B.; Bangale, P.; Barres de Almeida, U.; Barrio, J. A.; Becerra González, J.; Bednarek, W.; Bernardini, E.; Berti, A.; Biasuzzi, B.; Biland, A.; Blanch, O.; Bonnefoy, S.; Bonnoli, G.; Borracci, F.; Bretz, T.; Carosi, R.; Carosi, A.; Chatterjee, A.; Colin, P.; Colombo, E.; Contreras, J. L.; Cortina, J.; Covino, S.; Cumani, P.; da Vela, P.; Dazzi, F.; de Angelis, A.; de Lotto, B.; De Oña Wilhelmi, E.; Di Pierro, F.; Doert, M.; Domínguez, A.; Dominis Prester, D.; Dorner, D.; Doro, M.; Einecke, S.; Eisenacher Glawion, D.; Elsaesser, D.; Engelkemeier, M.; Fallah Ramazani, V.; Fernández-Barral, A.; Fidalgo, D.; Fonseca, M. V.; Font, L.; Fruck, C.; Galindo, D.; García López, R. J.; Garczarczyk, M.; Gaug, M.; Giammaria, P.; Godinović, N.; Gora, D.; Gozzini, S. R.; Griffiths, S.; Guberman, D.; Hadasch, D.; Hahn, A.; Hassan, T.; Hayashida, M.; Herrera, J.; Hose, J.; Hrupec, D.; Hughes, G.; Ishio, K.; Konno, Y.; Kubo, H.; Kushida, J.; Kuveždić, D.; Lelas, D.; Lindfors, E.; Lombardi, S.; Longo, F.; López, M.; Majumdar, P.; Makariev, M.; Maneva, G.; Manganaro, M.; Mannheim, K.; Maraschi, L.; Mariotti, M.; Martínez, M.; Mazin, D.; Menzel, U.; Mirzoyan, R.; Moralejo, A.; Moreno, V.; Moretti, E.; Neustroev, V.; Niedzwiecki, A.; Nievas Rosillo, M.; Nilsson, K.; Nishijima, K.; Noda, K.; Nogués, L.; Paiano, S.; Palacio, J.; Paneque, D.; Paoletti, R.; Paredes, J. M.; Paredes-Fortuny, X.; Pedaletti, G.; Peresano, M.; Perri, L.; Persic, M.; Poutanen, J.; Prada Moroni, P. G.; Prandini, E.; Puljak, I.; Garcia, J. R.; Reichardt, I.; Rhode, W.; Ribó, M.; Rico, J.; Saito, T.; Satalecka, K.; Schroeder, S.; Schweizer, T.; Sillanpää, A.; Sitarek, J.; Šnidarić, I.; Sobczynska, D.; Stamerra, A.; Strzys, M.; Surić, T.; Takalo, L.; Tavecchio, F.; Temnikov, P.; Terzić, T.; Tescaro, D.; Teshima, M.; Torres, D. F.; Torres-Albà, N.; Treves, A.; Vanzo, G.; Vazquez Acosta, M.; Vovk, I.; Ward, J. E.; Will, M.; Wu, M. H.; Zarić, D.; MAGIC Collaboration; Cognard, I.; Guillemot, L.

2017-10-01

B1957+20 is a millisecond pulsar located in a black-widow-type compact binary system with a low-mass stellar companion. The interaction of the pulsar wind with the companion star wind and/or the interstellar plasma is expected to create plausible conditions for acceleration of electrons to TeV energies and subsequent production of very high-energy γ-rays in the inverse Compton process. We performed extensive observations with the Major Atmospheric Gamma Imaging Cherenkov Telescopes (MAGIC) telescopes of B1957+20. We interpret results in the framework of a few different models, namely emission from the vicinity of the millisecond pulsar, the interaction of the pulsar and stellar companion wind region or bow shock nebula. No significant steady very high-energy γ-ray emission was found. We derived a 95 per cent confidence level upper limit of 3.0 × 10-12 cm-2 s-1 on the average γ-ray emission from the binary system above 200 GeV. The upper limits obtained with the MAGIC constrain, for the first time, different models of the high-energy emission in B1957+20. In particular, in the inner mixed wind nebula model with mono-energetic injection of electrons, the acceleration efficiency of electrons is constrained to be below ˜2-10 per cent of the pulsar spin-down power. For the pulsar emission, the obtained upper limits for each emission peak are well above the exponential cut-off fits to the Fermi-LAT data, extrapolated to energies above 50 GeV. The MAGIC upper limits can rule out a simple power-law tail extension through the sub-TeV energy range for the main peak seen at radio frequencies.

A polarized fast radio burst at low Galactic latitude

NASA Astrophysics Data System (ADS)

Petroff, E.; Burke-Spolaor, S.; Keane, E. F.; McLaughlin, M. A.; Miller, R.; Andreoni, I.; Bailes, M.; Barr, E. D.; Bernard, S. R.; Bhandari, S.; Bhat, N. D. R.; Burgay, M.; Caleb, M.; Champion, D.; Chandra, P.; Cooke, J.; Dhillon, V. S.; Farnes, J. S.; Hardy, L. K.; Jaroenjittichai, P.; Johnston, S.; Kasliwal, M.; Kramer, M.; Littlefair, S. P.; Macquart, J. P.; Mickaliger, M.; Possenti, A.; Pritchard, T.; Ravi, V.; Rest, A.; Rowlinson, A.; Sawangwit, U.; Stappers, B.; Sullivan, M.; Tiburzi, C.; van Straten, W.; ANTARES Collaboration; Albert, A.; André, M.; Anghinolfi, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Avgitas, T.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bormuth, R.; Bourret, S.; Bouwhuis, M. C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Celli, S.; Chiarusi, T.; Circella, M.; Coelho, J. A. B.; Coleiro, A.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Deschamps, A.; de Bonis, G.; Distefano, C.; di Palma, I.; Donzaud, C.; Dornic, D.; Drouhin, D.; Eberl, T.; El Bojaddaini, I.; Elsässer, D.; Enzenhöfer, A.; Felis, I.; Fusco, L. A.; Galatà, S.; Gay, P.; Geißelsöder, S.; Geyer, K.; Giordano, V.; Gleixner, A.; Glotin, H.; Grégoire, T.; Gracia-Ruiz, R.; Graf, K.; Hallmann, S.; van Haren, H.; Heijboer, A. J.; Hello, Y.; Hernández-Rey, J. J.; Hößl, J.; Hofestädt, J.; Hugon, C.; Illuminati, G.; James, C. W.; de Jong, M.; Jongen, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kouchner, A.; Kreter, M.; Kreykenbohm, I.; Kulikovskiy, V.; Lachaud, C.; Lahmann, R.; Lefèvre, D.; Leonora, E.; Lotze, M.; Loucatos, S.; Marcelin, M.; Margiotta, A.; Marinelli, A.; Martínez-Mora, J. A.; Mathieu, A.; Mele, R.; Melis, K.; Michael, T.; Migliozzi, P.; Moussa, A.; Mueller, C.; Nezri, E.; Pǎvǎlaş, G. E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Quinn, L.; Racca, C.; Riccobene, G.; Roensch, K.; Sánchez-Losa, A.; Saldaña, M.; Salvadori, I.; Samtleben, D. F. E.; Sanguineti, M.; Sapienza, P.; Schnabel, J.; Seitz, T.; Sieger, C.; Spurio, M.; Stolarczyk, Th.; Taiuti, M.; Tayalati, Y.; Trovato, A.; Tselengidou, M.; Turpin, D.; Tönnis, C.; Vallage, B.; Vallée, C.; van Elewyck, V.; Vivolo, D.; Vizzoca, A.; Wagner, S.; Wilms, J.; Zornoza, J. D.; Zúñiga, J.; H.E.S.S. Collaboration; Abdalla, H.; Abramowski, A.; Aharonian, F.; Ait Benkhali, F.; Akhperjanian, A. G.; Andersson, T.; Angüner, E. O.; Arrieta, M.; Aubert, P.; Backes, M.; Balzer, A.; Barnard, M.; Becherini, Y.; Tjus, J. Becker; Berge, D.; Bernhard, S.; Bernlöhr, K.; Blackwell, R.; Böttcher, M.; Boisson, C.; Bolmont, J.; Bordas, P.; Bregeon, J.; Brun, F.; Brun, P.; Bryan, M.; Bulik, T.; Capasso, M.; Casanova, S.; Cerruti, M.; Chakraborty, N.; Chalme-Calvet, R.; Chaves, R. C. G.; Chen, A.; Chevalier, J.; Chrétien, M.; Colafrancesco, S.; Cologna, G.; Condon, B.; Conrad, J.; Cui, Y.; Davids, I. D.; Decock, J.; Degrange, B.; Deil, C.; Devin, J.; Dewilt, P.; Dirson, L.; Djannati-Ataï, A.; Domainko, W.; Donath, A.; Drury, L. O'c.; Dubus, G.; Dutson, K.; Dyks, J.; Edwards, T.; Egberts, K.; Eger, P.; Ernenwein, J.-P.; Eschbach, S.; Farnier, C.; Fegan, S.; Fernandes, M. V.; Fiasson, A.; Fontaine, G.; Förster, A.; Funk, S.; Füßling, M.; Gabici, S.; Gajdus, M.; Gallant, Y. A.; Garrigoux, T.; Giavitto, G.; Giebels, B.; Glicenstein, J. F.; Gottschall, D.; Goyal, A.; Grondin, M.-H.; Hadasch, D.; Hahn, J.; Haupt, M.; Hawkes, J.; Heinzelmann, G.; Henri, G.; Hermann, G.; Hervet, O.; Hinton, J. A.; Hofmann, W.; Hoischen, C.; Holler, M.; Horns, D.; Ivascenko, A.; Jacholkowska, A.; Jamrozy, M.; Janiak, M.; Jankowsky, D.; Jankowsky, F.; Jingo, M.; Jogler, T.; Jouvin, L.; Jung-Richardt, I.; Kastendieck, M. A.; Katarzyński, K.; Kerszberg, D.; Khélifi, B.; Kieffer, M.; King, J.; Klepser, S.; Klochkov, D.; Kluźniak, W.; Kolitzus, D.; Komin, Nu.; Kosack, K.; Krakau, S.; Kraus, M.; Krayzel, F.; Krüger, P. P.; Laffon, H.; Lamanna, G.; Lau, J.; Lees, J.-P.; Lefaucheur, J.; Lefranc, V.; Lemière, A.; Lemoine-Goumard, M.; Lenain, J.-P.; Leser, E.; Lohse, T.; Lorentz, M.; Liu, R.; López-Coto, R.; Lypova, I.; Marandon, V.; Marcowith, A.; Mariaud, C.; Marx, R.; Maurin, G.; Maxted, N.; Mayer, M.; Meintjes, P. J.; Meyer, M.; Mitchell, A. M. W.; Moderski, R.; Mohamed, M.; Mohrmann, L.; Morâ, K.; Moulin, E.; Murach, T.; de Naurois, M.; Niederwanger, F.; Niemiec, J.; Oakes, L.; O'Brien, P.; Odaka, H.; Öttl, S.; Ohm, S.; Ostrowski, M.; Oya, I.; Padovani, M.; Panter, M.; Parsons, R. D.; Pekeur, N. W.; Pelletier, G.; Perennes, C.; Petrucci, P.-O.; Peyaud, B.; Piel, Q.; Pita, S.; Poon, H.; Prokhorov, D.; Prokoph, H.; Pühlhofer, G.; Punch, M.; Quirrenbach, A.; Raab, S.; Reimer, A.; Reimer, O.; Renaud, M.; Reyes, R. De Los; Rieger, F.; Romoli, C.; Rosier-Lees, S.; Rowell, G.; Rudak, B.; Rulten, C. B.; Sahakian, V.; Salek, D.; Sanchez, D. A.; Santangelo, A.; Sasaki, M.; Schlickeiser, R.; Schulz, A.; Schüssler, F.; Schwanke, U.; Schwemmer, S.; Settimo, M.; Seyffert, A. S.; Shafi, N.; Shilon, I.; Simoni, R.; Sol, H.; Spanier, F.; Spengler, G.; Spies, F.; Stawarz, Ł.; Steenkamp, R.; Stegmann, C.; Stinzing, F.; Stycz, K.; Sushch, I.; Tavernet, J.-P.; Tavernier, T.; Taylor, A. M.; Terrier, R.; Tibaldo, L.; Tiziani, D.; Tluczykont, M.; Trichard, C.; Tuffs, R.; Uchiyama, Y.; Walt, D. J. Van Der; van Eldik, C.; van Rensburg, C.; van Soelen, B.; Vasileiadis, G.; Veh, J.; Venter, C.; Viana, A.; Vincent, P.; Vink, J.; Voisin, F.; Völk, H. J.; Vuillaume, T.; Wadiasingh, Z.; Wagner, S. J.; Wagner, P.; Wagner, R. M.; White, R.; Wierzcholska, A.; Willmann, P.; Wörnlein, A.; Wouters, D.; Yang, R.; Zabalza, V.; Zaborov, D.; Zacharias, M.; Zanin, R.; Zdziarski, A. A.; Zech, A.; Zefi, F.; Ziegler, A.; Żywucka, N.

2017-08-01

We report on the discovery of a new fast radio burst (FRB), FRB 150215, with the Parkes radio telescope on 2015 February 15. The burst was detected in real time with a dispersion measure (DM) of 1105.6 ± 0.8 pc cm-3, a pulse duration of 2.8^{+1.2}_{-0.5} ms, and a measured peak flux density assuming that the burst was at beam centre of 0.7^{+0.2}_{-0.1} Jy. The FRB originated at a Galactic longitude and latitude of 24.66°, 5.28° and 25° away from the Galactic Center. The burst was found to be 43 ± 5 per cent linearly polarized with a rotation measure (RM) in the range -9 < RM < 12 rad m-2 (95 per cent confidence level), consistent with zero. The burst was followed up with 11 telescopes to search for radio, optical, X-ray, γ-ray and neutrino emission. Neither transient nor variable emission was found to be associated with the burst and no repeat pulses have been observed in 17.25 h of observing. The sightline to the burst is close to the Galactic plane and the observed physical properties of FRB 150215 demonstrate the existence of sight lines of anomalously low RM for a given electron column density. The Galactic RM foreground may approach a null value due to magnetic field reversals along the line of sight, a decreased total electron column density from the Milky Way, or some combination of these effects. A lower Galactic DM contribution might explain why this burst was detectable whereas previous searches at low latitude have had lower detection rates than those out of the plane.

Cervical lymph node metastasis in adenoid cystic carcinoma of the major salivary glands.

PubMed

2017-02-01

To verify the prevalence of cervical lymph node metastasis in adenoid cystic carcinoma of major salivary glands, and to establish recommendations for elective neck treatment. A search was conducted of the US National Library of Medicine database. Appropriate articles were selected from the abstracts, and the original publications were obtained to extract data. Among 483 cases of major salivary gland adenoid cystic carcinoma, a total of 90 (18.6 per cent) had cervical metastasis. The prevalence of positive nodes from adenoid cystic carcinoma was 14.5 per cent for parotid gland, 22.5 per cent for submandibular gland and 24.7 per cent for sublingual gland. Cervical lymph node metastasis occurred more frequently in patients with primary tumour stage T3-4 adenoid cystic carcinoma, and was usually located in levels II and III in the neck. Adenoid cystic carcinoma of the major salivary glands is associated with a significant prevalence of cervical node metastasis, and elective neck treatment is indicated for T3 and T4 primary tumours, as well as tumours with other histological risk factors.

Recent trends in the management of combined pancreatoduodenal injuries.

PubMed

Lopez, Peter P; Benjamin, Robert; Cockburn, Mark; Amortegui, Jose D; Schulman, Carl I; Soffer, Dror; Blackbourne, Lorne H; Habib, Fahim; Jerokhimov, Igor; Trankel, Susan; Cohn, Stephen M

2005-10-01

In an effort to better characterize the natural history of pancreatoduodenal injuries, we present a review of clinical experiences in the treatment of combined traumatic pancreatoduodenal injuries, focusing on patients in extremis. Records of patients with abdominal trauma admitted to a level 1 trauma center from 1997 to 2001 were reviewed. Of 240 patients who sustained a pancreatic or duodenal injury, 33 had combined pancreatoduodenal injuries. Eighty-two per cent of the patients (27/33) in this series had penetrating injuries, 72 per cent (24) sustained gunshot wounds (GSW). Thirty-one patients were male, and the mean age was 33 years (range, 7-74). These patients presented with an average Injury Severity Score (ISS) of 22 +/- 12 and an average Glasgow Coma Score of 14 +/- 2. Overall length of stay was 39 +/- 59 days (range, 0-351 days). These 33 patients underwent a total of 57 laparotomies with an average of 1.7 operations per patient (range, 1 to 5 operations). Eighty-four per cent of the patients had an associated gastrointestinal injury and 45 per cent had a major vascular injury. Thirteen of the 33 (39%) patients presented in extremis, all 13 underwent an abbreviated laparotomy. The complication rate was 36 per cent, including fistula, abscess, pancreatitis, and organ dysfunction. There were 6 hospital deaths for a mortality rate of 18 per cent. Pancreatoduodenal injuries are associated with a variety of other serious injuries, which add to the overall complexity of these patients. Abbreviated laparotomy may be helpful when managing combined pancreatoduodenal injuries in patients who are in extremis.

Vitamin A status and nutritional intake of carotenoids of preschool children in Ijaye Orile community in Nigeria.

PubMed

Oso, O O; Abiodun, P O; Omotade, O O; Oyewole, D

2003-02-01

This study was carried out to determine the vitamin A status and nutritional intake of carotenoids of 213 children between the ages of 6 months and 6 years in a rural community in Nigeria. There were 109 males and 104 females. A total of 57 (26.8 per cent) children were deficient in serum retinol levels (< 10 microg/dl) while 102 (47.9 per cent) had low levels (10-19 microg/dl). The highest prevalence of serum retinol deficiency was in the 6-12 months age group, most of whom were breastfeeding and there was poor correlation between duration of breastfeeding and serum retinol levels. The prevalence of night-blindness was 1.5 per cent; however, none of the children had xerophthalmia. Chronically malnourished children had lower mean serum retinol levels than well nourished children. There was a high consumption of carotenoid-containing food, but despite this there was a high prevalence of vitamin A deficiency. We therefore suggest that measures to combat vitamin A deficiency should include vitamin A supplementation on a short-term basis. On a long-term basis parents should be educated on the importance of the consumption of locally available sources of provitamin A and pre-formed vitamin A rich foods, and the avoidance of overcooking. Parents should also be encouraged to grow more beta-carotene containing foods.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brent, R.L.

Many professionals are unfamiliar with radiation biology or the quantitative nature of the risks. Frequently, microwave, ultrasound, and ionizing radiation risks are confused. Although it is impossible to prove no risk for any environmental hazard, it appears that exposure to microwave radiation below the maximal permissible levels present no measurable risk to the embryo. Ultrasound exposure from diagnostic ultrasonographic imaging equipment also is quite innocuous. It is true that continued surveillance and research into potential risks of these low-level exposures should continue, but at present ultrasound not only improves obstetric care but also reduces the necessity of diagnostic x-ray procedures.more » In the field of ionizing radiation, we have as good a comprehension of the biologic effects and the quantitative maximum risks as of any other environmental hazard. Although the animal and human data support the conclusion that no increases in the incidence of gross congenital malformations, intrauterine growth retardation, or abortion will occur with exposures less than 5 rad, that does not mean that there are definitely no risks to the embryo exposed to lower doses of radiation. Whether there exists a linear or exponential dose-response relationship or a threshold exposure for genetic, carcinogenic, cell-depleting, and life-shortening effects has not been determined. In establishing maximum permissible levels for the embryo at low exposures, refer to Tables 4, 5, 6, 8, and 9. It is obvious that the risks of 1-rad or 5-rad acute exposure are far below the spontaneous risks of the developing embryo because 15 per cent of human embryos abort, 2.7 to 3.0 per cent of human embryos have major malformations, 4 per cent have intrauterine growth retardation, and 8 to 10 per cent have early- or late-onset genetic disease. 98 references.« less

Research in higher surgical training--the West Midlands view.

PubMed

Kmiot, W A; Neoptolemos, J P; Temple, J G

1993-09-01

A questionnaire on the role of research in higher surgical training was posted to all in-post NHS Consultants (n = 96) and Higher Surgical Trainees (n = 42) in the West Midlands Region. Replies were received from 80 consultants (83 per cent) and 37 trainees (88 per cent). Over 95 per cent of responders had undertaken some research activity previously. The vast majority of consultants (90 per cent) and trainees (95 per cent) thought that their research period had been beneficial; most would undertake research again even if not essential for higher surgical training (consultants 80 per cent, trainees 70 per cent). Research was felt to be essential for all trainees by 50 per cent of respondents in both groups; 78 per cent of consultants and 86 per cent of trainees also thought that all potential academics should obtain a degree by thesis. Most of the study participants thought that the appropriate time for research activity was as a post-FRCS registrar (consultants 72 per cent, trainees 80 per cent); 80 per cent of consultants and 67 per cent of trainees felt that this research period should be funded by the NHS. A planned, supervised and funded one-year period of research was favoured by the majority of consultants (54 per cent) and trainees (73 per cent) for non-academic general surgical trainees in the future.

The X-Shooter Lens Survey - I. Dark matter domination and a Salpeter-type initial mass function in a massive early-type galaxy

NASA Astrophysics Data System (ADS)

Spiniello, C.; Koopmans, L. V. E.; Trager, S. C.; Czoske, O.; Treu, T.

2011-11-01

We present the first results from the X-Shooter Lens Survey: an analysis of the massive early-type galaxy SDSS J1148+1930 at redshift z= 0.444. We combine its extended kinematic profile - derived from spectra obtained with X-Shooter on the European Southern Observatory Very Large Telescope - with strong gravitational lensing and multicolour information derived from Sloan Digital Sky Survey (SDSS) images. Our main results are as follows. (i) The luminosity-weighted stellar velocity dispersion is <σ*>(≲Reff) = 352 ± 10 ± 16 km s-1, extracted from a rectangular aperture of 1.8 × 1.6 arcsec2 centred on the galaxy, more accurate and considerably lower than a previously published value of ˜450 km s-1. (ii) A single-component (stellar plus dark) mass model of the lens galaxy yields a logarithmic total-density slope of γ'= 1.72+0.05- 0.06 (68 per cent confidence level, CL; ?) within a projected radius of ˜2.16 arcsec. (iii) The projected stellar mass fraction, derived solely from the lensing and dynamical data, is f*(90 per cent CL and in some cases violate the total lensing-derived mass limit. We conclude that this very massive early-type galaxy is dark-matter-dominated inside one effective radius, consistent with the trend recently found from massive Sloan Lens ACS (SLACS) galaxies, with a total density slope shallower than isothermal and an IMF normalization consistent with Salpeter.

Reduction on NOx emissions on urban areas by changing specific vehicle fleets: effects on NO2 and O3 concentration

NASA Astrophysics Data System (ADS)

Goncalves, M.; Jimenez, P.; Baldasano, J.

2007-12-01

The largest amount of NOx emissions in urban areas comes from on-road traffic, which is the largest contributor to urban air pollution (Colvile et al., 2001). Currently different strategies are being tested in order to reduce its effects; many of them oriented to the reduction of the unitary vehicles emissions, by alternative fuels use (such as biofuels, natural gas or hydrogen) or introduction of new technologies (such as hybrid electric vehicles or fuel cells). Atmospheric modelling permits to predict their consequences on tropospheric chemistry (Vautard et al., 2007). Hence, this work assesses the changes on NO2 and O3 concentrations when substituting a 10 per cent of the urban private cars fleets by petrol hybrid electric cars (HEC) or by natural gas cars (NGC) in Madrid and Barcelona urban areas (Spain). These two cities are selected in order to highlight the different patterns of pollutants transport (inland vs. coastal city) and the different responses to emissions reductions. The results focus on a typical summertime episode of air pollution, by means of the Eulerian air quality model ARW- WRF/HERMES/CMAQ, applied with high resolution (1-hr, 1km2) since of the complexity of both areas under study. The detailed emissions scenarios are implemented in the HERMES traffic emissions module, based on the Copert III-EEA/EMEP-CORINAIR (Nztiachristos and Samaras, 2000) methodology. The HEC introduction reduces NOx emissions from on-road traffic in a 10.8 per cent and 8.2 per cent; and the NGC introduction in a 10.3 per cent and 7.8 per cent, for Madrid and Barcelona areas, respectively. The scenarios also affect the NMVOCs reduction (ranging from -3.1 to -6.9 per cent), influencing the tropospheric photochemistry through the NOx/NMVOCs ratio. The abatement of the NO photooxidation but also to the reduction on primary NO2 involves a decrease on NO2 levels centred on urban areas. For example, the NO2 24-hr average concentration in downtown areas reduces up to 8 per cent (-6 μg m-3 on average). The urban areas are VOC-controlled, therefore the reduction on NOx emissions involves a minor increase on tropospheric O3 concentration (Jiménez and Baldasano, 2004), up to 1.5 per cent at some points. Nevertheless, the O3 precursors reduction has positive effects in the downwind areas affected by the urban plume, slightly reducing the O3 levels, but at the regional scale the reduction applied on urban traffic emissions has negligible effects. Both scenarios tested are very similar in terms of emissions reductions and air quality changes, which means that the NOx/NMVOCs ratio do not involve an O3-sensitivity regime variation among scenarios. The HEC scenario is more effective in reducing NO2 levels in urban areas than the NGC scenario (with maximum reductions affecting a larger area) and involves a larger increase in urban O3 concentration.

Inefficiency, heterogeneity and spillover effects in maternal care in India: a spatial stochastic frontier analysis.

PubMed

Kinfu, Yohannes; Sawhney, Monika

2015-03-25

Institutional delivery is one of the key and proven strategies to reduce maternal deaths. Since the 1990s, the government of India has made substantial investment on maternal care to reduce the huge burden of maternal deaths in the country. However, despite the effort access to institutional delivery in India remains below the global average. In addition, even in places where health investments have been comparable, inter- and intra-state difference in access to maternal care services remain wide and substantial. This raises a fundamental question on whether the sub-national units themselves differ in terms of the efficiency with which they use available resources, and if so, why? Data obtained from round 3 of the country's District Level Health and Facility Survey was analyzed to measure the level and determinants of inefficiency of institutional delivery in the country. Analysis was conducted using spatial stochastic frontier models that correct for heterogeneity and spatial interactions between sub-national units. Inefficiency differences in maternal care services between and within states are substantial. The top one third of districts in the country has a mean efficiency score of 90 per cent or more, while the bottom 10 per cent of districts exhibit mean inefficiency score of as high as over 75 per cent or more. Overall mean inefficiency is about 30 per cent. The result also reveals the existence of both heterogeneity and spatial correlation in institutional delivery in the country. Given the high level of inefficiency in the system, further progress in improving coverage of institutional delivery in the country should focus both on improving the efficiency of resource utilization--especially where inefficiency levels are extremely high--and on bringing new resources in to the system. The additional investment should specifically focus on those parts of the country where coverage rates are still low but efficiency levels are already at a high level. In addition, given that inefficiency was also associated inversely with literacy and urbanization and positively related with proportion of households belonging to poor households, investment in these areas can also improve coverage of institutional delivery in the country.

The initial masses of the red supergiant progenitors to Type II supernovae

NASA Astrophysics Data System (ADS)

Davies, Ben; Beasor, Emma R.

2018-02-01

There are a growing number of nearby supernovae (SNe) for which the progenitor star is detected in archival pre-explosion imaging. From these images it is possible to measure the progenitor's brightness a few years before explosion, and ultimately estimate its initial mass. Previous work has shown that II-P and II-L SNe have red supergiant (RSG) progenitors, and that the range of initial masses for these progenitors seems to be limited to ≲ 17 M⊙. This is in contrast with the cut-off of 25-30 M⊙ predicted by evolutionary models, a result that is termed the `red supergiant problem'. Here we investigate one particular source of systematic error present in converting pre-explosion photometry into an initial mass, which of the bolometric correction (BC) used to convert a single-band flux into a bolometric luminosity. We show, using star clusters, that RSGs evolve to later spectral types as they approach SN, which in turn causes the BC to become larger. Failure to account for this results in a systematic underestimate of a star's luminosity, and hence its initial mass. Using our empirically motivated BCs we reappraise the II-P and II-L SNe that have their progenitors detected in pre-explosion imaging. Fitting an initial mass function to these updated masses results in an increased upper mass cut-off of Mhi = 19.0^{+2.5}_{-1.3} M⊙, with a 95 per cent upper confidence limit of <27 M⊙. Accounting for finite sample size effects and systematic uncertainties in the mass-luminosity relationship raises the cut-off to Mhi = 25 M⊙ (<33 M⊙, 95 per cent confidence). We therefore conclude that there is currently no strong evidence for `missing' high-mass progenitors to core-collapse SNe.

Trampoline-related injuries.

PubMed

Larson, B J; Davis, J W

1995-08-01

Two hundred and seventeen patients who had sustained an injury during the recreational use of a trampoline were managed in the emergency room of Logan Regional Hospital in Logan, Utah, from January 1991 through December 1992. We retrospectively reviewed the charts and radiographs of these patients to categorize the injuries. Additional details regarding the injuries of seventy-two patients (33 per cent) were obtained by means of a telephone interview with use of a questionnaire. The injuries occurred from February through November, with the peak incidence in July. The patients were eighteen months to forty-five years old (average, ten years old); ninety-four patients (43 per cent) were five to nine years old. Eighty-four patients (39 per cent) sustained a fracture; fifty-four (25 per cent), a sprain or strain; forty-five (21 per cent), a laceration; and thirty-four (16 per cent), a contusion. Fifty-seven injuries (26 per cent) involved the elbow or forearm; forty-six (21 per cent), the head or neck; forty (18 per cent), the ankle or foot; thirty-three (15 per cent), the knee or leg; nineteen (9 per cent), the trunk or back; thirteen (6 per cent), the shoulder or arm; and nine (4 per cent), the wrist or hand. Thirteen patients (6 per cent) had a back injury, but none of them had a permanent neurological deficit. One patient who had an ocular injury was transferred to a tertiary care center. One hundred and fifty-six patients (72 per cent) were evaluated radiographically, fifteen (7 per cent) were admitted to the hospital, and thirteen (6 per cent) had an operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacokinetics of insulin following intravenous and subcutaneous administration in canines.

PubMed

Ravis, W R; Comerci, C; Ganjam, V K

1986-01-01

Studies were conducted to examine the absorption and disposition kinetics of insulin in dogs following intravenous (IV) and subcutaneous (SC) administration of commercial preparations. After IV and SC dosing, the plasma levels were described by models which considered basal insulin level contributions. Intersubject variation in the disposition kinetics was small with half-lives of 0.52 +/- 0.05 h and total body clearances of 16.21 +/- 2.08 ml min-1 kg-1. Calculated insulin plasma secretion rates in the canines were 14.4 +/- 3.3 mUh-1 kg-1. Following SC injection of regular insulin, the rate and extent of absorption were noted to be quite variable. The absorption process appeared first-order with half-life values of 2.3 +/- 1.3 h and extents of absorption of 78 +/- 15 per cent with a range of 55-101 per cent. Insulin absorption from SC NPH preparations was evaluated as being composed of two zero-order release phases, a rapid and a slow release phase. With a dose of 1.65 U kg-1, the rapid release phase had an average duration of 1.5 h and a rate of 580 +/- 269 mUh-1 (4.2 per cent of dose) while the slow phase had a zero-order rate of 237 +/- 92 mU h-1 which continued beyond 12 h. The extent of absorption from the NPH preparation was 23.6 +/- 5.1 per cent and was significantly lower than that for the regular injection.

On the Path to SunShot. The Environmental and Public Health Benefits of Achieving High Solar Penetrations in the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiser, Ryan; Mai, Trieu; Millstein, Dev

Compared with fossil fuel generators, photovoltaics (PV) and concentrating solar power (CSP) produce far lower lifecycle levels of greenhouse gas (GHG) emissions and harmful pollutants including fine particular matter (PM2.5), sulfur dioxide (SO 2), and nitrogen oxides (NO x). In this report, we monetize the emission reductions from achieving the U.S. Department of Energy's SunShot deployment goals: 14% of U.S. electricity demand met by solar in 2030 and 27% in 2050. We estimate that achieving these goals could reduce cumulative power-sector GHG emissions by 10% between 2015 and 2050, resulting in savings of $238-$252 billion. This is equivalent to 2.0-2.2more » cents per kilowatt-hour of solar installed (cents/kWh-solar). Similarly, realizing these levels of solar deployment could reduce cumulative power-sector emissions of PM2.5 by 8%, SO 2 by 9%, and NOx by 11% between 2015 and 2050. This could produce $167 billion in savings from lower future health and environmental damages, or 1.4 cents/kWh-solar--while also preventing 25,000-59,000 premature deaths. To put this in perspective, this estimated combined benefit of 3.5 cents/kWh-solar due to SunShot-level solar deployment is approximately equal to the additional levelized cost of electricity reduction needed to make unsubsidized utility-scale solar competitive with conventional generators today. In addition, the analysis shows that achieving the SunShot goals could save 4% of total power-sector water withdrawals and 9% of total power-sector water consumption over the 2015-2050 period--a particularly important consideration for arid states where substantial solar will be deployed. These results have potential implications for policy innovation and the economic competitiveness of solar and other generation technologies.« less

An Evaluation of Parastomal Hernia Repair Using the Americas Hernia Society Quality Collaborative.

PubMed

Fox, Sarah S; Janczyk, Randy; Warren, Jeremy A; Carbonell, Alfredo M; Poulose, Benjamin K; Rosen, Michael J; Hope, William W

2017-08-01

The purpose of this review was to evaluate outcomes relating to parastomal hernia repair. Data from the Americas Hernia Society Quality Collaborative were used to identify patients undergoing parastomal hernia repair from 2013 to 2016. Parastomal hernia repairs were compared with other repairs using Pearson's test and Wilcoxon test with a P value <0.05 considered significant. Parastomal hernia repairs were performed in 311 patients. Techniques of repair include open in 85 per cent and laparoscopic in 15 per cent. Mesh was used in 92 per cent with keyhole in 34 per cent, flat mesh in 33 per cent, and Sugarbaker in 25 per cent. Mesh types were permanent synthetic in 79 per cent, biologic in 13 per cent, absorbable synthetic in 6 per cent, and hybrid synthetic/biologic in 2 per cent. Most common location for mesh was sublay in 84 per cent followed by onlay in 14 per cent and inlay in 2 per cent with 59 per cent of patients undergoing a myofascial release. Ostomy disposition included ostomy left in situ (47%), moved to a new site (18%), taken down (22%), and rematured in same location in (13%). Outcomes related to parastomal hernia repair included 10 per cent surgical site infection, 24 per cent surgical site occurrence, and 12 per cent surgical site occurrences requiring procedural interventions with a 13 per cent readmission rate and 6 per cent reoperation rate. When comparing parastomal hernias with other ventral hernia repairs, parastomal hernias had a significantly higher surgical site infection, surgical site occurrence, surgical site occurrences requiring procedural intervention, readmission, reoperation rate, and length of stay, and were less commonly performed laparoscopically (P < 0.05). Most parastomal hernias are being repaired open with synthetic mesh in the sublay position. Less favorable outcomes of parastomal hernia repair when compared with other ventral hernia repairs are likely related to the complexity of parastomal hernia repair.

ALFABURST: a commensal search for fast radio bursts with Arecibo

NASA Astrophysics Data System (ADS)

Foster, Griffin; Karastergiou, Aris; Golpayegani, Golnoosh; Surnis, Mayuresh; Lorimer, Duncan R.; Chennamangalam, Jayanth; McLaughlin, Maura; Armour, Wes; Cobb, Jeff; MacMahon, David H. E.; Pei, Xin; Rajwade, Kaustubh; Siemion, Andrew P. V.; Werthimer, Dan; Williams, Chris J.

2018-03-01

ALFABURST has been searching for fast radio bursts (FRBs) commensally with other projects using the Arecibo L-band Feed Array receiver at the Arecibo Observatory since 2015 July. We describe the observing system and report on the non-detection of any FRBs from that time until 2017 August for a total observing time of 518 h. With current FRB rate models, along with measurements of telescope sensitivity and beam size, we estimate that this survey probed redshifts out to about 3.4 with an effective survey volume of around 600 000 Mpc3. Based on this, we would expect, at the 99 per cent confidence level, to see at most two FRBs. We discuss the implications of this non-detection in the context of results from other telescopes and the limitation of our search pipeline. During the survey, single pulses from 17 known pulsars were detected. We also report the discovery of a Galactic radio transient with a pulse width of 3 ms and dispersion measure of 281 pc cm-3, which was detected while the telescope was slewing between fields.

Probing the stellar initial mass function with high-z supernovae

NASA Astrophysics Data System (ADS)

de Souza, R. S.; Ishida, E. E. O.; Whalen, D. J.; Johnson, J. L.; Ferrara, A.

2014-08-01

The first supernovae (SNe) will soon be visible at the edge of the observable universe, revealing the birthplaces of Population III stars. With upcoming near-infrared missions, a broad analysis of the detectability of high-z SNe is paramount. We combine cosmological and radiation transport simulations, instrument specifications and survey strategies to create synthetic observations of primeval core-collapse (CC), Type IIn and pair-instability (PI) SNe with the James Webb Space Telescope (JWST). We show that a dedicated observational campaign with the JWST can detect up to ˜15 PI explosions, ˜300 CC SNe, but less than one Type IIn explosion per year, depending on the Population III star formation history. Our synthetic survey also shows that ≈1-2 × 102 SNe detections, depending on the accuracy of the classification, are sufficient to discriminate between a Salpeter and flat mass distribution for high-redshift stars with a confidence level greater than 99.5 per cent. We discuss how the purity of the sample affects our results and how supervised learning methods may help to discriminate between CC and PI SNe.

Evaluation of previously embolized intracranial aneurysms: inter-and intra-rater reliability among neurosurgeons and interventional neuroradiologists.

PubMed

Zuckerman, Scott L; Lakomkin, Nikita; Magarik, Jordan A; Vargas, Jan; Stephens, Marcus; Akinpelu, Babatunde; Spiotta, Alejandro M; Ahmed, Azam; Arthur, Adam S; Fiorella, David; Hanel, Ricardo; Hirsch, Joshua A; Hui, Ferdinand K; James, Robert F; Kallmes, David F; Meyers, Philip M; Niemann, David B; Rasmussen, Peter; Turner, Raymond D; Welch, Babu G; Mocco, J

2018-05-01

The angiographic evaluation of previously coiled aneurysms can be difficult yet remains critical for determining re-treatment. The main objective of this study was to determine the inter-rater reliability for both the Raymond Scale and per cent embolization among a group of neurointerventionalists evaluating previously embolized aneurysms. A panel of 15 neurointerventionalists examined 92 distinct cases of immediate post-coil embolization and 1 year post-embolization angiographs. Each case was presented four times throughout the study, along with alterations in demographics in order to evaluate intra-rater reliability. All respondents were asked to provide the per cent embolization (0-100%) and Raymond Scale grade (1-3) for each aneurysm. Inter-rater reliability was evaluated by computing weighted kappa values (for the Raymond Scale) and intraclass correlation coefficients (ICC) for per cent embolization. 10 neurosurgeons and 5 interventional neuroradiologists evaluated 368 simulated cases. The agreement among all readers employing the Raymond Scale was fair (κ=0.35) while concordance in per cent embolization was good (ICC=0.64). Clinicians with fewer than 10 years of experience demonstrated a significantly greater level of agreement than the group with greater than 10 years (κ=0.39 and ICC=0.70 vs κ=0.28 and ICC=0.58). When the same aneurysm was presented multiple times, clinicians demonstrated excellent consistency when assessing per cent embolization (ICC=0.82), but moderate agreement when employing the Raymond classification (κ=0.58). Identifying the per cent embolization in previously coiled aneurysms resulted in good inter- and intra-rater agreement, regardless of years of experience. The strong agreement among providers employing per cent embolization may make it a valuable tool for embolization assessment in this patient population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A new strong-lensing galaxy at z=0.066: Another elliptical galaxy with a lightweight IMF

NASA Astrophysics Data System (ADS)

Collier, William P.; Smith, Russell J.; Lucey, John R.

2018-05-01

We report the discovery of a new low-redshift galaxy-scale gravitational lens, identified from a systematic search of publicly available MUSE observations. The lens galaxy, 2MASXJ04035024-0239275, is a giant elliptical at z = 0.06604 with a velocity dispersion of σ = 314 km s-1. The lensed source has a redshift of 0.19165 and forms a pair of bright images on either side of the lens centre. The Einstein radius is 1.5 arcsec, projecting to 1.8 kpc, which is just one quarter of the galaxy effective radius. After correcting for an estimated 19 per cent dark matter contribution, we find that the stellar mass-to-light ratio from lensing is consistent with that expected for a Milky Way initial mass function (IMF). Combining the new system with three previously-studied low-redshift lenses of similar σ, the derived mean mass excess factor (relative to a Kroupa IMF) is ⟨α⟩ = 1.09±0.08. With all four systems, the intrinsic scatter in α for massive elliptical galaxies can be limited to <0.32, at 90 per cent confidence.

Surgical treatment for women with breast cancer: do randomized clinical trials represent current medical practices?

PubMed

Frederick, Wayne A I; Ames, Sarah; Downing, Stephanie R; Oyetunji, Tolulope A; Chang, David C; Leffall, Lasalle D

2010-06-01

Randomized clinical trials have not shown survival differences between breast cancer patients who undergo breast-conserving surgery and those who undergo modified radical mastectomy (MRM). Recent studies however, have suggested that these randomized clinical trials findings may not be representative of the entire population or the nature of current patient care. A retrospective analysis of female invasive breast cancer patients who underwent surgery in the Surveillance, Epidemiology, and End Results database (1990-2003) was performed. Survival was compared amongst women who underwent partial mastectomy, partial mastectomy plus radiation (PMR), or MRM. Cox proportional hazards regressions were used to investigate the impact of method of treatment upon survival, after adjusting for patient and tumor characteristics. A total of 218,043 patients, mean age 62 years, were identified. MRM accounted for 51.5 per cent of the study population whereas PMR accounted for 34.9 per cent. On multivariate analyses, significant improvement was observed in patient survival associated with PMR when compared with MRM patients (hazard ratio = 0.71, 95% confidence interval = 0.67-0.74, P < 0.001). This population-based study suggests that there is a survival benefit for women undergoing PMR in the treatment of breast cancer.

Impact of a five-day short course on integration of health promotion into practice in north Queensland.

PubMed

Devine, Susan G; Llewellyn-Jones, Lorraine; Lloyd, Jacqui

2009-04-01

Workforce development is one element of health promotion capacity building. This paper describes the extent to which participants in a five-day short course in health promotion, delivered three times in north Queensland during 2007, reported greater adoption of health promotion within their work roles, and the factors that affected the level of adoption. Out of 54 course attendees, 39 completed a post-course survey five to nine months after completing the course (72% response rate). Additionally, 11 course attendees participated in a focus group or phone interview to explore survey findings. The courses succeeded in providing knowledge, skills, confidence and enthusiasm to undertake health promotion work. Eighty per cent of participants stated they had incorporated health promotion into their work frequently or all of the time since undertaking the course. Lack of understanding of health promotion from co-workers and managers, lack of organisational support and commitment, lack of resources, competing clinical priorities, and lack of time were cited as the main barriers for undertaking health promotion. The course met participant training needs. However, similar training across all levels of staff including management may help to develop organisational capacity, thereby building a more knowledgeable workforce that is supported to undertake health promotion as a core part of an organisation's business.

