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.

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.

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

PubMed

Mackenzie, H; Markar, S R; Askari, A; Ni, M; Faiz, O; Hanna, G B

2016-01-01

Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P < 0·001) and from 2·4 to 1·8 per cent (RRR 0·25, P = 0·058) respectively. The change point in the proficiency-gain curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

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.

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.

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).

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.

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.

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.

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.

Facial attractiveness of skeletal Class II patients before and after mandibular advancement surgery as perceived by people with different backgrounds.

PubMed

Ng, Doreen; De Silva, Rohana Kumara; Smit, Ryan; De Silva, Harsha; Farella, Mauro

2013-08-01

The purpose of this study was to determine the perceived level of improvement in facial attractiveness as assessed by people with different backgrounds in skeletal Class II patients treated by mandibular advancement with bilateral sagittal split osteotomy (BSSO). The frontal and lateral pre- and post-operative photographs of 10 Caucasian patients were selected. Changes in frontal and profile attractiveness were assessed by 10 orthodontists, 10 art students, and 10 laypersons. Frontal and lateral pre- and post-operative photographs were randomly distributed throughout two surveys. For each photograph, the evaluators ranked the attractiveness of face, chin, and lips on visual analogue scales. A third survey was administered to orthodontists only, by presenting the same pre and post-operative photographs but paired side-by-side with pre- and post-operative status disclosed. Overall, attractiveness scores after BSSO showed an 11.5 per cent improvement (95 per cent confidence intervals: 9.4-13.5 per cent) on the lateral post-operative photographs and a 7.5 per cent improvement (95 per cent confidence intervals: 5.4-9.5 per cent) on the frontal post-operative photographs. Attractiveness scores differed significantly between the groups (P = 0.015), with orthodontists being more generous with their improvement ratings and the art students tending to give a more critical assessment. There were no significant differences between male and female evaluators (P > 0.05). Ratings of before-after attractiveness almost doubled when the pre- and post-operative status was disclosed as compared to blinded evaluations, thus indicating that prior knowledge of pre- and post-treatment status markedly influences aesthetic evaluations, with a bias towards a more favourable outcome.

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.

Upper limits on the 21 cm power spectrum at z = 5.9 from quasar absorption line spectroscopy

NASA Astrophysics Data System (ADS)

Pober, Jonathan C.; Greig, Bradley; Mesinger, Andrei

2016-11-01

We present upper limits on the 21 cm power spectrum at z = 5.9 calculated from the model-independent limit on the neutral fraction of the intergalactic medium of x_{H I} < 0.06 + 0.05 (1σ ) derived from dark pixel statistics of quasar absorption spectra. Using 21CMMC, a Markov chain Monte Carlo Epoch of Reionization analysis code, we explore the probability distribution of 21 cm power spectra consistent with this constraint on the neutral fraction. We present 99 per cent confidence upper limits of Δ2(k) < 10-20 mK2 over a range of k from 0.5 to 2.0 h Mpc-1, with the exact limit dependent on the sampled k mode. This limit can be used as a null test for 21 cm experiments: a detection of power at z = 5.9 in excess of this value is highly suggestive of residual foreground contamination or other systematic errors affecting the analysis.

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.

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.

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.

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).

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

Epidemiology of tornado destruction in rural northern Bangladesh: risk factors for death and injury.

PubMed

Sugimoto, Jonathan D; Labrique, Alain B; Ahmad, Salahuddin; Rashid, Mahbubur; Shamim, Abu Ahmed; Ullah, Barkat; Klemm, Rolf D W; Christian, Parul; West, Keith P

2011-04-01

The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors during the tornado (AOR = 10.4 (95 per cent CI: 5.5-19.9) and AOR = 6.6 (95 per cent CI: 5.8-7.5), respectively). Females were 1.24 times (95 per cent CI: 1.15-1.33) more likely to be injured than males. Elevated risk of injury was significantly associated with structural damage to the house and tin construction materials. Seeking treatment was protective against death among the injured, odds ratio = 0.08 (95 per cent CI: 0.03-0.21). Further research is needed to develop injury prevention strategies and to address disparities in risk between age groups and between men and women. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Dispersal, environmental niches and oceanic-scale turnover in deep-sea bivalves

PubMed Central

McClain, Craig R.; Stegen, James C.; Hurlbert, Allen H.