Excise tax differences at Oklahoma smoke shops: an opportunity for inter-tribal coordination.

PubMed

Laux, Fritz L; Chaloupka, Frank J; Beebe, Laura A

2015-01-01

Oklahoma's tribal tobacco shops are distributed throughout the state, including in urban areas. During the time frame of this study, state excise tax rates for cigarettes varied by tribe and region, and took five distinct levels, ranging from 5.75 cents to $1.03 per pack. To describe the pricing behavior of these smoke shops in a way that could support potential increases in the tribal taxation of cigarettes within the state. Two waves (2010 and 2011) of site visits were conducted, covering nearly all tribal smoke shops in the northeastern quarter of the state, an area containing the city of Tulsa and 60% of all tribal outlets. Researchers recorded representative prices and verified the tax rate paid (via tax stamp) for each shop. Data were analyzed in 2013. Lower-taxed tribal cigarettes tended to be priced at discounts that were even greater than the differential in tax rates. For example, across waves, the average pack of Marlboros from a shop with a 5.75-cent tax stamp sold for 52 cents less than the same pack from a 25.75-cent shop and 60 cents less than from a 51.5-cent shop. The minimal inter-tribal price response to the discontinuation of large quantities of contraband cigarette sales suggests that inter-tribal price competition in the Tulsa area is not as intense as expected. Ample scope exists for either unilateral or coordinated cross-tribal tax and price increases that will increase tribal cigarette tax revenue collections and improve public health. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Alterations in left ventricular volumes induced by Valsalva manoeuvre

NASA Technical Reports Server (NTRS)

Brooker, J. Z.; Alderman, E. L.; Harrison, D. C.

1974-01-01

Five patients were studied with left ventriculography during different phases of the Valsalva manoeuvre. Small doses of contrast medium allowed adequate repetitive visualization of the left ventricle for volume calculation. During strain phase, the volume of the left ventricle decreased by nearly 50 per cent in each case, and stroke volume and cardiac output also dropped strikingly. Release of straining was attended by a sharp rebound of left ventricular volume to control levels, with a transient surge of increased cardiac output 42 per cent above that of the resting state.

The fracture criticality of crustal rocks

NASA Astrophysics Data System (ADS)

Crampin, Stuart

1994-08-01

The shear-wave splitting observed along almost all shear-wave ray paths in the Earth's crust is interpreted as the effects of stress-aligned fluid-filled cracks, microcracks, and preferentially oriented pore space. Once away from the free surface, where open joints and fractures may lead to strong anisotropy of 10 per cent or greater, intact ostensibly unfractured crustal rock exhibits a limited range of shear-wave splitting from about 1.5 to 4.5 per cent differential shear-wave velocity anisotropy. Interpreting this velocity anisotropy as normalized crack densities, a factor of less than two in crack radius covers the range from the minimum 1.5 per cent anisotropy observed in intact rock to the 10 per cent observed in heavily cracked almost disaggregated near-surface rocks. This narrow range of crack dimensions and the pronounced effect on rock cohesion suggests that there is a state of fracture criticality at some level of anisotropy between 4.5 and 10 per cent marking the boundary between essentially intact, and heavily fractured rock. When the level of fracture criticality is exceeded, cracking is so severe that there is a breakdown in shear strength, the likelihood of progressive fracturing and the dispersal of pore fluids through enhanced permeability. The range of normalized crack dimensions below fracture criticality is so small in intact rock, that any modification to the crack geometry by even minor changes of conditions or minor deformation (particularly in the presence of high pore-fluid pressures) may change rock from being essentially intact (below fracture criticality) to heavily fractured (above fracture criticality). This recognition of the essential compliance of most crustal rocks, and its effect on shear-wave splitting, has implications for monitoring changes in any conditions affecting the rock mass. These include monitoring changes in reservoir evolution during hydrocarbon production and enhanced oil recovery, and in monitoring changes before and after earthquakes, amongst others.

Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India.

PubMed

Muniyandi, M; Rao, V G; Bhat, J; Yadav, R; Sharma, R K; Bhondeley, M K

2015-05-01

Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged <45 yr. Living condition was very poor (62% living in huts/katcha houses, 84 per cent with single room, 89 per cent no separate kitchen, 97 per cent used wood/crop as a fuel). Overall literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was <40 per cent among 36 per cent of respondents, 41-60 per cent among 54 per cent and >60 per cent among 8 per cent of respondents. The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control.

A cross-sectional survey of optometrists and optometric practices in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Ntodie, Michael; Mashige, Khathutshelo Percy; Owusu-Ansah, Andrew; Antwi Osei, Kwaku

2015-09-01

The study was conducted to profile optometrists and optometric practices in Ghana. An online survey was conducted among 146 optometrists, who were registered with the Ghana Optometric Association (GOA). It included questions on their demographics, equipment, ophthalmic procedures routinely conducted and the barriers to providing a full scope of optometric services. Ninety registered optometrists (62 per cent) responded, their mean age being 28.97 ± 3.36 years. There were more males (68.9 per cent) than females and most had the Doctor of Optometry (OD) degree, the profession's highest degree in Ghana. There were more practitioners in urban centres (71.1 per cent) and most practices had basic optometric instruments, such as direct ophthalmoscopes, slitlamp biomicroscopes and retinoscopes. Many optometrists routinely conducted direct ophthalmoscopy (100 per cent), slitlamp biomicroscopy (87.5 per cent) and contact tonometry (55.7 per cent); however, few provided contact lens (10.2 per cent) and low vision (9.1 per cent) assessments, with 76 per cent stating that it was due to the unavailability of low vision devices, poor sources of contact lenses (27 per cent) and perceived insufficient training (11.2 per cent). Many practitioners (97 per cent) reported the use of diagnostic pharmaceutical agents and therapeutic pharmaceutical agents (96.6 per cent). Most practitioners (52.9 per cent) preferred conferences for the delivery of continuous professional development over publications (26.4 per cent) and internet resources (12.6 per cent). The data elicited in this study provide a basis for addressing the country's unmet eye-care needs and can be used to determine training and support guidelines for the profession. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

[Perception of common symptomatology during pregnancy, puerperium and lactation].

PubMed

Salinas Martínez, A M; Martínez Sánchez, C; Pérez Segura, J

1991-01-01

The objective of this investigation was to identify women's perception on normal and abnormal symptoms of pregnancy, puerperium and breastfeeding; its purpose was to assess the varying educational needs in the geographical area where a reproductive health education program will be implemented. 405 fertile females living in non-residential areas were interviewed in their homes. A predominantly pre-coded questionnaire was used; items related to reproductive health, preventable and susceptible to education were included. Symptomatology perceived incorrectly as normal: a) In pregnancy: Dysuria: 24 percent, genital hemorrhage: 15 per cent, absence of fetal movement: 23 per cent, did not know how to recognize preterm birth symptoms: 70 per cent. b) In puerperium: Increased quantity in lochia rubra: 17 per cent, fever: 22 per cent, fetid lochia: 28 per cent, and c) In breastfeeding: Breasts red and warm: 48 per cent, fever: 30 per cent, nipple fissures: 70 per cent. Symptomatology perceived incorrectly as abnormal: a) In pregnancy: Frequent urination: 17 per cent, morning nausea in the 1st trimester: 9 per cent, emotional instability: 21 per cent, Braxton Hicks contractions: 41 per cent, and b) Postpartum period: Decreased quantity in lochia rubra: 9 per cent, non-fetid lochia alba: 43 per cent, calostrum: 20 per cent. The assessment educational needs showed an inaccurate identification of abnormal and normal obstetric events; its frequency varied. It is essential that a pregnant woman be well informed and educated in order to preserve her own health as well as that of her unborn child. She must be able to recognize warning signs, take action and demand appropriate medical care. Health care personnel and health educators must be responsible for the promoting of maternal and child health during pregnancy.

Serum magnesium levels and cognitive impairment in hospitalized hypertensive patients.

PubMed

Corsonello, A; Pedone, C; Pahor, M; Malara, A; Carosella, L; Mazzei, B; Onder, G; Corsonello, F; Carbonin, P; Corica, F

2001-12-01

We performed this cross-sectional case control study to investigate the association between low serum magnesium levels and cognitive impairment in hypertensive hospitalized patients. The study was carried out in general medical care units at 81 hospitals participating in the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study throughout Italy, and a total of 1058 patients with diagnoses of hypertension at the discharge were studied. The occurrence of cognitive impairment at discharge was the primary outcome of our study. Cognitive impairment was ascertained using the Hodkinson Abbreviated Mental Test (HAMT). Sociodemographic variables, body mass index, laboratory parameters, comorbidity, use of antihypertensive drugs and number of drugs were considered as potential confounders. Twenty-nine percent of the selected hypertensive patients were classified as having cognitive impairment. In univariate analysis, older age, female sex, and low educational level showed a significant trend for association to cognitive impairment. Moreover the proportion of subjects with cognitive impairment decreased with increasing alcohol consumption, and the prevalence of ex smokers and smokers was significantly lower in patients with cognitive impairment. The lower tertiles for serum albumin and creatinine clearance were more frequent among patients with cognitive impairment, and the lower tertile for serum magnesium levels was significantly more frequent in these patients. Number of drugs was slightly lower in cognitively impaired patients, while number of diagnoses and length of hospital stay were higher in these subjects. In the multivariate logistic regression analysis cognitive impairment decreased with increasing education level (highest education: OR 0.11; 95 per cent CI 0.05-0.25). The lower tertile for serum albumin (< 3.5 g/dl) was significantly associated to cognitive impairment (OR 2.14; 95 per cent CI 1.31-3.49), as well as the lower tertiles for serum magnesium (0.74-0.86 mmol/L: OR 1.54; 95 per cent CI 1.06-2.22; < 0.74 mmol/L: OR 1.75; 95 per cent CI 1.13-2.72]. Our results demonstrate the existence of a significant association between magnesium imbalance and cognitive impairment. These data suggest that the assessment of magnesium status may be of some relevance in hypertensive subjects with cognitive disorders.

The retention of pit and fissure sealants placed in primary school children by Dental Health Services, Victoria.

PubMed

Messer, L B; Calache, H; Morgan, M V

1997-08-01

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6-12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross-sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post-placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.

External rhinoplasty: a critical analysis of 500 cases.

PubMed

Foda, Hossam M T

2003-06-01

The study presents a comprehensive statistical analysis of a series of 500 consecutive rhinoplasties of which 380 (76 per cent) were primary and 120 (24 per cent) were secondary cases. All cases were operated upon using the external rhinoplasty technique; simultaneous septal surgery was performed in 350 (70 per cent) of the cases. Deformities of the upper two-thirds of the nose that occurred significantly more in the secondary cases included; dorsal saddling, dorsal irregularities, valve collapse, open roof and pollybeak deformities. In the lower third of the nose; secondary cases showed significantly higher incidences of depressed tip, tip over-rotation, tip asymmetry, retracted columella, and alar notching. Suturing techniques were used significantly more in primary cases, while in secondary cases grafting techniques were used significantly more. The complications encountered intra-operatively included; septal flap tears (2.8 per cent) and alar cartilage injury (1.8 per cent), while post-operative complications included; nasal trauma (one per cent), epistaxis (two per cent), infection (2.4 per cent), prolonged oedema (17 per cent), and nasal obstruction (0.8 per cent). The overall patient satisfaction rate was 95.6 per cent and the transcolumellar scar was found to be unacceptable in only 0.8 per cent of the patients.

Morphologies of mid-IR variability-selected AGN host galaxies

NASA Astrophysics Data System (ADS)

Polimera, Mugdha; Sarajedini, Vicki; Ashby, Matthew L. N.; Willner, S. P.; Fazio, Giovanni G.

2018-05-01

We use multi-epoch 3.6 and 4.5 μm data from the Spitzer Extended Deep Survey (SEDS) to probe the AGN population among galaxies to redshifts ˜3 via their mid-IR variability. About 1 per cent of all galaxies in our survey contain varying nuclei, 80 per cent of which are likely to be AGN. Twenty-three per cent of mid-IR variables are also X-ray sources. The mid-IR variables have a slightly greater fraction of weakly disturbed morphologies compared to a control sample of normal galaxies. The increased fraction of weakly distorted hosts becomes more significant when we remove the X-ray emitting AGN, while the frequency of strongly disturbed hosts remains similar to the control galaxy sample. These results suggest that mid-IR variability identifies a unique population of obscured, Compton-thick AGN revealing elevated levels of weak distortion among their host galaxies.

Power processing for electric propulsion

NASA Technical Reports Server (NTRS)

Finke, R. C.; Herron, B. G.; Gant, G. D.

1975-01-01

The potential of achieving up to 30 per cent more spacecraft payload or 50 per cent more useful operating life by the use of electric propulsion in place of conventional cold gas or hydrazine systems in science, communications, and earth applications spacecraft is a compelling reason to consider the inclusion of electric thruster systems in new spacecraft design. The propulsion requirements of such spacecraft dictate a wide range of thruster power levels and operational lifetimes, which must be matched by lightweight, efficient, and reliable thruster power processing systems. This paper will present electron bombardment ion thruster requirements; review the performance characteristics of present power processing systems; discuss design philosophies and alternatives in areas such as inverter type, arc protection, and control methods; and project future performance potentials for meeting goals in the areas of power processor weight (10 kg/kW), efficiency (approaching 92 per cent), reliability (0.96 for 15,000 hr), and thermal control capability (0.3 to 5 AU).

Galaxy And Mass Assembly: automatic morphological classification of galaxies using statistical learning

NASA Astrophysics Data System (ADS)

Sreejith, Sreevarsha; Pereverzyev, Sergiy, Jr.; Kelvin, Lee S.; Marleau, Francine R.; Haltmeier, Markus; Ebner, Judith; Bland-Hawthorn, Joss; Driver, Simon P.; Graham, Alister W.; Holwerda, Benne W.; Hopkins, Andrew M.; Liske, Jochen; Loveday, Jon; Moffett, Amanda J.; Pimbblet, Kevin A.; Taylor, Edward N.; Wang, Lingyu; Wright, Angus H.

2018-03-01

We apply four statistical learning methods to a sample of 7941 galaxies (z < 0.06) from the Galaxy And Mass Assembly survey to test the feasibility of using automated algorithms to classify galaxies. Using 10 features measured for each galaxy (sizes, colours, shape parameters, and stellar mass), we apply the techniques of Support Vector Machines, Classification Trees, Classification Trees with Random Forest (CTRF) and Neural Networks, and returning True Prediction Ratios (TPRs) of 75.8 per cent, 69.0 per cent, 76.2 per cent, and 76.0 per cent, respectively. Those occasions whereby all four algorithms agree with each other yet disagree with the visual classification (`unanimous disagreement') serves as a potential indicator of human error in classification, occurring in ˜ 9 per cent of ellipticals, ˜ 9 per cent of little blue spheroids, ˜ 14 per cent of early-type spirals, ˜ 21 per cent of intermediate-type spirals, and ˜ 4 per cent of late-type spirals and irregulars. We observe that the choice of parameters rather than that of algorithms is more crucial in determining classification accuracy. Due to its simplicity in formulation and implementation, we recommend the CTRF algorithm for classifying future galaxy data sets. Adopting the CTRF algorithm, the TPRs of the five galaxy types are : E, 70.1 per cent; LBS, 75.6 per cent; S0-Sa, 63.6 per cent; Sab-Scd, 56.4 per cent, and Sd-Irr, 88.9 per cent. Further, we train a binary classifier using this CTRF algorithm that divides galaxies into spheroid-dominated (E, LBS, and S0-Sa) and disc-dominated (Sab-Scd and Sd-Irr), achieving an overall accuracy of 89.8 per cent. This translates into an accuracy of 84.9 per cent for spheroid-dominated systems and 92.5 per cent for disc-dominated systems.

Skin injuries identified in cattle and water buffaloes at livestock markets in Bangladesh.

PubMed

Alam, M R; Gregory, N G; Jabbar, M A; Uddin, M S; Kibria, A S M G; Silva-Fletcher, A

2010-09-11

Skin injuries were assessed in 560 imported and local cattle and water buffaloes at two livestock markets in Bangladesh. The body of each animal was divided into 11 anatomical regions, and abrasions, lacerations, penetrations, ulcerations, bleeding, swelling, hyperkeratosis and scars were recorded for each region. Among the 560 animals studied, 501 were found to have at least one injury. The prevalence of skin injuries was 89 per cent, with 84 per cent of the cattle and 99 per cent of the water buffaloes having obvious skin injuries. The most common types of injury were abrasions that were found in 73 per cent of the animals, followed by scars (50 per cent), and lacerations (41 per cent). Buffaloes had more abrasions (95 per cent), lacerations (57 per cent), swelling (15 per cent) and hyperkeratosis (32 per cent) compared with cattle, whereas scars (60 per cent) were more common in cattle (P<0.001). Within the 11 different anatomical regions, all types of injuries were present but in different proportions. The buttock region had a higher proportion of abrasions (36 per cent) followed by the hip, hindlimb and back regions. Penetration, ulceration, bleeding and swelling were present at lower frequencies in all regions. Causes for these injuries included rubbing against the inside wall of vehicles used for transportation and stock-handler abuse (59 per cent and 13 per cent, respectively). Buffaloes sustained more transport injuries than cattle, and the number of injuries was higher in imported than local animals.

Comparison of indium-labeled-leukocyte imaging with sequential technetium-gallium scanning in the diagnosis of low-grade musculoskeletal sepsis. A prospective study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Merkel, K.D.; Brown, M.L.; Dewanjee, M.K.

We prospectively compared sequential technetium-gallium imaging with indium-labeled-leukocyte imaging in fifty patients with suspected low-grade musculoskeletal sepsis. Adequate images and follow-up examinations were obtained for forty-two patients. The presence or absence of low-grade sepsis was confirmed by histological and bacteriological examinations of tissue specimens taken at surgery in thirty of the forty-two patients. In these thirty patients, the sensitivity of sequential Tc-Ga imaging was 48 per cent, the specificity was 86 per cent, and the accuracy was 57 per cent, whereas the sensitivity of the indium-labeled-leukocyte technique was 83 per cent, the specificity was 86 per cent, and the accuracymore » was 83 per cent. When the additional twelve patients for whom surgery was deemed unnecessary were considered, the sensitivity of sequential Tc-Ga imaging was 50 per cent, the specificity was 78 per cent, and the accuracy was 62 per cent, as compared with a sensitivity of 83 per cent, a specificity of 94 per cent, and an accuracy of 88 per cent with the indium-labeled-leukocyte method. In patients with a prosthesis the indium-labeled-leukocyte image was 94 per cent accurate, compared with 75 per cent accuracy for sequential Tc-Ga imaging. Statistical analysis of these data demonstrated that the indium-labeled-leukocyte technique was superior to sequential Tc-Ga imaging in detecting areas of low-grade musculoskeletal sepsis.« less

Identification and characterization of functional centromeres of the common bean.

PubMed

Iwata, Aiko; Tek, Ahmet L; Richard, Manon M S; Abernathy, Brian; Fonsêca, Artur; Schmutz, Jeremy; Chen, Nicolas W G; Thareau, Vincent; Magdelenat, Ghislaine; Li, Yupeng; Murata, Minoru; Pedrosa-Harand, Andrea; Geffroy, Valérie; Nagaki, Kiyotaka; Jackson, Scott A

2013-10-01

In higher eukaryotes, centromeres are typically composed of megabase-sized arrays of satellite repeats that evolve rapidly and homogenize within a species' genome. Despite the importance of centromeres, our knowledge is limited to a few model species. We conducted a comprehensive analysis of common bean (Phaseolus vulgaris) centromeric satellite DNA using genomic data, fluorescence in situ hybridization (FISH), immunofluorescence and chromatin immunoprecipitation (ChIP). Two unrelated centromere-specific satellite repeats, CentPv1 and CentPv2, and the common bean centromere-specific histone H3 (PvCENH3) were identified. FISH showed that CentPv1 and CentPv2 are predominantly located at subsets of eight and three centromeres, respectively. Immunofluorescence- and ChIP-based assays demonstrated the functional significance of CentPv1 and CentPv2 at centromeres. Genomic analysis revealed several interesting features of CentPv1 and CentPv2: (i) CentPv1 is organized into an higher-order repeat structure, named Nazca, of 528 bp, whereas CentPv2 is composed of tandemly organized monomers; (ii) CentPv1 and CentPv2 have undergone chromosome-specific homogenization; and (iii) CentPv1 and CentPv2 are not likely to be commingled in the genome. These findings suggest that two distinct sets of centromere sequences have evolved independently within the common bean genome, and provide insight into centromere satellite evolution. © 2013 The Authors The Plant Journal © 2013 John Wiley & Sons Ltd.

Model of cyclist accident characteristics in the city of Malang and Blitar

NASA Astrophysics Data System (ADS)

Arifin, M. Z.; Agustin, I. W.

2018-01-01

Utilization of bicycles as an environmentally friendly mode of transportation is reconcerned as the development of sustainable transportation programs. The use of bicycles in some developed countries such as the Netherlands is 27 per cent of total travel, while for developing countries such as Indonesia, cyclists are less than 1% of total travel with low educated characteristics (65 per cent) and low income (48 per cent). Cyclist reduces dependencies on petroleum and environmental pollution as well as lessen the occurrence of congestion and traffic accidents involving motor vehicles. It was necessary to know the behavior and interaction of bicycle riders with other vehicle users in a heterogeneous traffic flow. The main purpose of the research is to create a model of bicycle accidents to increase the road traffic safety in Malang city and Blitar city. The research used analyses of frequency, the road’s level of service, and multiple linear regression. The results showed that there was a need for a development basis of a special lane for bicycle. It aims to reduce the level and number of cyclist accidents and to achieve transportation safety as well as to raise public awareness in traffic safety.

[Burnout in Dutch medical students: prevalence and causes].

PubMed

Conijn, Maartjie; Boersma, Henri J M V; van Rhenen, Willem

2015-01-01

To investigate the prevalence and causes of burnout in Dutch medical students. Questionnaire survey. All 14,570 student members of the KNMG (Royal Dutch Medical Association) were invited to fill in a digital survey. Burnout was determined with the Utrecht Burnout Scale (UBOS). Triggering and protective factors for burnout were also investigated . 2,739 medical students (18.8%) completed the survey and 14.5 per cent of all respondents met the burnout criteria. 17.8 per cent of the hospital interns who responded and 11.6 per cent of the preclinical students who responded met these criteria. Work-home interference and high levels of emotional pressure had the strongest link to burn-out, while a sufficient amount of support from family, friends and peers reduced the risk of burnout in both undergraduates and hospital interns. Our exploratory research suggests that the prevalence of burnout is high, particularly among the hospital interns who responded. The most important contributory factors are high levels of emotional pressure and work-home interference. The low percentage of respondents makes it difficult to make any statement about the prevalence and causes of burnout among all Dutch medical students.

Nursery nutrition in Liverpool: an exploration of practice and nutritional analysis of food provided.

PubMed

Parker, Mike; Lloyd-Williams, Ffion; Weston, Gemma; Macklin, Julie; McFadden, Kate

2011-10-01

To explore nutrition and food provision in pre-school nurseries in order to develop interventions to promote healthy eating in pre-school settings. Quantitative data were gathered using questionnaires and professional menu analysis. In the community, at pre-school nurseries. All 130 nurseries across Liverpool were a sent questionnaire (38 % response rate); thirty-four menus were returned for analysis (26 % response rate). Only 21 % of respondents stated they had adequate knowledge on nutrition for pre-school children. Sixty-one per cent of cooks reported having received only a 'little' advice on healthy eating and this was often not specific to under-5 s nutrition. Fifty-seven per cent of nurseries did not regularly assess their menus for nutritional quality. The menu analysis revealed that all menus were deficient in energy, carbohydrate, Fe and Zn. Eighty-five per cent of nurseries had Na/salt levels which exceed guidelines. Nurseries require support on healthy eating at policy, knowledge and training levels. This support should address concerns relating to both menu planning and ingredients used in food provision and meet current guidelines on food provision for the under-5 s.

To fear or to feed: the effects of turbidity on perception of risk by a marine fish.

PubMed

Leahy, Susannah M; McCormick, Mark I; Mitchell, Matthew D; Ferrari, Maud C O

2011-12-23

Coral reefs are currently experiencing a number of worsening anthropogenic stressors, with nearshore reefs suffering from increasing sedimentation because of growing human populations and development in coastal regions. In habitats where vision and olfaction serve as the primary sources of information, reduced visual input from suspended sediment may lead to significant alterations in prey fish behaviour. Here, we test whether prey compensate for reduced visual information by increasing their antipredator responses to chemically mediated risk cues in turbid conditions. Experiments with the spiny damselfish, Acanthochromis polyacanthus, found that baseline activity levels were reduced by 23 per cent in high turbidity conditions relative to low turbidity conditions. Furthermore, risk cues elicited strong antipredator responses at all turbidity levels; the strongest antipredator responses were observed in high turbidity conditions, with fish reducing their foraging by almost 40 per cent, as compared with 17 per cent for fish in clear conditions. This provides unambiguous evidence of sensory compensation in a predation context for a tropical marine fish, and suggests that prey fish may be able to behaviourally offset some of the fitness reductions resulting from anthropogenic sedimentation of their habitats.

[Quantitative changes of serum immunglobulins during infectous diseases in childhood (author's transl)].

PubMed

Mietens, C; Bernhard, A

1975-07-01

Immunelektrophoreses and quantitative determinations of serum immunglobulins were performed for 298 children with infections of the upper and lower respiratory tract, chronic and recurrent infections, pyelonephritis and Salmonella infections. Minor changes were seen for IgG, 80% of the patients had levels within the normal range. Many patients, however had increased levels of IgA and IgM, while a decrease of these immunglobulins below the normal range were rarely detected. Children with upper respiratory tract infections had increased IgA in 28 per cent and increased IgM in 44 per cent, those with bronchitis in 21 per cent an IgA and in 45 an IgM increase. Most frequently immunglobulin elevations were seen in patients with pneumonia: IgA was in 50% and IgM in 67% increased above the normal range. Patients with recurrent infections had an IgA elevation in 34% and an IgM increase in 33%. 35% of children with pyelonephritis had an IgA and IgM increase. Children suffering from Salmonella infections had an increased IgA in 29 and IgM in 67%. The result of other authors and of factors leading to an elevation of serum immunglobulins are discussed.

To fear or to feed: the effects of turbidity on perception of risk by a marine fish

PubMed Central

Leahy, Susannah M.; McCormick, Mark I.; Mitchell, Matthew D.; Ferrari, Maud C. O.

2011-01-01

Coral reefs are currently experiencing a number of worsening anthropogenic stressors, with nearshore reefs suffering from increasing sedimentation because of growing human populations and development in coastal regions. In habitats where vision and olfaction serve as the primary sources of information, reduced visual input from suspended sediment may lead to significant alterations in prey fish behaviour. Here, we test whether prey compensate for reduced visual information by increasing their antipredator responses to chemically mediated risk cues in turbid conditions. Experiments with the spiny damselfish, Acanthochromis polyacanthus, found that baseline activity levels were reduced by 23 per cent in high turbidity conditions relative to low turbidity conditions. Furthermore, risk cues elicited strong antipredator responses at all turbidity levels; the strongest antipredator responses were observed in high turbidity conditions, with fish reducing their foraging by almost 40 per cent, as compared with 17 per cent for fish in clear conditions. This provides unambiguous evidence of sensory compensation in a predation context for a tropical marine fish, and suggests that prey fish may be able to behaviourally offset some of the fitness reductions resulting from anthropogenic sedimentation of their habitats. PMID:21849308

Comparison of hecter fuel with export aviation gasoline

NASA Technical Reports Server (NTRS)

Dickinson, H C; Gage, V R; Sparrow, S W

1921-01-01

Among the fuels which will operate at compression ratios up to at least 8.0 without preignition or "pinking" is hecter fuel, whence a careful determination of its performance is of importance. For the test data presented in this report the hecter fuel used was a mixture of 30 per cent benzol and 70 per cent cyclohexane, having a low freezing point, and distilling from first drop to 90 per cent at nearly a constant temperature, about 20 degrees c. below the average distillation temperature ("mean volatility") of the x gasoline (export grade). The results of these experiments show that the power developed by hecter fuel is the same as that developed by export aviation gasoline at about 1,800 r.p.m. at all altitudes. At lower speeds differences in the power developed by the fuels become evident. Comparisons at ground level were omitted to avoid any possibility of damaging the engine by operating with open throttle on gasoline at so high a compression. The fuel consumption per unit power based on weight, not volume, averaged more than 10 per cent greater with hecter than with x gasoline. The thermal efficiency of the engine when using hecter is less than when using gasoline, particularly at higher speeds. A generalization of the difference for all altitudes and speeds being 8 per cent. A general deduction from these facts is that more hecter is exhausted unburnt. Hecter can withstand high compression pressures and temperature without preignition. (author)

Association of treponeme species with atypical foot lesions in goats.

PubMed

Groenevelt, M; Anzuino, K; Langton, D A; Grogono-Thomas, R

2015-06-13

Five UK goat farms with high levels of lameness (prevalence 14-67 per cent) were investigated. On two farms (farms 1 and 2), the animals presented with typical footrot lesions. The remaining three farms (farms 3, 4 and 5) presented with infected lesions on the foot that did not resemble footrot. These lesions were observed to start from the white line or sole but the interdigital space was rarely affected. Swabs were processed by PCR to assess the presence of Dichelobacter nodosus and three specific treponeme groups (group 1: Treponema medium/Treponema vincentii-like, group 2: Treponema phagedenis-like and group 3: Treponema denticola/Treponema putidum-like) that are reported to be associated with bovine digital dermatitis and contagious ovine digital dermatitis. On farms 1 and 2, 85.7 per cent of samples were found to be positive for D nodosus while only 9.5 per cent were positive for treponeme groups 1, 2 and 3. In contrast, 5.3 per cent of samples from farms 3, 4 and 5 were positive for D nodosus, while 34.2, 68.4 and 36.8 per cent of samples from these farms tested positive for treponeme groups 1, 2 and 3, respectively. T medium/T vincentii-like, T phagedenis-like and T denticola/T putidum-like treponemes were detected on foot lesions of lame goats suggesting that they have a role in the aetiology of this lameness, which has not previously been described in dairy goats. British Veterinary Association.

Predicting the prevalence of cerebral palsy by severity level in children aged 3 to 15 years across England and Wales by 2020.

PubMed

Glinianaia, Svetlana V; Best, Kate E; Lingam, Raghu; Rankin, Judith

2017-08-01

To estimate the number of children living with cerebral palsy (CP) in England and Wales in 2013 by severity, and to extrapolate this figure to 2020. Data from the North of England Collaborative Cerebral Palsy Survey for births during the period 1991 to 2000 were restricted to individuals aged at or above 3 years to estimate the prevalence of CP and to calculate 15-year survival by severity according to the number of severe impairments and lifestyle assessment score. The number of 3- to 15-year-olds with CP of different severity in England and Wales was estimated in 2013 and 2019 using actual and nationally projected births. Cumulative survival estimates up to the age of 16 years in children with CP differ significantly by severity, ranging between 97 per cent and 100 per cent for children with non-severe CP, and between 64 per cent and 67 per cent for those with the most severe CP. By the end of 2013, the estimated number of children aged 3 to 15 years living with CP in England and Wales will be about 20 500 rising to approximately 22 100 by 2020, a 7.5 per cent increase. Owing to an increasing population, the number of children living with CP in England and Wales will increase by 2020. This will have significant implications for health and social care service planning. © 2017 Mac Keith Press.

Temporal lobe epilepsy. Social conditions and rehabilitation after surgery.

PubMed

Jensen, I

1976-07-01

A social investigation was performed of 74 patients with temporal lobe epilepsy resistant to medication, who underwent unilateral temporal lobectomy 1960-1969. The patients were compared to their sibilings and to the general population in Denmark. Comparatively many patients were born out of wedlock. The level of schooling achieved was lower than expected, and this was most pronounced in patients with an early onset of epilepsy. The number of patients having received further education was also smaller than calculated. At the time of the operation all patients were socially incapacitated by their epilepsy; this was most pronounced in males, of whom 30 per cent were institutionalized and 32 per cent were receiving disablement pension; at follow-up the figures were 6 per cent and 52 per cent, respectively. Working capacity was markedly improved postoperatively, and at follow-up 39 per cent were in full-time employment. Relief from seizures (or almost complete relief), normal intelligence, normal psychiatric status, and operation before the age of 18 years were factors which favourably influenced the postoperative working capacity. The majority of the patients were unmarried or divorced, and few of the group had children. Their housing conditions were inferior to those of their siblings and of the general population. Parental social class distribution showed an excess in the highest and lowest social classes compared to the Danish population. The patients were subjected to downward social mobility, presumably caused by their illness, as their siblings displayed an upward mobility, which was most marked in the females.

Impact of a global temperature rise of 1.5 degrees Celsius on Asia’s glaciers

NASA Astrophysics Data System (ADS)

Kraaijenbrink, P. D. A.; Bierkens, M. F. P.; Lutz, A. F.; Immerzeel, W. W.

2017-09-01

Glaciers in the high mountains of Asia (HMA) make a substantial contribution to the water supply of millions of people, and they are retreating and losing mass as a result of anthropogenic climate change at similar rates to those seen elsewhere. In the Paris Agreement of 2015, 195 nations agreed on the aspiration to limit the level of global temperature rise to 1.5 degrees Celsius ( °C) above pre-industrial levels. However, it is not known what an increase of 1.5 °C would mean for the glaciers in HMA. Here we show that a global temperature rise of 1.5 °C will lead to a warming of 2.1 ± 0.1 °C in HMA, and that 64 ± 7 per cent of the present-day ice mass stored in the HMA glaciers will remain by the end of the century. The 1.5 °C goal is extremely ambitious and is projected by only a small number of climate models of the conservative IPCC’s Representative Concentration Pathway (RCP)2.6 ensemble. Projections for RCP4.5, RCP6.0 and RCP8.5 reveal that much of the glacier ice is likely to disappear, with projected mass losses of 49 ± 7 per cent, 51 ± 6 per cent and 64 ± 5 per cent, respectively, by the end of the century; these projections have potentially serious consequences for regional water management and mountain communities.

Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes.

PubMed

2013-07-01

The management of primary rectal cancer beyond total mesorectal excision planes (PRC-bTME) and recurrent rectal cancer (RRC) is challenging. There is global variation in standards and no guidelines exist. To achieve cure most patients require extended, multivisceral, exenterative surgery, beyond conventional total mesorectal excision planes. The aim of the Beyond TME Group was to achieve consensus on the definitions and principles of management, and to identify areas of research priority. Delphi methodology was used to achieve consensus. The Group consisted of invited experts from surgery, radiology, oncology and pathology. The process included two international dedicated discussion conferences, formal feedback, three rounds of editing and two rounds of anonymized web-based voting. Consensus was achieved with more than 80 per cent agreement; less than 80 per cent agreement indicated low consensus. During conferences held in September 2011 and March 2012, open discussion took place on areas in which there is a low level of consensus. The final consensus document included 51 voted statements, making recommendations on ten key areas of PRC-bTME and RRC. Consensus agreement was achieved on the recommendations of 49 statements, with 34 achieving consensus in over 95 per cent. The lowest level of consensus obtained was 76 per cent. There was clear identification of the need for referral to a specialist multidisciplinary team for diagnosis, assessment and further management. The consensus process has provided guidance for the management of patients with PRC-bTME or RRC, taking into account global variations in surgical techniques and technology. It has further identified areas of research priority.

Impact of a global temperature rise of 1.5 degrees Celsius on Asia's glaciers.

PubMed

Kraaijenbrink, P D A; Bierkens, M F P; Lutz, A F; Immerzeel, W W

2017-09-13

Glaciers in the high mountains of Asia (HMA) make a substantial contribution to the water supply of millions of people, and they are retreating and losing mass as a result of anthropogenic climate change at similar rates to those seen elsewhere. In the Paris Agreement of 2015, 195 nations agreed on the aspiration to limit the level of global temperature rise to 1.5 degrees Celsius ( °C) above pre-industrial levels. However, it is not known what an increase of 1.5 °C would mean for the glaciers in HMA. Here we show that a global temperature rise of 1.5 °C will lead to a warming of 2.1 ± 0.1 °C in HMA, and that 64 ± 7 per cent of the present-day ice mass stored in the HMA glaciers will remain by the end of the century. The 1.5 °C goal is extremely ambitious and is projected by only a small number of climate models of the conservative IPCC's Representative Concentration Pathway (RCP)2.6 ensemble. Projections for RCP4.5, RCP6.0 and RCP8.5 reveal that much of the glacier ice is likely to disappear, with projected mass losses of 49 ± 7 per cent, 51 ± 6 per cent and 64 ± 5 per cent, respectively, by the end of the century; these projections have potentially serious consequences for regional water management and mountain communities.

A temperate rocky super-Earth transiting a nearby cool star

NASA Astrophysics Data System (ADS)

Dittmann, Jason A.; Irwin, Jonathan M.; Charbonneau, David; Bonfils, Xavier; Astudillo-Defru, Nicola; Haywood, Raphaëlle D.; Berta-Thompson, Zachory K.; Newton, Elisabeth R.; Rodriguez, Joseph E.; Winters, Jennifer G.; Tan, Thiam-Guan; Almenara, Jose-Manuel; Bouchy, François; Delfosse, Xavier; Forveille, Thierry; Lovis, Christophe; Murgas, Felipe; Pepe, Francesco; Santos, Nuno C.; Udry, Stephane; Wünsche, Anaël; Esquerdo, Gilbert A.; Latham, David W.; Dressing, Courtney D.

2017-04-01

M dwarf stars, which have masses less than 60 per cent that of the Sun, make up 75 per cent of the population of the stars in the Galaxy. The atmospheres of orbiting Earth-sized planets are observationally accessible via transmission spectroscopy when the planets pass in front of these stars. Statistical results suggest that the nearest transiting Earth-sized planet in the liquid-water, habitable zone of an M dwarf star is probably around 10.5 parsecs away. A temperate planet has been discovered orbiting Proxima Centauri, the closest M dwarf, but it probably does not transit and its true mass is unknown. Seven Earth-sized planets transit the very low-mass star TRAPPIST-1, which is 12 parsecs away, but their masses and, particularly, their densities are poorly constrained. Here we report observations of LHS 1140b, a planet with a radius of 1.4 Earth radii transiting a small, cool star (LHS 1140) 12 parsecs away. We measure the mass of the planet to be 6.6 times that of Earth, consistent with a rocky bulk composition. LHS 1140b receives an insolation of 0.46 times that of Earth, placing it within the liquid-water, habitable zone. With 90 per cent confidence, we place an upper limit on the orbital eccentricity of 0.29. The circular orbit is unlikely to be the result of tides and therefore was probably present at formation. Given its large surface gravity and cool insolation, the planet may have retained its atmosphere despite the greater luminosity (compared to the present-day) of its host star in its youth. Because LHS 1140 is nearby, telescopes currently under construction might be able to search for specific atmospheric gases in the future.

Progress and Challenges in Predicting Crop Responses to Atmospheric [CO2

NASA Astrophysics Data System (ADS)

Kent, J.; Paustian, K.

2017-12-01

Increasing atmospheric [CO2] directly accelerates photosynthesis in C3 crops, and indirectly promotes yields by reducing stomatal conductance and associated water losses in C3 and C4 crops. Several decades of experiments have exposed crops to eCO2 in greenhouses and other enclosures and observed yield increases on the order of 33%. FACE systems were developed in the early 1990s to better replicate open-field growing conditions. Some authors contend that FACE results indicate lower crop yield responses than enclosure studies, while others maintain no significant difference or attribute differences to various methodological factors. The crop CO2 response processes in many crop models were developed using results from enclosure experiments. This work tested the ability of one such model, DayCent, to reproduce crop responses to CO2 enrichment from several FACE experiments. DayCent performed well at simulating yield and transpiration responses in C4 crops, but significantly overestimated yield responses in C3 crops. After adjustment of CO2-response parameters, DayCent was able to reproduce mean yield responses for specific crops. However, crop yield responses from FACE experiments vary widely across years and sites, and likely reflect complex interactions between conditions such as weather, soils, cultivars, and biotic stressors. Further experimental work is needed to identify the secondary variables that explain this variability so that models can more reliably forecast crop yields under climate change. Likewise, CO2 impacts on crop outcomes such as belowground biomass allocation and grain N content have implications for agricultural C fluxes and human nutrition, respectively, but are poorly understood and thus difficult to simulate with confidence.

A temperate rocky super-Earth transiting a nearby cool star.

PubMed

Dittmann, Jason A; Irwin, Jonathan M; Charbonneau, David; Bonfils, Xavier; Astudillo-Defru, Nicola; Haywood, Raphaëlle D; Berta-Thompson, Zachory K; Newton, Elisabeth R; Rodriguez, Joseph E; Winters, Jennifer G; Tan, Thiam-Guan; Almenara, Jose-Manuel; Bouchy, François; Delfosse, Xavier; Forveille, Thierry; Lovis, Christophe; Murgas, Felipe; Pepe, Francesco; Santos, Nuno C; Udry, Stephane; Wünsche, Anaël; Esquerdo, Gilbert A; Latham, David W; Dressing, Courtney D

2017-04-19

M dwarf stars, which have masses less than 60 per cent that of the Sun, make up 75 per cent of the population of the stars in the Galaxy. The atmospheres of orbiting Earth-sized planets are observationally accessible via transmission spectroscopy when the planets pass in front of these stars. Statistical results suggest that the nearest transiting Earth-sized planet in the liquid-water, habitable zone of an M dwarf star is probably around 10.5 parsecs away. A temperate planet has been discovered orbiting Proxima Centauri, the closest M dwarf, but it probably does not transit and its true mass is unknown. Seven Earth-sized planets transit the very low-mass star TRAPPIST-1, which is 12 parsecs away, but their masses and, particularly, their densities are poorly constrained. Here we report observations of LHS 1140b, a planet with a radius of 1.4 Earth radii transiting a small, cool star (LHS 1140) 12 parsecs away. We measure the mass of the planet to be 6.6 times that of Earth, consistent with a rocky bulk composition. LHS 1140b receives an insolation of 0.46 times that of Earth, placing it within the liquid-water, habitable zone. With 90 per cent confidence, we place an upper limit on the orbital eccentricity of 0.29. The circular orbit is unlikely to be the result of tides and therefore was probably present at formation. Given its large surface gravity and cool insolation, the planet may have retained its atmosphere despite the greater luminosity (compared to the present-day) of its host star in its youth. Because LHS 1140 is nearby, telescopes currently under construction might be able to search for specific atmospheric gases in the future.

Ischaemic heart disease mortality in Serbia, 1991-2013; a joinpoint analysis

PubMed Central

Ilic, Milena; Ilic, Irena

2017-01-01

Background & objectives: Ischaemic heart disease (IHD) has been one of the leading causes of mortality in the world. In many European countries the mortality rates due to IHD have been rising rapidly. This study was aimed to assess the IHD mortality trend in Serbia. Methods: A population-based cross-sectional study analyzing IHD mortality in Serbia in the period 1991-2013 was carried out based on official data. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the European standard population. Joinpoint analysis was used to estimate the average annual percentage change (AAPC) with the corresponding 95 per cent confidence interval (CI). Results: More than 253,000 people (143,420 men and 110,276 women) died due to IHD in Serbia during the observed period, and most of them (over 160,000 people) were patients with myocardial infarction (MI). Average annual ASR for IHD was 113.6/100,000. There was no overall significant trend for mortality due to IHD (AAPC=+0.1%, 95% CI −0.8-1.0), but there was one joinpoint: the trend significantly increased by +2.3 per cent per year from 1991 to 2006 and then significantly decreased by −6.4 per cent from 2006 to onwards. Significantly decreased mortality trends for MI in both genders were observed: according to the comparability test, mortality trends in men and women were parallel (final selected model failed to reject parallelism, P=0.0567). Interpretation & conclusions: No significant trend for mortality due to IHD was observed in Serbia during the study period. The substantial decline of mortality from IHD seen in most developed countries during the past decades was not observed in Serbia. Further efforts are required to reduce mortality from IHD in Serbian population. PMID:29664033

Changing atmospheric CO2 concentration was the primary driver of early Cenozoic climate

NASA Astrophysics Data System (ADS)

Anagnostou, Eleni; John, Eleanor H.; Edgar, Kirsty M.; Foster, Gavin L.; Ridgwell, Andy; Inglis, Gordon N.; Pancost, Richard D.; Lunt, Daniel J.; Pearson, Paul N.

2016-05-01

The Early Eocene Climate Optimum (EECO, which occurred about 51 to 53 million years ago), was the warmest interval of the past 65 million years, with mean annual surface air temperature over ten degrees Celsius warmer than during the pre-industrial period. Subsequent global cooling in the middle and late Eocene epoch, especially at high latitudes, eventually led to continental ice sheet development in Antarctica in the early Oligocene epoch (about 33.6 million years ago). However, existing estimates place atmospheric carbon dioxide (CO2) levels during the Eocene at 500-3,000 parts per million, and in the absence of tighter constraints carbon-climate interactions over this interval remain uncertain. Here we use recent analytical and methodological developments to generate a new high-fidelity record of CO2 concentrations using the boron isotope (δ11B) composition of well preserved planktonic foraminifera from the Tanzania Drilling Project, revising previous estimates. Although species-level uncertainties make absolute values difficult to constrain, CO2 concentrations during the EECO were around 1,400 parts per million. The relative decline in CO2 concentration through the Eocene is more robustly constrained at about fifty per cent, with a further decline into the Oligocene. Provided the latitudinal dependency of sea surface temperature change for a given climate forcing in the Eocene was similar to that of the late Quaternary period, this CO2 decline was sufficient to drive the well documented high- and low-latitude cooling that occurred through the Eocene. Once the change in global temperature between the pre-industrial period and the Eocene caused by the action of all known slow feedbacks (apart from those associated with the carbon cycle) is removed, both the EECO and the late Eocene exhibit an equilibrium climate sensitivity relative to the pre-industrial period of 2.1 to 4.6 degrees Celsius per CO2 doubling (66 per cent confidence), which is similar to the canonical range (1.5 to 4.5 degrees Celsius), indicating that a large fraction of the warmth of the early Eocene greenhouse was driven by increased CO2 concentrations, and that climate sensitivity was relatively constant throughout this period.

Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India

PubMed Central

Muniyandi, M.; Rao, V.G.; Bhat, J.; Yadav, R.; Sharma, R.K.; Bhondeley, M.K.

2015-01-01

Background & objectives: Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. Methods: In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Results: Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged <45 yr. Living condition was very poor (62% living in huts/katcha houses, 84 per cent with single room, 89 per cent no separate kitchen, 97 per cent used wood/crop as a fuel). Overall literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was <40 per cent among 36 per cent of respondents, 41-60 per cent among 54 per cent and >60 per cent among 8 per cent of respondents. Interpretation & conclusions: The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control. PMID:26139783

Duane's retraction syndrome: a retrospective review from Kathmandu, Nepal.

PubMed

Shrestha, Gauri Shankar; Sharma, Ananda Kumar

2012-01-01

  The aim was to study the clinical characteristics of Duane's retraction syndrome (DRS) in Nepalese patients.   Medical records from 52 cases of DRS from May 2003 to April 2010 were retrospectively reviewed for age, gender, laterality and clinical characteristics. Forty-one case records (78.8 per cent) that had complete clinical findings were considered for further evaluation. Examination included visual acuity by Snellen chart, refraction, associated horizontal and vertical strabismus in primary gaze, upshoot and downshoot on attempted adduction, binocular vision assessed with the Worth four-dot test on adopted gaze and stereopsis examined with the Titmus stereo test.   DRS type I was the most common type observed in 73.2 per cent of cases, followed by DRS type II (14.6 per cent) and DRS type III (12.2 per cent). It was more common in female patients (58.5 per cent) than male patients (χ(2) = 4.6, df = 1, p = 0.03). DRS was more common in the left eye (68.3 per cent) than the right eye and unilaterally present in 95.1 per cent of subjects. In primary gaze, orthotropia (41.5 per cent) was more common than exotropia (34.1 per cent) and esotropia (24.4 per cent) and vertical strabismus was present in 24.4 per cent of subjects. Upshoot and downshoot on attempted adduction was seen in 14.6 and 9.8 per cent, respectively. Binocular single vision was present in 68.3 per cent of subjects by Worth four-dot test at near. Stereopsis of 3,000 seconds of arc was present in 9.8 per cent, 100 to 200 seconds of arc in 14.6 per cent and 40 to 60 seconds of arc in 43.9 per cent with the Titmus stereo test.   DRS is more common in female patients and the left eye. DRS type I is the most common type. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

Comparison of two shampoos as sole treatment for canine bacterial overgrowth syndrome.

PubMed

Viaud, S; Maynard, L; Sanquer, A

2012-06-30

Two antibacterial shampoos for the treatment of canine bacterial overgrowth syndrome (BOGS) were compared in a prospective controlled clinical trial. Forty dogs with clinical signs (pruritus, erythema and excoriations without pustules and/or collarettes) and cytological findings compatible with bacterial overgrowth were treated twice weekly with 3 per cent chlorhexidine shampoo (3 per cent CHX) or 2.5 per cent benzoyl peroxide shampoo (2.5 per cent BPO) and evaluated every two weeks for up to six weeks until cytological cure. Pruritus, erythema, greasy seborrhoea, malodour, excoriations, secondary hair loss, lichenification, hyperpigmentation and lesion extent were each scored on a 0 to 3 severity scale and combined to calculate an aggregate score. Among the 34 dogs with good compliance to treatment, reduction of cocci counts of at least 90 per cent was recorded in 11 of 18 dogs after 3 per cent CHX and nine of 16 dogs after 2.5 per cent BPO, with no significant difference between the two products (P=0.98). Lesion score was significantly reduced in both groups (63.48 (34.45)) per cent with 3 per cent CHX v 54.45 (33.61) per cent with 2.5 per cent BPO, P=0.36) and time to cytological cure was not significantly different between groups (P=0.13), at the end of the treatment. In the present study, 3 per cent CHX and 2.5 per cent BPO were similarly effective in the treatment of canine BOGS.

Low parental awareness about energy (calorie) recommendations for children's restaurant meals: findings from a national survey in the USA.

PubMed

Lynskey, Vanessa M; Anzman-Frasca, Stephanie; Harelick, Linda; Korn, Ariella; Sharma, Shanti; Simms, Stephanie; Economos, Christina D

2017-08-01

To assess parental awareness of per-meal energy (calorie) recommendations for children's restaurant meals and to explore whether calorie awareness was associated with parental sociodemographic characteristics and frequency of eating restaurant food. Cross-sectional online survey administered in July 2014. Parents estimated calories (i.e. kilocalories; 1 kcal=4·184 kJ) recommended for a child's lunch/dinner restaurant meal (range: 0-2000 kcal). Responses were categorized as 'underestimate' (600 kcal). Confidence in response was measured on a 4-point scale from 'very unsure' to 'very sure'. Logistic regressions estimated the odds of an 'accurate' response and confident response ('somewhat' or 'very sure') by parental sociodemographic characteristics and frequency of eating from restaurants. Sampling weights based on demographics were incorporated in all analyses. USA. Parents (n 1207) of 5-12-year-old children. On average, parents estimated 631 (se 19·4) kcal as the appropriate amount for a 5-12-year-old child's meal. Thirty-five per cent answered in the accurate range, while 33·3 and 31·8 % underestimated and overestimated, respectively. Frequent dining at restaurants, lower income and urban geography were associated with lower odds of answering accurately. Parents' confidence in their estimates was low across the sample (26·0 % confident) and only 10·1 % were both accurate and confident. Parent education about calorie recommendations for children could improve understanding and use of menu labelling information in restaurants. Targeted strategies are recommended to ensure that such efforts address, rather than exacerbate, health disparities.

Evaluation of glucose as a cryoprotectant for boar semen.

PubMed

De los Reyes, M; Saenz, L; Lapierre, L; Crosby, J; Barros, C

2002-10-19

Fertility parameters of boar spermatozoa were evaluated in vitro, after freeze-thawing the semen in three different extenders containing permeable and non-permeable cryoprotectants: A (111.0 mM Tris, 31.4 mM citric acid, 185.0 mM glucose, 20 per cent egg yolk, 3 per cent glycerol and 100 iu/ml penicillin G); B (200 mM Tris; 70.8 mM citric acid, 55.5 mM glucose, 20 per cent egg yolk, three per cent glycerol and 100 iu/ml penicillin G); C (200 mM Tris, 70.8 mM citric acid, 55.5 mM fructose, 20 per cent egg yolk, 3 per cent glycerol and 100 iu/ml penicillin G). The freeze-thawing techniques were the same for each extender. Eight ejaculates from four boars were obtained; the sperm-rich fraction of each ejaculate was extended in each of the three media at a final concentration of 400 x 106 sperm/ml, loaded into 0.5 ml straws and frozen at a rate of 30 degrees C/minute to -196 degrees C. The straws were thawed at 60 degrees C for eight seconds. Sperm motility, acrosomal integrity and in vitro sperm penetration through the zona pellucida of gilt oocytes matured in vitro were evaluated. The motility of unfrozen spermatozoa was 93.1 per cent compared with 60.7 per cent, 48.2 per cent and 35 per cent for sperm frozen in extenders A, B and C respectively; these values were all significantly different (P<0.05). There was no significant decline in sperm motility after incubation for 30 minutes in extender A, but there were significant decreases in sperm motility after 30 minutes of incubation in B and C. The percentage acrosomal integrities were 97.2 per cent for the control and 45.5 per cent, 30.3 per cent and 16.8 per cent for the frozen-thawed spermatozoa in extenders A, B and C respectively. The results of the in vitro penetration assay were 80.7 per cent when using control spermatozoa, and 42.2 per cent, 18.4 per cent and 3.3 per cent when using frozen-thawed spermatozoa in extenders A, B and C respectively

Research and Development on Titanium Alloys

DTIC Science & Technology

1949-08-31

present contract was submitted in lieu of the first regular bimonthly progress report. The attached report contains an account of the following: 1 . A...and 5 to 11 per cent, respectively. l. Titanium - 5 per cent molybdenum base alloys with additions of 1 per cent copper, 2 per cent copper, 1 per...cent manganese, and 2 per cent iron, BATTELLE MEMORIAL INSTITUTE TABLE OF CONTENTS SUMMARY. ** * se0* .0. • • 0000 0 C 0, 00 1 INTRODUCTION. . . o

Solid state RF power: The route to 1W per euro cent

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heid, Oliver

2013-04-19

In most particle accelerators RF power is a decisive design constraint due to high costs and relative inflexibility of current electron beam based RF sources, i.e. Klystrons, Magnetrons, Tetrodes etc. At VHF/UHF frequencies the transition to solid state devices promises to fundamentally change the situation. Recent progress brings 1 Watt per Euro cent installed cost within reach. We present a Silicon Carbide semiconductor solution utilising the Solid State Direct Drive technology at unprecedented efficiency, power levels and power densities. The proposed solution allows retrofitting of existing RF accelerators and opens the route to novel particle accelerator concepts.

Pre- and post-operative dizziness, tinnitus, and taste disturbances among cochlear implant recipients.

PubMed

Mikkelsen, K S; Ovesen, T; Swan, C Z

2017-04-01

To determine the pre- and post-operative prevalence of dizziness, tinnitus and taste disturbances in adult cochlear implant recipients. A questionnaire regarding pre- and post-operative dizziness, tinnitus and taste disturbances was sent to 170 cochlear implant recipients implanted between January 2003 and March 2009. Seventy-seven patients (41 per cent) responded. Pre-operatively, 20 per cent of the participants experienced dizziness, 52 per cent experienced tinnitus and 3 per cent experienced taste disturbances. Post-operative dizziness developed in 46 per cent of patients and resolved in the majority of these; however, 15 per cent reported dizziness more than six months after implantation. Tinnitus worsened in 25 per cent of patients, whereas 73 per cent reported attenuation or termination of tinnitus. Post-operatively, tinnitus developed in 12 per cent and taste disturbances developed in 17 per cent of the patients. The high prevalence of dizziness, tinnitus and taste disturbances reported by cochlear implant recipients necessitates that assessment of symptoms related to inner ear and chorda tympani damage are included when evaluating operative results.

Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features.

PubMed

Goodell, S E; Quinn, T C; Mkrtichian, E; Schuffler, M D; Holmes, K K; Corey, L

1983-04-14

Acute herpes simplex virus (HSV) infection was detected in 23 of 102 consecutively examined, sexually active male homosexuals who presented with anorectal pain, discharge, tenesmus, or hematochezia, as compared with 3 of 75 homosexual men without gastrointestinal symptoms (P less than 0.01). Findings that were significantly more frequent in men with HSV proctitis than in men with proctitis due to other infectious causes included fever (48 per cent), difficulty in urinating (48 per cent), sacral paresthesias (26 per cent), inguinal lymphadenopathy (57 per cent), severe anorectal pain (100 per cent), tenesmus (100 per cent), constipation (78 per cent), perianal ulcerations (70 per cent), and the presence of diffuse ulcerative or discrete vesicular or pustular lesions in the distal 5 cm of the rectum (50 per cent). Serologic evidence indicated that 85 per cent of the men with symptomatic HSV proctitis were having their first episode of HSV-2 infection. The diagnosis of HSV proctitis is suggested by the presence of severe anorectal pain, difficulty in urinating, sacral paresthesias or pain, and diffuse ulceration of the distal rectal mucosa.

Demographic and clinical characteristics of a paediatric low vision population in a low vision clinic in China.

PubMed

Gao, Guohong; Yu, Manrong; Dai, Jinhui; Xue, Feng; Wang, Xiaoying; Zou, Leilei; Chen, Minjie; Ma, Fei

2016-05-01

The aim was to describe the characteristics of the paediatric population attending the low vision clinic of the Eye and ENT Hospital, located in Shanghai, China. The clinical records of all the children attending the low vision clinic of Eye and ENT Hospital affiliated to Fudan University between January 1, 2009 and May 31, 2014 were retrospectively reviewed. The main data analysed were age, gender, education, visual demand, diagnosis, visual acuity and prescription of low vision aids. Of the 162 patients, 104 (64.20 per cent) were male. The age range of the study population was three to 20 years, with a mean of 10.73 ± 5.08 years. There were 43.21 per cent with moderate visual impairment, 26.54 per cent had severe visual impairment and 19.75 per cent were blind. The leading causes of visual impairment were congenital cataract (21.61 per cent), optic atrophy (14.20 per cent), macular dystrophy (11.73 per cent), nystagmus (9.88 per cent) and congenital glaucoma (9.26 per cent). The most frequently prescribed low vision devices for distant and near vision were binocular telescopes (23.57 per cent) and stand magnifiers (22.93 per cent), respectively. Young age (up to six years, 37.93 per cent), high cost (24.14 per cent), cosmetic reasons (17.24 per cent) and inconvenience (13.79 per cent) were the main reasons that children or parents refused to accept useful low vision aids. Congenital and hereditary diseases constituted the major causes of low vision in the study population. Strategies that make good-quality rehabilitation services available, affordable and accessible, especially in developing countries, will have the greatest impact on visual impairment. In China, both urban and rural, the coverage of low vision services should be strengthened. © 2016 The Authors. Clinical and Experimental Optometry © 2016 Optometry Australia.

Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season.

PubMed

Harris, K A; Eglin, R D; Hayward, S; Milnes, A; Davies, I; Cook, A J C; Downs, S H

2014-08-16

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011-2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss. British Veterinary Association.

Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season

PubMed Central

Harris, K. A.; Eglin, R. D.; Hayward, S.; Milnes, A.; Davies, I.; Cook, A. J. C.; Downs, S. H.

2014-01-01

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011–2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss. PMID:24795165

A detection of wobbling brightest cluster galaxies within massive galaxy clusters

NASA Astrophysics Data System (ADS)

Harvey, David; Courbin, F.; Kneib, J. P.; McCarthy, Ian G.

2017-12-01

A striking signal of dark matter beyond the standard model is the existence of cores in the centre of galaxy clusters. Recent simulations predict that a brightest cluster galaxy (BCG) inside a cored galaxy cluster will exhibit residual wobbling due to previous major mergers, long after the relaxation of the overall cluster. This phenomenon is absent with standard cold dark matter where a cuspy density profile keeps a BCG tightly bound at the centre. We test this hypothesis using cosmological simulations and deep observations of 10 galaxy clusters acting as strong gravitational lenses. Modelling the BCG wobble as a simple harmonic oscillator, we measure the wobble amplitude, Aw, in the BAHAMAS suite of cosmological hydrodynamical simulations, finding an upper limit for the cold dark matter paradigm of Aw < 2 kpc at the 95 per cent confidence limit. We carry out the same test on the data finding a non-zero amplitude of A_w=11.82^{+7.3}_{-3.0} kpc, with the observations dis-favouring Aw = 0 at the 3σ confidence level. This detection of BCG wobbling is evidence for a dark matter core at the heart of galaxy clusters. It also shows that strong lensing models of clusters cannot assume that the BCG is exactly coincident with the large-scale halo. While our small sample of galaxy clusters already indicates a non-zero Aw, with larger surveys, e.g. Euclid, we will be able to not only confirm the effect but also to use it to determine whether or not the wobbling finds its origin in new fundamental physics or astrophysical process.

The effects of marriage and separation on the psychotropic medication use of non-married cohabiters: a register-based longitudinal study among adult Finns.

PubMed

Metsä-Simola, Niina; Martikainen, Pekka

2014-11-01

Non-marital cohabitation has become increasingly common and is suggested to offer similar mental-health benefits as marriage does. We studied levels and changes in cohabiters' mental health five years before and five years after entering into marriage or separating, and compared long-term non-married and married cohabiters. We analysed changes in the three-month prevalence of psychotropic medication use (psycholeptics and psychoanaleptics, excluding medication for dementia) by proximity to non-marital transition and gender, using register data on 189,394 Finns aged 25 to 64. Similar levels of psychotropic-medication use were found among individuals in long unions that continued throughout the follow-up and were non-marital, marital, or changed from non-marital to marital. Among men and women who separated from longer cohabiting unions of more than five years, however, an increase in medication prevalence was observed immediately before separation, followed by a similar decline after separation. At the time of separation the level of medication use was 9.9 per cent (95% CI = 8.7 - 11.3) among men and 15.7 per cent (95% CI = 14.2 - 17.4) among women compared to 4.3 per cent (95% CI = 3.7 - 5.0) and 8.0 per cent (95% CI = 7.2 - 9.0), respectively, among those who cohabited continuously. No changes in medication use were observed before or after separation among those leaving shorter cohabiting unions of less than five years. Among those marrying following shorter cohabiting unions a positive effect of approaching marriage was observed only among women. Compared to continuous cohabiters, the level of medication use was higher among men and women separating from both short-term and long-term cohabiting unions five years before separation. This selective effect suggests that cohabiters with mental-health problems might benefit from relationship counselling. In a long-term stable union it seems to matter little for mental health whether the union is marital or non-marital, the break-up of a long-term non-marital union being strongly associated with adverse mental-health effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin.

PubMed Central

Shohat, M; Shohat, T; Mimouni, M; Nitzan, M; Danon, Y L

1989-01-01

We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent. PMID:2705591

Smoking habits and plasma lipid peroxide and vitamin E levels in never-treated first-episode patients with schizophrenia.

PubMed

2000-03-01

Lipid peroxidation may be increased in schizophrenia, due to the illness, lifestyle or medication. To determine plasma lipid peroxide levels and serum vitamin E and A levels in first-episode never-treated people with schizophrenia and in controls. Thirty in-patients with a first episode of schizophrenia or schizophreniform psychosis were recruited, as were controls matched for gender, age, smoking and dietary status. Blood samples were taken, smoking status was recorded and body mass index measured. There were no significant differences between patients and controls in plasma peroxide levels. Seventy-three per cent of the patients smoked. Patients who smoked had a higher mean lipid peroxide level than non-smokers. Seventy-seven per cent of patients and 70% of controls had a ratio of vitamin E to cholesterol of less than 5. Body mass index was lower in patients than in controls. As a result of the high prevalence of smoking this group shows increased lipid peroxidation. Low serum ratios of vitamin E to cholesterol in both patients and controls suggest an unsatisfactory diet.

In vivo oxalate degradation by liposome encapsulated oxalate oxidase in rat model of hyperoxaluria

PubMed Central

Dahiya, Tulika; Pundir, C.S.

2013-01-01

Background & objectives: High level of urinary oxalate substantially increases the risk of hyperoxaluria, a significant risk factor for urolithiasis. The primary goal of this study was to reduce urinary oxalate excretion employing liposome encapsulated oxalate oxidase in animal model. Methods: A membrane bound oxalate oxidase was purified from Bougainvillea leaves. The enzyme in its native form was less effective at the physiological pH of the recipient animal. To increase its functional viability, the enzyme was immobilized on to ethylene maleic anhydride (EMA). Rats were injected with liposome encapsulated EMA- oxalate oxidase and the effect was observed on degradation of oxalic acid. Results: The enzyme was purified to apparent homogeneity with 60-fold purification and 31 per cent yield. The optimum pH of EMA-derivative enzyme was 6.0 and it showed 70 per cent of its optimal activity at pH 7.0. The EMA-bound enzyme encapsulated into liposome showed greater oxalate degradation in 15 per cent casein vitamin B6 deficient fed rats as compared with 30 per cent casein vitamin B6 deficient fed rats and control rats. Interpretation & conclusions: EMA-oxalate oxidase encapsulated liposome caused oxalate degradation in experimental hyperoxaluria indicating that the enzyme could be used as a therapeutic agent in hyperoxaluria leading to urinary stones. PMID:23481063

Investigating the Lyman photon escape in local starburst galaxies with the Cosmic Origins Spectrograph

NASA Astrophysics Data System (ADS)

Hernandez, Svea; Leitherer, Claus; Boquien, Médéric; Buat, Véronique; Burgarella, Denis; Calzetti, Daniela; Noll, Stefan

2018-07-01

We present a study of seven star-forming galaxies from the Cosmic Evolution Survey observed with the Cosmic Origins Spectrograph (COS) onboard the Hubble Space Telescope (HST). The galaxies are located at relatively low redshifts, z ˜ 0.3, with morphologies ranging from extended and disturbed to compact and smooth. To complement the HST observations, we also analyse observations taken with the Visible Multi-object Spectrograph (VIMOS) on the Very Large Telescope (VLT). In our galaxy sample, we identify three objects with double peak Lyman-α profiles similar to those seen in Green Pea compact galaxies and measure peak separations of 655, 374, and 275 km s-1. We measure Lyman-α escape fractions with values ranging between 5 per cent and 13 per cent. Given the low flux levels in the individual COS exposures, we apply a weighted stacking approach to obtain a single spectrum. From this COS combined spectrum, we infer upper limits for the absolute and relative Lyman continuum escape fractions of f_abs(LyC) = 0.4^{+10.1}_{-0.4} per cent and f_res(LyC) = 1.7^{+15.2}_{-1.7}per cent, respectively. Finally, we find that most of these galaxies have moderate ultraviolet and optical star formation rates (SFRs) (SFRs ≲10 M⊙ yr-1).

Evidence from dynamic integrated proctography to redefine anismus.

PubMed

Roberts, J P; Womack, N R; Hallan, R I; Thorpe, A C; Williams, N S

1992-11-01

The role of anismus in the aetiology of defective rectal evacuation was investigated by dynamic integrated proctography in 20 controls and 71 constipated patients. Normal parameters were defined and compared between 21 constipated patients with poor evacuation during proctography (< 40 per cent of contrast evacuated; group 1) and 50 who evacuated fully (> 90 per cent of contrast evacuated; group 2). Nine patients in group 1 failed to evacuate. Radiological abnormalities of the rectum were recorded in all groups but obstructed evacuation was not observed. Anismus (defined as a recruitment of puborectalis electromyogram (EMG) activity of > 50 per cent) was significantly more common in group 1 than group 2 patients (14 of 21 versus 12 of 50, P < 0.01) and present in seven of those unable to evacuate. Eight patients in group 1 failed to raise intrarectal pressure > 50 cmH2O compared with two in group 2 (P < 0.001). Six patients in group 1 demonstrated both anismus and inability to raise intrarectal pressure, which may combine to cause defective evacuation. EMG recruitment alone is insufficient to diagnose anismus. Definition should be based on three criteria: demonstration of puborectalis EMG recruitment of > 50 per cent; evidence of an adequate level of intrarectal pressure (> 50 cmH2O) on straining; and presence of defective evacuation.

Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial

PubMed Central

Keller, Diana; Sundrum, Albert

2018-01-01

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture-positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60–81 per cent) but was more effective than individualised homeopathy (33–43 per cent) whose effects appeared little different to those of placebos (45–47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2–21 per cent, individualised homeopathy 0–8 per cent and placebo 3–13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture-negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample. Trial registration number NTP-ID: 00008011-1-9, Pre-results. PMID:29374099

A comparative study of results of the von Langenbeck and the V-Y pushback palatoplasties.

PubMed

Krause, C J; Tharp, R F; Morris, H L

1976-01-01

The incidence of velopharyngeal competence noted in 267 cleft palate patients following palatoplsty has been reviewed. Comparisons have been drawn with regard to the cleft type and the surgical technique performed. Since there were relatively small numbers of subjects in some categories, differences in age at last examination between the von Langenbeck and V-Y palatoplasty groups, some patients were very young at time of evaluation, and a number of different surgeons at different levels of training and experience performed the surgery, the differences in velopharyngeal competence found should be viewed as trends and this report as preliminary. In general, there was a trend toward smaller percentages of patients attaining acceptable velopharyngeal competence as the severity of the cleft increased. Of those with clefts of the soft palate only 86 per cent achieved competence. Among those patients with clefts of the palate only, 67 per cent achieved competence, whereas only 57 per cent of those with clefts of the lip and palate were able to do so. When comparing all cleft types, the V-Y palatoplasty resulted in a significantly higher percentage of velopharyngeal competence (74 per cent) than did the von Langenbeck method (56 per cent), although the data for the V-Y group are probably less reliable than those for the von Langenbeck group. In the soft palate only category, the results were slightly better with the von Langenbeck technique, though not significantly so. In all other cleft types, the results with the V-Y method were better than those with the von Langenbeck.

Finance salaries. Account the cost.

PubMed

Robling, Andy

2003-02-06

Post-qualification salaries have increased by 4-7 per cent, a slowdown on last year's figures when increases were often more than 10 per cent. The highest increases this year tended to be in medium-sized trusts where newly qualified accountants' salaries rose 8.2 per cent. Directors of finance in large trusts earn about 20 per cent more than in medium trusts and about 40 per cent more than in small ones. Newly qualified accountants in large trusts earn 5 per cent more than in medium-sized trusts and 13 per cent more than in small ones. The survey is based on an analysis of salaries from Hays' jobs database, and salaries of registered candidates.

Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

PubMed

Hansen, Eric; Panwala, Kathryn; Holland, John

2002-11-01

Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

INDIVIDUAL BLOOD DIFFERENCES IN MEXICAN INDIANS, WITH SPECIAL REFERENCE TO THE Rh BLOOD TYPES AND Hr FACTOR

PubMed Central

Wiener, Alexander S.; Zepeda, J. Preciado; Sonn, Eve B.; Polivka, H. R.

1945-01-01

98 Mexican Indians were tested for the blood properties A-B-O, A1-A2, M-N, P, Rh'-Rh''-Rh0-rh, and Hr. Of the 98 Indians, 90.8 per cent belonged to group 0, 6.1 per cent belonged to A1, and 3.1 per cent to group B. There were 61.2 per cent of type M, 3.1 per cent of type N, and 35.7 per cent of type MN. Of the 95 Mexican Indians tested with anti-P serum, 21.1 per cent were found to lack the P agglutinogen. In tests for the Rh blood types, 48.0 per cent of the Indians were found to belong to type Rh1, 9.2 per cent to type Rh2, 41.8 per cent to type Rh1Rh2, and 1 per cent to type Rh0. There were no bloods giving intermediate reactions. Of the 95 Indians tested for the Hr factor 44.2 per cent were found to lack this property. The reactions for the Rh blood types and Hr factor were correlated with each other and the results supported the conclusion of Race et al. that in addition to the six standard allelic genes and the so called intermediate genes, there is one or possibly two genes having the property of determining agglutinogens which react with anti-Rh' and anti-Rh'' sera, but not with anti-Hr serum. This gene (or genes) appears to be relatively common among Mexican Indians (approximately 3.3 per cent) in contrast to its rareness in white individuals. PMID:19871476

[Psychophysiological regin for rehabilition of chronic polydrug users in the Center of the Le Patriarche. 446 cases (author's transl)].

PubMed

Laffont, F; Engelmajer, L; Vourc'h, G; Nahas, G

1980-01-01

From 1974 to 1979, the rehabilitation centers of the association "Le Patriarche" located in the country side of southern France, have received 446 chronic polydrugs users who has consumed at one time or an other cannabis (marihuana, hashish) (87 p. cent), LSD (66 p. cent) and other hallucinogens (35 p. cent), psychodepressants (55 p. cent), psychostimulants (amphetamines, 85 p. cent; cocaïne, 50 p. cent) and opium and its derivatives (brown sugar, 47 p. cent; opiates, 67 p. cent; heroin, 50 p. cent). The dominant addictive drug was heroin and opiates, 52 p. cent, psychodepressants (barbitutiques and benzodiazepines, 33 p. cent, psychostimulants, 15 p. cent. Males were twice as numerous as female. Average age was 21 (range 14-38). Mean duration of drug abuse was 7 years. All these drug abusers display at entrance withdrawal symptoms. These were treated successfully by a drug free, psycho-physiological regimen comprising: 1. An elimination of all psychoactive drugs, including coffee, and alcohol. Tobacco was permitted. 2. Physical therapy (bath, exercise, massage) and forced fluid diuresis. 3. A supportive psychotherapy dispensed by rehabilitated addicts who had undergone successfully a similar regimen. This non-pharmacological method of treating withdrawal symptoms associated with opium, barbiturate and amphetamine addiction, was successful, and was not associated with any major clinical symptoms threatening the vital signs. Mean duration of detoxification was 5 days for opiates, 6 days for amphetamines and 10 days for barbiturates. 78 p. cent of these subjects remained in the centers from 3 months to 2 years, partaking in physical occupational and physiological rehabilitation paograms which allowed then to adopt a drug free life style and prepared them for social reinsertion.

A global country-level comparison of the financial burden of surgery.

PubMed

Shrime, M G; Dare, A; Alkire, B C; Meara, J G

2016-10-01

Approximately 30 per cent of the global burden of disease is surgical, and nearly one-quarter of individuals who undergo surgery each year face financial hardship because of its cost. The Lancet Commission on Global Surgery has proposed the elimination of impoverishment due to surgery by 2030, but no country-level estimates exist of the financial burden of surgical access. Using publicly available data, the incidence and risk of financial hardship owing to surgery was estimated for each country. Four measures of financial catastrophe were examined: catastrophic expenditure, and impoverishment at the national poverty line, at 2 international dollars (I$) per day and at I$1·25 per day. Stochastic models of income and surgical costs were built for each country. Results were validated against available primary data. Direct medical costs of surgery put 43·9 (95 per cent posterior credible interval 2·2 to 87·1) per cent of the examined population at risk of catastrophic expenditure, and 57·0 (21·8 to 85·1) per cent at risk of being pushed below I$2 per day. The risk of financial hardship from surgery was highest in sub-Saharan Africa. Correlations were found between the risk of financial catastrophe and external financing of healthcare (positive correlation), national measures of well-being (negative correlation) and the percentage of a country's gross domestic product spent on healthcare (negative correlation). The model performed well against primary data on the costs of surgery. Country-specific estimates of financial catastrophe owing to surgical care are presented. The economic benefits projected to occur with the scale-up of surgery are placed at risk if the financial burden of accessing surgery is not addressed in national policies. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Is maternal serum triple screening a better predictor of Down syndrome in female than in male fetuses?

PubMed

Ghidini, A; Spong, C Y; Grier, R E; Walker, C N; Pezzullo, J C

1998-02-01

Among euploid gestations, female fetuses have been reported to have significantly lower maternal serum alpha-fetoprotein (MSAFP) and higher human chorionic gonadotropin (hCG) levels than male fetuses. Since in maternal serum triple screening, low MSAFP and high hCG MOM independently confer greater risk of a Down syndrome fetus, we investigated the hypothesis that maternal serum triple screening is more efficacious at detecting female than male Down syndrome fetuses. A database containing all karyotypes from amniocentesis performed between August 1994 and August 1996 was accessed. All trisomy 21 cases were identified. The male-to-female ratio among trisomy 21 fetuses detected at amniocentesis after abnormal maternal serum triple screening was compared with that among trisomy 21 fetuses detected at amniocentesis for advanced maternal age (AMA), which served as the control group. Statistical analysis utilized chi-square, Fisher's exact test, and Student's t-test. A P value of less than 0.05 was considered statistically significant. Forty-nine trisomy 21 fetuses were detected in the women who underwent amniocentesis because of abnormal triple screening and 311 were detected in the control group. The proportion of male fetuses among the triple screening group was not significantly different from that of the AMA group (55 per cent vs. 57 per cent; P=0.9). Our study had a power of 80 per cent to detect a difference of 25 per cent in the male-to-female ratio (alpha=0.05, beta=0.20). The reported differences in MSAFP and hCG levels between male and female euploid fetuses do not appear to affect the sex ratio among Down syndrome fetuses detected because of an abnormal maternal serum triple screening.

Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications

PubMed Central

Ratto, C; Parello, A; Donisi, L; Litta, F; Zaccone, G; Doglietto, G B

2012-01-01

Background Dearterialization should reduce arterial overflow to haemorrhoids. The purpose of this study was to assess the topography of haemorrhoidal arteries. Methods Fifty patients with haemorrhoidal disease were studied. Using endorectal ultrasonography, six sectors were identified within the lower rectal circumference. Starting from the highest level (6 cm above the anorectal junction), the same procedure was repeated every 1 cm until the lowest level was reached (1 cm above the anorectal junction). Colour duplex imaging examinations identified haemorrhoidal arteries related to the rectal wall layers, and the arterial depth was calculated. Results Haemorrhoidal arteries were detected in 64·3, 66·0, 66·0, 98·3, 99·3 and 99·7 per cent of the sectors 6, 5, 4, 3, 2 and 1 cm above the anorectal junction respectively (P < 0·001). Most of the haemorrhoidal arteries were external to the rectal wall at 6 and 5 cm (97·9 and 90·9 per cent), intramuscular at 4 cm (55·0 per cent), and within the submucosa at 3, 2 and 1 cm above the anorectal junction (67·1, 96·6 and 100 per cent) (P < 0·001). The mean arterial depth decreased significantly from 8·3 mm at 6 cm to 1·9 mm at 1 cm above the anorectal junction (P < 0·001). Conclusion This study demonstrated that the vast majority of haemorrhoidal arteries lie within the rectal submucosa at the lowest 2 cm above the anorectal junction. This should therefore be the best site for performing haemorrhoidal dearterialization. PMID:22021046

The less healthy urban population: income-related health inequality in China.

PubMed

Yang, Wei; Kanavos, Panos

2012-09-18

Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

The less healthy urban population: income-related health inequality in China

PubMed Central

2012-01-01

Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200

Stable centromere positioning in diverse sequence contexts of complex and satellite centromeres of maize and wild relatives.

PubMed

Gent, Jonathan I; Wang, Na; Dawe, R Kelly

2017-06-21

Paradoxically, centromeres are known both for their characteristic repeat sequences (satellite DNA) and for being epigenetically defined. Maize (Zea mays mays) is an attractive model for studying centromere positioning because many of its large (~2 Mb) centromeres are not dominated by satellite DNA. These centromeres, which we call complex centromeres, allow for both assembly into reference genomes and for mapping short reads from ChIP-seq with antibodies to centromeric histone H3 (cenH3). We found frequent complex centromeres in maize and its wild relatives Z. mays parviglumis, Z. mays mexicana, and particularly Z. mays huehuetenangensis. Analysis of individual plants reveals minor variation in the positions of complex centromeres among siblings. However, such positional shifts are stochastic and not heritable, consistent with prior findings that centromere positioning is stable at the population level. Centromeres are also stable in multiple F1 hybrid contexts. Analysis of repeats in Z. mays and other species (Zea diploperennis, Zea luxurians, and Tripsacum dactyloides) reveals tenfold differences in abundance of the major satellite CentC, but similar high levels of sequence polymorphism in individual CentC copies. Deviation from the CentC consensus has little or no effect on binding of cenH3. These data indicate that complex centromeres are neither a peculiarity of cultivation nor inbreeding in Z. mays. While extensive arrays of CentC may be the norm for other Zea and Tripsacum species, these data also reveal that a wide diversity of DNA sequences and multiple types of genetic elements in and near centromeres support centromere function and constrain centromere positions.

Contribution of medical colleges to tuberculosis control in India under the Revised National Tuberculosis Control Programme (RNTCP): Lessons learnt & challenges ahead

PubMed Central

Sharma, Surendra K.; Mohan, Alladi; Chauhan, L.S.; Narain, J.P.; Kumar, P.; Behera, D.; Sachdeva, K.S.; Kumar, Ashok

2013-01-01

Medical college faculty, who are academicians are seldom directly involved in the implementation of national public health programmes. More than a decade ago for the first time in the global history of tuberculosis (TB) control, medical colleges of India were involved in the Revised National TB Control Programme (RNTCP) of Government of India (GOI). This report documents the unique and extraordinary course of events that led to the involvement of medical colleges in the RNTCP of GOI. It also reports the contributions made by the medical colleges to TB control in India. For more than a decade, medical colleges have been providing diagnostic services (Designated Microscopy Centres), treatment [Directly Observed Treatment (DOT) Centres] referral for treatment, recording and reporting data, carrying out advocacy for RNTCP and conducting operational research relevant to RNTCP. Medical colleges are contributing to diagnosis and treatment of human immunodeficiency virus (HIV)-TB co-infection and development of laboratory infrastructure for early diagnosis of multidrug-resistant and/or extensively drug-resistant TB (M/XDR-TB) and DOTS-Plus sites for treatment of MDR-TB cases. Overall, at a national level, medical colleges have contributed to 25 per cent of TB suspects referred for diagnosis; 23 per cent of ‘new smear-positives’ diagnosed; 7 per cent of DOT provision within medical college; and 86 per cent treatment success rate among new smear-positive patients. As the Programme widens its scope, future challenges include sustenance of this contribution and facilitating universal access to quality TB care; greater involvement in operational research relevant to the Programme needs; and better co-ordination mechanisms between district, state, zonal and national level to encourage their involvement. PMID:23563371

Frequent detection of a human fecal indicator in the urban ocean: environmental drivers and covariation with enterococci.

PubMed

Jennings, Wiley C; Chern, Eunice C; O'Donohue, Diane; Kellogg, Michael G; Boehm, Alexandria B

2018-03-01

Fecal pollution of surface waters presents a global human health threat. New molecular indicators of fecal pollution have been developed to address shortcomings of traditional culturable fecal indicators. However, there is still little information on their fate and transport in the environment. The present study uses spatially and temporally extensive data on traditional (culturable enterococci, cENT) and molecular (qPCR-enterococci, qENT and human-associated marker, HF183/BacR287) indicator concentrations in marine water surrounding highly-urbanized San Francisco, California, USA to investigate environmental and anthropogenic processes that impact fecal pollution. We constructed multivariable regression models for fecal indicator bacteria at 14 sampling stations. The human marker was detected more frequently in our study than in many other published studies, with detection frequency at some stations as high as 97%. The odds of cENT, qENT, and HF183/BacR287 exceeding health-relevant thresholds were statistically elevated immediately following discharges of partially treated combined sewage, and cENT levels dissipated after approximately 1 day. However, combined sewer discharges were not important predictors of indicator levels typically measured in weekly monitoring samples. Instead, precipitation and solar insolation were important predictors of cENT in weekly samples, while precipitation and water temperature were important predictors of HF183/BacR287 and qENT. The importance of precipitation highlights the significance of untreated storm water as a source of fecal pollution to the urban ocean, even for a city served by a combined sewage system. Sunlight and water temperature likely control persistence of the indicators via photoinactivation and dark decay processes, respectively.

The efficacy of exercise referral as an intervention for Irish male prisoners presenting with mental health symptoms.

PubMed

O'Toole, Shay; Maguire, Jim; Murphy, Pearse

2018-06-11

Purpose The use of exercise as an intervention to improve health in the general population is well documented. The purpose of this paper is to explore whether an exercise referral scheme can be an effective health promotion tool for male prisoners in Ireland, presenting with mental health symptoms. Design/methodology/approach This mixed methods study with a pre- and post-intervention design was conducted in Mountjoy Prison, Dublin, which has a capacity for approximately 790 prisoners. Reliable and validated symptom assessment scales were used to assess levels of depression, anxiety, stress, self-esteem and anger amongst a sample of 40 prisoners pre- and post-intervention. The scales used were the Depression, Anxiety and Stress scale or DASS-42 (Lovibond and Lovibond, 1995), the Novaco Anger Scale (Novaco, 1994), the Rosenberg Self-Esteem Scale ( Rosenberg, 1965 ) and the Zung Self-Rated Anxiety Scale (Zung, 1971). Semi-structured interviews were also conducted with a subset of the participants post-intervention to further test and contextualise the symptom ratings. The data gathered from the self-rating scales were imported into SPSS 22 for statistical testing for significance. Wilcoxon's signed-rank test was then used to measure significance of changes. Thematic analysis was performed on the qualitative data. Findings In the post-intervention, significant levels of improvement were achieved in the levels of depression, anxiety (DASS), anxiety (Zung), stress, anger, and self-esteem for 29 of the 30 prisoners who completed the study. The incidence of normal mood scores rose from 33 to 90 per cent after the intervention; the incidence of extremely severe scores for anxiety changed from 40 to 7 per cent, severe stress scores changed from 27 to 3 per cent, normal stress levels rose from 17 to 73 per cent, marked anger ratings reduced from 40 to 3 per cent and low self-esteem levels reduced from 20 per cent of participants pre-intervention to 7 per cent post-intervention. In the main, participants perceived the experiences and outcomes of the intervention positively. Research limitations/implications There are some limitations to the design of this study. Operational circumstances within the prison at the start of this study prevented the authors from accessing a larger sample. A control group would add greatly to the study but this was not possible within a single prison setting. The possible influence of extraneous variables such as increased attention and social contact, and more time out of one's cell may have contributed to improved symptom scores as much as the exercise intervention in this study. This possibility was recognised from the outset but the authors proceeded because the aim was to test if an exercise referral package (and all that inevitably goes with that) would make a difference for symptomatic prisoners. Practical implications The organisation and smooth running of the intervention and the positive results therein underpinned the practicality of this project. The significantly positive results contribute new knowledge to the profile of Irish male prisoners' mental health. Social implications This study could be the foundation for a larger study or set of studies which should include a control group and one or more female prisoner cohorts. The impact of positive changes in prisoners' mental health on the prison staff and environment could also be researched. This type of study could lead to important social implications in relation to its impact on prisoner rehabilitation. Originality/value This study was the first of its kind to explore the effectiveness of exercise referral as a health promotion intervention for Irish male prisoners presenting with mental health symptoms.

Concurrent immune-mediated haemolytic anaemia and severe thrombocytopenia in 21 dogs.

PubMed

Goggs, R; Boag, A K; Chan, D L

2008-09-13

The medical records of 21 dogs with concurrent immune-mediated haemolytic anaemia (imha) and severe thrombocytopenia (defined as an automated platelet count of less than 50x10(9)/l, confirmed by the examination of a blood smear) were reviewed. Their mean (sd) age was 5.8 (2.5) years. When compared with the 24,759 dogs in the hospital population for the same period Airedale terriers and dobermanns appeared to be over-represented with odds ratios of 22.5 (95 per cent confidence interval [ci] 5.2 to 97.9) and 7.6 (95 per cent ci 1.8 to 32.7) respectively. The median duration of the dogs' clinical signs was seven days, with a range from one to 17 days. Eleven of the dogs had a history of a tendency to bleed, and 15 had evidence of bleeding when examined. Twenty of the 21 dogs had been treated with glucocorticoids, nine with vincristine, and seven with azathioprine. Their median stay in hospital was four days, with a range from one to 17 days. The median period for which they survived after admission to hospital was five days, with a range from one to 558 days, and 16 of the 21 dogs had died or been euthanased within 30 days of their admission.

First-trimester maternal serum alpha-fetoprotein as a marker for fetal chromosomal disorders. Dutch Working Party on Prenatal Diagnosis.

PubMed

Van Lith, J M

1994-10-01

We evaluated first-trimester maternal serum alpha-fetoprotein (MS-AFP) as a marker for fetal chromosomal disorders. The multicentre study was performed under the auspices of the Dutch Working Party on Prenatal Diagnosis. MS-AFP was measured in 2404 normal pregnancies and 72 chromosomally abnormal pregnancies. The median multiple of the normal median (MOM) in 32 Down's syndrome pregnancies was 0.83 with a 95 per cent confidence interval ranging from 0.60 to 1.04. The difference between the distributions of first-trimester MS-AFP in normal and Down's syndrome pregnancies was statistically significant (t-test: t = 2.34, P < 0.05). Thirty-one per cent of the Down's syndrome pregnancies were found below the tenth percentile. We found no difference between normal pregnancies and pregnancies with other chromosomal disorders (eight cases with trisomy 18, MOM = 1.26; seven cases with sex chromosome abnormalities, MOM = 1.07; 22 cases with a chromosomal mosaic pattern in chorionic villi, MOM = 1.08). We conclude that first-trimester MS-AFP can discriminate between normal and Down's syndrome pregnancies, but is not an effective marker. First-trimester MS-AFP has no value as a marker for other fetal chromosomal disorders.

Global carbon dioxide emissions from inland waters

USGS Publications Warehouse

Raymond, Peter A.; Hartmann, Jens; Lauerwald, Ronny; Sobek, Sebastian; McDonald, Cory P.; Hoover, Mark; Butman, David; Striegl, Robert G.; Mayorga, Emilio; Humborg, Christoph; Kortelainen, Pirkko; Durr, Hans H.; Meybeck, Michel; Ciais, Philippe; Guth, Peter

2013-01-01

Carbon dioxide (CO2) transfer from inland waters to the atmosphere, known as CO2 evasion, is a component of the global carbon cycle. Global estimates of CO2 evasion have been hampered, however, by the lack of a framework for estimating the inland water surface area and gas transfer velocity and by the absence of a global CO2 database. Here we report regional variations in global inland water surface area, dissolved CO2 and gas transfer velocity. We obtain global CO2 evasion rates of 1.8   petagrams of carbon (Pg C) per year from streams and rivers and 0.32  Pg C yr−1 from lakes and reservoirs, where the upper and lower limits are respectively the 5th and 95th confidence interval percentiles. The resulting global evasion rate of 2.1 Pg C yr−1 is higher than previous estimates owing to a larger stream and river evasion rate. Our analysis predicts global hotspots in stream and river evasion, with about 70 per cent of the flux occurring over just 20 per cent of the land surface. The source of inland water CO2 is still not known with certainty and new studies are needed to research the mechanisms controlling CO2 evasion globally.

The prevalence of stroke and associated disability.

PubMed

O'Mahony, P G; Thomson, R G; Dobson, R; Rodgers, H; James, O F

1999-06-01

There are limited data available on the prevalence of stroke in the United Kingdom. Such data are important for the assessment of the health needs of the population. This study aimed to determine the prevalence of stroke and the prevalence of associated dependence in a district of northern England. This was a two-stage point prevalence study. A valid screening questionnaire was used to identify stroke survivors from an age- and sex-stratified sample of the population aged 45 years and over in a family health services authority district. This was followed by assessment of stroke patients with scales of disability and handicap. The overall prevalence of stroke was found to be 17.5/1000 (95 per cent confidence interval (CI) 17.0, 18.0). The prevalence of stroke-associated dependence was 11.7/1000 (95 per cent CI 11.3, 12.1). Self-reported comorbidity was most commonly due to circulatory and musculoskeletal disorders. The prevalence of stroke in this district is considerably higher than current guidelines and previous results suggest. Nevertheless, the result from this study combined with that from a previous study in another district in the United Kingdom should allow those interested in epidemiologically based health needs assessment to make reasonable estimates of the burden of stroke in their area.

Is 50 cent the price of the optimal copayment? - a qualitative study of patient opinions and attitudes in response to a 50 cent charge on prescription drugs in a publicly funded health system in Ireland

PubMed Central

2013-01-01

Background A 50 cent prescription levy was introduced in 2010 on the General Medical Services (GMS) scheme (Irish public health insurance). This study sought to examine patient attitudes and opinions surrounding the 50 cent copayment. Given the small momentary value of the prescription fee, these results are of interest to policymakers internationally who wish to reduce copayments rather than abolish them. Methods A qualitative research design was used; semi structured interviews were carried out. Twenty four GMS eligible participants were interviewed in 23 interviews. Fifteen females and 9 males took part. Ages varied from 31- >70 years. Patients were invited to be interviewed in both independent and chain community pharmacies in three types of setting; 1) a socially deprived urban area, 2) a suburban affluent area and 3) a rural area. The Framework method was used for data management and analysis using QSR International’s NVivo 9.2 qualitative data analysis software. The “Francis method” was used to test for data saturation. Results Results are of interest to the Irish context and also at a broader international level. Patients were mostly accepting of the prescription levy with some reservations concerning an increased price and the way in which generated revenue would be used by government. Participants identified waste of prescription drugs at the hand of patients (moral hazard), but there was discordant opinion on whether the 50 cent copayment would halt this moral hazard. Interviewees felt the levy was affordable, albeit some may suffer a financial impact more than others. Conclusions This qualitative study gives important insights into the experiences of GMS patients with regard to the prescription levy. Information regarding the appropriateness of a 50 cent copayment as a symbolic copayment needs to be confirmed by quantitative analysis. Further insight is required from a younger population. PMID:23305316

Influence of national centralization of oesophagogastric cancer on management and clinical outcome from emergency upper gastrointestinal conditions.

PubMed

Markar, S R; Mackenzie, H; Wiggins, T; Askari, A; Karthikesalingam, A; Faiz, O; Griffin, S M; Birkmeyer, J D; Hanna, G B

2018-01-01

In England in 2001 oesophagogastric cancer surgery was centralized. The aim of this study was to evaluate whether centralization of oesophagogastric cancer to high-volume centres has had an effect on mortality from different emergency upper gastrointestinal conditions. The Hospital Episode Statistics database was used to identify patients admitted to hospitals in England (1997-2012). The influence of oesophagogastric high-volume cancer centre status (20 or more resections per year) on 30- and 90-day mortality from oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer was analysed. Over the study interval, 3707, 12 441 and 56 822 patients with oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer respectively were included. There was a passive centralization to high-volume cancer centres for oesophageal perforation (26·9 per cent increase), paraoesophageal hernia (19·5 per cent increase) and perforated peptic ulcer (23·0 per cent increase). Management of oesophageal perforation in high-volume centres was associated with a reduction in 30-day (HR 0·58, 95 per cent c.i. 0·45 to 0·74) and 90-day (HR 0·62, 0·49 to 0·77) mortality. High-volume cancer centre status did not affect mortality from paraoesophageal hernia or perforated peptic ulcer. Annual emergency admission volume thresholds at which mortality improved were observed for oesophageal perforation (5 patients) and paraoesophageal hernia (11). Following centralization, the proportion of patients managed in high-volume cancer centres that reached this volume threshold was 88·0 per cent for oesophageal perforation, but only 30·3 per cent for paraoesophageal hernia. Centralization of low incidence conditions such as oesophageal perforation to high-volume cancer centres provides a greater level of expertise and ultimately reduces mortality. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Comparison of animal and plant proteins for young pen-reared bobwhite quail

USGS Publications Warehouse

Nestler, R.B.; Llewellyn, L.M.; Rensberger, M.J.

1945-01-01

Bobwhite quail chicks, when given a choice of balanced diets in which the essential difference was the protein supplement, showed preferences for one diet containing 49 per cent peanut oil meal, another containing a mixture of 9 per cent meat and bone scraps (50% protein) with 38 per cent soybean oil meal, and a third (control) diet containing a mixture of 16 per cent dried buttermilk with 42 per cent soybean oil meal, in contrast to diets containing sardine meal or menhaden fish meal. ....Feeding tests during the first five weeks of life showed that diets containing 14 per cent sardine fish meal consistently gave high live weights, low mortality, and high efficiency of feed utilization. Diets with 9 to 10 per cent menhaden meal produced nearly as good results....Live weights, survival, and efficiency of feed utilization were markedly better on a diet containing 9 per cent meat and bone scrap (50% protein) than on one with 9 per cent meat scrap (55% protein), but not as good as with diets containing fish meal without meat....The chicks grew and survived more successfully on diets containing either soybean oil meal or peanut oil meal as the sole protein supplement, than on diets containing either linseed oil meal, cottonseed oil meal, or dried buttermilk as the sole protein concentrate. None of these was as satisfactory as the diets containing fish meal.....All chicks died on diets containing either linseed oil meal, cottonseed oil meal, or dried buttermilk as the sole source of protein. All three of these concentrates, however, gave satisfactory results, when used as 10 per cent of the diet. In fact, survival and efficiency of feed utilization were nearly as good on a diet containing 10 per cent dried buttermilk, 10 per cent linseed oil meal, 10 per cent peanut oil meal, and 27 per cent soybean oil meal, as on diets containing fish meal.

Migratory fish, a problem of interstate cooperation?

USGS Publications Warehouse

Van Oosten, John; Adams, William C.; Finley, William L.; Westerman, Fred A.

1939-01-01

Bobwhite quail chicks, when given a choice of balanced diets in which the essential difference was the protein supplement, showed preferences for one diet containing 49 per cent peanut oil meal, another containing a mixture of 9 per cent meat and bone scraps (50% protein) with 38 per cent soybean oil meal, and a third (control) diet containing a mixture of 16 per cent dried buttermilk with 42 per cent soybean oil meal, in contrast to diets containing sardine meal or menhaden fish meal. ....Feeding tests during the first five weeks of life showed that diets containing 14 per cent sardine fish meal consistently gave high live weights, low mortality, and high efficiency of feed utilization. Diets with 9 to 10 per cent menhaden meal produced nearly as good results....Live weights, survival, and efficiency of feed utilization were markedly better on a diet containing 9 per cent meat and bone scrap (50% protein) than on one with 9 per cent meat scrap (55% protein), but not as good as with diets containing fish meal without meat....The chicks grew and survived more successfully on diets containing either soybean oil meal or peanut oil meal as the sole protein supplement, than on diets containing either linseed oil meal, cottonseed oil meal, or dried buttermilk as the sole protein concentrate. None of these was as satisfactory as the diets containing fish meal.....All chicks died on diets containing either linseed oil meal, cottonseed oil meal, or dried buttermilk as the sole source of protein. All three of these concentrates, however, gave satisfactory results, when used as 10 per cent of the diet. In fact, survival and efficiency of feed utilization were nearly as good on a diet containing 10 per cent dried buttermilk, 10 per cent linseed oil meal, 10 per cent peanut oil meal, and 27 per cent soybean oil meal, as on diets containing fish meal.

Epidemiology of burns due to domestic flammable agents.

PubMed

Pegg, S P; Beecham, L; Dore, N; Hrdlicka, D; Hukins, C

1990-04-01

An analysis of the epidemiological factors relating to domestic flammable agents has shown that 17.7 per cent of admissions over a 5-year period were involved in domestic flammable injuries; 87.7 per cent of the patients were male, with 38.9 per cent being young males between 12 and 19 years old. Petrol and diesel accounted for 56.8 per cent of the burns and the average body surface area burned was 17.7 per cent. Most commonly the face, hands and limbs were burned, and the average length of stay was 18.25 days, 69.2 per cent of the burns were due to human error and were thus potentially preventable, 21.2 per cent had predisposing conditions with 8.9 per cent being due to alcohol. It was considered that the strategies to prevent these burns injuries should be aimed particularly at young males.

Testing the association between the incidence of schizophrenia and social capital in an urban area.

PubMed

Kirkbride, J B; Boydell, J; Ploubidis, G B; Morgan, C; Dazzan, P; McKenzie, K; Murray, R M; Jones, P B

2008-08-01

Social capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20). MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics. We identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2-3.3] and high (IRR 2.5, 95% CI 1.3-4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation. ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.

A Study to Determine Whether Nurse Practitioners are Appropriately Utilized at Moncrief Army Hospital, Fort Jackson, South Carolina

DTIC Science & Technology

1981-08-01

cent are family practice, 17.6 per cent are adult medicine, 10.7 per cent are maternity, 8.4 per cent are midwifery , 13 and 3 per cent are psychiatric...authority to prescribe drugs listed in the algorithm. 15 The Physician Assistants (PA) are corpsmen who are given a two year 5 training program and

Dental public health capacity worldwide: Results of a global survey.

PubMed

Lomazzi, Marta; Wordley, Valerie; Bedi, Raman

2016-12-01

The World Federation of Public Health Associations' Oral Health Working Group (WFPHA OHWG) carried out a survey to establish the extent of global dental public health (DPH) capacity. Senior stakeholders in DPH completed 124 surveys, covering 73 countries and all WHO regions. The survey evaluated DPH workforce within the country, funding, education, current services, and integration between public health and DPH in countries across the world. In 62 per cent of countries, DPH is only partially integrated in the public health system, while in 25 per cent of countries it has not yet been formally integrated. DPH programs at Masters level are available in 44 per cent of countries. Over half of countries have 0 to 10 trained DPH professionals. Because both poor oral and general health share several common risk factors, DPH must be integrated into national health systems and budgets, with an emphasis on having trained DPH specialists available in every country to collaborate in healthcare policy and provision.

Prion protein genotype survey confirms low frequency of scrapie-resistant K222 allele in British goat herds.

PubMed

Goldmann, W; Marier, E; Stewart, P; Konold, T; Street, S; Langeveld, J; Windl, O; Ortiz-Pelaez, A

2016-02-13

Scrapie in goats is a transmissible, fatal prion disease, which is endemic in the British goat population. The recent success in defining caprine PRNP gene variants that provide resistance to experimental and natural classical scrapie has prompted the authors to conduct a survey of PRNP genotypes in 10 goat breeds and 52 herds to find goats with the resistant K222 allele. They report here the frequencies in 1236 tested animals of the resistance-associated K222 and several other alleles by breed and herd. Eight animals were found to be heterozygous QK222 goats (0.64 per cent genotype frequency, 95 per cent CI 0.28 to 1.27 per cent) but no homozygous KK222 goats were detected. The K222 allele was found in Saanen, Toggenburg and Anglo-Nubian goats. The fact that only a few goats with the K222 allele have been identified does not preclude the possibility to design and implement successful breeding programmes at national level. British Veterinary Association.

Chemotherapy drug handling in first opinion small animal veterinary practices in the United Kingdom: results of a questionnaire survey.

PubMed

Edery, E G

2017-05-27

To investigate how first opinion small animal veterinary surgeons in the UK handled chemotherapeutic agents, a questionnaire was distributed at the 2014 British Small Animal Veterinary Association congress and by internet. Chemotherapy was regularly offered by 70.4 per cent of the respondents. Gold standards defined according to available guidelines for safe handling of antineoplastic drugs were poorly followed by general practitioners with only 2 per cent of respondents complying with all of them. Dedicated facilities for preparation and administration of cytotoxic drugs were variably available among participants. The level of training of staff indirectly involved in handling chemotherapy was appropriate in less than 50 per cent of practices. No association was found between demographic characteristics of the sampled population and the decision to perform chemotherapy. The results of this study raise concerns about the safety of the veterinary staff in first opinion practices involved in handling chemotherapy. British Veterinary Association.

Assessing deforestation in the coastal zone of the Campeche State, Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mas, J.F.; Vega, A.P.; Aponte, G.P.

1997-06-01

In order to determine rates of deforestation in the State of Campeche, Mexico, forest maps of 1978/80 and 1992 were compared within a geographic information system (GIS). Results indicate that more than 25 per cent of the tropical forest and mangroves were deforested and other 29 per cent were fragmented during this period. The rate of deforestation in the whole state is about 4.4 per cent per year, but the analysis showed that rates of deforestation are much higher in the coastal zone. For this reason an attempt was made to study deforestation patterns in the coastal zone. Data suchmore » as distance from roads and from settlements images were incorporated in the GIS data base and a model which represents influence of population on its environment was developed in order to establish the influence of socioeconomic factors on forest clearing. Results indicate that deforestation presents a higher correlation with levels of poverty and social abandonment than with demographic aspects.« less

31 CFR 82.2 - Exceptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exportation of 5-cent coins and one-cent coins carried on an individual, or in the personal effects of an... incidental to the recycling of other materials so long as— (1) Such 5-cent and one-cent coins were not added...

Highly siderophile elements in Earth's mantle as a clock for the Moon-forming impact.

PubMed

Jacobson, Seth A; Morbidelli, Alessandro; Raymond, Sean N; O'Brien, David P; Walsh, Kevin J; Rubie, David C

2014-04-03

According to the generally accepted scenario, the last giant impact on Earth formed the Moon and initiated the final phase of core formation by melting Earth's mantle. A key goal of geochemistry is to date this event, but different ages have been proposed. Some argue for an early Moon-forming event, approximately 30 million years (Myr) after the condensation of the first solids in the Solar System, whereas others claim a date later than 50 Myr (and possibly as late as around 100 Myr) after condensation. Here we show that a Moon-forming event at 40 Myr after condensation, or earlier, is ruled out at a 99.9 per cent confidence level. We use a large number of N-body simulations to demonstrate a relationship between the time of the last giant impact on an Earth-like planet and the amount of mass subsequently added during the era known as Late Accretion. As the last giant impact is delayed, the late-accreted mass decreases in a predictable fashion. This relationship exists within both the classical scenario and the Grand Tack scenario of terrestrial planet formation, and holds across a wide range of disk conditions. The concentration of highly siderophile elements (HSEs) in Earth's mantle constrains the mass of chondritic material added to Earth during Late Accretion. Using HSE abundance measurements, we determine a Moon-formation age of 95 ± 32 Myr after condensation. The possibility exists that some late projectiles were differentiated and left an incomplete HSE record in Earth's mantle. Even in this case, various isotopic constraints strongly suggest that the late-accreted mass did not exceed 1 per cent of Earth's mass, and so the HSE clock still robustly limits the timing of the Moon-forming event to significantly later than 40 Myr after condensation.

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social Well-Being and Health longitudinal study.

PubMed

Astell-Burt, Thomas; Maynard, Maria J; Lenguerrand, Erik; Harding, Seeromanie

2012-01-01

To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being. Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11-16 years in 51 London (U.K.) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socio-economic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity. Ethnic minorities were more likely to report racism than whites. Ethnic minority boys (except Indian boys) and Indian girls reported better psychological well-being throughout adolescence compared to their white peers. Notably, lowest mean TDS scores were observed for Nigerian/Ghanaian boys, among whom the reporting of racism increased with age. Adjusted for individual characteristics, psychological well-being improved with age across all ethnic groups. Racism was associated with poorer psychological well-being trajectories for all ethnic groups (p<0.001), reducing with age. For example, mean difference in TDS (95% confidence interval) between boys who experienced racism and those who did not at age 12 years=1.88 (+1.75 to +2.01); at 16 years = +1.19 (+1.07 to +1.31). Less racism was generally reported in schools and neighbourhoods with high than low own-group density. Own ethnic density and diversity were not consistently associated with TDS for any ethnic group. Living in more deprived neighbourhoods was associated with poorer psychological well-being for whites and black Caribbeans (p<0.05). Racism, but not ethnic density and deprivation in schools or neighbourhoods, was an important influence on psychological well-being. However, exposure to racism did not explain the advantage in psychological well-being of ethnic minority groups over whites.

Retrospective study of congenital heart defects in 151 dogs.

PubMed

Tidholm, A

1997-03-01

The case records of 151 dogs diagnosed with congenital heart disease were reviewed retrospectively. The most common defect was aortic stenosis, accounting for 35 per cent of all cases, followed by pulmonic stenosis (20 per cent), ventricular septal defect (12 per cent), patent ductus arteriosus (11 per cent), mitral valve dysplasia (8 per cent), tricuspid valve dysplasia (7 per cent), endocardial fibroelastosis (1.9 per cent) and tetralogy of Fallot (0.6 per cent). Fifty-one breeds were represented, with golden retrievers, German shepherd dogs and boxers predominating. No overall sex predilection was obvious. Seventy-five per cent of the dogs were asymptomatic at presentation. The defects most often associated with presenting symptoms, such as dyspnoea, syncope, ascites, failure to grow and depression, were mitral valve dysplasia, atrial septal defect, tricuspid valve dysplasia and endocardial fibroelastosis. The latter presented with the most severe signs of heart failure. In some cases of aortic stenosis and pulmonic stenosis, where the defect could not be accurately visualised with two-dimensional echocardiography, Doppler echocardiographic examination was needed for definitive diagnosis.

Prevalence of self-reported depressive symptoms in young adolescents.

PubMed Central

Schoenbach, V J; Kaplan, B H; Wagner, E H; Grimson, R C; Miller, F T

1983-01-01

To investigate the significance and measurement of depressive symptoms in young adolescents, 624 junior high school students were asked to complete the Center for Epidemiologic Studies Depression Scale (CES-D) during home interviews. In 384 usable symptom scales, item-scale correlations (most were above .50), inter-item correlations, coefficient alpha (.85), and patterns of reported symptoms were reasonable. Persistent symptoms were reported more often by Blacks, especially Black males. Prevalence of persistent symptoms in Whites was quite close to reported figures for adults, ranging from 1 per cent to 15 per cent in adolescent males and 2 per cent to 13 per cent in adolescent females. Adolescents reported persistent vegetative symptoms less often and psychosocial symptoms more often. Reports of symptoms without regard to duration were much more frequent in the adolescents, ranging from 18 per cent to 76 per cent in White males, 34 per cent to 76 per cent in White and Black females, and 41 per cent to 85 per cent in Black males. The results support the feasibility of using a self-report symptom scale to measure depressive symptoms in young adolescents. Transient symptoms reported by adolescents probably reflect their stage of development, but persistent symptoms are likely to have social psychiatric importance. PMID:6625033

Survey of the provision of prophylactic dental care for horses in Great Britain and Ireland between 1999 and 2002.

PubMed

Dixon, P M; Andrew, R; Brannon, H; Burgess, R; Gibson, A; Little, J C; Orange, B; Ross, L; Rudolph, T; Shaw, D J

2004-11-27

A survey of 854 horse owners, trainers and equestrian managers in 10 regions of Great Britain and Ireland showed that 83 per cent provided their horses with routine prophylactic dental care at fixed intervals, including 49 per cent at intervals of 12 months and 30 per cent at intervals of six months; a further 10 per cent provided it only when they felt it was required and 7 per cent did not provide it at all. Overall, 44 per cent of the owners had their horse's wolf teeth (first premolar) extracted routinely; when prophylactic dentistry was provided, it was carried out solely by equine dental technicians (EDTS) for 53 per cent of owners, solely by veterinarians for 35 per cent, by both EDTS or veterinarians for 10 per cent of owners and by other than veterinarians or EDTS for 1 per cent. There was confusion among some horse owners concerning the qualifications of the EDTS, because no recognised British qualification was available until towards the end of this survey in 2001. Several reasons were cited by owners for choosing between veterinarians and EDTS including their perceived qualifications, personal recommendations, costs, the availability of a wide range of dental equipment and sedation, and the time and effort devoted to the procedures.

Attitudes toward euthanasia, assisted suicide and termination of life-sustaining treatment of Puerto Rican medical students, medical residents, and faculty.

PubMed

Ramirez Rivera, J; Rodríguez, R; Otero Igaravidez, Y

2000-01-01

To elicit the opinion of Puerto Rican medical students, residents and internal medicine faculty as to the appropriateness of euthanasia and physician-assisted suicide and end-of-life management. Survey using a 16-item questionnaire answered within a two-month period in the fall of 1996. Rounds or faculty meetings at teaching hospitals located in the north, south and southwest of the island of Puerto Rico. There were 424 participants. The questionnaires of 279 medical students, 75 medical residents, and 35 internal medicine faculty members were analyzed. Thirty-five questionnaires, which were incomplete or answered by non-Puerto Rican participants, were excluded. Frequency of support of active euthanasia, physician-assisted suicide, withholding or withdrawing life-sustaining treatment with informed consent was determined. Whether it was ethical to prescribe full doses of drugs needed to alleviate pain even if it would hasten death, or agree to limit or restrict resources for the terminally ill was also determined. Forty per cent of the students, 33% of the residents, and 20% of the faculty supported euthanasia. If physician-assisted suicide were legalized, 50 per cent of the students, 43 per cent of the residents and 45 percent of the faculty would not be opposed to it. Sixty-eight per cent of the students, 67 per cent of the residents and 88 per cent of the faculty would support withholding or withdrawing life-sustaining treatment for dying patients with informed consent. Seventy-nine per cent of residents, 80 per cent of the faculty but only 54 per cent of medical students would prescribe full doses of drugs needed to alleviate pain in dying patients even if they would hasten death. Thirty-six per cent of the residents and faculty would agree to limit the use of medical resources for the terminally ill but only sixteen per cent of medical students would do so. The acceptance of euthanasia was inversely proportional to the clinical experience of the respondents: 40 per cent among students but only 20 per cent by the faculty. Withholding and withdrawing of life-sustaining treatment was most acceptable to the faculty (88 per cent) but it was also favored by most of the students and residents (68 and 67 per cent respectively). Eighty per cent of the faculty, 79 per cent of the residents, but only 50 per cent of the students considered that prescribing full doses of drugs to alleviate pain if they knew it would hasten death, was ethical. The medical profession should take notice of evolving concepts in end-of-life management.

Riding the wave or paddling in the shallows? Understanding older Australians' use of the internet.

PubMed

Burns, Pippa; Jones, Sandra C; Iverson, Don; Caputi, Peter

2012-08-01

Australia's ageing population is set to become an increasing burden on an already over-stretched primary health care system. Potential strategies to alleviate this pressure need to be investigated. Increased knowledge of older Australians' use of the internet would allow the appropriateness of online health intervention to be assessed. This initial, exploratory study examined the proportion of people aged 55 years and older who accessed the internet. It investigated their duration of use, level of comfort, use of the internet to seek health information and perceived reliability of information found on the internet. A paper based survey was distributed to a purposive sample of adults in metropolitan New South Wales. Complete data was received from 115 respondents. Sixty-two per cent of respondents reported internet use, with use decreasing with age. The majority of respondents who used the internet reported high confidence levels and long-term use. The majority had used the internet to search for health information which was generally perceived to be reliable. Logistic regression showed tertiary education and household income greater than $40,000 per year predicted use of a computer to access the internet. The majority of older Australians surveyed were successfully riding the internet wave. They have both the skills and equipment to access health information online and many were already doing so.

Raw Starch Degrading Amylase Production by Various Fungal Cultures Grown on Cassava Waste

PubMed Central

Balaji, P.; Eyini, M.

2006-01-01

The solid waste of sago industry using cassava was fermented by Aspergillus niger, Aspergillus terreus and Rhizopus stolonifer in solid state fermentation. Cassava waste contained 52 per cent starch and 2.9 per cent protein by dry weight. The amylase activity was maintained at a high level and the highest amylase activity was observed on the 8th day in R. stolonifer mediated fermentation. R. stolonifer was more efficient than Aspergillus niger and Aspergillus terreus in bioconverting cassava waste into fungal protein (90.24 mg/g) by saccharifying 70% starch and releasing 44.5% reducing sugars in eight days of solid state fermentation. PMID:24039485

THE BIOLOGY OF DEUTERIUM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katz, J.J.; Crespi, H.L.; Finkel, A.J.

1958-10-31

g been noted, but the full scope and nature of these effects still remain largely unexplored. Early work was greatly hampered by the difficulties of obtaining deuterium but the development of a vast nuclear energy technology has made deuterium available on a larghe scale. It has now become opportune to undertake comprehensive reports work undertaken on algae, fungi, bacteria, and mammals. Mice will tolerate up to about 40 per cent D/sub 2/O in the drinking water for at least four months; of about 30 per cent heavy water. When deuteration is into various tissues and organs to the amount ofmore » from 40 to 50 per cent of the deuterium in the body fluids. 25 atom per cent, for as long as 12 months without obcal effects of deuterium is the kinetic isotpe effect. In general, bonds to deuterium react less readily than bonds to hydrogen; in consequence, reaction reates are decreased, and a depression in tissue metabolism should result. At concentrations about 30 atom per cen deuterium mice and rats show weakness, neutrmuscular por and death Since neoplastic cells metabolize rapidly, presumably these should be particularly sensitive to the effects of deuteration. Deuteration of host mice resulted in reduced growth rates of injected Krebs-2 ascites tumors and of inoculated P-1534 lymphatic leukemia. The general effects of deuterium on growth has been Chlorella vulgaris and Scenedesmus obliquus, have been have been harvested that yield water of combustion containing more than 90 atom per cent deuterium. The e were altered by deuteration. The fungi Penicillium notatum and Aspergillus fonsecaeus have been grown in media containing various concentrations of D/sub 2/O up to 99.6 per cent, and here, too, morphology, sporulation, pigment production, and growth rate were all affected by deuteration. The results obtained with algae clearly indicate the feasibility of producing fully deuterated compounds of biological significance by biosynthetic procedures. Bacterial studies on Group C hemolytic streptococci, Type I pnemococci, Mycobacterium tuberculosis and M.phlei, and Escherichia coli showed that the growth rates were diminished with elevation of the D/.sub 2/O concentration above 50 per cent and that cessation of growth uniformly occurred at D/sub 2/O levels greater than 90 per cent. Deuterium may also be utilized in the study of metabolism by the administration of deuterated essential metabolites. Experiments are described wherein fungi have been grown on glucose in which the hydrogen on carbon-1 (D-glucose-d/sub 1/) has been completely replaced by deuterium. (auth)« less

Chemical composition of phosphorites of the Phosphoria Formation

USGS Publications Warehouse

Gulbrandsen, R.A.

1966-01-01

The chemical composition, both major and minor constituents, of 60 samples of phosphorite from the Phosphoria Formation was determined. Major constituents of the average phosphorite are, by weight per cent: SiO2, 11??9; Al2O3, 1??7; Fe2O3,1??1; MgO, 0??3; CaO, 44??0; Na2O, 0??6; K2O, 0??5; total H2O, 2??2; H2O-, 0??6; TiO2, 0??1; P2O5, 30??5; CO2, 2??2; SO3, 1??8; F, 3??1; organic matter, 2??1; and oil, 0??2. Uranium averages 0??009 per cent. The phosphate mineral is basically apatite, Ca5(PO4)3F, with small but significant and variable substitutions-Na, Sr, U and Th for Ca, and CO3 and SO4 for PO4. Rare metals not associated with apatite are associated principally with the organic-matter component of the rocks. This group includes As, Ag, Cd, Cr, Cu, Mo, Ni, Sb, Se, V and Zn. Chromium is the most abundant, having a modal abundance of 0??1 per cent and a maximum concentration of 0??3 per cent. The average phosphorite is composed of approximately 80 per cent apatite, 10 per cent quartz, 5 per cent muscovite-illite, 2 per cent organic matter, 1 per cent dolomite-calcite, 1 per cent iron oxide, and 1 per cent other components. It is texturally a medium-grained pellet phosphorite. ?? 1966.

Free adrenaline and noradrenaline excretion related to occupational stress.

PubMed Central

Timio, M; Gentili, S; Pede, S

1979-01-01

Urinary levels of free adrenaline and noradrenaline were measured in two groups of healthy male industrial workers exposed to alternate four-day periods of working conditions with and without time stress, to test the hypothesis that the sympathetic nervous system is overactivated by occupational stress. Thirty confectionary workers alternated piece-work (payment by results) and work with a fixed daily wage while 30 metal workers alternated work on an assembly line with work off it. Under time stress urinary free adrenaline was 450 per cent and noradrenaline 230 per cent of the levels for similar work without time stress but involving equal oxygen consumption. These differences were statistically highly significant and they persisted on retesting after six months of alternating work regimens. They support the concept that occupational stress in industrial workers influences the adrenosympathetic system and they indicate a possible method for assessing the effects of high levels of sympathetic activity on the aetiology of ischaemic heart disease. PMID:508478

Anatrophic nephrolithotomy for removal of staghorn or branched renal calculi.

PubMed

James, R; Novick, A C; Straffon, R A; Stewart, B H

1980-02-01

Forty anatrophic nephrolithotomies were performed in 38 patients between November, 1965, and December, 1977, to remove staghorn or branched renal calculi. Thirty-six (95 per cent) of the patients' preoperative urine cultures were infected, and postoperatively 35 of the cultures (88 per cent) were sterile. Magnesium ammonium phosphate calculi were present in the majority of patients (67 per cent). In 6 patients (15 per cent) transient nephrocutaneous fistulas developed. Thirty-six of the 40 renal units (90 per cent) had improved or stable intravenous pyelograms postoperatively. The patients had been followed for an average of twenty months (four to one hundred and twelve months). In 6 patients (15 per cent) recurrent renal calculi developed, and 3 patients (8 per cent) had residual calculi during this period.

Antimicrobial resistance and phylogenetic groups in isolates of Escherichia coli from seagulls at the Berlengas nature reserve.

PubMed

Radhouani, H; Poeta, P; Igrejas, G; Gonçalves, A; Vinué, L; Torres, C

2009-08-01

Fifty-three faecal samples from yellow-legged gulls (Larus cachinnans) at the Berlengas nature reserve in Portugal were cultured on Levine agar plates not supplemented with antimicrobial agents, and one Escherichia coli colony was isolated and identified from each sample. The percentages of resistant isolates for each of the drugs were ampicillin (43.4 per cent), tetracycline (39.6 per cent), nalidixic acid (34.0 per cent), streptomycin (32.1 per cent), trimethoprim-sulfamethoxazole (SXT) (26.4 per cent), ciprofloxacin (18.9 per cent), chloramphenicol (18.9 per cent), gentamicin (7.5 per cent), tobramycin (7.5 per cent) amikacin (5.7 per cent) and amoxicillin-clavulanic acid (1.9 per cent). All the isolates were susceptible to cefoxitin, ceftazidime, cefotaxime, aztreonam and imipenem. The following resistance genes were detected: bla(TEM) (17 of 23 ampicillin-resistant isolates), tet(A) and/or tet(B) (18 of 21 tetracycline-resistant isolates), aadA (12 of 17 streptomycin-resistant isolates), cmlA (all chloramphenicol-resistant isolates), aac(3)-II with or without aac(3)-IV (all four gentamicin-resistant isolates), and sul1 and/or sul2 and/or sul3 (all 14 SXT-resistant isolates). The intI1 gene was detected in 10 of 14 SXT-resistant isolates, and three of them also contained class 2 integrons; four different gene cassette arrangements were identified among class 1 integrons (aadA, dfrA1+aadA1, dfrA12+orfF+aadA2 and sat+psp+aadA2) and one among the class 2 integrons (dfrA1+sat+aadA1). Ninety per cent of the isolates were included in the A or B1 phylogenetic groups.

Multi-band polarimetry of post-asymptotic giant branch stars - I. Optical measurements

NASA Astrophysics Data System (ADS)

Akras, S.; Ramírez Vélez, J. C.; Nanouris, N.; Ramos-Larios, G.; López, J. M.; Hiriart, D.; Panoglou, D.

2017-04-01

We present new optical broad-band (UBVRI) aperture polarimetric observations of 53 post-asymptotic giant branch (AGB) stars selected to exhibit a large near-infrared excess. 24 out of the 53 stars (45 per cent of our sample) are presented for the first time. A statistical analysis shows four distinctive groups of polarized post-AGB stars: unpolarized or very lowly polarized (degree of polarization or DoP < 1 per cent), lowly polarized (1 per cent < DoP < 4 per cent), moderately polarized (4 per cent < DoP < 8 per cent) and highly polarized (DoP > 8 per cent). 23 out of the 53 (66 per cent) belong to the first group, 10 (19 per cent) to the second, five (9 per cent) to the third and only three (6 per cent) to the last group. Approximately 34 per cent of our sample was found to be unpolarized objects, which is close to the percentage of round planetary nebulae. On average, the low and moderate groups show a wavelength-dependent polarization that increases towards shorter wavelengths, implying an intrinsic origin of the polarization, which signifies a Rayleigh-like scattering spectrum typical for non-symmetrical envelopes composed principally of small dust grains. The moderately polarized stars exhibit higher K - W3 and W1 - W3 colour indices compared with the group of lowly polarized stars, suggesting a possible relation between DoP and mass-loss rate. Moreover, they are found to be systematically colder (redder in B - V), which may be associated with the condensation process close to these stars that results in a higher degree of polarization. We also provide evidence that multiple scattering in optically thin polar outflows is the mechanism that gives high DoP in post-AGB stars with bipolar or multi-polar envelopes.

Oral rehydration therapy in a rural area, northern Thailand.

PubMed

Varavithya, W; Sangshaisirisak, S; Ramaboot, S; Ruangkanchanasetr, S; Vivatwongkasem, C

1989-01-01

A cross-sectional sampling survey of mothers' practice of ORT in Amphoe Bunpotphesai in the northern part of Thailand included 1,619 children under five. Two hundred and six children were reported to have 223 diarrheal episodes. The incidence of diarrhea in children under five was 3.4 episodes per child per year. When children had diarrhea 65.5 per cent of mothers sought help from health providers, 25.2 per cent treated their children with drugs bought from stores, 2.3 per cent used herbal medicine and 6.1 per cent did not treat their children. 50.7 per cent of diarrheal episodes mother gave ORT, using ORS 19.7, commercial electrolytes mixture 16.6 and home available fluid 14.4 per cent. The accuracy of dilution of electrolytes powder from the packets was checked in 80 incidences. 31.8 and 27.8 per cent of mothers made correct dilution of ORS and commercial electrolytes products respectively. Health providers carried both ORS and commercial electrolytes packets. ORS added to a glass of water was found in 13.6 per cent which was 3 times concentrated. Commercial electrolytes products were too dilute in 72.2 per cent. 17.5 per cent of mothers divided electrolytes powder to add in one spoon of water to treat their children as one drug dose. Data showed that the ORT use rate was 50.7 per cent. Home available fluid was used by 14.4 per cent. ORT should be further promoted to control diarrheal diseases and health providers should give instructions to every mother or child minder on how to dispense ORS or electrolytes packets for appropriate dilution and use.

Quality improvement tools for chronic disease care--more effective processes are less likely to be implemented in developing countries.

PubMed

Hashim, Muhammad Jawad; Prinsloo, Adrianna; Mirza, Deen M

2013-01-01

Chronic disease services may be improved if care management processes (CMPs), such as disease-specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues. A cross-sectional survey using self-administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data. All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease-specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse-educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open-ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self-management. The study used a small, non-random sample and the survey instrument's psychometric properties were not collected. Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder-tracking systems, patient self-management support and quality incentives. This report highlights the lag regarding adopting more effective CMPs in developing countries.

[Reduction in the mortality from acute diarrheal diseases. The experiences of an action-research program].

PubMed

Gutiérrez, G; Guiscafré, H; Reyes, H; Pérez, R; Vega, R; Tomé, P

1994-01-01

In order to accelerate the descending mortality rate of acute diarrhea in children under five years of age in Mexico, six strategies were implemented. The results showed that after nine months, 49 per cent of mothers had been trained, and improved significantly their home management of diarrhea. The use of oral rehydration salts increased from 10 to 30 per cent; use of oral rehydration therapy increased from 77 to 83 per cent; and timely and appropriate demand for medical help increased from 51 to 62 per cent (p < 0.05). One hundred percent of all physicians received training, and they improved their therapeutic practices, as shown by a decrease in the use of antibiotics from 48 to 34 per cent; prescription of restrictive diets diminished from 33 to 4 per cent; and oral rehydration therapy increased from 74 to 87 per cent. Thirty-four verbal autopsies were carried out, and they showed that 70 per cent of the children who died did so in their homes or in their way to the hospital, despite the fact that 94 per cent of them had received medical care previous to their death, and that 84 per cent of these had been seen by a doctor within 24 hours previous to their death. In 85 per cent of these cases, the physician involved was a private physician of rural or marginal areas. Monthly analysis of death certificates showed that, during the first year of the program (1991), deaths due to diarrhea diminished 20 per cent, while the corresponding figure for 1992 was 52 per cent. In conclusion, the combination of strategies followed in the program made it possible to accelerate, on a short-term basis, the descending trend of deaths due to diarrhea. It was also shown that an intervention project such as the one presented here may efficiently link results from research to decisions taken by policy-makers, and that these can be effectively turned into actions.

Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm.

PubMed

Drury, D; Michaels, J A; Jones, L; Ayiku, L

2005-08-01

Conventional management of abdominal aortic aneurysm (AAA) is by open repair and is associated with a mortality rate of 2-6 per cent. Endovascular aneurysm repair (EVAR) is an alternative technique first introduced in 1991. A systematic review was undertaken of the evidence for the safety and efficacy of elective EVAR in the management of asymptomatic infrarenal AAA. Thirteen electronic bibliographical databases were searched, covering biomedical, health-related, science and social science literature. Outcomes were assessed with respect to efficacy (successful deployment, technical success, conversion rates and secondary intervention rates) and safety (30-day mortality rate, procedure morbidity rates and technical issues-endoleaks, graft thrombosis, stenosis and migration). Of 606 reports identified, 61 met the inclusion criteria (three randomized and 15 non-randomized controlled trials, and 43 uncontrolled studies). There were 29 059 participants in total; 19,804 underwent EVAR. Deployment was successful in 97.6 per cent of cases. Technical success (complete aneurysm exclusion) was 81.9 per cent at discharge and 88.8 per cent at 30 days. Secondary intervention to treat endoleak or maintain graft patency was required in 16.2 per cent of patients. Mean stay in the intensive care unit and mean hospital stay were significantly shorter following EVAR. The 30-day mortality rate for EVAR was 1.6 per cent (randomized controlled trials) and 2.0 per cent in nonrandomized trials and case series. Technical complications comprised stent migration (4.0 per cent), graft limb thrombosis (3.9 per cent), endoleak (type I, 6.8 per cent; type II, 10.3 per cent; type III, 4.2 per cent) and access artery injury (4.8 per cent). EVAR is technically effective and safe, with lower short-term morbidity and mortality rates than open surgery. However, there is a need for extended follow-up as the long-term success of EVAR in preventing aneurysm-related deaths is not yet known.

The Cleveland Clinic experience with adrenal cortical carcinoma.

PubMed

Bodie, B; Novick, A C; Pontes, J E; Straffon, R A; Montie, J E; Babiak, T; Sheeler, L; Schumacher, P

1989-02-01

Between 1936 and 1987, 82 patients with adrenal cortical carcinoma were seen at our clinic. Of these patients 49 (72 per cent) have been seen during the last 25 years. A total of 40 patients (48.8 per cent) presented with a hormonally functional tumor and 42 (51.2 per cent) had a nonfunctional tumor. Forty patients (48.8 per cent) presented with localized disease, 12 (14.6 per cent) with regional disease and 30 (36.6 per cent) with distant metastases. Complete surgical removal of all gross tumor was achieved in 49 patients. Over-all 3 and 5-year patient survival rates in this series were 37.5 and 25.1 per cent, respectively. Survival was significantly improved (43.9 per cent at 5 years, p equals 0.0001) in patients with localized disease that was completely removed surgically; postoperative adjuvant therapy with op'-DDD was of no benefit in these patients. Survival in patients with metastatic disease was poor and was not improved by treatment with op'-DDD, cytotoxic chemotherapy or radiation therapy.

Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study.

PubMed

Kumar, Gajendra; Srivastava, Amita; Sharma, Surinder Kumar; Rao, T Divakara; Gupta, Yogendra Kumar

2015-01-01

In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and ß2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were was observed after treatment. The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings.

Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study

PubMed Central

Kumar, Gajendra; Srivastava, Amita; Sharma, Surinder Kumar; Rao, T. Divakara; Gupta, Yogendra Kumar

2015-01-01

Background & objectives: In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. Methods: One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and ß2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. Results: The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were was observed after treatment. Interpretation & conclusions: The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings. PMID:25857501

Semi-supervised learning for photometric supernova classification

NASA Astrophysics Data System (ADS)

Richards, Joseph W.; Homrighausen, Darren; Freeman, Peter E.; Schafer, Chad M.; Poznanski, Dovi

2012-01-01

We present a semi-supervised method for photometric supernova typing. Our approach is to first use the non-linear dimension reduction technique diffusion map to detect structure in a data base of supernova light curves and subsequently employ random forest classification on a spectroscopically confirmed training set to learn a model that can predict the type of each newly observed supernova. We demonstrate that this is an effective method for supernova typing. As supernova numbers increase, our semi-supervised method efficiently utilizes this information to improve classification, a property not enjoyed by template-based methods. Applied to supernova data simulated by Kessler et al. to mimic those of the Dark Energy Survey, our methods achieve (cross-validated) 95 per cent Type Ia purity and 87 per cent Type Ia efficiency on the spectroscopic sample, but only 50 per cent Type Ia purity and 50 per cent efficiency on the photometric sample due to their spectroscopic follow-up strategy. To improve the performance on the photometric sample, we search for better spectroscopic follow-up procedures by studying the sensitivity of our machine-learned supernova classification on the specific strategy used to obtain training sets. With a fixed amount of spectroscopic follow-up time, we find that, despite collecting data on a smaller number of supernovae, deeper magnitude-limited spectroscopic surveys are better for producing training sets. For supernova Ia (II-P) typing, we obtain a 44 per cent (1 per cent) increase in purity to 72 per cent (87 per cent) and 30 per cent (162 per cent) increase in efficiency to 65 per cent (84 per cent) of the sample using a 25th (24.5th) magnitude-limited survey instead of the shallower spectroscopic sample used in the original simulations. When redshift information is available, we incorporate it into our analysis using a novel method of altering the diffusion map representation of the supernovae. Incorporating host redshifts leads to a 5 per cent improvement in Type Ia purity and 13 per cent improvement in Type Ia efficiency. A web service for the supernova classification method used in this paper can be found at .

Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong.

PubMed

Fielding, R; Chee, Y Y; Choi, K M; Chu, T K; Kato, K; Lam, S K; Sin, K L; Tang, K T; Wong, H M; Wong, K M

2004-03-01

We compared the recognition of tobacco brands and ever-smoking rates in young children before (1991) and after (2001) the implementation of cigarette advertising restrictions in Hong Kong and identified continuing sources of tobacco promotion exposure. A cross-sectional survey of 824 primary school children aged from 8 to 11 (Primary classes 3-4) living in two Hong Kong districts was carried out using self-completed questionnaires examining smoking behaviour and recognition of names and logos from 18 tobacco, food, drink and other brands common in Hong Kong. Ever-smoking prevalence in 2001 was 3.8 per cent (1991, 7.8 per cent). Tobacco brand recognition rates ranged from 5.3 per cent (Viceroy name) to 72.8 per cent (Viceroy logo). Compared with 1991, in 2001 never-smoker children recognized fewer tobacco brand names and logos: Marlboro logo recognition rate fell by 55.3 per cent. Similar declines were also seen in ever-smoker children, with recognition of the Marlboro logo decreasing 48 per cent. Recognition rates declined amongst both boys and girls. Children from non-smoking families constituted 51 per cent (426) of the sample, whereas 34.5 per cent (284), 8.5 per cent (70), 1.7 per cent (14) and 4.4 per cent (36) of the children had one, two, three or more than three smoking family members at home, respectively. Tobacco brand recognition rates and ever-smoking prevalence were significantly higher among children with smoking family members compared with those without. Among 12 possible sources of exposure to cigarette brand names and logos, retail stalls (75.5 per cent; 622), indirect advertisements (71.5 per cent; 589) and magazines (65.3 per cent; 538) were ranked the most common. Advertising restrictions in Hong Kong have effectively decreased primary-age children's recognition of tobacco branding. However, these children remain vulnerable to branding, mostly through exposure from family smokers, point-of-sale tobacco advertisement and occasional promotions. Action to curb these is now required.

Acid reflux management: ENT perspective.

PubMed

Ahmad, Ijaz; Batch, A J G

2004-01-01

Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms; and the constellation of symptoms has been called laryngopharyngeal reflux. This is a prospective study in a cohort of patients with various throat symptoms suggestive of laryngopharyngeal reflux (LPR) who underwent flexible oesophago-gastroscopy, as a principal investigation. The aims were to look at the most reliable symptom(s) and sign(s), the diagnostic role of flexible oesophago-gastroscopy and the treatment response in these patients. The endoscopy score of 0 to 3 was based on endoscopic findings and the treatment response was measured from 0 to 100 per cent improvement of symptoms, as described by the patients. There were a total of 303 patients, 174 females and 129 males with ages ranging from 19 to 88 years. Seventy-five per cent had had symptoms for more than a year. Fifteen per cent were smokers. Globus, voice change, sore throat, dysphagia and cough were the predominant symptoms. Most patients, however, presented with a complex of various other secondary symptoms. The endoscopic findings were abnormal in 98 per cent of patients. Apart from the finding of non-specific hyperaemia, usually of the posterior larynx (13 per cent), lesions of the larynx and vocal folds were surprisingly uncommon. Proton pump inhibitors (PPI) were prescribed in 90 per cent of patients. A total of 233 (76.8 per cent) responded to treatment. The improvement of symptoms ranged from 25 per cent in 36 (23 per cent), 50 per cent in 60 (20 per cent), 75 per cent in 59 (19 per cent) and 100 per cent in 78 (26 per cent) patients. Accumulative analysis of variance showed a significant difference between treatment responders and non-responders (p <0.04). In a logistic regression model patients with globus, voice change and gastric prolapse were more likely to respond to treatment (p <0.04). It can be concluded that voice change, sore throat, globus and cough choking are the most reliable symptoms of laryngopharyngeal reflux. Voice change and globus symptoms can be of predictive value in terms of successful treatment response. Flexible oesophago-gastroscopy (FOG) is a simple, safe and reliable way of assessment in these cases and treatment with PPI can be effective in the majority of patients.

Effect of preoperative biliary drainage on bacterial flora in bile of patients with periampullary cancer.

PubMed

Scheufele, F; Aichinger, L; Jäger, C; Demir, I E; Schorn, S; Sargut, M; Erkan, M; Kleeff, J; Friess, H; Ceyhan, G O

2017-01-01

Patients with obstructive jaundice due to periampullary tumours may undergo preoperative biliary drainage (PBD). The effect of PBD on the microbiome of the biliary system and on postoperative outcome remains unclear. A single-centre retrospective study of patients with obstructive jaundice due to periampullary cancer, treated between July 2007 and July 2015, was undertaken. Intraoperative bile samples were obtained for microbiological analysis after transection of the common bile duct. Postoperative complications were registered. Of 290 patients treated, intraoperative bile samples were present for 172 patients (59·3 per cent) who had PBD and 118 (40·7 per cent) who did not. Contamination of bile was increased significantly in patients who underwent stenting (97·1 per cent versus 18·6 per cent in those without stenting; P < 0·001). PBD resulted in a shift in the biliary microbiome from Escherichia coli in non-stented patients (45 per cent versus 19·2 per cent in stented patients; P = 0·009) towards increased contamination with Enterococcus faecalis (9 versus 37·7 per cent respectively; P = 0·008) and Enterobacter cloacae (0 versus 20·4 per cent; P = 0·033). This shift was associated with a high incidence of bacterial resistance against ampicillin-sulbactam (63·6 per cent versus 18 per cent in patients with no PBD; P < 0·001), piperacillin-tazobactam (30·1 versus 0 per cent respectively; P = 0·003), ciprofloxacin (28·5 versus 5 per cent; P = 0·047) and imipenem (26·6 versus 0 per cent; P = 0·011). The rate of wound infection was higher in patients with a positive bile culture (21·0 per cent versus 6 per cent in patients with sterile bile; P = 0·002). Regression analysis revealed the presence of Enterococcus faecium (odds ratio 2·83, 95 per cent c.i. 1·17 to 6·84; P = 0·021) and Citrobacter species (odds ratio 5·09, 1·65 to 15·71; P = 0·005) as independent risk factors for postoperative wound infection. There are fundamental differences in the biliary microbiome of patients with periampullary cancer who undergo PBD and those who do not. PBD induces a shift of the biliary microbiome towards a more aggressive and resistant spectrum, which requires a differentiated perioperative antibiotic treatment strategy. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Conjunctival bacterial and fungal flora in clinically normal sheep.

PubMed

Bonelli, Francesca; Barsotti, Giovanni; Attili, Anna Rita; Mugnaini, Linda; Cuteri, Vincenzo; Preziuso, Silvia; Corazza, Michele; Preziuso, Giovanna; Sgorbini, Micaela

2014-01-01

The aim was to identify conjunctival bacterial and fungal flora in clinically normal sheep. Prospective study. Tuscany. 100 eyes from 50 adult Massese female sheep were examined. The sheep included in the study were considered free of anterior ophthalmic abnormalities. Bacteria were identified by morphological assessment, Gram staining, biochemical tests. Identification of filamentous fungi was achieved at the genus level, and Aspergillus species were identified based on keys provided by other authors. Yeast colonies were highlighted, but not identified. Positive cultures were obtained from 100/100 eyes for bacteria, and from 86/100 eyes for fungi. A total of 14 types of bacteria and 5 types of fungi were isolated. Yeasts were isolated from 13/100 eyes. The most frequent fungal isolates were saprophytic fungi. Conjunctival bacterial and fungal flora of clinically normal eyes were reported in sheep. The positivity obtained for conjunctival bacteria was higher compared to findings in the literature by other authors in the same species (100 per cent v 40 per cent), while our results were in line with a recent work performed on mouflons (Ovis Musimon) with a 100 per cent positivity for bacterial conjunctival fornix. In our survey, Gram-positive species were prevalent, as reported by other authors in different species. Few data are available in the literature regarding conjunctival fungal flora in healthy small ruminants. The prevalence of conjunctival fungal flora in this study was higher than findings reported in mouflons (86 per cent v 45 per cent). Differences in fungal prevalence may be due to different methods of managing herds, though further studies are required to verify this hypothesis. The similarities in bacterial and fungal isolates between sheep and mouflons suggest a genera pattern of conjunctival colonisation by bacteria and fungi.

ICE-COLA: towards fast and accurate synthetic galaxy catalogues optimizing a quasi-N-body method

NASA Astrophysics Data System (ADS)

Izard, Albert; Crocce, Martin; Fosalba, Pablo

2016-07-01

Next generation galaxy surveys demand the development of massive ensembles of galaxy mocks to model the observables and their covariances, what is computationally prohibitive using N-body simulations. COmoving Lagrangian Acceleration (COLA) is a novel method designed to make this feasible by following an approximate dynamics but with up to three orders of magnitude speed-ups when compared to an exact N-body. In this paper, we investigate the optimization of the code parameters in the compromise between computational cost and recovered accuracy in observables such as two-point clustering and halo abundance. We benchmark those observables with a state-of-the-art N-body run, the MICE Grand Challenge simulation. We find that using 40 time-steps linearly spaced since zI ˜ 20, and a force mesh resolution three times finer than that of the number of particles, yields a matter power spectrum within 1 per cent for k ≲ 1 h Mpc-1 and a halo mass function within 5 per cent of those in the N-body. In turn, the halo bias is accurate within 2 per cent for k ≲ 0.7 h Mpc-1 whereas, in redshift space, the halo monopole and quadrupole are within 4 per cent for k ≲ 0.4 h Mpc-1. These results hold for a broad range in redshift (0 < z < 1) and for all halo mass bins investigated (M > 1012.5 h-1 M⊙). To bring accuracy in clustering to one per cent level we study various methods that re-calibrate halo masses and/or velocities. We thus propose an optimized choice of COLA code parameters as a powerful tool to optimally exploit future galaxy surveys.

Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial.

PubMed

Keller, Diana; Sundrum, Albert

2018-04-07

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture-positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60-81 per cent) but was more effective than individualised homeopathy (33-43 per cent) whose effects appeared little different to those of placebos (45-47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2-21 per cent, individualised homeopathy 0-8 per cent and placebo 3-13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture-negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample. NTP-ID: 00008011-1-9, Pre-results. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Establishing communication mechanism for malaria prevention in Baiga tribal villages in Baiga Chak area of Dindori district, Madhya Pradesh.

PubMed

Saha, Kalyan B; Sharma, Ravendra K; Mishra, Rajdeep; Verma, Arvind; Tiwari, B K; Singh, Neeru

2015-05-01

Malaria is a serious public health concern in several parts of India, particularly in tribal areas of Madhya Pradesh (MP). Dindori district inhabitated by Baiga tribe, contributes about 15 per cent to the total malaria burden in MP. The tribal and other local inhabitants believe in magico-religious treatment of malaria and use modern health facilities only as second line of treatment. The present study was planned in the villages of one of the particularly vulnerable tribal group of MP, the Baigas. The objective of the study was to generate awareness and utilization of health services for malaria by establishing a communication strategy using local students and unemployed youths as agents of change. The study was undertaken in 47 villages and the need based IEC (information, education and communication) intervention was evaluated within four months of initiation by adopting before and after with control design. For both baseline and resurvey the households covered each time were 2350. The baseline data generated revealed that around 53 per cent of the people in the study villages were aware of malaria. Among the non Baigas, 59 per cent were aware of malaria, while among the Baigas it was 49 per cent. IEC intervention could raise the level of awareness to malaria significantly with a net intervention effect of 23 per cent. The IEC intervention also improved the utilization of modern health services significantly. The IEC strategy designed by using local children and youths was effective as the malaria was on decline in the study area. The same strategy with necessary modifications may be replicated in other areas pandemic for malaria.

Nuptiality pattern in Saudi Arabia.

PubMed

Farag, M K; al-Mazrou, Y Y; Baldo, M H; Aziz, K M; al-Shehri, S N

1995-01-01

The data of this work are based on the 'Saudi Maternal and Child Health Survey' conducted in 1991. This was a nationwide house to house field survey. The study included 6294 ever-married Saudi female in the childbearing age who represent the target population. They were randomly selected from both urban and rural settings of the five geographical areas of Saudi Arabia. The mean current age of the sample of ever-married women was 31 years and the mean age at first marriage was 17 and 16 years for urban and rural females, respectively. Education was associated with upward shift of the age at first marriage. About 20 per cent of the sampled ever-married Saudi females got married before their 15th birthday and 83 per cent before reaching 20 years of age. These percentages are even higher in rural than urban settings. The overall percentage of women who were currently married at the time of the survey was 96 per cent. The divorced and widowed women of childbearing age were 2 and 3 per cent, respectively, of the total. Husband's educational level had positive impact on the frequency of divorce. The latter was highest among women married to illiterate husbands with a dose response pattern. Comparison has been made with the situation 4 years ago. An increase in literacy rates among Saudi ever-married women and their husbands was observed, however, a significant (P < 0.05) difference still exists between female and male literacy rates (38 and 71 per cent, respectively). The events of early marriage, before the age of 15 years, became less frequent. There is an overall decline in teenage marriages which explains a large part of the recent changes observed in nuptiality and pattern of birth in Saudi Arabia.

Mortality and management of 96 shark attacks and development of a shark bite severity scoring system.

PubMed

Lentz, Ashley K; Burgess, George H; Perrin, Karen; Brown, Jennifer A; Mozingo, David W; Lottenberg, Lawrence

2010-01-01

Humans share a fascination and fear of sharks. We predict that most shark attacks are nonfatal but require skilled, timely medical intervention. The development of a shark bite severity scoring scale will assist communication and understanding of such an injury. We retrospectively reviewed records of the prospectively maintained International Shark Attack File (ISAF) at the University of Florida. The ISAF contains 4409 investigations, including 2979 documented attacks, 96 of which have complete medical records. We developed a Shark-Induced Trauma (SIT) Scale and calculated the level of injury for each attack. Medical records were reviewed for the 96 documented shark attack victims since 1921. Calculated levels of injury in the SIT Scale reveal 40 Level 1 injuries (41.7%), 16 Level 2 injuries (16.7%), 18 Level 3 injuries (18.8%), 14 Level 4 injuries (14.6%), and eight Level 5 injuries (8.3%). The overall mortality of shark attacks was 8.3 per cent. However, SIT Scale Level 1 injuries comprised the greatest percentage of cases at 41.7 per cent. Injury to major vascular structures increases mortality and necessitates immediate medical attention and definitive care by a surgeon. Shark bites deserve recognition with prompt resuscitation, washout, débridement, and follow up for prevention of infection and closure of more complex wounds.

A serosurvey for selected pathogens in Greek European wild boar

PubMed Central

Touloudi, A.; Valiakos, G.; Athanasiou, L. V.; Birtsas, P.; Giannakopoulos, A.; Papaspyropoulos, K.; Kalaitzis, C.; Sokos, C.; Tsokana, C. N.; Spyrou, V.; Petrovska, L.; Billinis, C.

2015-01-01

Objectives Serum samples, collected from 94 European wild boar (Sus scrofa) during the hunting seasons 2006 -2010 from different regions of Greece, were examined in order to estimate the role of these wildlife species as reservoir of pathogens important for livestock and/or public health. Materials and Methods The assays used for this purpose were commercial indirect ELISA for the detection of antibodies against porcine circovirus type 2 (PCV-2), porcine reproductive and respiratory syndrome (virus) (PRRSV), Aujeszky's disease virus (ADV), influenza A (IA) virus, Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae, Salmonella species, Trichinella species and indirect immunofluorescence antibody test for the detection of antibodies against Toxoplasma gondii and Neospora caninum. Results Antibodies against PCV-2, PRRSV, ADV, IA virus,A. pleuropneumoniae, M. hyopneumoniae,Salmonella species, Trichinella species, T. gondii and N. caninum were detected in 19.1 per cent, 12.8 per cent, 35.1 per cent, 1.1 per cent, 57.4 per cent, 0 per cent, 4.3 per cent, 6.4 per cent, 5.2 per cent and 1.1 per cent of the samples, respectively. Cluster analysis revealed a hot spot of seropositivity near Bulgarian border; seropositivity to ADV was more common among female animals. Conclusions These results indicate exposure of wild boar to most of the above-mentioned pathogens, raising concern about the possibility that these species may pose a significant health risk for livestock and/or humans. PMID:26392908

Pathogen profile of clinical mastitis in Irish milk-recording herds reveals a complex aetiology.

PubMed

Keane, O M; Budd, K E; Flynn, J; McCoy, F

2013-07-06

Effective mastitis control requires knowledge of the predominant pathogen challenges on the farm. In order to quantify this challenge, the aetiological agents associated with clinical mastitis in 30 milk-recording dairy herds in Ireland over a complete lactation were investigated. Standard bacteriology was performed on 630 pretreatment quarter milk samples, of which 56 per cent were culture-positive, 42 per cent culture-negative and 2 per cent contaminated. Two micro-organisms were isolated from almost 5 per cent of the culture-positive samples. The bacteria isolated were Staphylococcus aureus (23 per cent), Streptococcus uberis (17 per cent), Escherichia coli (9 per cent), Streptococcus species (6 per cent), coagulase-negative Staphylococci (4 per cent) and other species (1 per cent). A wide variety of bacterial species were associated with clinical mastitis, with S aureus the most prevalent pathogen overall, followed by S uberis. However, the bacterial challenges varied widely from farm to farm. In comparison with previous reports, in the present study, the contagious pathogens S aureus and Streptococcus agalactiae were less commonly associated with clinical mastitis, whereas, the environmental pathogens S uberis and E coli were found more commonly associated with clinical mastitis. While S aureus remains the pathogen most commonly associated with intramammary infection in these herds, environmental pathogens, such as S uberis and E coli also present a considerable challenge.

Prevalence of enteropathic Escherichia coli in dogs with acute and chronic diarrhoea.

PubMed

Sancak, A A; Rutgers, H C; Hart, C A; Batt, R M

2004-01-24

Samples of faeces from 57 dogs with acute diarrhoea, 82 dogs with chronic diarrhoea, 34 clinically healthy household dogs and 88 kennelled control dogs were analysed by hybridisation, using DNA probes to detect enteropathogenic Escherichia coli (EPEC) and enterotoxigenic E coli (ETEC), verocytotoxin-producing E coli (VTEC), enterohaemorrhagic E coli (EHEC), enteroinvasive E coli (EIEC) and enteroaggregative E coli (EAggEC). Samples of duodenal juice from 60 of the 82 dogs with chronic diarrhoea were also examined. Significantly more of the dogs with diarrhoea were excreting EPEC (acute 35.1 per cent, chronic 31.7 per cent) and VTEC (acute 24.6 per cent, chronic 28 per cent) than the kennelled dogs (EPEC 17.1 per cent, VTEC 0 per cent) or the household control dogs (EPEC 6 per cent, VTEC 5.9 per cent). Enteropathic E coli was also detected in the duodenal juice of 23 of 60 (38.3 per cent) of the dogs with chronic diarrhoea. The EPEC attaching and effacing A (eaeA) gene and the verocytotoxin 1 (VR1) gene coding for VTEC were often found together. There was good agreement between in vitro studies and hybridisation for the detection of eaeA and VT1. Isolates from the dogs with diarrhoea adhered significantly more to Hep-2 cells, and VT1-positive strains from the dogs with diarrhoea consistently killed more than 50 per cent of Vero cells.

Sexual and marital relationships after radiotherapy for seminoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schover, L.R.; Gonzales, M.; von Eschenbach, A.C.

Questionnaires on sexual function, marital status, and fertility were returned by 84 men who received radiotherapy for seminoma (Stage I, II, or III). The mean length of follow-up was ten years. Although 93 per cent were married, 19 per cent had low rates of sexual activity, 12 per cent reported low sexual desire, 15 per cent had erectile dysfunction, 10 per cent had difficulty reaching orgasm, and 14 per cent had premature ejaculation. The most common problems were reduced intensity of orgasm (33%) and reduced semen volume (49%). Twenty-one men remained childless, and 30 per cent of men worried atmore » least occasionally about infertility. Thirteen children were conceived after cancer therapy. The data suggest that sexual dysfunction and infertility are important concerns for a subgroup of men treated for seminoma.« less

Exploring the safety measures by doctors on after-hours house call services.

PubMed

Ifediora, Chris

2015-01-01

Aggression against doctors involved in after-hours house calls (AHHC) is widely perceived to be high. It is, however, unclear how doctors who perform this service manage the risk of aggressive patients during home visits. The aim of this paper is to explore if and how doctors manage the risk of violence against them during AHHC. A survey was designed and administered to all 300 Australian-based doctors engaged in AHHC under the National Home Doctor Service (NHDS). The survey was conducted from September 2014 to November 2014. There were 172 responses (57.3 per cent). Only 43 per cent of respondents adopted personal protective measures. The remaining 57 per cent had none; of those 6 per cent had never considered protective measures, and 31.8 per cent were aware of the risk of violence, but were unsure of what to do. Measures adopted include the use of chaperones/security personnel (34.1 per cent), dependence on surgery policies (31.2 per cent), de-escalation techniques (15.2 per cent), panic buttons (7.2 per cent), personal alarms (6.1 per cent), and others (6.5 per cent). Females were more likely to adopt personal protective measures than males (OR 4.94; p<0.01; CI 1.70-14.34), and Australian-trained doctors were less likely to do so relative to overseas-trained doctors (OR 0.35; p=0.04; CI 0.12-0.99). Just over half of the doctors involved in AHHC took no precautions against aggressive attacks while on duty, and nearly one-third relied on the policies of their employing surgeries.

A comparative study on accuracy of liquid crystal forehead, digital electronic axillary, infrared tympanic with glass-mercury rectal thermometer in infants and young children.

PubMed

Kongpanichkul, A; Bunjongpak, S

2000-09-01

This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.

Precarious employment, working hours, work-life conflict and health in hotel work.

PubMed

McNamara, Maria; Bohle, Philip; Quinlan, Michael

2011-01-01

Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Standardized, Interdepartmental, Simulation-Based Central Line Insertion Course Closes an Educational Gap and Improves Intern Comfort with the Procedure.

PubMed

Grudziak, Joanna; Herndon, Blair; Dancel, Ria D; Arora, Harendra; Tignanelli, Christopher J; Phillips, Michael R; Crowner, Jason R; True, Nicholas A; Kiser, Andy C; Brown, Rebecca F; Goodell, Harry P; Murty, Neil; Meyers, Michael O; Montgomery, Sean P

2017-06-01

Central line placement is a common procedure, routinely performed by junior residents in medical and surgical departments. Before this project, no standardized instructional course on the insertion of central lines existed at our institution, and few interns had received formal ultrasound training. Interns from five departments participated in a simulation-based central line insertion course. Intern familiarity with the procedure and with ultrasound, as well as their prior experience with line placement and their level of comfort, was assessed. Of the 99 interns in participating departments, 45 per cent had been trained as of October 2015. Forty-one per cent were female. The majority (59.5%) had no prior formal ultrasound training, and 46.0 per cent had never placed a line as primary operator. Scores increased significantly, from a precourse score mean of 13.7 to a postcourse score mean of 16.1, P < 0.001. All three of the self-reported measures of comfort with ultrasound also improved significantly. All interns reported the course was "very much" helpful, and 100 per cent reported they felt "somewhat" or "much" more comfortable with the procedure after attendance. To our knowledge, this is the first hospital-wide, standardized, simulation-based central line insertion course in the United States. Preliminary results indicate overwhelming satisfaction with the course, better ultrasound preparedness, and improved comfort with central line insertion.

Winter protein requirements of bobwhite quail

USGS Publications Warehouse

Nestler, R.B.; Bailey, W.W.; Llewellyn, L.M.; Rensberger, M.J.

1944-01-01

Three experiments involving 714 bobwhite quail were conducted at the Patuxent Research Refuge, Bowie, Maryland, during the winters of 1939-1941 to determine the protein requirement of quail maintained throug'h the winter.....Considering survival, live weights, feed consumption, and subsequent reproduction by the birds, the-9 to 13 per cent levels of crude dietary protein gave as good results as higher levels eggs, which in all cases was over 90 per and in some respects were better.....On the basis of these studies, it is recommended that the winter maintenance diet for bobwhite quail contain . about 11 to 12 per cent of crude protein. The following diet (parts by weight) conforms to these specifications and should be satisfactory:...Ground yellow corn 85.6....Dehvdrated alfalfa leaf meal 5 .O.....Soybean oil meal 7.0.....Special steamed bonemeal 1.2....Salt (or Salt Mixture II,see text) 1.0...Vitamin A and D feeding oil, fortified 0.2.

Progression of aortic stenosis in the boxer.

PubMed

French, A; Luis Fuentes, V; Dukes-McEwan, J; Darke, P G; Martin, M; Corcoran, B

2000-10-01

Thirty-five boxers that had been referred to the Royal (Dick) School of Veterinary Studies between 1989 and 1994 with left heart base murmurs and aortic velocities greater than 1.5 m/second on Doppler echocardiography were recalled for clinical examination and Doppler echocardiography between 1995 and 1996. Five dogs (14 per cent) showed an increase in murmur grade on repeat visit. Six dogs (17 per cent) showed an increase in aortic velocity of greater than 20 per cent. Eight dogs (23 per cent) had developed aortic valvular or subvalvular two-dimensional echocardiographic changes that had not been present at the initial visit. Seven dogs (20 per cent) had developed aortic regurgitation, and three dogs (8 per cent) mitral regurgitation.

FRB strength distribution challenges the cosmological principle

NASA Astrophysics Data System (ADS)

Katz, J. I.

2017-11-01

The distribution of fast radio burst (FRB) fluxes and fluences is characterized by a few very bright events and a deficiency of fainter events, compared to expectations for a homogeneous space-filling distribution. I define a metric to quantify this, and apply it to the 17 presently known Parkes FRB, products of a comparatively homogeneous search. With 98 per cent confidence, we reject the hypothesis of a homogeneous distribution in Euclidean space. Possible explanations include a reduction of fainter events by cosmological redshifts or evolution or a cosmologically local concentration of events. The former is opposed by the small value of the one known FRB redshift. The latter contradicts the Cosmological Principle, but may be explained if the brighter FRB originates in the Local Supercluster.

31 CFR 82.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Definitions. 82.3 Section 82.3 Money and Finance: Treasury Regulations Relating to Money and Finance 5-CENT AND ONE-CENT COIN REGULATIONS § 82.3 Definitions. (a) 5-cent coin of the United States means a 5-cent coin minted and issued by the...

31 CFR 82.4 - Penalties.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Penalties. 82.4 Section 82.4 Money and Finance: Treasury Regulations Relating to Money and Finance 5-CENT AND ONE-CENT COIN REGULATIONS § 82.4 Penalties. (a) Any person who exports, melts, or treats 5-cent coins or one-cent coins of the...

76 FR 4395 - Postal Service Price Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... the First-Class Mail, single- piece first-ounce letter price; however, the additional-ounce rate for single-piece letters and flats increases from 17 cents to 20 cents. Id. at 12. The price of a single-piece postcard increases from 28 cents to 29 cents. Id. However, to meet the cap average increase for...

38 CFR 3.112 - Fractions of one cent.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Fractions of one cent. 3... Pension, Compensation, and Dependency and Indemnity Compensation Administrative § 3.112 Fractions of one cent. In all cases where the amount to be paid under any award involves a fraction of a cent, the...

Collagen matrix as an inlay in endoscopic skull base reconstruction.

PubMed

Oakley, G M; Christensen, J M; Winder, M; Jonker, B P; Davidson, A; Steel, T; Teo, C; Harvey, R J

2018-03-01

Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described. A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined. Of 120 patients (51.0 ± 17.5 years, 41.7 per cent female), peri-operative complications totalled 12.7 per cent (cerebrospinal fluid leak, 3.3 per cent; meningitis, 3.3 per cent; other intracranial infections, 2.5 per cent; intracranial bleeding, 1.7 per cent; epistaxis, 1.7 per cent; and seizures, 0 per cent). Delayed complications did not occur in any patients. Collagen matrix is an effective inlay material. It provides robust long-term separation between sinus and cranial cavities, and avoids donor site morbidity, but carries additional cost.

Diagnosis, treatment and outcome of orbital neoplasia in dogs: a retrospective study of 44 cases.

PubMed

Hendrix, D V; Gelatt, K N

2000-03-01

Forty-four dogs with confirmed orbital neoplasia were studied. Eighteen tumour types were represented and 95 per cent of the neoplasms were classified as malignant. The tumour types most commonly diagnosed were osteosarcoma, fibrosarcoma and nasal adenocarcinoma. Thirty-six per cent of the dogs had at least one clinical sign that was compatible with a diagnosis of orbital abscessation or cellulitis. Fifty-six per cent of the dogs, where follow-up information was available, were euthanased or had died within six months of diagnosis, while 19 per cent of the total were still alive after one year post-diagnosis. Cytological examination was diagnostic for orbital neoplasia in 49 per cent of the fine needle aspirates of the retrobulbar space. In contrast, 56 per cent of the non-surgical biopsies were diagnostic for orbital neoplasia. Of those dogs that had died or been euthanased within six months of diagnosis, only 22 per cent had undergone some form of therapy for orbital neoplasia. In comparison, 86 per cent of dogs surviving longer than six months post-diagnosis had undergone such therapy.

Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients.

PubMed

Fischer, S P; Fox, J M; Del Pizzo, W; Friedman, M J; Snyder, S J; Ferkel, R D

1991-01-01

Magnetic resonance images of the knee were made for 1014 patients, and the diagnosis was subsequently confirmed arthroscopically. The accuracy of the diagnoses from the imaging was 89 per cent for the medial meniscus, 88 per cent for the lateral meniscus, 93 per cent for the anterior cruciate ligament, and 99 per cent for the posterior cruciate ligament. The magnetic resonance examinations were done at several centers, and the results varied substantially among centers. The accuracy ranged from 64 to 95 per cent for the medial meniscus, from 83 to 94 per cent for the lateral meniscus, and from 78 to 97 per cent for the anterior cruciate ligament. The results from different magnetic-resonance units were also compared, and the findings suggested increased accuracy for the units that had a stronger magnetic field. Of the menisci for which the magnetic resonance signal was reported to be Grade II (a linear intrameniscal signal not extending to the superior or inferior meniscal surface), 17 per cent were found to be torn at arthroscopy.

Open cholecystectomy in the laparoscopic era.

PubMed

Jenkins, P J; Paterson, H M; Parks, R W; Garden, O J

2007-11-01

As techniques in laparoscopic cholecystectomy have improved, surgeon experience of open cholecystectomy may be limited. This study examined the current indications for and techniques used in primary open cholecystectomy. Some 3100 consecutive patients undergoing elective or emergency cholecystectomy over a 5-year interval were identified from a prospective surgical audit database. Demographic, diagnostic and procedural data were examined. There were 123 (4.0 per cent) primary and 219 (7.4 per cent) converted open cholecystectomies. Some 48.0 and 45.6 per cent of patients in the primary open cholecystectomy and converted groups respectively were men, compared with 24.0 per cent of 2758 who had a successful laparoscopic procedure. Primary open cholecystectomy was employed principally for previous upper abdominal open surgery (22.7 per cent) and emergency operation for general peritonitis (19.5 per cent). The fundus-first approach was employed in 53.7 per cent of primary open procedures and 53.0 per cent of conversions, with subtotal excision in 4.9 and 13.2 per cent respectively. Primary open cholecystectomy remains a common procedure in the treatment of gallbladder disease despite the success of laparoscopic cholecystectomy. Successful outcome in difficult cases requires familiarity with specific techniques, exposure to which may be limited in current training programmes. Copyright (c) 2007 British Journal of Surgery Society Ltd.

Potential of phytoceuticals to affect antibiotic residue detection tests in cow milk in a randomised trial

PubMed Central

Mullen, Keena AE; Beasley, Erin; Rizzo, Julio Q; Washburn, Steven P; Baynes, Ronald E; Mason, Sharon E

2017-01-01

Mastitis is a costly disease for dairy farmers. Some dairy farmers use herbal products, or phytoceuticals, to treat mastitis. Phytoceuticals have not been approved for this use by the United States Food and Drug Administration, and have not been tested to determine how they impact antibiotic residue detection testing. The current study tested the potential for phytoceuticals to cause positive results on two milk antibiotic residue screening tests, the Delvotest P and Charm SL Beta-lactam test, or to interfere with the detection of antibiotics by these tests. The three phytoceuticals tested were labelled for intramammary, topical or intravulvar administration. Testing was performed in vitro using the products diluted in milk obtained from healthy organic dairy cows. Phytoceuticals were tested at concentrations ranging from 1.5 per cent to 100 per cent. Concentration levels were replicated at least twice on each milk antibiotic residue screening test. The Delvotest P is based on detection of bacterial inhibitors and no positive results were obtained for any product at concentrations less than 50 per cent. The Charm SL Beta-lactam test uses a receptor for the detection of beta-lactam antibiotics and no concentration of phytoceuticals caused an interference with these tests. Based on dilution of the products in bovine milk at physiologically achievable levels, phytoceutical products tested at levels expected after treatment do not cause positive test results for the Delvotest P nor do they interfere with the Charm SL Beta-lactam test in detection of various antibiotics. PMID:28890791

Selection biases in empirical p(z) methods for weak lensing

DOE PAGES

Gruen, D.; Brimioulle, F.

2017-02-23

To measure the mass of foreground objects with weak gravitational lensing, one needs to estimate the redshift distribution of lensed background sources. This is commonly done in an empirical fashion, i.e. with a reference sample of galaxies of known spectroscopic redshift, matched to the source population. In this paper, we develop a simple decision tree framework that, under the ideal conditions of a large, purely magnitude-limited reference sample, allows an unbiased recovery of the source redshift probability density function p(z), as a function of magnitude and colour. We use this framework to quantify biases in empirically estimated p(z) caused bymore » selection effects present in realistic reference and weak lensing source catalogues, namely (1) complex selection of reference objects by the targeting strategy and success rate of existing spectroscopic surveys and (2) selection of background sources by the success of object detection and shape measurement at low signal to noise. For intermediate-to-high redshift clusters, and for depths and filter combinations appropriate for ongoing lensing surveys, we find that (1) spectroscopic selection can cause biases above the 10 per cent level, which can be reduced to ≈5 per cent by optimal lensing weighting, while (2) selection effects in the shape catalogue bias mass estimates at or below the 2 per cent level. Finally, this illustrates the importance of completeness of the reference catalogues for empirical redshift estimation.« less

The food of the lake trout (Cristivomer namaycush namaycush) and of the lawyer (Lota maculosa) of Lake Michigan

USGS Publications Warehouse

Van Oosten, John; Deason, Hilary J.

1938-01-01

This paper reports on a qualitative and quantitative analysis of the contents of 4,979 lake trout stomachs (593 examined in 1930 and 1,253 collected in 1931 from southern Lake Michigan, 1,446 from northern Lake Michigan and 1,687 from Green Bay in 1932), and of a total of 1,528 lawyer stomachs (172 examined in 1930 and 734 collected in 1931 from southern Lake Michigan, 612 from northern Lake Michigan and 10 from Green Bay in 1932). The food of the trout consisted of 98 per cent by volume of fish of which Cottidae and Coregonidae were the principal constituents. Cottidae were dominant in southern Lake Michigan (72 per cent by volume), Coregonidae in northern Lake Michigan (51 per cent) but the lake shiner, Notropis atherinides, was most important in Green Bay in the spring of the year (64 per cent). The lawyer food consisted of 74 per cent by volume of fish and 26 per cent invertebrates. Dominant items were Cottidae (76 per cent by volume) in southern Lake Michigan, Coregonidae (51 per cent) and Pontoporeia (37 per cent) in northern Lake Michigan, and Percopsis (34 per cent) and Mysis (26 per cent) in Green Bay. Data are also presented on the frequency of occurrence (number of stomachs) of the food items and its variation with the sizes of the trout and lawyers, depths of water, seasons, and localities; on the number of individual fish of each species destroyed by the trout and lawyers; and on the calculated volume of the food fishes preceding digestion. The lake trout and lawyer are competitors for the same food, are both predators of the commercially important Coregonidae, and the lawyer through its consumption of invertebrates is a food competitor of the Coregonidae.

Reoperative fundoplications are effective treatment for dysphagia and recurrent gastroesophageal reflux.

PubMed

Rosemurgy, Alexander S; Arnaoutakis, Dean J; Thometz, Donald P; Binitie, Odion; Giarelli, Natalie B; Bloomston, Mark; Goldin, Steve G; Albrink, Michael H

2004-12-01

With wide application of antireflux surgery, reoperations for failed fundoplications are increasingly seen. This study was undertaken to document outcomes after reoperative fundoplications. Sixty-four patients, 26 men and 38 women, of average age 55 years+/-15.6 (SD), underwent reoperative antireflux surgery between 1992 and 2003. Fundoplication prior to reoperation had been undertaken via celiotomy in 27 and laparoscopically in 37. Both before and after reoperative antireflux surgery, patients scored their reflux and dysphagia on a Likert Scale (0 = none, 10 = continuous). Reoperation was undertaken because of dysphagia in 16 per cent, recurrent reflux in 52 per cent (median DeMeester Score 52), or both in 27 per cent. Failure leading to reoperation was due to hiatal failure in 28 per cent, wrap failure in 19 per cent, both in 33 per cent, and slipped Nissen fundoplication in 20 per cent. Laparoscopic reoperations were completed in 49 of 54 patients (91%); 15 had reoperations undertaken via celiotomy. Eighty-eight per cent of reoperations were Nissen fundoplications. With reoperation, Dysphagia Scores improved from 9.5+/-0.7 to 2.6+/-2.8, and Reflux Scores improved from 9.1+/-1.4 to 1.8+/-2.7. Seventy-nine per cent of patients with reflux prior to reoperation, 100 per cent with dysphagia, and 74 per cent with both noted excellent or good outcomes after reoperation. We conclude that failure after fundoplication occurs. Reoperations reduce the severity of dysphagia and reflux, thus salvaging excellent and good outcomes in most. Laparoscopic reoperations are generally possible. Reoperative fundoplications are effective treatment for dysphagia and recurrent gastroesophageal reflux, and their application is encouraged.

A clinical survey on the prevalence and types of cheek teeth disorders present in 400 Zamorano-Leonés and 400 Mirandês donkeys (Equus asinus).

PubMed

Rodrigues, J B; Dixon, P M; Bastos, E; San Roman, F; Viegas, C

2013-12-14

Dental disease is now recognised as a major but often unrecognised disorder of equids, including horses and donkeys. However, very few large clinical studies have documented the prevalence and type of dental disease present in different equid populations and no dental studies have been reported in Zamorano-Leonés or Mirandês donkeys, two endangered donkey breeds. Clinical and detailed oral examinations were performed in 400 Mirandês and 400 Zamorano-Leonés donkeys in Portugal and Spain. It was found that just 4.5 per cent had ever received any previous dental care. Cheek teeth (CT) disorders were present in 82.8 per cent of these donkeys, ranging from a prevalence of 29.6 per cent in the <2.5-year-old group to 100 per cent in the >25-year-old group. These CT disorders included enamel overgrowths (73.1 per cent prevalence but with just 6.3 per cent having associated soft tissue injuries), focal overgrowths (37.3 per cent), periodontal disease (23.5 per cent) and diastemata (19.9 per cent). Peripheral caries was present in 5.9 per cent of cases, but inexplicably, infundibular caries was very rare (1.3 per cent prevalence); this may have been due to their almost fully foraged diet. The high prevalence of enamel overgrowths in these donkeys, most which never received concentrates, also raises questions about the aetiology of this disorder. This very high prevalence of CT disorders, especially in older donkeys, was of great welfare concern in some cases and emphasises the need for routine dental care in these cases on welfare grounds and in order to help preserve these unique breeds.

Evaluation of corneal anaesthesia after the application of topical 2 per cent lidocaine, 0.5 per cent bupivacaine and 1 per cent ropivacaine in dogs.

PubMed

Costa, D; Peña, M T; Ríos, J; Leiva, M

2014-05-10

The objective of this study was to describe and compare the efficacy and duration of topical anaesthesia induced by 2 per cent lidocaine (L), 0.5 per cent bupivacaine (B) and 1 per cent ropivacaine (R) in the dog using 24 clinically healthy beagles with normal ocular examination. Dogs were randomly divided into three groups: 2 per cent lidocaine (n=8), 0.5 per cent bupivacaine (n=8) and 1 per cent ropivacaine (n=8). The baseline corneal touch threshold (CTT) was measured using a Cochet-Bonnet aesthesiometer. Following baseline CTT measurement, a single drop of the assigned anaesthetic was applied to each eye and the CTT was measured bilaterally within one minute after administration and every five minutes until the basal CTT value was restored. Data were analysed with non-parametric analysis of variance models and Dunnet's test for post hoc analysis. One per cent ropivacaine was the most effective drug (LCTTmax=3 cm, BCTTmax=2 cm, RCTTmax=0 cm; P<0.001), and had the shortest latency (LLatency=5 minutes, BLatency=5 minutes, RLatency=1 minute; P<0.001) and the smallest AUC (LAUC=80 cm×minute, BAUC=68.25 cm×minute, RAUC=36.88 cm×minute; P<0.001). There was no statistical difference in the duration of corneal anaesthesia between the groups (P=0.09) and all topical anaesthetics tested reduced corneal sensitivity, although 1 per cent ropivacaine had the maximal and quickest anaesthetic effect. This drug could be used for specific diagnostic procedures where quick and short, but effective, corneal anaesthesia is needed.

Development and testing of novel bisphenol A-free adhesives for lingual fixed retainer bonding.

PubMed

Iliadi, Anna; Eliades, Theodore; Silikas, Nick; Eliades, George

2017-02-01

To comparatively evaluate the properties of two BPA-free experimental adhesives (EXA, EXB) for lingual fixed retainer bonding versus a commercially available reference material (Transbond LR-TLR) based on BPA-compound. The experimental materials were a flowable 60 per cent glass filler-filled UEDMA/TEGDMA flowable composite (EXB) and a 70 per cent glass filler-filled paste composite with PCDMA/UEDMA/TEGDMA co-monomers. The properties tested were degree of conversion (DC%), mechanical properties (Martens hardness-MH, elastic modulus-E IT , elastic index-n IT ), effect of prolonged (6 months) water storage (changes in Vickers microhardness-VHN) and pull-out strength employing a multi-stranded wire. EXB showed the highest DC% (63.6 per cent), followed by EXA (50.5 per cent) and TRL (44.1 per cent), with all means differences being statistically significant (P < 0.05). The statistical rankings of MH (MPa) and E IT (GPa) means were TLR (76.1MPa; 17.3GPa) > EXA (53MPa; 12.9GPa) > EXB (12.9MPa; 6.7GPa), whereas for n IT, EXB (40 per cent) > EXA (34.9 per cent), TLR (33.6 per cent). All materials were affected by prolonged water storage with significant differences among them in VHN. TLR was the most affected material (ΔVHN = -11 per cent), followed by EXA (ΔVHN = -6.8 per cent) and EXB (ΔVHN = -4.2 per cent). No statistically significant differences were found in the pull-out strength testing (24-24.2 N range) and failure mode (70-77 per cent mixed). Considering the differences between the two experimental materials, it may be concluded that the material containing the PCDMA/UEDMA/TEGDMA co-monomers may be used as an alternative to the control. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Asteroseismic modelling of solar-type stars: internal systematics from input physics and surface correction methods

NASA Astrophysics Data System (ADS)

Nsamba, B.; Campante, T. L.; Monteiro, M. J. P. F. G.; Cunha, M. S.; Rendle, B. M.; Reese, D. R.; Verma, K.

2018-07-01

Asteroseismic forward modelling techniques are being used to determine fundamental properties (e.g. mass, radius, and age) of solar-type stars. The need to take into account all possible sources of error is of paramount importance towards a robust determination of stellar properties. We present a study of 34 solar-type stars for which high signal-to-noise asteroseismic data are available from multiyear Kepler photometry. We explore the internal systematics on the stellar properties, that is associated with the uncertainty in the input physics used to construct the stellar models. In particular, we explore the systematics arising from (i) the inclusion of the diffusion of helium and heavy elements; (ii) the uncertainty in solar metallicity mixture; and (iii) different surface correction methods used in optimization/fitting procedures. The systematics arising from comparing results of models with and without diffusion are found to be 0.5 per cent, 0.8 per cent, 2.1 per cent, and 16 per cent in mean density, radius, mass, and age, respectively. The internal systematics in age are significantly larger than the statistical uncertainties. We find the internal systematics resulting from the uncertainty in solar metallicity mixture to be 0.7 per cent in mean density, 0.5 per cent in radius, 1.4 per cent in mass, and 6.7 per cent in age. The surface correction method by Sonoi et al. and Ball & Gizon's two-term correction produce the lowest internal systematics among the different correction methods, namely, ˜1 per cent, ˜1 per cent, ˜2 per cent, and ˜8 per cent in mean density, radius, mass, and age, respectively. Stellar masses obtained using the surface correction methods by Kjeldsen et al. and Ball & Gizon's one-term correction are systematically higher than those obtained using frequency ratios.

Mortality of emergency abdominal surgery in high-, middle- and low-income countries.

PubMed

2016-07-01

Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1·6 per cent at 24 h (high 1·1 per cent, middle 1·9 per cent, low 3·4 per cent; P < 0·001), increasing to 5·4 per cent by 30 days (high 4·5 per cent, middle 6·0 per cent, low 8·6 per cent; P < 0·001). Of the 578 patients who died, 404 (69·9 per cent) did so between 24 h and 30 days following surgery (high 74·2 per cent, middle 68·8 per cent, low 60·5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2·78, 95 per cent c.i. 1·84 to 4·20) and low-income (OR 2·97, 1·84 to 4·81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. NCT02179112 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Dioxin-related compounds in breast milk of women from Vietnamese e-waste recycling sites: levels, toxic equivalents and relevance of non-dietary exposure.

PubMed

Tue, Nguyen Minh; Katsura, Kana; Suzuki, Go; Tuyen, Le Huu; Takasuga, Takumi; Takahashi, Shin; Viet, Pham Hung; Tanabe, Shinsuke

2014-08-01

Although informal e-waste recycling sites (EWRSs) are hotspots of both polychlorinated and polybrominated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs and PBDD/Fs), human exposure to the latter has not been studied in details. This study investigated the accumulation levels and profiles of dioxin-related compounds (DRCs) in breast milk samples from women living in two Vietnamese EWRSs and estimated the intake contribution from e-waste-related exposure. Screening results using Dioxin-Responsive Chemically Activated LUciferase gene eXpression assay (DR-CALUX) showed higher dioxin-like (DL) activities in samples from the EWRS Bui Dau than in those from the EWRS Trang Minh and a reference site (2.3-10 vs 1.7-4.8 and 0.60-5.7 pg CALUX-TEQ/g lipid, n=10, 6 and 9, respectively). Chemical analysis results of selected samples show that the WHO-TEQ levels of PCDD/Fs, DL-PCBs and PBDD/Fs in EWRS samples were not significantly higher than in those from the reference site (0.22-7.4 vs 1.1-3.0 pg/g lipid) and within the Vietnamese background range, but women involved in recycling accumulated higher concentrations of PCDFs (13-15 vs 2.3-8.8 pg/g lipid) and PBDFs (1.1-1.5 vs <1.1 pg/g lipid). By comparing the DRC profile in milk of these women with the reported profile in house dust from the same site, dust ingestion was estimated to contribute most of the intake for tetraBDF, 37 per cent to 55 per cent for penta-octaCDFs, but less than twenty per cent for PCDDs and DL-PCBs, and 26 per cent for total WHO-TEQs. The DL activities in some EWRS milk samples were not fully explained by chemical data, suggesting contribution from unidentified compounds. The estimated WHO-TEQ intake doses for breastfed infants (1.3-33 pg/kg/d) mostly exceeded the tolerable value, especially for those living in the EWRSs; and unidentified DRCs might increase further the dioxin-related health risk. Copyright © 2014 Elsevier Inc. All rights reserved.

Behind start of take-off roll aircraft sound level directivity study - revision 1

DOT National Transportation Integrated Search

2015-04-30

The National Aeronautics and Space Administration (NASA), Langley Research Center (LaRC) and the Environmental Measurement and Modeling Division of the United States Department of Transportations John A. Volpe National Transportation Systems Cente...

Variations in Paper Electrophoretic Serum Lipoprotein Patterns in Healthy Subjects

PubMed Central

Buckley, G. C.; Little, J. A.; Csima, A.

1970-01-01

The normal variations in the paper electrophoretic lipoprotein patterns in 240 healthy Canadian males and females, aged 10 to 59 years, have been described and compared with serum cholesterol and triglyceride levels. The incidence of abnormal chylomicra, beta and pre-beta lipoproteins was similar in both sexes and increased with age in both sexes. Chylomicron bands and/or pre-beta trails from the origin occurred in 4% of subjects, pre-beta bands in 27% and “abnormally” dense beta bands in 28%. Five per cent of subjects were considered to have definite hyperlipoproteinemia, another 19% had slight and 21% had questionable hyperlipoproteinemia. Fifty-five per cent were normal. PMID:5538493

Restaurant staff's knowledge of anaphylaxis and dietary care of people with allergies.

PubMed

Bailey, S; Albardiaz, R; Frew, A J; Smith, H

2011-05-01

Deaths caused by food-induced anaphylactic reactions are increasing, with most caused by food purchased outside the home. Primary prevention by allergen avoidance is desirable, but is easier in the home than when eating out, where the responsibility is shared with restaurant staff. To investigate restaurant staff's knowledge about food allergies. A structured telephone questionnaire was administered to a member of staff at 90 table-service restaurants in Brighton. Fifty-six percent (90/162) restaurants that were contacted agreed to participate. Responders included seven owners, 48 managers, 20 waiters and 15 chefs. Ninety per cent (81/90) reported food hygiene training; 33% (30/90) reported specific food allergy training. Fifty-six percent (50/90) could name three or more food allergens. Eighty-one percent reported confidence (very or somewhat) in providing a safe meal to a food-allergic customer. Answers to true-false questions indicated some frequent misunderstandings: 38% believed an individual experiencing a reaction should drink water to dilute the allergen; 23% thought consuming a small amount of an allergen is safe; 21% reported allergen removal from a finished meal would render it safe; 16% agreed cooking food prevents it causing allergy and 12% were unaware allergy could cause death. Forty-eight percent expressed interest in further training on food allergy. Despite a high confidence level, there are obvious gaps in restaurant staff's knowledge of allergy. Food-allergic patients need to be aware of this and adapt their behaviour accordingly. Our data challenge the impact of current food allergy training practice for restaurant staff, and support the need for more rigorous and accessible training. © 2011 Blackwell Publishing Ltd.

WISDOM Project - II. Molecular gas measurement of the supermassive black hole mass in NGC 4697

NASA Astrophysics Data System (ADS)

Davis, Timothy A.; Bureau, Martin; Onishi, Kyoko; Cappellari, Michele; Iguchi, Satoru; Sarzi, Marc

2017-07-01

As part of the mm-Wave Interferometric Survey of Dark Object Masses (WISDOM) project, we present an estimate of the mass of the supermassive black hole (SMBH) in the nearby fast-rotating early-type galaxy NGC 4697. This estimate is based on Atacama Large Millimeter/submillimeter Array (ALMA) cycle-3 observations of the 12CO(2-1) emission line with a linear resolution of 29 pc (0.53 arcsec). We find that NGC 4697 hosts a small relaxed central molecular gas disc with a mass of 1.6 × 107 M⊙, co-spatial with the obscuring dust disc visible in optical Hubble Space Telescope imaging. We also resolve thermal 1 mm continuum emission from the dust in this disc. NGC 4697 is found to have a very low molecular gas velocity dispersion, σgas = 1.65^{+0.68}_{-0.65} km s-1. This seems to be partially because the giant molecular cloud mass function is not fully sampled, but other mechanisms such as chemical differentiation in a hard radiation field or morphological quenching also seem to be required. We detect a Keplerian increase of the rotation of the molecular gas in the very centre of NGC 4697, and use forward modelling of the ALMA data cube in a Bayesian framework with the KINematic Molecular Simulation (kinms) code to estimate an SMBH mass of (1.3_{-0.17}^{+0.18}) × 108 M⊙ and an I-band mass-to-light ratio of 2.14_{-0.05}^{+0.04} M⊙/L⊙ (at the 99 per cent confidence level). Our estimate of the SMBH mass is entirely consistent with previous measurements from stellar kinematics. This increases confidence in the growing number of SMBH mass estimates being obtained in the ALMA era.

Perceptions, opinions and knowledge of pharmacists towards the use of complementary medicines by people living with cancer.

PubMed

Harnett, Joanna; Le, Trong Quy; Smith, Lorraine; Krass, Ines

2018-05-09

Background Biologically-based complementary medicine (BB-CM) use is prevalent amongst people living with cancer. Pharmacists play an important role in the provision of standard treatments for cancer. Less is known about pharmacist's provision of BB-CM information. Objective This study investigated the opinions, perceptions and knowledge of pharmacists regarding the use of BB-CMs by people living with cancer and the facilitators and barriers to providing information and advice. Setting Australia. Method A cross-sectional 53-item survey was developed and the survey link distributed in two professional associations newsletters. The associations represent ~29,000 pharmacists. Questions were categories into pharmacist's perceptions, opinions, and knowledge towards the use of BB-CM in cancer. Main Outcome Measure Scores obtained from responses to perception, opinion and knowledge statements and responses to demographic questions Results Respondents (n=70) were predominantly female (73%), Caucasian (66%) and under 40 years of age (78%). Respondents estimated that 19% of daily inquiries related to BB-CMs. Seventy-two per cent of respondents believed they had a responsibility to advise about the concomitant use of BB-CM with standard cancer treatments despite 60% reporting a lack of confidence in their knowledge. There was a moderate positive association (Spearman's rho 0.41 p= 0.001) between a pharmacists confidence in their level of knowledge and their total knowledge scores. The main barriers to providing information about BB-CMs reported were inadequate training in BB-CMs (94%) and reservations about the evidence base for efficacy and safety (50%). Conclusion Pharmacists have a role to play in counselling people living with cancer about their use of BB-CMs and this role could be maximized with further training and education in this area.

Quality Assurance in the Polio Laboratory. Cell Sensitivity and Cell Authentication Assays.

PubMed

Dunn, Glynis

2016-01-01

The accuracy of poliovirus surveillance is largely dependent on the quality of the cell lines used for virus isolation, which is the foundation of poliovirus diagnostic work. Many cell lines are available for the isolation of enteroviruses, whilst genetically modified L20B cells can be used as a diagnostic tool for the identification of polioviruses. To be confident that cells can consistently isolate the virus of interest, it is necessary to have a quality assurance system in place, which will ensure that the cells in use are not contaminated with other cell lines or microorganisms and that they remain sensitive to the viruses being studied.The sensitivity of cell lines can be assessed by the regular testing of a virus standard of known titer in the cell lines used for virus isolation. The titers obtained are compared to previously obtained titers in the same assay, so that any loss of sensitivity can be detected.However, the detection of cell line cross contamination is more difficult. DNA bar coding is a technique that uses a short DNA sequence from a standardized position in the genome as a molecular diagnostic assay for species-level identification. For almost all groups of higher animals, the cytochrome c oxidase subunit 1 of mitochondrial DNA (CO1) is emerging as the standard barcode region. This region is 648 nucleotide base pairs long in most phylogenetic groups and is flanked by regions of conserved sequences, making it relatively easy to isolate and analyze. DNA barcodes vary among individuals of the same species to a very minor degree (generally less than 1-2 %), and a growing number of studies have shown that the COI sequences of even closely related species differ by several per cent, making it possible to identify different species with high confidence.

75 FR 17832 - Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 Lincoln One-Cent Coin Two-Roll Set. The 2010 Lincoln One-Cent...

A Builder's Guide to Super Good Cents Contruction and Sales.

DOE Office of Scientific and Technical Information (OSTI.GOV)

OSU Extension Energy Program; United States. Bonneville Power Administration.

This Builder's guide describes the Super Good Cents {reg sign} program and the benefits available to participating builders. It explains the program standards and the typical building techniques used by Super Good Cents builders. Finally, the guide tells how you can participate and answers many of the questions asked by builders about the Super Good Cents program.

Efficacy of moxidectin against nematodes in naturally infected sheep.

PubMed

Coles, G C; Giordano-Fenton, D J; Tritschler, J P

1994-07-09

The activity of an oral drench of moxidectin against nematodes in naturally infected sheep known to harbour Nematodirus species was evaluated at doses of 0.2 and 0.4 mg/kg bodyweight. Moxidectin was 100 per cent effective against nematodes in the abomasum and 100 per cent effective against nematodes in the small intestine except for adult Trichostrongylus species, against which its efficacy was 94 per cent. It was 100 per cent effective against nematodes in the large intestine except for Trichuris ovis, against which its efficacy was 83 per cent.

Deep Chandra Observation and Numerical Studies of the Nearest Cluster Cold Front in the Sky

NASA Technical Reports Server (NTRS)

Werner, N.; ZuHone, J. A.; Zhuravleva, I.; Ichinohe, Y.; Simionescu, A.; Allen, S. W.; Markevitch, M.; Fabian, A. C.; Keshet, U.; Roediger, E.;

The OGLE view of microlensing towards the Magellanic Clouds - II. OGLE-II Small Magellanic Cloud data

NASA Astrophysics Data System (ADS)

Wyrzykowski, Ł.; Kozłowski, S.; Skowron, J.; Belokurov, V.; Smith, M. C.; Udalski, A.; Szymański, M. K.; Kubiak, M.; Pietrzyński, G.; Soszyński, I.; Szewczyk, O.

2010-09-01

The primary goal of this paper is to provide evidence that can prove true or false the hypothesis that dark matter in the Galactic halo can clump into stellar-mass compact objects. If such objects exist, they would act as lenses to external sources in the Magellanic Clouds, giving rise to an observable effect of microlensing. We present the results of our search for such events, based on data from the second phase of the OGLE survey (1996-2000) towards the Small Magellanic Cloud (SMC). The data set we used comprises 2.1 million monitored sources distributed over an area of 2.4deg2. We found only one microlensing event candidate, however its poor-quality light curve limited our discussion of the exact distance to the lensing object. Given a single event, taking blending (crowding of stars) into account for the detection-efficiency simulations and deriving the Hubble Space Telescope (HST)-corrected number of monitored stars, the microlensing optical depth is τ = (1.55 +/- 1.55) × 10-7. This result is consistent with the expected SMC self-lensing signal, with no need to introduce dark matter microlenses. Rejecting the unconvincing event leads to an upper limit on the fraction of dark matter in the form of massive compact halo objects (MACHOs) of f < 20 per cent for deflector masses around 0.4Msolar and f < 11 per cent for masses between 0.003 and 0.2Msolar (95 per cent confidence limit). Our result indicates that the Milky Way's dark matter is unlikely to be clumpy and to form compact objects in the subsolar-mass range. Based on observations obtained with the 1.3-m Warsaw Telescope at the Las Campanas Observatory of the Carnegie Institution of Washington. E-mail: wyrzykow@ast.cam.ac.uk ‡ Name pronunciation: Woocash Vizhikovsky

Diuretic or sodium-restricted diet for obstructive sleep apnea-a randomized trial.

PubMed

Fiori, Cintia Zappe; Martinez, Denis; Montanari, Carolina Caruccio; Lopez, Pedro; Camargo, Rodrigo; Sezerá, Lauren; Gonçalves, Sandro Cadaval; Fuchs, Flavio Danni

2018-04-01

Interventions that decrease leg fluid retention reduce obstructive sleep apnea (OSA) severity in nonrandomized experiments. We aimed to investigate in a randomized trial the effect of interventions that reduce fluid volume on OSA severity. Men diagnosed with severe OSA were randomized to receive daily spironolactone 100 mg + furosemide 20 mg or nutritional counseling to sodium-restricted diet plus placebo pill or placebo pill. All participants underwent home sleep apnea testing at baseline and after 1 week follow-up. The change in apnea-hypopnea index (AHI) was the primary outcome. The study included 54 participants and all were assessed at follow-up. The average baseline value of the AHI was similar among groups and from baseline to follow-up the AHI reduced 14.4 per cent (δ value -7.3 events per hour; 95% confidence interval, -13.8 to -0.9) in the diuretic group, 22.3 per cent (-10.7; 95% CI, -15.6 to -5.7) in the diet group, and 0.8 per cent (0.4; 95% CI, -2.5 to 3.2) in the placebo group (p = .001 for time × group interaction). None of the patients had their AHI returned to normal. The reduction in the total body water was 2.2 ± 2.2 L in the diuretic group (p < .001) and 1.0 ± 1.6 l in the low salt diet group (p = .002). Sleepiness and neck circumference were significantly reduced only in the diet group (p = .007 and p < .001 for the time × group interactions, respectively). Interventions to reduce bodily fluid content in men with severe OSA promoted a limited decrease of apnea frequency. This finding suggests that rostral fluid displacement affects only partially the OSA severity and/or that other factors prevail in determining pharyngeal collapsibility. Sodium-Restricted Diet and Diuretic in the Treatment of Severe Sleep Apnea (DESALT), https://clinicaltrials.gov/ct2/show/NCT01945801 ClinicalTrials.gov number: NCT01945801.

Serum antibody titres to canine parvovirus, adenovirus and distemper virus in dogs in the UK which had not been vaccinated for at least three years.

PubMed

Böhm, M; Thompson, H; Weir, A; Hasted, A M; Maxwell, N S; Herrtage, M E

2004-04-10

Antibody titres to canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus (CAV) were measured in 144 adult dogs that had not been vaccinated for between three and 15 years. Protective antibodies to CPV were present in 95 per cent of the population, to CDV in 71.5 per cent and to CAV in 82 per cent. The prevalence of protective titres did not decrease with increasing time interval from the last vaccination for any of the three diseases studied. Booster vaccination increased the dogs CAV titres. For comparative purposes, 199 puppies were sampled at the time of their first and second vaccination. In the case of CPV and CAV a significantly higher proportion of the adult dogs were protected than of the puppies immediately after they were vaccinated. Natural CPV boosting was strongly suspected because the dogs had significantly higher titres three years after their primary vaccination than two weeks after it and three unvaccinated dogs had acquired protective antibody levels uneventfully. There was no evidence of natural exposure to CDV.

A terrestrial planet candidate in a temperate orbit around Proxima Centauri

NASA Astrophysics Data System (ADS)

Anglada-Escudé, Guillem; Amado, Pedro J.; Barnes, John; Berdiñas, Zaira M.; Butler, R. Paul; Coleman, Gavin A. L.; de La Cueva, Ignacio; Dreizler, Stefan; Endl, Michael; Giesers, Benjamin; Jeffers, Sandra V.; Jenkins, James S.; Jones, Hugh R. A.; Kiraga, Marcin; Kürster, Martin; López-González, María J.; Marvin, Christopher J.; Morales, Nicolás; Morin, Julien; Nelson, Richard P.; Ortiz, José L.; Ofir, Aviv; Paardekooper, Sijme-Jan; Reiners, Ansgar; Rodríguez, Eloy; Rodríguez-López, Cristina; Sarmiento, Luis F.; Strachan, John P.; Tsapras, Yiannis; Tuomi, Mikko; Zechmeister, Mathias

2016-08-01

At a distance of 1.295 parsecs, the red dwarf Proxima Centauri (α Centauri C, GL 551, HIP 70890 or simply Proxima) is the Sun’s closest stellar neighbour and one of the best-studied low-mass stars. It has an effective temperature of only around 3,050 kelvin, a luminosity of 0.15 per cent of that of the Sun, a measured radius of 14 per cent of the radius of the Sun and a mass of about 12 per cent of the mass of the Sun. Although Proxima is considered a moderately active star, its rotation period is about 83 days (ref. 3) and its quiescent activity levels and X-ray luminosity are comparable to those of the Sun. Here we report observations that reveal the presence of a small planet with a minimum mass of about 1.3 Earth masses orbiting Proxima with a period of approximately 11.2 days at a semi-major-axis distance of around 0.05 astronomical units. Its equilibrium temperature is within the range where water could be liquid on its surface.

A terrestrial planet candidate in a temperate orbit around Proxima Centauri.

PubMed

Anglada-Escudé, Guillem; Amado, Pedro J; Barnes, John; Berdiñas, Zaira M; Butler, R Paul; Coleman, Gavin A L; de la Cueva, Ignacio; Dreizler, Stefan; Endl, Michael; Giesers, Benjamin; Jeffers, Sandra V; Jenkins, James S; Jones, Hugh R A; Kiraga, Marcin; Kürster, Martin; López-González, Marίa J; Marvin, Christopher J; Morales, Nicolás; Morin, Julien; Nelson, Richard P; Ortiz, José L; Ofir, Aviv; Paardekooper, Sijme-Jan; Reiners, Ansgar; Rodríguez, Eloy; Rodrίguez-López, Cristina; Sarmiento, Luis F; Strachan, John P; Tsapras, Yiannis; Tuomi, Mikko; Zechmeister, Mathias

2016-08-25

At a distance of 1.295 parsecs, the red dwarf Proxima Centauri (α Centauri C, GL 551, HIP 70890 or simply Proxima) is the Sun's closest stellar neighbour and one of the best-studied low-mass stars. It has an effective temperature of only around 3,050 kelvin, a luminosity of 0.15 per cent of that of the Sun, a measured radius of 14 per cent of the radius of the Sun and a mass of about 12 per cent of the mass of the Sun. Although Proxima is considered a moderately active star, its rotation period is about 83 days (ref. 3) and its quiescent activity levels and X-ray luminosity are comparable to those of the Sun. Here we report observations that reveal the presence of a small planet with a minimum mass of about 1.3 Earth masses orbiting Proxima with a period of approximately 11.2 days at a semi-major-axis distance of around 0.05 astronomical units. Its equilibrium temperature is within the range where water could be liquid on its surface.

Are BTS guidelines followed?

PubMed

2002-03-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.

[The isolation and characteristics of mutants of the Saccharopolyspora erythraea strain resistant to thiostrepton].

PubMed

Nastasiak, I N; Fedorenko, V A; Danilenko, V N

1997-01-01

The formation of thiostreptone resistant spontaneous and nitrosoguanidine-induced mutants in the erythromycin-producing organism Saccharopolyspora erythraea was investigated. The investigated collection of the mutants was heterogeneous by the level of the thiostreptone resistance (2.5 to 20 micrograms/ml). The thiostreptone resistance mutations had a pleiotropic effect: 17 per cent of the mutants was characterized by the growth thermosensitivity and 26 and 5.8 per cent of the mutants were characterized by loss of the ability to form melanine and aerial mycelium respectively. Such phenotypes were most frequent in the mutants resistant to low concentrations of thiostreptone (2 to 5 micrograms/ml). The absolute majority of the isolated thiostreptone resistant mutants was unstable and formed both the antibiotic resistant and the antibiotic sensitive clones. The greatest portion of the strains with high antibiotic activity (20 per cent) was detected among the S. erythraea spontaneous mutants on the medium with 2.5 micrograms/ ml of thiostreptone. It was shown that the instability of the high antibiotic activity in the mutants was associated with loss of the thiostreptone resistance property.

Addressing refractive error visual impairment: volunteer organisations' alignment with Vision 2020 and public health principles.

PubMed

Pearce, Matthew G; Pearce, Nicole

2012-11-01

Eye care professionals have been making short visits to developing countries for decades in an effort to reduce visual impairment caused by refractive error. A 2006 survey revealed that volunteer organisations were not working within the Vision 2020 framework. Recommendations were made for volunteer organisations that would better align their work with accepted Vision 2020 and public health principles. This study re-evaluates the alignment of volunteer organisations with Vision 2020 and public health principles. To determine their philosophies and methods, a web-based survey was sent to 89 volunteer organisations identified from an internet search. The response rate was 48 per cent. Many (70.7 per cent) organisations exclusively mention direct service provision in their statement of purpose, often provided by student volunteers (75.6 per cent). A few (19.5 per cent) provide short training in refraction, not necessarily following best principles. The majority (82.1 per cent) dispenses recycled spectacles and many use medications not on national essential drug lists. Few attempt to follow aid effectiveness principles with only 26.8 per cent stating they follow Vision 2020 country plans. Overall, as in 2006, the work of these organisations is largely not in alignment with Vision 2020 and public health principles. Organisations interested in decreasing visual impairment due to refractive error in the developing world are encouraged to transition to organisations that not only recognise but also implement public health principles. This should include reprioritisation of their work to developing human resources and infrastructure, determining the burden and causes of disease, assisting in the training of mid-level personnel and providing professional and community education, collaborating via partnerships, discontinuing the use of recycled spectacles and inappropriate medications, and evaluating their outcomes. Following these recommendations as well as creating a better alignment with public health principles in general will increase the likelihood that their programs will be effective in decreasing visual impairment due to refractive error in the developing world. © 2012 The Authors. Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

Analysis of broad-band regional waveforms of the 1996 September 29 earthquake at Bárdarbunga volcano, central Iceland: investigation of the magma injection hypothesis

NASA Astrophysics Data System (ADS)

Konstantinou, Konstantinos I.; Kao, Honn; Lin, Cheng-Horng; Liang, Wen-Tzong

2003-07-01

Large earthquakes near active volcanoes, that exhibit non-double-couple source properties are usually interpreted as result the of either magma intrusion or geometrical complexity along the fault plane. Such an earthquake occurred in 1996 September 29 at Bárdarbunga volcano in central Iceland, to be followed 2 days later by a major volcanic eruption at the area between Bárdarbunga and the nearby Grimsvötn volcano. Both of these active volcanic centres lie underneath the Vatnajökull glacier, a permanent ice cap that covers a large area of central Iceland. This event was recorded by a temporary network (HOTSPOT) that consisted of 30 broad-band three-component seismometers covering most of Iceland. The waveforms of this event at all stations show an emergent, low-amplitude, high-frequency onset that is superposed on a longer-period signal. The corresponding amplitude spectra show a low-frequency content (<1 Hz) and prominent peaks around the corner frequency (~0.25 Hz) and higher frequencies. These regional waveforms were inverted in order to obtain the best-fitting deviatoric and full moment tensor using a linear, time-domain inversion method. The results for the deviatoric moment tensor indicate a large (~60 per cent) compensated linear vector dipole (CLVD) component, a hypocentral depth of 3.5 km, a moment magnitude of 5.4 and a best double-couple solution showing thrust motion in good agreement with the previously published Harvard CMT solution. The results for the full moment tensor on the other hand, indicate an implosive isotropic component of 8.5 per cent, a reduced CLVD component of 47.2 per cent and a best double-couple solution showing normal faulting. However, a statistical F-test revealed that the full moment tensor does not fit the data significantly better than the deviatoric at a confidence level of not more than 76 per cent. All of these results were found not to change substantially when a different source time function was used or when the data were weighted according to their distance from the source. The data are consistent with an earthquake of this magnitude, caused by the failure of an asperity and the formation of a tensile crack due to increasing fluid pressure. The dimensions of the crack may have been 10 × 3 km2 and 0.5 m thickness and the volume of the injected fluid was found to be 15 × 106 m3. The calculated viscosity for the fluid (0.04 Pa s) points to the possibility of water being injected rather than magma, that is also supported by the short source duration of the earthquake (~5 s). Taking into account the water saturation of the upper crust in Vatnajökull due to the presence of the glacier, this event may have been caused by increased pressure of water that was heated by magma injected through a dyke below the asperity.

Technical and financial evaluation of assays for progesterone in canine practice in the UK.

PubMed

Moxon, R; Copley, D; England, G C W

2010-10-02

The concentration of progesterone was measured in 60 plasma samples from bitches at various stages of the oestrous cycle, using commercially available quantitative and semi-quantitative ELISA test kits, as well as by two commercial laboratories undertaking radioimmunoassay (RIA). The RIA, which was assumed to be the 'gold standard' in terms of reliability and accuracy, was the most expensive method when analysing more than one sample per week, and had the longest delay in obtaining results, but had minimal requirements for practice staff time. When compared with the RIA, the quantitative ELISA had a strong positive correlation (r=0.97, P<0.05) and a sensitivity and specificity of 70.6 per cent and 100.0 per cent, respectively, and positive and negative predictive values of 100.0 per cent and 71.0 per cent, respectively, with an overall accuracy of 90.0 per cent. This method was the least expensive when analysing five or more samples per week, but had longer turnaround times than that of the semi-quantitative ELISA and required more staff time. When compared with the RIA, the semi-quantitative ELISA had a sensitivity and specificity of 100.0 per cent and 95.5 per cent, respectively, and positive and negative predictive values of 73.9 per cent and 77.8 per cent, respectively, with an overall accuracy of 89.2 per cent. This method was more expensive than the quantitative ELISA when analysing five or more samples per week, but had the shortest turnaround time and low requirements in terms of staff time.

Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California

PubMed Central

Rojas, Nadia; Grummon, Anna H.; Madsen, Kristine A.

2015-01-01

Objectives. We assessed the short-term ability to increase retail prices of the first US 1-cent-per-ounce excise tax on the distribution of sugar-sweetened beverages (SSBs), which was implemented in March 2015 by Berkeley, California. Methods. In 2014 and 2015, we examined pre- to posttax price changes of SSBs and non-SSBs in a variety of retailers in Berkeley and in the comparison cities Oakland and San Francisco, California. We examined price changes by beverage, brand, size, and retailer type. Results. For smaller beverages (≤ 33.8 oz), price increases (cents/oz) in Berkeley relative to those in comparison cities were 0.69 (95% confidence interval [CI] = 0.36, 1.03) for soda, 0.47 (95% CI = 0.08, 0.87) for fruit-flavored beverages, and 0.47 (95% CI = 0.25, 0.69) for SSBs overall. For 2-liter bottles and multipacks of soda, relative price increases were 0.46 (95% CI = 0.03, 0.89) and 0.49 (95% CI = 0.21, 0.77). We observed no relative price increases for nontaxed beverages overall. Conclusions. Approximately 3 months after the tax was implemented, SSB retail prices increased more in Berkeley than in nearby cities, marking a step in the causal pathway between the tax and reduced SSB consumption. PMID:26444622

A Neptune-sized transiting planet closely orbiting a 5–10-million-year-old star.

PubMed

David, Trevor J; Hillenbrand, Lynne A; Petigura, Erik A; Carpenter, John M; Crossfield, Ian J M; Hinkley, Sasha; Ciardi, David R; Howard, Andrew W; Isaacson, Howard T; Cody, Ann Marie; Schlieder, Joshua E; Beichman, Charles A; Barenfeld, Scott A

2016-06-30

Theories of the formation and early evolution of planetary systems postulate that planets are born in circumstellar disks, and undergo radial migration during and after dissipation of the dust and gas disk from which they formed. The precise ages of meteorites indicate that planetesimals—the building blocks of planets—are produced within the first million years of a star’s life. Fully formed planets are frequently detected on short orbital periods around mature stars. Some theories suggest that the in situ formation of planets close to their host stars is unlikely and that the existence of such planets is therefore evidence of large-scale migration. Other theories posit that planet assembly at small orbital separations may be common. Here we report a newly born, transiting planet orbiting its star with a period of 5.4 days. The planet is 50 per cent larger than Neptune, and its mass is less than 3.6 times that of Jupiter (at 99.7 per cent confidence), with a true mass likely to be similar to that of Neptune. The star is 5–10 million years old and has a tenuous dust disk extending outward from about twice the Earth–Sun separation, in addition to the fully formed planet located at less than one-twentieth of the Earth–Sun separation.

Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California.

PubMed

Falbe, Jennifer; Rojas, Nadia; Grummon, Anna H; Madsen, Kristine A

2015-11-01

We assessed the short-term ability to increase retail prices of the first US 1-cent-per-ounce excise tax on the distribution of sugar-sweetened beverages (SSBs), which was implemented in March 2015 by Berkeley, California. In 2014 and 2015, we examined pre- to posttax price changes of SSBs and non-SSBs in a variety of retailers in Berkeley and in the comparison cities Oakland and San Francisco, California. We examined price changes by beverage, brand, size, and retailer type. For smaller beverages (≤ 33.8 oz), price increases (cents/oz) in Berkeley relative to those in comparison cities were 0.69 (95% confidence interval [CI] = 0.36, 1.03) for soda, 0.47 (95% CI = 0.08, 0.87) for fruit-flavored beverages, and 0.47 (95% CI = 0.25, 0.69) for SSBs overall. For 2-liter bottles and multipacks of soda, relative price increases were 0.46 (95% CI = 0.03, 0.89) and 0.49 (95% CI = 0.21, 0.77). We observed no relative price increases for nontaxed beverages overall. Approximately 3 months after the tax was implemented, SSB retail prices increased more in Berkeley than in nearby cities, marking a step in the causal pathway between the tax and reduced SSB consumption.

Clinical features and natural history of von Hippel-Lindau disease.

PubMed

Maher, E R; Yates, J R; Harries, R; Benjamin, C; Harris, R; Moore, A T; Ferguson-Smith, M A

1990-11-01

The clinical features, age at onset and survival of 152 patients with von Hippel-Lindau disease were studied. Mean age at onset was 26.3 years and 97 per cent of patients had presented by aged 60 years. Retinal angioma was the first manifestation in 65 patients (43 per cent), followed by cerebellar haemangioblastoma (n = 60, 39 per cent) and renal cell carcinoma (n = 15, 10 per cent). Overall, 89 patients (59 per cent) developed a cerebellar haemangioblastoma, 89 (59 per cent) a retinal angioma, 43 (28 per cent) renal cell carcinoma, 20 (13 per cent) spinal haemangioblastoma and 11 (7 per cent) a phaeochromocytoma. Renal, pancreatic and epididymal cysts were frequent findings but their exact incidence was not accurately assessed. Mean age at diagnosis of renal cell carcinoma (44.0 +/- 10.9 years) was significantly older than that for cerebellar haemangioblastoma (29.0 +/- 10.0 years) and retinal angioma (25.4 +/- 12.7 years). The probability of a patient with von Hippel-Lindan disease developing a cerebellar haemangioblastoma, retinal angioma or renal cell carcinoma by age 60 years was 0.84, 0.7 and 0.69, respectively. A comprehensive screening protocol for affected patients and at-risk relatives is presented, based on detailed analysis of age at onset data for each of the major complications. Median actuarial survival was 49 years, with renal cell carcinoma the leading cause of death.

Acute haemorrhagic diarrhoea syndrome in dogs: 108 cases.

PubMed

Mortier, F; Strohmeyer, K; Hartmann, K; Unterer, S

2015-06-13

No prospective studies including large numbers of dogs with acute haemorrhagic diarrhoea syndrome (AHDS) are published so far. The aim of this case-control study was to describe signalment, history, clinical signs, laboratory values and course of disease in dogs with AHDS. Dogs (108) with idiopathic acute haemorrhagic diarrhoea (<3 days) were prospectively enrolled. Clinical assessment was performed by calculation of the 'AHDS index' (0-18). The hospital population and 21 healthy dogs served as control groups. Dogs with AHDS had a significantly lower body weight (median 9.8 kg) and age (median five years) than other dogs of the hospital population (20 kg; 10 years) (P<0.001). Predisposed breeds were Yorkshire terrier, miniature pinscher, miniature schnauzer and Maltese. The syndrome was more likely to occur during winter. Vomiting preceded the onset of bloody diarrhoea in 80 per cent of dogs and haematemesis was observed in half of those cases. Median AHDS index at presentation was 12 (range 3-17). Haematocrit was generally high (median 57.1 per cent; range 33-76 per cent), but exceeded 60 per cent only in 31.4 per cent of dogs. Haematocrit of 48.1 per cent of dogs was above reference range, as was monocyte (50.0 per cent), segmented (59.6 per cent) and band neutrophil count (45.2 per cent). A rapid clinical improvement occurred during the first 48 hours. British Veterinary Association.

Further characterization of field strains of rotavirus from Nigeria VP4 genotype P6 most frequently identified among symptomatically infected children.

PubMed

Adah, M I; Rohwedder, A; Olaleye, O D; Durojaiye, O A; Werchau, H

1997-10-01

Polymerase chain reaction was utilized to characterize the VP4 types of 39 Rotavirus field isolates from symptomatically infected children in Nigeria. Genotype P6 was identified most frequently, occurring in 41.03 per cent of the typed specimens. Genotype P8 was identified as the next most prevalent (33.3% per cent). Genotype p6 was widespread (68.75 per cent) among infected neonates in Southern Nigeria, but mix infection was more prevalent (70 per cent) among Northern Nigerian children. Four distinct strains were identified with four different P genotypes. Overall strain G1P8 predominated (22.22 per cent) followed by G3P6 (17.8 per cent). Strain G1P8 was most prevalent (70 per cent) among infants aged 3.1-9 months, but strain G3P6 was most frequently identified among neonates < or = 3 months (50 per cent). While strain G1P8 was circulating across the country at this time, strain G3P6 was regionally most identified (77.8 per cent) in Southern Nigeria. The presence of untypeable VP4 gene in Nigeria was demonstrated. The occurance of mix infection genotype demonstrates the potential for reassortment events among different rotavirus genogroups in Nigeria. The epidemiological implications of these findings for rotavirus vaccine development and application in the country were discussed.

Experience with the artificial urinary sphincter model AS800 in 148 patients.

PubMed

Fishman, I J; Shabsigh, R; Scott, F B

1989-02-01

The latest version of the artificial urinary sphincter, AS800, was used in 148 patients with urinary incontinence of different etiologies. Followup ranged from 3 to 37 months, with an average of 20.8 months. There were 112 (76 per cent) male and 36 (24 per cent) female patients. The cuff was implanted around the bladder neck in 78 patients (53 per cent) and around the bulbar urethra in 70 (47 per cent). Socially acceptable urinary control was achieved in 90 per cent of the 139 patients with active devices in place. It was necessary to remove the sphincter in 11 patients (7.4 per cent). The reasons for removal were infection and erosion in 8 patients (5.4 per cent), infection without erosion in 2 (1.3 per cent), and erosion due to excess pressure and poor tissues in 1 (0.7 per cent). Comparison of success and failure rates associated with incontinence of different etiologies revealed that patients with incontinence after failure of a conventional antistress incontinence operation and those with incontinence after transurethral resection or radical prostactectomy had the highest success rate, and that patients with incontinence secondary to pelvic fracture or exstrophy and epispadias had the highest failure rates. The deactivation feature (the lock) of the new artificial sphincter model was beneficial for primary deactivation, urethral catheterization or cystoscopy, or for elective nocturnal decompression of the bladder neck or urethral tissues.

A Builder`s Guide to Super Good Cents Contruction and Sales.

DOE Office of Scientific and Technical Information (OSTI.GOV)

OSU Extension Energy Program; United States. Bonneville Power Administration.

This Builder`s guide describes the Super Good Cents {reg_sign} program and the benefits available to participating builders. It explains the program standards and the typical building techniques used by Super Good Cents builders. Finally, the guide tells how you can participate and answers many of the questions asked by builders about the Super Good Cents program.

A survey of patients' receipt of prescription drug information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, L.A.

1982-06-01

A nationwide telephone survey of 1,223 individuals investigated the nature and source of information provided to patients regarding prescription drugs. About half of the respondents said that they had received information from their doctor about the purpose and directions for use for their most recent prescription. Only a few people (11 per cent) said that they had been informed about the drug's side effects and 19 per cent said that they had been told nothing by their doctor. Most (72 per cent) related that nothing had been said to them at the pharmacy. Written information (stickers on the medicine container,more » leaflets or brochures) were said to be infrequently provided at the pharmacy. About 12 per cent of the respondents said they had expected they might get a drug side effect, but only 9 per cent said that they had experienced one. The most frequently cited action in response to side effects was to consult the physician (40 per cent); however, a sizeable percentage of people stopped the medicine completely or temporarily (36 per cent) or kept on taking the drug as prescribed (32 per cent).« less

Latest trends in the assessment and management of paediatric snoring and sleep apnoea.

PubMed

Sharma, S D; Kanona, H; Kumar, G; Kotecha, B

2016-05-01

To investigate the assessment and management of paediatric snoring and obstructive sleep apnoea in UK otolaryngology departments. A telephone questionnaire survey of UK otolaryngology departments was conducted over a 16-week period. The response rate was 61 per cent (85 out of 139 trusts). Use of pre-operative pulse oximetry was reported by 84 per cent of respondents, mainly to diagnose obstructive sleep apnoea (73 per cent) or stratify post-operative risk (46 per cent). Thirty-one per cent of respondents reported using post-operative pulse oximetry. Twenty-five per cent of respondents have a dedicated management protocol for paediatric obstructive sleep apnoea and snoring. Thirty-four per cent require prior clinical commissioning group approval before performing surgery. Fifty-eight per cent of respondents reported following up their obstructive sleep apnoea patients after surgery. The mean follow-up period (±standard deviation) was 6.8 ± 1.2 weeks. There is variation in the assessment and management of paediatric snoring and obstructive sleep apnoea across the UK, particularly in the use of pre- and post-operative pulse oximetry monitoring, and further guidelines regarding this are necessary.

Association between the level of antibodies in bulk tank milk and bovine respiratory syncytial virus exposure in the herd

PubMed Central

Klem, T. B.; Tollersrud, T.; Østerås, O.; Stokstad, M.

2014-01-01

Antibody levels in bulk tank milk (BTM) against bovine respiratory syncytial virus (BRSV) are used to classify BRSV status of herds. The aim of this study was to investigate how these levels correspond with the time at which the herds were infected. Bulk tank milk, individual milk and serum samples from cows and young stock were investigated using an indirect ELISA. Screenings of BTM from 89 dairy herds during two winter seasons revealed a prevalence of positive herds from 82 per cent to 85 per cent. Eleven herds showed a marked increase in antibody levels between two screenings, indicating new infection. However, two of these herds had been free from BRSV for the last five to seven years. Two newly infected herds were monitored for four years and did not appear to get reinfected. Surprisingly, the BTM antibody levels in these herds remained high throughout the study period, but fluctuated significantly. This shows that the levels of antibodies in BTM can remain high for several years, even in herds where reinfection does not occur. BTM serology is a useful tool in the monitoring of infectious diseases in dairy herds, but has limitations as a diagnostic tool for BRSV infections. PMID:24864076

Association between the level of antibodies in bulk tank milk and bovine respiratory syncytial virus exposure in the herd.

PubMed

Klem, T B; Tollersrud, T; Osterås, O; Stokstad, M

2014-07-12

Antibody levels in bulk tank milk (BTM) against bovine respiratory syncytial virus (BRSV) are used to classify BRSV status of herds. The aim of this study was to investigate how these levels correspond with the time at which the herds were infected. Bulk tank milk, individual milk and serum samples from cows and young stock were investigated using an indirect ELISA. Screenings of BTM from 89 dairy herds during two winter seasons revealed a prevalence of positive herds from 82 per cent to 85 per cent. Eleven herds showed a marked increase in antibody levels between two screenings, indicating new infection. However, two of these herds had been free from BRSV for the last five to seven years. Two newly infected herds were monitored for four years and did not appear to get reinfected. Surprisingly, the BTM antibody levels in these herds remained high throughout the study period, but fluctuated significantly. This shows that the levels of antibodies in BTM can remain high for several years, even in herds where reinfection does not occur. BTM serology is a useful tool in the monitoring of infectious diseases in dairy herds, but has limitations as a diagnostic tool for BRSV infections. British Veterinary Association.

A Tumor-Associated Mutation of FYVE-CENT Prevents Its Interaction with Beclin 1 and Interferes with Cytokinesis

PubMed Central

Sagona, Antonia P.; Nezis, Ioannis P.; Bache, Kristi G.; Haglund, Kaisa; Bakken, Anne Cathrine; Skotheim, Rolf I.; Stenmark, Harald

2011-01-01

The tumor suppressor activity of Beclin 1 (BECN1), a subunit of class III phosphatidylinositol 3-kinase complex, has been attributed to its regulation of apoptosis and autophagy. Here, we identify FYVE-CENT (ZFYVE26), a phosphatidylinositol 3-phosphate binding protein important for cytokinesis, as a novel interacting protein of Beclin 1. A mutation in FYVE-CENT (R1945Q) associated with breast cancer abolished the interaction between FYVE-CENT and Beclin 1, and reduced the localization of these proteins at the intercellular bridge during cytokinesis. Breast cancer cells containing the FYVE-CENT R1945Q mutation displayed a significant increase in cytokinetic profiles and bi - multinuclear phenotype. Both Beclin 1 and FYVE-CENT were found to be downregulated in advanced breast cancers. These findings suggest a positive feedback loop for recruitment of FYVE-CENT and Beclin 1 to the intercellular bridge during cytokinesis, and reveal a novel potential tumor suppressor mechanism for Beclin 1. PMID:21455500

Liver abscess in ancient Greek and Greco-Roman texts.

PubMed

Papavramidou, Niki; Samara, Anastasia; Christopoulou-Aletra, Helen

2014-01-01

This paper presents liver abscesses, as studied in the ancient Greek and Greco-Roman bibliography. Numerous references concerning this entity can be found in the writings of the Hippocratic doctors (5th cent. B.C.), Archigenes of Apamea (1st cent. A.D.), Galen (2nd cent. A.D.), Aretaeus of Cappadocia (2nd cent. A.D), Oribasius (4th cent. A.D.), Theophilus Protospatharius (7th cent. A.D.), and Paulus Nicaeensis (7th-10th cent. A.D.). In most cases the clinical manifestations, the prognosis and the method of treatment are presented. In all ancient writings we studied, the rupture of a liver abscess is also part of the main theme. In specific, the path that the fluid would follow after a rupture was considered to be a main prognostic factor, i.e. if the fluid "coursed into the stomach", the patient would definitely die. In this work, an attempt is also made to correlate the ancient descriptions to modern medical entities, such as amebic or pyogenic liver abscess.

A tumor-associated mutation of FYVE-CENT prevents its interaction with Beclin 1 and interferes with cytokinesis.

PubMed

Sagona, Antonia P; Nezis, Ioannis P; Bache, Kristi G; Haglund, Kaisa; Bakken, Anne Cathrine; Skotheim, Rolf I; Stenmark, Harald

2011-03-24

The tumor suppressor activity of Beclin 1 (BECN1), a subunit of class III phosphatidylinositol 3-kinase complex, has been attributed to its regulation of apoptosis and autophagy. Here, we identify FYVE-CENT (ZFYVE26), a phosphatidylinositol 3-phosphate binding protein important for cytokinesis, as a novel interacting protein of Beclin 1. A mutation in FYVE-CENT (R1945Q) associated with breast cancer abolished the interaction between FYVE-CENT and Beclin 1, and reduced the localization of these proteins at the intercellular bridge during cytokinesis. Breast cancer cells containing the FYVE-CENT R1945Q mutation displayed a significant increase in cytokinetic profiles and bi-multinuclear phenotype. Both Beclin 1 and FYVE-CENT were found to be downregulated in advanced breast cancers. These findings suggest a positive feedback loop for recruitment of FYVE-CENT and Beclin 1 to the intercellular bridge during cytokinesis, and reveal a novel potential tumor suppressor mechanism for Beclin 1.

Bacteria profile and antibiogram of the bacteria isolated from the exposed pulp of dog canine teeth.

PubMed

Almansa Ruiz, José Carlos; Jonker, Annelize; Bosman, Anna-Mari; Steenkamp, Gerhard

2018-04-27

Twenty-seven microbiological samples were taken from root canals (RC) of the canine teeth of 20 dogs where the pulps were non-vital and exposed due to complicated crown fractures. These pulps were cultured for aerobic/anaerobic bacteria. Antimicrobial susceptibility of isolates was determined using the Kirby-Bauer diffusion test. A total of 49 cultivable isolates, belonging to 27 different microbial species and 18 different genera, were recovered from the 27 RCs sampled. Twenty (40.81 per cent) of the cultivable isolates were Gram positive while 29 (59.19 per cent) were Gram negative. Facultative anaerobes were the most common bacteria (77.56 per cent). Aerobic isolates represented 18.36 per cent, and strict anaerobes 4.08 per cent. The antimicrobials with the highest in vitro efficacy were gentamicin (100 per cent) and enrofloxacin (93.32 per cent). © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures.

PubMed

McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

2015-09-01

The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a quarter of laboratories were providing a service that would allow clinicians to fully comply with the first line recommendations in the 2007 NICE UTI in children guidance. Laboratory urine submission report figures suggest that the guidance has not led to an increase in diagnosis of UTI in children under 3 years old.

Accuracy of circulating histones in predicting persistent organ failure and mortality in patients with acute pancreatitis.

PubMed

Liu, T; Huang, W; Szatmary, P; Abrams, S T; Alhamdi, Y; Lin, Z; Greenhalf, W; Wang, G; Sutton, R; Toh, C H

2017-08-01

Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014. Blood samples were obtained within 48 h of abdominal pain onset and relevant clinical data during the hospital stay were collected. Healthy volunteers were enrolled as controls. The primary endpoint was occurrence of persistent organ failure. The predictive values of circulating histones, clinical scores and other biomarkers were determined. Among 236 patients with acute pancreatitis, there were 156 (66·1 per cent), 57 (24·2 per cent) and 23 (9·7 per cent) with mild, moderate and severe disease respectively, according to the revised Atlanta classification. Forty-seven healthy volunteers were included. The area under the receiver operating characteristic (ROC) curve (AUC) for circulating histones in predicting persistent organ failure and mortality was 0·92 (95 per cent c.i. 0·85 to 0·99) and 0·96 (0·92 to 1·00) respectively; histones were at least as accurate as clinical scores or biochemical markers. For infected pancreatic necrosis and/or sepsis, the AUC was 0·78 (0·62 to 0·94). Histones did not predict or correlate with local pancreatic complications, but correlated negatively with leucocyte cell viability (r = -0·511, P = 0·001). Quantitative assessment of circulating histones in plasma within 48 h of abdominal pain onset can predict persistent organ failure and mortality in patients with acute pancreatitis. Early death of immune cells may contribute to raised circulating histone levels in acute pancreatitis. © 2017 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Facial burns in children: a series analysis with implications for resuscitation and forensic odontology.

PubMed

Acton, C; Nixon, J; Pearn, J; Williams, D; Leditschke, F

1999-03-01

This study comprises a continuous (1981-1995) unselected series of all children who died from thermal injuries in the State of Queensland, Australia. One hundred and six children, so identified, died from incineration (35 per cent), respiratory burns with smoke or carbon monoxide inhalation (33 per cent), body surface area burns comprising greater than 60 per cent (9 per cent) and electrocution (20 per cent). The burn fatality rate was 0.98 per hundred thousand children (0-14 years) per year, with no secular trend and, specifically, no reduction in the annual rate of such fatalities. Eighty-two children (49 males) had concomitant facial injuries, both thermal and nonthermal; of whom 55 per cent were under the age of five years. Sixty (73 per cent) child burn victims died in house fires. Forensic odontology is important in confirming the age of such victims in single incinerations but is of limited value when larger numbers of children are incinerated, because of the relative lack of dental restorations in the infant and pre-school age group. Of the 82 children with facial and airway injuries, 12 per cent had only mild or superficial facial damage and only seven (8 per cent) were alive or resuscitable at the time of rescue from the conflagration or burning injury. child deaths from burns contributed an annual loss rate of 506 years of potential life lost (YPLL) in a population of 3 million of whom 21.5 per cent were children under the age of 15 years. Airway management and resuscitation, in the context of managing surviving burn victims of any age with facial injuries, pose special difficulties. Inhalational burns (smoke and the gases of conflagration) result in a mortality greater than 60 per cent. Although 81 per cent of children showed evidence of airway obstruction, analysis of current data indicates that a maximum of 8 per cent could have survived with airway maintenance and protection. Inhalational burns (to both upper and lower airways) grossly reduce survivability. Primary prevention would seem vital and thus remains a major challenge to reduce the incidence of such deaths. Some strategies include advocacy to promote the compulsory installation of smoke alarms, family drills to practise escape and the teaching of 'first aid for all'

Background-free search for neutrinoless double-β decay of 76Ge with GERDA.

PubMed

2017-04-05

Many extensions of the Standard Model of particle physics explain the dominance of matter over antimatter in our Universe by neutrinos being their own antiparticles. This would imply the existence of neutrinoless double-β decay, which is an extremely rare lepton-number-violating radioactive decay process whose detection requires the utmost background suppression. Among the programmes that aim to detect this decay, the GERDA Collaboration is searching for neutrinoless double-β decay of 76 Ge by operating bare detectors, made of germanium with an enriched 76 Ge fraction, in liquid argon. After having completed Phase I of data taking, we have recently launched Phase II. Here we report that in GERDA Phase II we have achieved a background level of approximately 10 -3 counts keV -1 kg -1 yr -1 . This implies that the experiment is background-free, even when increasing the exposure up to design level. This is achieved by use of an active veto system, superior germanium detector energy resolution and improved background recognition of our new detectors. No signal of neutrinoless double-β decay was found when Phase I and Phase II data were combined, and we deduce a lower-limit half-life of 5.3 × 10 25 years at the 90 per cent confidence level. Our half-life sensitivity of 4.0 × 10 25 years is competitive with the best experiments that use a substantially larger isotope mass. The potential of an essentially background-free search for neutrinoless double-β decay will facilitate a larger germanium experiment with sensitivity levels that will bring us closer to clarifying whether neutrinos are their own antiparticles.

Background-free search for neutrinoless double-β decay of 76Ge with GERDA

NASA Astrophysics Data System (ADS)

Agostini, M.; Allardt, M.; Bakalyarov, A. M.; Balata, M.; Barabanov, I.; Baudis, L.; Bauer, C.; Bellotti, E.; Belogurov, S.; Belyaev, S. T.; Benato, G.; Bettini, A.; Bezrukov, L.; Bode, T.; Borowicz, D.; Brudanin, V.; Brugnera, R.; Caldwell, A.; Cattadori, C.; Chernogorov, A.; D'Andrea, V.; Demidova, E. V.; di Marco, N.; di Vacri, A.; Domula, A.; Doroshkevich, E.; Egorov, V.; Falkenstein, R.; Fedorova, O.; Freund, K.; Frodyma, N.; Gangapshev, A.; Garfagnini, A.; Gooch, C.; Grabmayr, P.; Gurentsov, V.; Gusev, K.; Hakenmüller, J.; Hegai, A.; Heisel, M.; Hemmer, S.; Hofmann, W.; Hult, M.; Inzhechik, L. V.; Janicskó Csáthy, J.; Jochum, J.; Junker, M.; Kazalov, V.; Kihm, T.; Kirpichnikov, I. V.; Kirsch, A.; Kish, A.; Klimenko, A.; Kneißl, R.; Knöpfle, K. T.; Kochetov, O.; Kornoukhov, V. N.; Kuzminov, V. V.; Laubenstein, M.; Lazzaro, A.; Lebedev, V. I.; Lehnert, B.; Liao, H. Y.; Lindner, M.; Lippi, I.; Lubashevskiy, A.; Lubsandorzhiev, B.; Lutter, G.; Macolino, C.; Majorovits, B.; Maneschg, W.; Medinaceli, E.; Miloradovic, M.; Mingazheva, R.; Misiaszek, M.; Moseev, P.; Nemchenok, I.; Palioselitis, D.; Panas, K.; Pandola, L.; Pelczar, K.; Pullia, A.; Riboldi, S.; Rumyantseva, N.; Sada, C.; Salamida, F.; Salathe, M.; Schmitt, C.; Schneider, B.; Schönert, S.; Schreiner, J.; Schulz, O.; Schütz, A.-K.; Schwingenheuer, B.; Selivanenko, O.; Shevchik, E.; Shirchenko, M.; Simgen, H.; Smolnikov, A.; Stanco, L.; Vanhoefer, L.; Vasenko, A. A.; Veresnikova, A.; von Sturm, K.; Wagner, V.; Walter, M.; Wegmann, A.; Wester, T.; Wiesinger, C.; Wojcik, M.; Yanovich, E.; Zhitnikov, I.; Zhukov, S. V.; Zinatulina, D.; Zuber, K.; Zuzel, G.; GERDA Collaboration

2017-04-01

Many extensions of the Standard Model of particle physics explain the dominance of matter over antimatter in our Universe by neutrinos being their own antiparticles. This would imply the existence of neutrinoless double-β decay, which is an extremely rare lepton-number-violating radioactive decay process whose detection requires the utmost background suppression. Among the programmes that aim to detect this decay, the GERDA Collaboration is searching for neutrinoless double-β decay of 76Ge by operating bare detectors, made of germanium with an enriched 76Ge fraction, in liquid argon. After having completed Phase I of data taking, we have recently launched Phase II. Here we report that in GERDA Phase II we have achieved a background level of approximately 10-3 counts keV-1 kg-1 yr-1. This implies that the experiment is background-free, even when increasing the exposure up to design level. This is achieved by use of an active veto system, superior germanium detector energy resolution and improved background recognition of our new detectors. No signal of neutrinoless double-β decay was found when Phase I and Phase II data were combined, and we deduce a lower-limit half-life of 5.3 × 1025 years at the 90 per cent confidence level. Our half-life sensitivity of 4.0 × 1025 years is competitive with the best experiments that use a substantially larger isotope mass. The potential of an essentially background-free search for neutrinoless double-β decay will facilitate a larger germanium experiment with sensitivity levels that will bring us closer to clarifying whether neutrinos are their own antiparticles.

ForCent model development and testing using the Enriched Background Isotope Study experiment

Treesearch

William J. Parton; Paul J. Hanson; Chris Swanston; Margaret Torn; Susan E. Trumbore; William Riley; Robin Kelly

2010-01-01

The ForCent forest ecosystem model was developed by making major revisions to the DayCent model including: (1) adding a humus organic pool, (2) incorporating a detailed root growth model, and (3) including plant phenological growth patterns. Observed plant production and soil respiration data from 1993 to 2000 were used to demonstrate that the ForCent model could...

Comparing the effects of Bentonite & Calendula on the improvement of infantile diaper dermatitis: A randomized controlled trial.

PubMed

Mahmoudi, Mansoreh; Adib-Hajbaghery, Mohsen; Mashaiekhi, Mahdi

2015-12-01

Infantile diaper dermatitis is a common, acute inflammatory reaction of the skin around diaper among infants. This study was undertaken to compare the effect of topical application of Bentonite and Calendula creams on the improvement of infantile diaper dermatitis. This double blind randomized controlled trial was undertaken on 100 patients of infantile diaper dermatitis. The 100 participants were randomly assigned into two groups of 50 each, and were prescribed the coded medicine. The mothers were trained to apply the cream and level of improvement was judged by observing the affected area on the first visit and then after three days of receiving treatment. The mean age of infants was 6.45±5.53 months in Calendula group and 7.35±6.28 months in Bentonite group. Overall, 88 per cent of lesions in the Bentonite group started improving in the first six hours while this rate was 54 per cent in Calendula group (P<0.001). The risk ratio for the improvement in the first six hours was 2.99 folds in the Bentonite group. Also, lesions in 86 per cent infants in the Bentonite group and 52 per cent in the Calendula group were completely improved in the first three days after treatment (P<0.001). Our results showed that in comparison with Calendula, Bentonite had faster healing effect and was more effective on the improvement of infantile diaper dermatitis (IRCT ID: IRCT 2012112811593N1).

Genetic variations in the Dravidian population of South West coast of India: Implications in designing case-control studies.

PubMed

D'Cunha, Anitha; Pandit, Lekha; Malli, Chaithra

2017-06-01

Indian data have been largely missing from genome-wide databases that provide information on genetic variations in different populations. This hinders association studies for complex disorders in India. This study was aimed to determine whether the complex genetic structure and endogamy among Indians could potentially influence the design of case-control studies for autoimmune disorders in the south Indian population. A total of 12 single nucleotide variations (SNVs) related to genes associated with autoimmune disorders were genotyped in 370 healthy individuals belonging to six different caste groups in southern India. Allele frequencies were estimated; genetic divergence and phylogenetic relationship within the various caste groups and other HapMap populations were ascertained. Allele frequencies for all genotyped SNVs did not vary significantly among the different groups studied. Wright's FSTwas 0.001 per cent among study population and 0.38 per cent when compared with Gujarati in Houston (GIH) population on HapMap data. The analysis of molecular variance results showed a 97 per cent variation attributable to differences within the study population and <1 per cent variation due to differences between castes. Phylogenetic analysis showed a separation of Dravidian population from other HapMap populations and particularly from GIH population. Despite the complex genetic origins of the Indian population, our study indicated a low level of genetic differentiation among Dravidian language-speaking people of south India. Case-control studies of association among Dravidians of south India may not require stratification based on language and caste.

Prospective cohort study to assess rates of contagious disease in pre-weaned UK dairy heifers: management practices, passive transfer of immunity and associated calf health

PubMed Central

Johnson, Kate F; Chancellor, Natalie; Burn, Charlotte C; Wathes, D Claire

2017-01-01

Dairy calves are vulnerable to infectious diseases, particularly diarrhoea and bovine respiratory disease (BRD), causing mortality and reducing welfare and growth. A prospective cohort study was performed on 11 UK dairy farms to determine the underlying causes for calf disease. This first paper describes the incidence, timing and duration of infectious disease, mortality rates, passive transfer of immunity and key management practices that may contribute to disease incidence. Heifer calves were recruited in the first week of life (n=492) and a blood sample taken to measure IgG and total protein (TP). Each animal was examined weekly for nine weeks using a standardised health scoring system. Recruitment of calves occurred between August and February. Four farms provided supplementary colostrum to more than 75 per cent of calves born, whereas on the remainder only 0 to 19 per cent were supplemented. Mean serum IgG and TP were 19.0±10 and 56.7±10.3 mg/ml respectively, with 20.7 per cent (95CI: 17.2 to 24.7 per cent) of all calves classified as having failure of passive transfer (IgG <10 mg/ml). The overall preweaning mortality rate was 4.5 per cent. (95 per cent CI: 2.9 to 6.8 per cent). During this period,48.2 per cent of all calves (range 24.1 to 74.4 per cent between farms) were diagnosed with diarrhoea and 45.9 per cent (range 20.4 to 77.8 per cent) with BRD. The incidence rates were 7.8 cases of diarrhoea and 10.1 cases of BRD per 100 calf weeks at risk, respectively. Rates of infectious disease were therefore high despite relatively good passive transfer. PMID:29259784

Motile Salmonella serotypes causing high mortality in poultry farms in three South-Western States of Nigeria

PubMed Central

Ibrahim, Najume Doguwar-Giginya; Saidu, Shehu NaAllah; Azeez, Aminullah Ajiyobiojo; Akinduti, Paul Akinniyi; Kwanashie, Clara Nna; Fakilahyel Kadiri, Amina Kinta; Muhammed, Maryam; Fagbamila, Idowu Oluwabunmi; Luka, Pam Dachung

2017-01-01

This study was carried out to identify the Salmonella serotypes causing high mortality in chickens in Lagos, Ogun and Oyo states, Nigeria. Chickens presented for postmortem examination during disease outbreaks that were characterised by high mortality (40 per cent to 80 per cent) in poultry farms in the study area were examined from January to December, 2013. Samples of the lungs, heart, liver, spleen, kidneys, proventriculus, intestine and caecum were collected from suspected cases of salmonellosis, for bacterial culture and identification. Salmonella isolates were confirmed using PCR and serotyped using the Kauffman-White scheme. Twenty-six day-old pullets were raised to two weeks and inoculated orally with 0.2 mL of 1×108 colony forming units of Salmonella Zega identified in the present study to determine their pathogenicity, while another 26 served as control. The Salmonella serotypes were S Zega (n=13; 35.14 per cent), Salmonella Kentucky (n=9; 24.32 per cent), Salmonella Herston (n=6; 16.22 per cent), Salmonella Nima (n=4; 10.81 per cent), Salmonella Telelkebir (n=3; 8.11 per cent), Salmonella Colindale (n=1; 2.70 per cent) and Salmonella Tshiongwe (n=1; 2.70 per cent). Clinical signs in both natural and experimental infections were acute (70 per cent) and chronic (30 per cent), and included weakness, anorexia, yellowish diarrhoea, pasted vents, somnolescence and mortality, while gross lesions showed marked pulmonary congestion and oedema, necrotic foci in the myocardium; the liver, spleen and kidneys were markedly enlarged and had subcapsular multifocal necrosis. There were catarrhal proventriculitis and enteritis, and haemorrhagic typhlitis. While most of the serotypes identified in the present study have been isolated from poultry sources from commercial farms in Nigeria, to the best of the authors' knowledge, they have not been previously reported to cause high mortality in chickens in the study area. PMID:29344363

Field evaluation of the biolarvicide, spinosad 20 per cent emulsifiable concentrate in comparison to its 12 per cent suspension concentrate formulation against Culex quinquefasciatus, the vector of bancroftian filariasis in India.

PubMed

Sadanandane, Candasamy; Gunasekaran, Kasinathan; Boopathi Doss, Ponnusamy Sivagnana; Jambulingam, Purushothaman

2018-01-01

Biolarvicides may offer alternatives to chemical larvicides as these are known to be safe to environment and selective against the target species. However, only a limited number of biolarvicides have been approved for mosquito larval control. In the current study, a new formulation of spinosad, 20 per cent emulsifiable concentrate (EC) was tested for its efficacy against Culex quinquefasciatus, in comparison to its 12 per cent suspension concentrate (SC). Spinosad 20 per cent EC was tested against Cx. quinquefasciatus immature at 25, 50, 100 and 150 mg active ingredient (ai)/m [2] in cesspits, drains and abandoned wells in comparison with spinosad 12 per cent SC at the optimum field application dosage of 50 mg ai/m [2] . The 20 per cent EC caused 90-100 per cent reduction of pupal density for 7-14 days in cesspits, 10-17 days in drains and 14-30 days in abandoned wells at all dosages tested. At lower dosages of 25 and 50 mg ai/m [2] , >90 per cent reduction of pupal density was observed for one week in cesspits and street drains and for two weeks in abandoned wells. The effective duration of control provided by the higher dosages, 100 and 150 mg ai/m [2] was 1.4 to 2 times greater than the lower dosages, 25 and 50 mg ai/m [2] . The findings showed that the spinosad 20 per cent EC can be used for larval control against Cx. quinquefasciatus, at the dosage of 25 mg ai/m [2] at weekly interval in cesspits and drains and at fortnightly interval in abandoned wells. Spinosad 20 per cent EC could be one of the options to be considered for larval control under integrated vector management.

Hybridization rapidly reduces fitness of a native trout in the wild

USGS Publications Warehouse

Muhlfeld, C.C.; Kalinowski, S.T.; McMahon, T.E.; Taper, M.L.; Painter, S.; Leary, R.F.; Allendorf, F.W.

2009-01-01

Human-mediated hybridization is a leading cause of biodiversity loss worldwide. How hybridization affects fitness and what level of hybridization is permissible pose difficult conservation questions with little empirical information to guide policy and management decisions. This is particularly true for salmonids, where widespread introgression among non-native and native taxa has often created hybrid swarms over extensive geographical areas resulting in genomic extinction. Here, we used parentage analysis with multilocus microsatellite markers to measure how varying levels of genetic introgression with non-native rainbow trout (Oncorhynchus mykiss) affect reproductive success (number of offspring per adult) of native westslope cutthroat trout (Oncorhynchus clarkii lewisi) in the wild. Small amounts of hybridization markedly reduced fitness of male and female trout, with reproductive success sharply declining by approximately 50 per cent, with only 20 per cent admixture. Despite apparent fitness costs, our data suggest that hybridization may spread due to relatively high reproductive success of first-generation hybrids and high reproductive success of a few males with high levels of admixture. This outbreeding depression suggests that even low levels of admixture may have negative effects on fitness in the wild and that policies protecting hybridized populations may need reconsideration. ?? 2009 The Royal Society.

A comparative study between 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride gel in the treatment of scabies in children.

PubMed

Singalavanija, Srisupalak; Limpongsanurak, Wanida; Soponsakunkul, Siritorn

2003-08-01

Scabies is a common contagious skin disease in children. Treatment of scabies in infants and children is the subject of worldwide concern because of risk and benefit of the variety of scabicides. To compare the efficacy of 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride gel for the treatment of scabies in children. A randomized investigator blind study was conducted to compare the efficacy of 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride (GBH) for the treatment of scabies in children at Queen Sirikit National Institute of Child Health from December 1999 to May 2000. Diagnosis was made by the clinical signs of excoriated papules in the classic distribution with nocturnal pruritus and family history of similar symptoms. Diagnosis for all patients was confirmed by positive skin scrapings for eggs, larva, mites or fecal pellets by light microscopy. Patients were followed-up at intervals of 2 and 4 weeks. One hundred children with an age range from 6 months to 13 years were randomized into 2 groups, 10 per cent sulfur group (50 cases) and 0.3 per cent GBH (50 cases). Age, sex, history of contact cases and clinical manifestations were not statistically different between the two groups. After 4 weeks of treatment, there were no statistical differences between the two groups in patients assessed cured (92% vs 94%), clinical cure (92% vs 91%) and parasitic cure (83% vs 84%). The adverse effect of foul odor in the sulfur group was more common than in the GBH group (p < 0.05). 10 per cent sulfur ointment is as safe and efficacious as 0.3 per cent GBH for the treatment of scabies in children.

ELDAR, a new method to identify AGN in multi-filter surveys: the ALHAMBRA test case

NASA Astrophysics Data System (ADS)

Chaves-Montero, Jonás; Bonoli, Silvia; Salvato, Mara; Greisel, Natascha; Díaz-García, Luis A.; López-Sanjuan, Carlos; Viironen, Kerttu; Fernández-Soto, Alberto; Pović, Mirjana; Ascaso, Begoña; Arnalte-Mur, Pablo; Masegosa, Josefa; Matute, Israel; Márquez, Isabel; Cenarro, A. Javier; Abramo, L. Raul; Ederoclite, Alessandro; Alfaro, Emilio J.; Marin-Franch, Antonio; Varela, Jesus; Cristobal-Hornillos, David

2017-12-01

We present ELDAR, a new method that exploits the potential of medium- and narrow-band filter surveys to securely identify active galactic nuclei (AGN) and determine their redshifts. Our methodology improves on traditional approaches by looking for AGN emission lines expected to be identified against the continuum, thanks to the width of the filters. To assess its performance, we apply ELDAR to the data of the ALHAMBRA (Advance Large Homogeneous Area Medium Band Redshift Astronomical) survey, which covered an effective area of 2.38 deg2 with 20 contiguous medium-band optical filters down to F814W ≃ 24.5. Using two different configurations of ELDAR in which we require the detection of at least two and three emission lines, respectively, we extract two catalogues of type-I AGN. The first is composed of 585 sources (79 per cent of them spectroscopically unknown) down to F814W = 22.5 at zphot > 1, which corresponds to a surface density of 209 deg-2. In the second, the 494 selected sources (83 per cent of them spectroscopically unknown) reach F814W = 23 at zphot > 1.5, for a corresponding number density of 176 deg-2. Then, using samples of spectroscopically known AGN in the ALHAMBRA fields, for the two catalogues we estimate a completeness of 73 per cent and 67 per cent, and a redshift precision of 1.01 per cent and 0.86 per cent (with outliers fractions of 8.1 per cent and 5.8 per cent). At z > 2, where our selection performs best, we reach 85 per cent and 77 per cent completeness and we find no contamination from galaxies.

Electrical burns in Kuwait: a review and analysis of 64 cases.

PubMed

Gang, R K; Bajec, J

1992-12-01

Sixty-four patients with electrical burns were admitted to the Department of Plastic Surgery, Ibn Sina Hospital, Kuwait during the past 6 years. There were 1202 admissions during this period, the incidence of electrical burns being 5.3 per cent. Sixty-nine per cent of the patients sustained injury from direct contact with live electrical wire, the remaining 31 per cent sustained flash burns. The incidence of low voltage injury was much higher as compared to high voltage. Forty-four per cent of these injuries were not work related. Less than 10 per cent of the body surface area was involved in about 80 per cent of the patients. A total of 65 operations was carried out in 39 patients. Twenty of these patients had repeated debridements until the wound was ready for coverage. All 64 patients survived.

Verocytotoxigenic Escherichia coli O157 in animals on public amenity premises in England and Wales, 1997 to 2007.

PubMed

Pritchard, G C; Smith, R; Ellis-Iversen, J; Cheasty, T; Willshaw, G A

2009-05-02

At the request of the public health authorities, 31 public amenity premises in England and Wales containing animals of various species were investigated for the presence of verocytotoxigenic Escherichia coli (VTEC) O157 between 1997 and 2007, because of putative associations with human cases. VTEC O157 was confirmed in one or more species on 19 (61.3 per cent) of the premises. There were significant associations between the presence of VTEC O157 and the number of species sampled, the size of the enterprise, the presence of young cattle and the presence of adult pigs. E coli O157 was isolated from 305 (17.8 per cent) of 1715 samples taken from all the premises, and verocytotoxin genes were detected by PCR in 184 (98.4 per cent) of 187 representative isolates. On positive premises, the highest mean proportion of positive samples (29.0 per cent) was in cattle, followed by sheep (24.4 per cent), donkeys (14.6 per cent), pigs (14.3 per cent), horses (12.3 per cent) and goats (9.9 per cent). A high proportion of positive samples was obtained from camelid species sampled on three of the premises. The main phage types (PT) were 2 and 21/28, which were those most commonly isolated from human cases during the same period. A single PT was detected on 14 of the 19 positive premises, with up to six different species having the same PT.

The Effect of mandible advancement splints in mild, moderate, and severe obstructive sleep apnea-the need for sleep registrations during follow up.

PubMed

Palotie, Tuula; Riekki, Siru; Mäkitie, Antti; Bachour, Adel; Arte, Sirpa; Bäck, Leif

2017-10-01

Our aim was to evaluate the effect of mandible advancement splint (MAS) in mild, moderate, and severe obstructive sleep apnea (OSA). We also determined, if and in which OSA-groups the adequate forward movement in MAS could be quantified without sleep registration for different OSA levels. A retrospective study. The effect of MAS was measured with clinical methods and by sleep registration. The series consisted of 103 patients, 75 males and 28 females (mean age 52 years) suffering from mild (32 per cent), moderate (32 per cent), or severe (36 per cent) OSA, who were treated with MAS at Helsinki University Hospital, Finland during the years 2011-2012. Seventy per cent of the patients had tried continuous positive airway pressure (CPAP) before MAS. The lower the body mass index (BMI) was the bigger the probability was to get apnea/hypopnea index (AHI) values <5 per hour with MAS (P < 0.01). The total AHI decreased significantly from the baseline with MAS: 23 per hour (range 5-89) to 6 per hour (range 0.3-54), (P < 0.001). The mean oxygen desaturation index (ODI4%) improved significantly from 16 per hour (range 1-76) to 5.3 per hour (range 0.2-49), (P < 0.01), and the minimum oxygen saturation improved significantly from 84 per cent (67-91) to 87 per cent (68-93), (P < 0.01). The reduction of AHI with MAS was significantly bigger in patients with a previous CPAP experience (73 per cent) than those who did not tried CPAP therapy. The positive correlation was found between the decrease in AHI and the increase of the protrusion in MAS. Both sleep recordings and subjective indicators demonstrated that MAS therapy was successful in OSA based on ESS, total AHI, ODI4%, and minimum oxygen saturation values. It seems useful to increase the protrusion at its maximal clinical tolerance. An experienced dentist could make therapeutically decision concerning the follow up of MAS efficacy regardless of the result of sleep study. We suggest that MAS is a valuable treatment alternative for CPAP. However, the previous use of CPAP with MAS as well as lower baseline BMI seem to have a positive correlation with the success of MAS therapy. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

Australian Students in a Digital World. Policy Insights, Issue #3

ERIC Educational Resources Information Center

Thomson, Sue

2015-01-01

This century has seen continued exponential growth in the use of digital technologies. In Australia, the proportion of students having access to a computer at home rose from about 91 per cent in 2000 to over 99 per cent in 2013, and access to the internet grew from 67 per cent in 2000 to 98 per cent in 2013. According to the 2013 report on the…

Satellite characterization of four interesting sites for astronomical instrumentation

NASA Astrophysics Data System (ADS)

Cavazzani, S.; Zitelli, V.

2013-03-01

In this paper we have evaluated the amount of available telescope time at four interesting sites for astronomical instrumentation. We use the GOES 12 data for years 2008 and 2009. We use a homogeneous methodology presented in several previous papers to classify the nights as clear (completely cloud-free), mixed (partially cloud-covered) or covered. Additionally, for the clear nights we have evaluated the number of satellite-stable nights, corresponding to the number of ground-based photometric nights, and the clear nights, corresponding to the spectroscopic nights. We have applied this model to two sites in the Northern Hemisphere (San Pedro Martir (SPM), Mexico and Izaña, Canary Islands) and to two sites in the Southern Hemisphere (El Leoncito, Argentina and San Antonio de Los Cobres (SAC), Argentina). We have obtained, for the two years considered, mean percentages of cloud-free nights of 68.6 per cent at Izaña, 76.0 per cent at SPM, 70.6 per cent at Leoncito and 70.0 per cent at SAC. We have evaluated, amongst the cloud-free nights, a proportion of stable nights of 62.6 per cent at Izaña, 69.6 per cent at SPM, 64.9 per cent at Leoncito and 59.7 per cent at SAC.

Prevalence of cardiovascular risk factors in the urban population of Soussa in Tunisia.

PubMed

Ghannem, H; Hadj Fredj, A

1997-12-01

With the epidemiological transition phenomenon, Tunisia is now facing the growing prevalence of chronic diseases. Environmental and behavioural changes such as the adoption of new dietary habits and a sedentary lifestyle, and the stress of urbanization and of working conditions all lead to the rise in cardiovascular disease (CVD) risk factors. The aim of this study is to estimate the prevalence of the main CVD risk factors in an urban context. For this, we have undertaken a household epidemiological survey of a representative sample of the adult urban population of Soussa, Tunisia (n = 957). This study shows high prevalences of hypertension (blood pressure >160/95 mmHg) of 18.8 per cent with an adjusted rate of 15.6 per cent, history of diabetes of 10.2 per cent, and obesity (body mass index > 30) of 27.7 per cent [significantly higher in women (34.4 per cent)], android obesity 36 per cent, smoking habits 21.5 per cent [significantly higher in men (61.4 per cent)]. With this profile of CVD risk factors, Tunisia must implement a national strategy of primary prevention and heart health promotion in addition to the efforts recently made in secondary prevention of some chronic diseases such as hypertension and diabetes.

Identification and diversity of functional centromere satellites in the wild rice species Oryza brachyantha.

PubMed

Yi, Chuandeng; Zhang, Wenli; Dai, Xibin; Li, Xing; Gong, Zhiyun; Zhou, Yong; Liang, Guohua; Gu, Minghong

2013-12-01

The centromere is a key chromosomal component for sister chromatid cohesion and is the site for kinetochore assembly and spindle fiber attachment, allowing each sister chromatid to faithfully segregate to each daughter cell during cell division. It is not clear what types of sequences act as functional centromeres and how centromere sequences are organized in Oryza brachyantha, an FF genome species. In this study, we found that the three classes of centromere-specific CentO-F satellites (CentO-F1, CentO-F2, and CentOF3) in O. brachyantha share no homology with the CentO satellites in Oryza sativa. The three classes of CentO-F satellites are all located within the chromosomal regions to which the spindle fibers attach and are characterized by megabase tandem arrays that are flanked by centromere-specific retrotransposons, CRR-F, in the O. brachyantha centromeres. Although these CentO-F satellites are quantitatively variable among 12 O. brachyantha centromeres, immunostaining with an antibody specific to CENH3 indicates that they are colocated with CENH3 in functional centromere regions. Our results demonstrate that the three classes of CentO-F satellites may be the major components of functional centromeres in O. brachyantha.

A core city problem: recruitment and retention of salaried physicians.

PubMed

Paxton, G S; Sbarbaro, J A; Nossaman, N

1975-03-01

The professional and personal characteristics of all physicians recruited into a large urban governmentally sponsored health system were evaluated and correlated to staff retention and loss. The results were tabulated for 84 physicians, approximately 90 per cent of the physician work force, over a three-year period. Eighty per cent resided in either Denver or the state of Colorado prior to entry. This is further reflected in a significant percentage being enrolled in the local medical school or training programs prior to entry. These facts suggest a possible source of manpower for beginning programs. Twenty-six per cent came from private practice, 32 per cent from the military and 14 per cent from the Public Health Service. The turnover rate averaged 6.2 per cent per year, with 4.4 per cent being initiated by the physician and 1.8 per cent leaving because of administrative pressure. Data from other studies are reviewed. Factors which appear to influence retention positively were residency training (pediatricians), sex (females), age (over 38) and those with team experience. These factors suggest directions as to the type of physician who, if recruited, tend to reduce turnover. The establishment of a group practice atmosphere with rewards for clinical skills and the offering of unusual specialty opportunities are proposed as positive factors in the retention of staff.

A proof of concept phase II non-inferiority criterion.

PubMed

Neuenschwander, Beat; Rouyrre, Nicolas; Hollaender, Norbert; Zuber, Emmanuel; Branson, Michael

2011-06-15

Traditional phase III non-inferiority trials require compelling evidence that the treatment vs control effect bfθ is better than a pre-specified non-inferiority margin θ(NI) . The standard approach compares this margin to the 95 per cent confidence interval of the effect parameter. In the phase II setting, in order to declare Proof of Concept (PoC) for non-inferiority and proceed in the development of the drug, different criteria that are specifically tailored toward company internal decision making may be more appropriate. For example, less evidence may be needed as long as the effect estimate is reasonably convincing. We propose a non-inferiority design that addresses the specifics of the phase II setting. The requirements are that (1) the effect estimate be better than a critical threshold θ(C), and (2) the type I error with regard to θ(NI) is controlled at a pre-specified level. This design is compared with the traditional design from a frequentist as well as a Bayesian perspective, where the latter relies on the Level of Proof (LoP) metric, i.e. the probability that the true effect is better than effect values of interest. Clinical input is required to establish the value θ(C), which makes the design transparent and improves interactions within clinical teams. The proposed design is illustrated for a non-inferiority trial for a time-to-event endpoint in oncology. Copyright © 2011 John Wiley & Sons, Ltd.

Outcome of hypocalcaemia after thyroidectomy treated only in symptomatic patients.

PubMed

Järhult, J; Landerholm, K

2016-05-01

Calcium supplementation has been proposed after bilateral thyroid surgery, either to all patients or to those with biochemical hypocalcaemia. It has also been suggested that supplementation aids parathyroid recovery and prevents permanent hypoparathyroidism. This single-centre study investigated the feasibility of a restrictive management of post-thyroidectomy hypocalcaemia. Serum calcium was checked before surgery, on postoperative day 1 (POD) 1, at a follow-up visit 6-8 weeks after surgery and after a minimum of 12 months in all patients. Regardless of serum calcium levels, patients with symptoms of hypocalcaemia were prescribed oral calcium supplementation (0·5-1·0 g twice daily) and asymptomatic patients were not. Asymptomatic patients were informed about hypocalcaemic symptoms and instructed to contact the surgical ward should symptoms appear. Some 640 patients underwent bilateral thyroid surgery without previous or intentional simultaneous parathyroidectomy. A subnormal serum calcium level (below 2·15 mmol/l) was observed in 412 patients (64·4 per cent) on POD 1. By comparison, only 63 patients (9·8 per cent) experienced symptoms of hypocalcaemia in the postoperative period, all but one with a corresponding biochemical hypocalcaemia on POD 1. Calcium levels in all patients with asymptomatic postoperative hypocalcaemia recovered to normal without supplementation. Serum calcium was also normalized during follow-up in all symptomatic patients, except 22 (3·4 per cent) who became permanently hypoparathyroid. No patient without early hypocalcaemic symptoms developed permanent hypoparathyroidism. The proposed restrictive management of postoperative hypocalcaemia after bilateral thyroid surgery avoids unnecessary supplementation for most patients. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Immunostimulant, cerebroprotective & nootropic activities of Andrographis paniculata leaves extract in normal & type 2 diabetic rats.

PubMed

Radhika, P; Annapurna, A; Rao, S Nageswara

2012-05-01

A large number of plants have been recognized to be effective in the treatment of diabetes mellitus. Persistent hyperglycaemia is associated with decreased function of immune system and cerebral ischaemia mainly due to increased oxidative stress and inflammatory response. Andrographis paniculata is a medicinal plant widely used in folk medicine for various purposes. In this study the effect of chronic administration (7 days) of methanolic extract of A. paniculata leaves was studied in rats with experimentally induced diabetes, nootropic and immunostimulant activities were evaluated. The effect of acute administration of methanolic extract of A. paniculata leaves was also studied for cerebroprotective activity. Type 2 diabetes was induced in rats by streptozotocin (STZ) (65 mg/kg) + nicotinamide (150 mg/kg). Various biochemical parameters were estimated using standard methods. A significant (P<0.05) increase in cognitive function was observed in both normal and type 2 diabetic rats. Nootropic activity in terms of per cent reduction in latency period was more in type 2 diabetic rats. A significant increase in blood lymphocyte count, splenic lymphocyte count and peritoneal macrophage count was observed in both normal and type 2 diabetic rats. Immunostimulant activity was observed more in type 2 diabetic rats. The per cent decrease in cerebral infarction was more in type 2 diabetic rats when compared to normal rats. The per cent increase in superoxide dismutase (SOD) levels was more in type 2 diabetic rats. The antioxidant activity of the methanolic extract of A. paniculata leaves was evident by decreased tissue malondialdehyde (MDA) levels and increased SOD levels. These properties may be responsible for the observed cerebroprotective activity. The methanolic leaf extract of A. paniculata showed significant immunostimulant, cerebroprotective and nootropic activities in normal and type 2 diabetic rats.

Immunostimulant, cerebroprotective & nootropic activities of Andrographis paniculata leaves extract in normal & type 2 diabetic rats

PubMed Central

Radhika, P.; Annapurna, A.; Rao, S. Nageswara

2012-01-01

Background & objectives: A large number of plants have been recognized to be effective in the treatment of diabetes mellitus. Persistent hyperglycaemia is associated with decreased function of immune system and cerebral ischaemia mainly due to increased oxidative stress and inflammatory response. Andrographis paniculata is a medicinal plant widely used in folk medicine for various purposes. In this study the effect of chronic administration (7 days) of methanolic extract of A. paniculata leaves was studied in rats with experimentally induced diabetes, nootropic and immunostimulant activities were evaluated. The effect of acute administration of methanolic extract of A. paniculata leaves was also studied for cerebroprotective activity. Methods: Type 2 diabetes was induced in rats by streptozotocin (STZ) (65 mg/kg) + nicotinamide (150 mg/kg). Various biochemical parameters were estimated using standard methods. Results: A significant (P<0.05) increase in cognitive function was observed in both normal and type 2 diabetic rats. Nootropic activity in terms of per cent reduction in latency period was more in type 2 diabetic rats. A significant increase in blood lymphocyte count, splenic lymphocyte count and peritoneal macrophage count was observed in both normal and type 2 diabetic rats. Immunostimulant activity was observed more in type 2 diabetic rats. The per cent decrease in cerebral infarction was more in type 2 diabetic rats when compared to normal rats. The per cent increase in superoxide dismutase (SOD) levels was more in type 2 diabetic rats. Interpretation & conclusions: The antioxidant activity of the methanolic extract of A. paniculata leaves was evident by decreased tissue malondialdehyde (MDA) levels and increased SOD levels. These properties may be responsible for the observed cerebroprotective activity. The methanolic leaf extract of A. paniculata showed significant immunostimulant, cerebroprotective and nootropic activities in normal and type 2 diabetic rats. PMID:22771592

Comparison of circadian rhythms in male and female humans

NASA Technical Reports Server (NTRS)

Winget, C. M.; Deroshia, C. W.; Vernikos-Danellis, J.; Rosenblatt, W. S.; Hetherington, N. W.

1977-01-01

Heart rate (HR) and rectal temperature (RT) data were obtained from 12 female and 27 male subjects. The subjects were housed in a facility where the environment was controlled. Human male and female RT and HR exhibit a circadian rhythm with an excursion of about 1.2 C and 30 beats/min, respectively. The acrophases, amplitudes, and level crossings are only slightly different between the sexes. The male HR and RT circadian wave forms are more stable than those of the females. However, the actual RT and HR of males were always lower than that of females at all time points around the clock. The HR during sleep in females is 15 per cent below the daily mean heart rate and in males, 22 per cent.

The CentO satellite confers translational and rotational phasing on cenH3 nucleosomes in rice centromeres.

PubMed

Zhang, Tao; Talbert, Paul B; Zhang, Wenli; Wu, Yufeng; Yang, Zujun; Henikoff, Jorja G; Henikoff, Steven; Jiang, Jiming

2013-12-10

Plant and animal centromeres comprise megabases of highly repeated satellite sequences, yet centromere function can be specified epigenetically on single-copy DNA by the presence of nucleosomes containing a centromere-specific variant of histone H3 (cenH3). We determined the positions of cenH3 nucleosomes in rice (Oryza sativa), which has centromeres composed of both the 155-bp CentO satellite repeat and single-copy non-CentO sequences. We find that cenH3 nucleosomes protect 90-100 bp of DNA from micrococcal nuclease digestion, sufficient for only a single wrap of DNA around the cenH3 nucleosome core. cenH3 nucleosomes are translationally phased with 155-bp periodicity on CentO repeats, but not on non-CentO sequences. CentO repeats have an ∼10-bp periodicity in WW dinucleotides and in micrococcal nuclease cleavage, providing evidence for rotational phasing of cenH3 nucleosomes on CentO and suggesting that satellites evolve for translational and rotational stabilization of centromeric nucleosomes.

Occurrence of otitis media in children and assessment of treatment options.

PubMed

Nwokoye, N N; Egwari, L O; Olubi, O O

2015-08-01

Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

Behavioral problems among patients in skilled nursing facilities.

PubMed Central

Zimmer, J G; Watson, N; Treat, A

1984-01-01

This survey of a 33 per cent random sample (1,139) of 3,456 patients in 42 skilled nursing facilities (SNFs) in upstate New York yielded 64.2 per cent with significant behavioral problems. Of these, 257 (22.6 per cent) of the total sample had what were defined as "serious" problems (i.e., excluding those with only impaired judgment and/or physical restraint orders). Details of the problem behaviors of this group, their previous history, current management, frequency of psychiatric consultation, and adequacy of documentation were analyzed. Median age was the same as the general SNF population, a slightly lower proportion was female, and, while 66.5 per cent had diagnoses indicating organic brain syndrome, very few had specific psychiatric diagnoses, and only 4.7 per cent had been admitted from a psychiatric facility. The attending physician had noted the behavioral problem in the record in only 9.7 per cent and had requested psychiatric consultation in 14.8 per cent of these "serious" cases. The need for more staff training in mental health care, and more physician and psychiatric consultative assistance are discussed. PMID:6476166

Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes.

PubMed

Binfield, P M; Maffulli, N; King, J B

1993-09-01

In this study, 400 clinically anterior cruciate ligament (ACL) deficient knees were arthroscoped and studied prospectively in the period January 1986 to April 1992. An ACL tear was always confirmed, and 41 per cent of these patients did not have an associated meniscal tear. In 30.25 per cent the lateral meniscus was torn; in 21.25 per cent the ACL tear was associated with a medial meniscus tear, and in the remaining 7 per cent both menisci were torn. The most frequently associated meniscal injury was the bucket handle tear of the medial meniscus (9 per cent), followed by the posterior horn tear of the lateral meniscus, which showed the same frequency as the ragged (or degenerated) tear of the lateral meniscus (6 per cent). The horizontal tear of the posterior part of the lateral meniscus showed a prevalence of 4.3 per cent. This picture is probably dependent on a secondary referral nature of the centre surveyed, in which the average time between injury and arthroscopy was 23.3 months.

Climatic control of Mississippi River flood hazard amplified by river engineering

NASA Astrophysics Data System (ADS)

Munoz, Samuel E.; Giosan, Liviu; Therrell, Matthew D.; Remo, Jonathan W. F.; Shen, Zhixiong; Sullivan, Richard M.; Wiman, Charlotte; O’Donnell, Michelle; Donnelly, Jeffrey P.

2018-04-01

Over the past century, many of the world’s major rivers have been modified for the purposes of flood mitigation, power generation and commercial navigation. Engineering modifications to the Mississippi River system have altered the river’s sediment levels and channel morphology, but the influence of these modifications on flood hazard is debated. Detecting and attributing changes in river discharge is challenging because instrumental streamflow records are often too short to evaluate the range of natural hydrological variability before the establishment of flood mitigation infrastructure. Here we show that multi-decadal trends of flood hazard on the lower Mississippi River are strongly modulated by dynamical modes of climate variability, particularly the El Niño–Southern Oscillation and the Atlantic Multidecadal Oscillation, but that the artificial channelization (confinement to a straightened channel) has greatly amplified flood magnitudes over the past century. Our results, based on a multi-proxy reconstruction of flood frequency and magnitude spanning the past 500 years, reveal that the magnitude of the 100-year flood (a flood with a 1 per cent chance of being exceeded in any year) has increased by 20 per cent over those five centuries, with about 75 per cent of this increase attributed to river engineering. We conclude that the interaction of human alterations to the Mississippi River system with dynamical modes of climate variability has elevated the current flood hazard to levels that are unprecedented within the past five centuries.

Cosmic variance of the galaxy cluster weak lensing signal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gruen, D.; Seitz, S.; Becker, M. R.

Intrinsic variations of the projected density profiles of clusters of galaxies at fixed mass are a source of uncertainty for cluster weak lensing. We present a semi-analytical model to account for this effect, based on a combination of variations in halo concentration, ellipticity and orientation, and the presence of correlated haloes. We calibrate the parameters of our model at the 10 per cent level to match the empirical cosmic variance of cluster profiles at M 200m ≈ 10 14…10 15h –1M ⊙, z = 0.25…0.5 in a cosmological simulation. We show that weak lensing measurements of clusters significantly underestimate massmore » uncertainties if intrinsic profile variations are ignored, and that our model can be used to provide correct mass likelihoods. Effects on the achievable accuracy of weak lensing cluster mass measurements are particularly strong for the most massive clusters and deep observations (with ≈20 per cent uncertainty from cosmic variance alone at M 200m ≈ 10 15h –1M ⊙ and z = 0.25), but significant also under typical ground-based conditions. We show that neglecting intrinsic profile variations leads to biases in the mass-observable relation constrained with weak lensing, both for intrinsic scatter and overall scale (the latter at the 15 per cent level). Furthermore, these biases are in excess of the statistical errors of upcoming surveys and can be avoided if the cosmic variance of cluster profiles is accounted for.« less

Climatic control of Mississippi River flood hazard amplified by river engineering.

PubMed

Munoz, Samuel E; Giosan, Liviu; Therrell, Matthew D; Remo, Jonathan W F; Shen, Zhixiong; Sullivan, Richard M; Wiman, Charlotte; O'Donnell, Michelle; Donnelly, Jeffrey P

2018-04-04

Over the past century, many of the world's major rivers have been modified for the purposes of flood mitigation, power generation and commercial navigation. Engineering modifications to the Mississippi River system have altered the river's sediment levels and channel morphology, but the influence of these modifications on flood hazard is debated. Detecting and attributing changes in river discharge is challenging because instrumental streamflow records are often too short to evaluate the range of natural hydrological variability before the establishment of flood mitigation infrastructure. Here we show that multi-decadal trends of flood hazard on the lower Mississippi River are strongly modulated by dynamical modes of climate variability, particularly the El Niño-Southern Oscillation and the Atlantic Multidecadal Oscillation, but that the artificial channelization (confinement to a straightened channel) has greatly amplified flood magnitudes over the past century. Our results, based on a multi-proxy reconstruction of flood frequency and magnitude spanning the past 500 years, reveal that the magnitude of the 100-year flood (a flood with a 1 per cent chance of being exceeded in any year) has increased by 20 per cent over those five centuries, with about 75 per cent of this increase attributed to river engineering. We conclude that the interaction of human alterations to the Mississippi River system with dynamical modes of climate variability has elevated the current flood hazard to levels that are unprecedented within the past five centuries.

Continuing education: the 1998 Survey of the Royal Australasian College of Dental Surgeons.

PubMed

Sambrook, P; Thomson, D; Bastiaan, R; Goss, A

2001-06-01

Continuing education (CE) is an essential professional activity. In the last decade, CE has been actively pursued by the medical profession in Australia and abroad. However, the uptake of CE in dentistry has been much slower and there is minimal Australian data on dental CE. To determine the level of CE activity, in 1998, postal questionnaires were sent to all fellows of the Royal Australasian College of Dental Surgeons. The responses were analysed. There was a high response rate (90 per cent) but a moderate usable rate (54 per cent). The results show a biphasic distribution between high and low CE activity. The average amount of activity of those involved in CE was 116 hours per year, above the usually accepted minimum of 100 hours/year. Some groups, particularly members of the specialist divisions of oral and maxillofacial surgeons (215 hours) and periodontists (205 hours), have high levels of CE. However, approximately 25 per cent of college fellows reported little or no CE activity. The survey revealed that inactive fellows are more likely to be older and in general practice. Inactive fellows were also tardy in replying to the questionnaire. The high activity CE group needs to be recognised and encouraged to continue. Specific plans to help the low CE activity group should be developed. Although these findings relate directly to the Royal Australasian College of Dental Surgeons, they are presented as they have implications for the dental profession at large.

Cosmic variance of the galaxy cluster weak lensing signal

DOE PAGES

Gruen, D.; Seitz, S.; Becker, M. R.; ...

2015-04-13

Intrinsic variations of the projected density profiles of clusters of galaxies at fixed mass are a source of uncertainty for cluster weak lensing. We present a semi-analytical model to account for this effect, based on a combination of variations in halo concentration, ellipticity and orientation, and the presence of correlated haloes. We calibrate the parameters of our model at the 10 per cent level to match the empirical cosmic variance of cluster profiles at M 200m ≈ 10 14…10 15h –1M ⊙, z = 0.25…0.5 in a cosmological simulation. We show that weak lensing measurements of clusters significantly underestimate massmore » uncertainties if intrinsic profile variations are ignored, and that our model can be used to provide correct mass likelihoods. Effects on the achievable accuracy of weak lensing cluster mass measurements are particularly strong for the most massive clusters and deep observations (with ≈20 per cent uncertainty from cosmic variance alone at M 200m ≈ 10 15h –1M ⊙ and z = 0.25), but significant also under typical ground-based conditions. We show that neglecting intrinsic profile variations leads to biases in the mass-observable relation constrained with weak lensing, both for intrinsic scatter and overall scale (the latter at the 15 per cent level). Furthermore, these biases are in excess of the statistical errors of upcoming surveys and can be avoided if the cosmic variance of cluster profiles is accounted for.« less

Mathematics Anxiety and Preservice Elementary Teachers' Confidence to Teach Mathematics and Science

ERIC Educational Resources Information Center

Bursal, Murat; Paznokas, Lynda

2006-01-01

Sixty-five preservice elementary teachers' math anxiety levels and confidence levels to teach elementary mathematics and science were measured. The confidence scores of subjects in different math anxiety groups were compared and the relationships between their math anxiety levels and confidence levels to teach mathematics and science were…

Locations and magnitudes of historical earthquakes in the Sierra of Ecuador (1587-1996)

NASA Astrophysics Data System (ADS)

Beauval, Céline; Yepes, Hugo; Bakun, William H.; Egred, José; Alvarado, Alexandra; Singaucho, Juan-Carlos

2010-06-01

The whole territory of Ecuador is exposed to seismic hazard. Great earthquakes can occur in the subduction zone (e.g. Esmeraldas, 1906, Mw 8.8), whereas lower magnitude but shallower and potentially more destructive earthquakes can occur in the highlands. This study focuses on the historical crustal earthquakes of the Andean Cordillera. Several large cities are located in the Interandean Valley, among them Quito, the capital (~2.5 millions inhabitants). A total population of ~6 millions inhabitants currently live in the highlands, raising the seismic risk. At present, precise instrumental data for the Ecuadorian territory is not available for periods earlier than 1990 (beginning date of the revised instrumental Ecuadorian seismic catalogue); therefore historical data are of utmost importance for assessing seismic hazard. In this study, the Bakun & Wentworth method is applied in order to determine magnitudes, locations, and associated uncertainties for historical earthquakes of the Sierra over the period 1587-1976. An intensity-magnitude equation is derived from the four most reliable instrumental earthquakes (Mw between 5.3 and 7.1). Intensity data available per historical earthquake vary between 10 (Quito, 1587, Intensity >=VI) and 117 (Riobamba, 1797, Intensity >=III). The bootstrap resampling technique is coupled to the B&W method for deriving geographical confidence contours for the intensity centre depending on the data set of each earthquake, as well as confidence intervals for the magnitude. The extension of the area delineating the intensity centre location at the 67 per cent confidence level (+/-1σ) depends on the amount of intensity data, on their internal coherence, on the number of intensity degrees available, and on their spatial distribution. Special attention is dedicated to the few earthquakes described by intensities reaching IX, X and XI degrees. Twenty-five events are studied, and nineteen new epicentral locations are obtained, yielding equivalent moment magnitudes between 5.0 and 7.6. Large earthquakes seem to be related to strike slip faults between the North Andean Block and stable South America to the east, while moderate earthquakes (Mw <= 6) seem to be associated with to thrust faults located on the western internal slopes of the Interandean Valley.

Locations and magnitudes of historical earthquakes in the Sierra of Ecuador (1587–1996)

USGS Publications Warehouse

Beauval, Celine; Yepes, Hugo; Bakun, William H.; Egred, Jose; Alvarado, Alexandra; Singaucho, Juan-Carlos

2010-01-01

The whole territory of Ecuador is exposed to seismic hazard. Great earthquakes can occur in the subduction zone (e.g. Esmeraldas, 1906, Mw8.8), whereas lower magnitude but shallower and potentially more destructive earthquakes can occur in the highlands. This study focuses on the historical crustal earthquakes of the Andean Cordillera. Several large cities are located in the Interandean Valley, among them Quito, the capital (∼2.5 millions inhabitants). A total population of ∼6 millions inhabitants currently live in the highlands, raising the seismic risk. At present, precise instrumental data for the Ecuadorian territory is not available for periods earlier than 1990 (beginning date of the revised instrumental Ecuadorian seismic catalogue); therefore historical data are of utmost importance for assessing seismic hazard. In this study, the Bakun & Wentworth method is applied in order to determine magnitudes, locations, and associated uncertainties for historical earthquakes of the Sierra over the period 1587–1976. An intensity-magnitude equation is derived from the four most reliable instrumental earthquakes (Mwbetween 5.3 and 7.1). Intensity data available per historical earthquake vary between 10 (Quito, 1587, Intensity ≥VI) and 117 (Riobamba, 1797, Intensity ≥III). The bootstrap resampling technique is coupled to the B&W method for deriving geographical confidence contours for the intensity centre depending on the data set of each earthquake, as well as confidence intervals for the magnitude. The extension of the area delineating the intensity centre location at the 67 per cent confidence level (±1σ) depends on the amount of intensity data, on their internal coherence, on the number of intensity degrees available, and on their spatial distribution. Special attention is dedicated to the few earthquakes described by intensities reaching IX, X and XI degrees. Twenty-five events are studied, and nineteen new epicentral locations are obtained, yielding equivalent moment magnitudes between 5.0 and 7.6. Large earthquakes seem to be related to strike slip faults between the North Andean Block and stable South America to the east, while moderate earthquakes (Mw≤ 6) seem to be associated with to thrust faults located on the western internal slopes of the Interandean Valley.

Cambrian palaeomagnetic data confirm a Natal Embayment location for the Ellsworth-Whitmore Mountains, Antarctica, in Gondwana reconstructions

NASA Astrophysics Data System (ADS)

Randall, Darren E.; Mac Niocaill, Conall

2004-04-01

The Ellsworth-Whitmore Mountains (EWM) are one of five terranes that form West Antarctica. Constraining the positions of these terranes in pre-break up Gondwana is crucial to understanding the history of the palaeo-Pacific Gondwana margin. We report the results of a detailed palaeomagnetic investigation of the EWM, which comprises some 150 sites in six formations, ranging in age from Cambrian to Permian. Five of the studied units yield only viscous remnant magnetizations of recent age, or unstable natural remanent magnetizations. The remaining unit, the mid-late Cambrian Frazier Ridge Formation, yielded stable magnetizations at 16 of 35 sites. This component passes a fold test at the 95 per cent confidence level, indicating that it pre-dates Permian deformation, and we argue that it is of primary origin. The resulting palaeopole (9°N 293°E A95= 5.1°) is in good agreement with two previously published palaeopoles from similarly aged rocks in the EWM. Collectively these data indicate that the EWM were located in the Natal Embayment prior to Gondwana break-up, and underwent 90° of anticlockwise rotation during break-up. All three studies, however, yield inclinations that are slightly too shallow when compared with coeval Gondwana reference poles.

The integrated Sachs-Wolfe signal from BOSS superstructures

NASA Astrophysics Data System (ADS)

Granett, B. R.; Kovács, A.; Hawken, A. J.

2015-12-01

Cosmic structures leave an imprint on the microwave background radiation through the integrated Sachs-Wolfe (ISW) effect. We construct a template map of the linear signal using the Sloan Digital Sky Survey-III Baryon Acoustic Oscillation Survey at redshift 0.43 < z < 0.65. We verify the imprint of this map on the Planck cosmic microwave background (CMB) temperature map at the 97 per cent confidence level and show consistency with the density-temperature cross-correlation measurement. Using this ISW reconstruction as a template, we investigate the presence of ISW sources and further examine the properties of the Granett-Neyrinck-Szapudi supervoid and supercluster catalogue. We characterize the three-dimensional density profiles of these structures for the first time and demonstrate that they are significant structures. Model fits demonstrate that the supervoids are elongated along the line of sight and we suggest that this special orientation may be picked out by the void-finding algorithm in photometric redshift space. We measure the mean temperature profiles in Planck maps from public void and cluster catalogues. In an attempt to maximize the stacked ISW signal, we construct a new catalogue of superstructures based upon local peaks and troughs of the gravitational potential. However, we do not find a significant correlation between these structures and the CMB temperature.

Therapist effects and IAPT Psychological Wellbeing Practitioners (PWPs): a multilevel modelling and mixed methods analysis.

PubMed

Green, Helen; Barkham, Michael; Kellett, Stephen; Saxon, David

2014-12-01

The aim of this research was (a) to determine the extent of therapist effects in Psychological Wellbeing Practitioners (PWPs) delivering guided self-help in IAPT services and (b) to identify factors that defined effective PWP clinical practice. Using patient (N = 1122) anxiety and depression outcomes (PHQ-9 and GAD-7), the effectiveness of N = 21 PWPs across 6 service sites was examined using multi-level modelling. PWPs and their clinical supervisors were also interviewed and completed measures of ego strength, intuition and resilience. Therapist effects accounted for around 9 per cent of the variance in patient outcomes. One PWP had significantly better than average outcomes on both PHQ-9 and GAD-7 while 3 PWPs were significantly below average on the PHQ-9 and 2 were below average on the GAD-7. Computed PWP ranks identified quartile clusters of the most (N = 5) and least (N = 5) effective PWPs. More effective PWPs generated higher rates of reliable and clinically significant change and displayed greater resilience, organisational abilities, knowledge and confidence. Study weaknesses are identified and methodological considerations for future studies examining therapist effects in low intensity cognitive behaviour therapy are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

Heritage or Hate? A Pedagogical Guide to the Confederate Flag in Post-Race America

ERIC Educational Resources Information Center

Lippard, Cameron D.

2017-01-01

The Confederate flag has been a hotly debated symbol of heritage or hate in the United States. In 2015, 54 per cent of Americans polled saw the flag as a symbol of 'Southern pride' whereas 34 per cent saw it as racist. However, 27 per cent of Whites compared to 69 per cent of Blacks saw the flag as racist. In this article, I suggest how…

Comparison of Battlefield-expedient Topical Antimicrobial Agents for the Prevention of Burn Wound Sepsis in a Rat Model

DTIC Science & Technology

2005-08-01

Bertek Pharmaceuticals, Morgantown WV); 5% mafenide hydrochloride solution (MHS, Sigma, St. Louis, MO), and 4% chlorhexidine digluconate solution...silver sulphadiazine 1 per cent, silver sulphadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent and mafenide acetate 8.5 per cent for...Comparison of silver sulfadiazine 1% with chlorhexidine digluconate 0.2% to silver sulfadiazine 1% alone in the prophylactic topical anti- bacterial treatment

Qualitative Research in the CJA/RCV: An 18-Year Analysis (1995-2012).

PubMed

Humble, Áine M; Green, Maureen

2016-03-01

Some researchers have suggested that qualitative research is increasing in the gerontology field, but little systematic analysis has tested this assertion. Using the Canadian Journal on Aging/La Revue canadienne du vieillissement as a case study, we analysed articles reporting on original research from 1995 to 2012. One in four articles were qualitative, and results in three-year intervals show a clear increase in qualitative research findings during this 18-year time frame: (a) 1995-1997: 10 per cent; (b) 1998-2000: 19 per cent; (c) 2001-2003: 25 per cent; (d) 2004-2006: 25 per cent; (e) 2007-2009: 29 per cent; and (f) 2010-2012: 43 per cent. In all time intervals (with the exception of 2004-2006), French language articles were more likely to use a qualitative research design compared to English language articles. Topics, methodologies, and data collection strategies are also discussed.

Sun tanning-related burns--a 3-year experience.

PubMed

Piccolo-Lobo, M S; Piccolo, N S; Piccolo-Daher, M T; Cardoso, V M

1992-04-01

A retrospective study has analyzed 562 sun-related burns out of 19,643 patients treated at our institution from 1 March 1988 to 28 February 1991. These patients were analysed according to sex, age, burn area, mode and length of treatment and outcome. Females, mainly adults, represented 60.8 per cent of all patients presenting burned due to sun bathing. There is a marked seasonal incidence, proportionally constant throughout these 3 years. The main causes of injury were sun only (36.7 per cent), sun plus fig leaf 'tea' tanning lotion (17.7 per cent) and lemon juice (17.7 per cent). Healing to normal skin appearance was achieved in 99.1 per cent, 0.7 per cent healed with scarring and one patient died due to massive sepsis. The effect of sunlight on skin and the process of 'sunburn' when using homemade plant-derived tanning lotions containing substances which can induce a photodermatitis reaction is also discussed.

COMMUNITY STRESS, DEMORALIZATION AND BODY MASS INDEX: EVIDENCE FOR SOCIAL SIGNAL TRANSDUCTION. (R827027)

EPA Science Inventory

Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Cente...

Parentage assignment and extra-group paternity in a cooperative breeder: the Seychelles warbler (Acrocephalus sechellensis).

PubMed

Richardson, D S; Jury, F L; Blaakmeer, K; Komdeur, J; Burke, T

2001-09-01

We describe the development and initial application of a semiautomated parentage testing system in the Seychelles warbler (Acrocephalus sechellensis). This system used fluorescently labelled primers for 14 polymorphic microsatellite loci in two multiplex loading groups to genotype efficiently over 96% of the warbler population on Cousin island. When used in conjunction with the program CERVUS, this system provided sufficient power to assign maternity and paternity within the Seychelles warbler, despite the complications associated with its cooperative breeding system and a relatively low level of genetic variation. Parentage analyses showed that subordinate 'helper' females as well as the dominant 'primary' females laid eggs in communal nests, indicating that the Seychelles warbler has an intermediate level of female reproductive skew, in between the alternative extremes of helper-at-the-nest and joint nesting systems. Forty-four per cent of helpers bred successfully, accounting for 15% of all offspring. Forty per cent of young resulted from extra-group paternity.

Molecular characterization of chikungunya virus from Andhra Pradesh, India & phylogenetic relationship with Central African isolates.

PubMed

M Naresh Kumar, C V; Anthony Johnson, A M; R Sai Gopal, D V

2007-12-01

Chikungunya virus has caused numerous large outbreaks in India. Suspected blood samples from the epidemic were collected and characterized for the identification of the responsible causative from Rayalaseema region of Andhra Pradesh. RT-PCR was used for screening of suspected blood samples. Primers were designed to amplify partial E1 gene and the amplified fragment was cloned and sequenced. The sequence was analyzed and compared with other geographical isolates to find the phylogenetic relationship. The sequence was submitted to the Gen bank DNA database (accession DQ888620). Comparative nucleotide homology analysis of the AP Ra-CTR isolate with the other isolates revealed 94.7+/-3.6 per cent of homology of CHIKAPRa-CTR with other isolates of Chikungunya virus at nucleotide level and 96.8+/-3.2 per cent of homology at amino acid level. The current epidemic was caused by the Central African genotype of CHIKV, grouped in Central Africa cluster in phylogenetic trees generated based on nucleotide and amino acid sequences.

Nurses' knowledge of prevention and management of pressure ulcer at a health insurance hospital in Alexandria.

PubMed

El Enein, Nagwa Younes Abou; Zaghloul, Ashraf Ahmad

2011-06-01

Nurses' knowledge of pressure ulcer prediction, prevention and management plays a very important role in the incidence and prevalence of pressure ulcers in health-care systems. The aim of the current study was to assess the nurse's knowledge about prevention and management of pressure ulcer at one of the largest health insurance hospitals in Alexandria. A descriptive cross-sectional study using an interview questionnaire format to assess the nurses' knowledge (n = 122) regarding prevention of pressure ulcers. The overall mean per cent score for nurses was below the minimum acceptable level. The mean per cent score for nurses was below 70% for nine measures of the 15 correct measures, which accounted for 60% of the measures of pressure ulcer prevention. Correct answers for non-useful measures for preventing pressure ulcers accounted for 66% of the non-useful measures on the questionnaire. It had been concluded that the nurses' knowledge regarding pressure ulcer prevention is below the acceptable levels. © 2011 Blackwell Publishing Asia Pty Ltd.

METHOD AND FLUX COMPOSITION FOR TREATING URANIUM

DOEpatents

Foote, F.

1958-08-23

ABS>A flux composition is described fer use with molten uranium or uranium alloys. The flux consists of about 46 weight per cent calcium fiuoride, 46 weight per cent magnesium fluoride and about 8 weight per cent of uranium tetrafiuoride.

Self-actuated shutdown-system development: system response-analysis status

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deane, N.A.; Gregoire, K.E.; Tatsumi, J.T.

1980-09-01

This report provides a preliminary evaluation of the SASS response time requirements for the safe shutdown earthquake (SSE), the flow coastdown (FCD), and two transient overpower (TOP) events. The driving functions for the SSE are a 20 cent step reactivity insertion with a +- 60 cent oscillation super imposed for 10 seconds combined with a flow coastdown defined by F/F/sub (0)/ = 1/(1+.2788t). The driving function of the FCD is just the relative flow curve defined above for the SSE. The TOP event driving function represents a control rod runout to a total of 60 cents at ramp rates ofmore » .76 cents/s and 6.1 cents/s. 3 figures.« less

Omission of polysomnography in treatment of snoring: common reasons and medico-legal implications.

PubMed

Goh, Y H; Choy, D K

2000-07-01

Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to December 1998, 36 (30.5 per cent) of patients did not have pre-operative PSG and only 21 (17.8 per cent) of patients had post-operative PSG. In this cohort, 43 (36.4 per cent) patients presented with snoring as their only complaint and not associated with symptoms indicative of obstructive sleep apnoea syndrome (OSAS). Thirty-one of these 'simple snorers' underwent sleep studies with the following outcome: two (6.5 per cent) true simple snorers, two (6.5 per cent) upper airway resistance syndrome, nine (29 per cent) mild OSAS, seven (22.6 per cent) moderate OSAS and 11 (35.5 per cent) severe OSAS. Our study showed that without the aid of PSG, it would be difficult to predict the severity of sleep apnoea based on clinical history alone. In an increasingly litigation-conscious society such as Singapore, there is therefore little justification in omitting PSG in the treatment of snoring. The common reasons for omission of pre-operative PSG and the medico-legal implications are also discussed.

Role of clay minerals in the transportation of iron

USGS Publications Warehouse

Carroll, D.

1958-01-01

The clay minerals have iron associated with them in several ways: 1. (1) as an essential constituent 2. (2) as a minor constituent within the crystal lattice where it is in isomorphous substitution and 3. (3) as iron oxide on the surface of the mineral platelets. Nontronite, "hydromica," some chlorites, vermiculite, glauconite and chamosite contain iron as an essential constituent. Kaolinite and halloysite have no site within the lattice for iron, but in certain environments iron oxide (goethite or hematite) is intimately associated as a coating on the micelles. Analyses of clay minerals show that the content of Fe2O3 varies: 29 per cent (nontronite), 7??3 per cent (griffithite), 4.5 per cent ("hydromica"), 5.5 per cent (chlorite), 4 per cent (vermiculite) and 18 per cent (glauconite). The FeO content is: 40 per cent (chamosite), 7.8 per cent (griffithite), 1-2 per cent ("hydromica"), 3 per cent (glauconite) and 2 per cent (chlorite). The iron associated with the clay minerals remains stable in the environment in which the minerals occur, but if either pH or Eh or both are changed the iron may be affected. Change of environment will cause: 1. (1) removal of iron by reduction of Fe3+ to Fe2+; 2. (2) ion-exchange reactions; 3. (3) instability of the crystal lattice. Experiments using bacterial activity to produce reducing conditions with kaolinite and halloysite coated with iron oxides and with nontronite in which ferric iron is in the octahedral position within the lattice showed that ferric oxide is removed at Eh +0??215 in fresh water and at Eh +0.098 in sea water. Hematite, goethite, and indefinite iron oxides were removed at different rates. Red ferric oxides were changed to black indefinite noncrystalline ferrous sulphide at Eh -0.020 but reverted to ferric oxide under oxidizing conditions. Nontronite turned bright green under reducing conditions and some of the ferrous iron remained within the lattice on a return to oxidizing conditions. Bacterial activity seems to be necessary for maintaining reducing conditions in the environments studied. ?? 1958.

Problems associated with restorative materials--dentists' views in Finland and Sweden.

PubMed

Widström, E; Sundberg, H

1991-01-01

During the past 10-15 years the possible side-effects of dental restorative materials, especially due to amalgam fillings, have caused a lively debate in Sweden. There is an extensive literature on the chemical and biological properties of dental materials but no investigations have dealt with the providers' attitudes. The purpose of this study was to find out the dentists' experiences of and attitudes to patients who state they have problems related to dental restorative materials and compare the dentists' subjective assessments of those side-effects in two neighboring countries, Finland and Sweden. Information was collected by postal questionnaires addressed to dentists chosen at random in Finland (n = 625) and in Sweden (n = 960). The response rate was 73 per cent and 72 per cent respectively. The results showed that 99 per cent of the respondents had patients questioning the safety of dental materials. The number of such patients was estimated to be three times higher in Sweden (124 patients per dentist in 1989) than in Finland (39 patients per dentist). More than 90 per cent of the questions from the patients regarded amalgam fillings. Statistically significant differences were found between the respondents' opinions of amalgam, 81 per cent of the Finnish contrary to 59 per cent of the Swedish respondents considered the risk of side-effects to be low when using this material. About 90 per cent of the respondents considered glass-ionomer, gold and ceramic restorations safe, but only half of them were convinced of the safety of composite. A great majority of the Swedish respondents (79 per cent) claimed that the patients should get their fillings changed without odontologic indications if they insisted on it and paid for the treatment in comparison to 22 per cent of the Finnish respondents (p less than 0.001). In case dental insurance was to pay for this kind of treatment it was accepted by 6 per cent of the Finns and 25 per cent of the Swedes. The attitude to amalgam was in general less favorable among the dentists in Sweden than in Finland.

Levels, trends & predictors of infant & child mortality among Scheduled Tribes in rural India

PubMed Central

Sahu, Damodar; Nair, Saritha; Singh, Lucky; Gulati, B.K.; Pandey, Arvind

2015-01-01

Background & objectives: The level of infant and child mortality is high among Scheduled Tribes particularly those living in rural areas. This study examines levels, trends and socio-demographic factors associated with infant and child mortality among Scheduled Tribes in rural areas. Methods: Data from the three rounds of the National Family Health Survey (NFHS) of India from 1992 to 2006 were analysed to assess the levels and trends of infant and child mortality. Univariate and multivariate Cox proportional hazard model were used to understand the socio-economic and demographic factors associated with mortality during 1992–2006. Results: Significant change was observed in infant and child mortality over the time period from 1992-2006 among Scheduled Tribes in rural areas. After controlling for other factors, birth interval, household wealth, and region were found to be significantly associated with infant and child mortality. Hazard of infant mortality was highest among births to mothers aged 30 yr or more (HR=1.3, 95% CI=1.1-1.7) as compared with births to the mother's aged 20-29 yr. Hazard of under-five mortality was 42 per cent (95% CI=1.3-1.6) higher among four or more birth order compared with the first birth order. The risk of infant dying was higher among male children (HR = 1.2, 95% CI=1.1-1.4) than among female children while male children were at 30 per cent (HR=0.7, 95% CI=0.6-0.7) less hazard of child mortality than female children. Literate women were at 40 per cent (HR=0.6, 95% CI=0.50-0.76) less hazard of child death than illiterate women. Interpretation & conclusions: Mortality differentials by socio-demographic and economic factors were observed over the time period (1992-2006) among Scheduled Tribes (STs) in rural India. Findings support the need to focus on age at first birth and spacing between two births. PMID:26139791

Picking among pen-reared quail

USGS Publications Warehouse

Nestler, R.B.; Coburn, D.R.; Titus, H.W.

1945-01-01

During five years (1939-43) of nutritional research on pen-reared bobwhite quail at the Patuxent Research Refuge, Bowie, Maryland, observations on picking among birds of all ages showed the following results: 1. Picking occurred on all grains tested: corn, wheat, oats, oat groats, barley, millet, buckwheat, kaffir, and mixtures of cereals. The lowest incidence was with buckwheat as the sole grain in a growing diet....2. Picking occurred on all levels of fiber from one to 11per cent in a growing diet....3. Picking occurred on various grinds of corn, barley, and oats, but was least when these cereals were ground in a hammer mill with 3/32 inch mesh screen....4. The incidence was as high on diets containing animal protein as on those containing no animal protein. ....5. After picking began, the addition of one or two per cent of salt to the diet for several days was effective, in many instances, in checking the disorder. Results at the Refuge and the answers to questionnaires from 222 private propagators of gamebirds showed that in two-thirds. of the cases, treatment with an increased quantity of salt successfully stopped the trouble. As a preventative, however, salt was of little value. Picking occurred on both low and high levels of salt.....6. Supplementing the regular diet with certain feed concentrates such as fishmeal, soybean oil meal, liver meal, or chopped greens offered in a separate feeder for a day or two, was as efficacious as the addition of salt.....7. More picking occurred among quail chicks on a 22 per cent level of protein than on higher levels.....8. There was less picking on diets relished by the birds than on those seemingly unpalatable.....9. There was no correlation. between the amount of floor space per chick and the incidence of picking.....10. Increasing the feeding and drinking space seemed to have a marked beneficial effect.....11. Some adult birds on wire floors resorted to self-picking of their feet after the toes were frost-bitten.