2012-01-01

Patterns of beta-diversity or distance decay at oceanic scales are completely unknown for deep-sea communities. Even when appropriate data exist, methodological problems have made it difficult to discern the relative roles of environmental filtering and dispersal limitation for generating faunal turnover patterns. Here, we combine a spatially extensive dataset on deep-sea bivalves with a model incorporating ecological dynamics and shared evolutionary history to quantify the effects of environmental filtering and dispersal limitation. Both the model and empirical data are used to relate functional, taxonomic and phylogenetic similarity between communities to environmental and spatial distances separating them for 270 sites across the Atlantic Ocean. This study represents the first ocean-wide analysis examining distance decay as a function of a broad suite of explanatory variables. We find that both strong environmental filtering and dispersal limitation drive turnover in taxonomic, functional and phylogenetic composition in deep-sea bivalves, explaining 26 per cent, 34 per cent and 9 per cent of the variation, respectively. This contrasts with previous suggestions that dispersal is not limiting in broad-scale biogeographic and biodiversity patterning in marine systems. However, rates of decay in similarity with environmental distance were eightfold to 44-fold steeper than with spatial distance. Energy availability is the most influential environmental variable evaluated, accounting for 3.9 per cent, 9.4 per cent and 22.3 per cent of the variation in functional, phylogenetic and taxonomic similarity, respectively. Comparing empirical patterns with process-based theoretical predictions provided quantitative estimates of dispersal limitation and niche breadth, indicating that 95 per cent of deep-sea bivalve propagules will be able to persist in environments that deviate from their optimum by up to 2.1 g m−2 yr−1 and typically disperse 749 km from their natal site. PMID:22189399

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.

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.

Veterinarian's dilemma: a study of how Danish small animal practitioners handle financially limited clients.

PubMed

Kondrup, S V; Anhøj, K P; Rødsgaard-Rosenbeck, C; Lund, T B; Nissen, M H; Sandøe, P

2016-12-10

This study examined the extent to which Danish veterinary practices encounter financially limited clients and how different factors relating to the animal, the client and the veterinarian affect decisions to provide treatment for these clients. 300 small animal practices were invited to participate in an online survey. 195 participated, giving a response rate of 65 per cent. The results show that Danish small animal veterinary practices encounter clients with limited finances regularly: 33.8 per cent of them 3-4 times, 24.6 per cent 5-10 times and 19.5 per cent 1-2 times a month. Only around 9 per cent reported having a written practice policy on handling financially limited clients. Factors affecting decisions to treat include the severity and type of the animal's condition, the medical care needed and the client's expressed emotions. The propensity to treat is significantly higher in female veterinarians and in situations involving unborn animals. The overall conclusion is that small animal veterinary practices often provide treatment to clients who are not able to pay-far beyond what is legally required. This can be considered a major economic and psychological challenge for the practising veterinarians. British Veterinary Association.

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.

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

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.

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.

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

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.

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.

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 .

16 CFR 502.100 - “Cents-off” representations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the “cents-off” representation imprinted on the commodity package or label. (3) Each “cents-off” representation imprinted on the package or label is limited to a phrase which reflects that the price marked by..., designated as the “regular price”, clearly and conspicuously on the package or label of the commodity or on a...

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.

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).

Uncovering the identities of compact objects in high-mass X-ray binaries and gamma-ray binaries by astrometric measurements

NASA Astrophysics Data System (ADS)

Yamaguchi, M. S.; Yano, T.; Gouda, N.

2018-03-01

We develop a method for identifying a compact object in binary systems with astrometric measurements and apply it to some binaries. Compact objects in some high-mass X-ray binaries and gamma-ray binaries are unknown, which is responsible for the fact that emission mechanisms in such systems have not yet confirmed. The accurate estimate of the mass of the compact object allows us to identify the compact object in such systems. Astrometric measurements are expected to enable us to estimate the masses of the compact objects in the binary systems via a determination of a binary orbit. We aim to evaluate the possibility of the identification of the compact objects for some binary systems. We then calculate probabilities that the compact object is correctly identified with astrometric observation (= confidence level) by taking into account a dependence of the orbital shape on orbital parameters and distributions of masses of white dwarfs, neutron stars and black holes. We find that the astrometric measurements with the precision of 70 μas for γ Cas allow us to identify the compact object at 99 per cent confidence level if the compact object is a white dwarf with 0.6 M⊙. In addition, we can identify the compact object with the precision of 10 μas at 97 per cent or larger confidence level for LS I +61° 303 and 99 per cent or larger for HESS J0632+057. These results imply that the astrometric measurements with the 10 μas precision level can realize the identification of compact objects for γ Cas, LS I +61° 303, and HESS J0632+057.

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).

Diagnosis and initial management of urological injuries associated with 200 consecutive pelvic fractures.

PubMed

Palmer, J K; Benson, G S; Corriere, J N

1983-10-01

During 26 months 200 consecutive patients with fracture of the bony pelvis were evaluated and treated for urological injury. There was no correlation between the extent of pelvic injury and degree of hematuria but hematuria was present in all patients with a urological injury. All urological injuries occurred with anterior arch fractures. The over-all incidence of injury was 13.5 per cent (bladder 9 per cent, urethra 3.5 per cent and combined 1 per cent). Limited extraperitoneal bladder ruptures were treated successfully by Foley catheter drainage.

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.

Association of matrix metalloproteinase-7 (-181A/G) promoter polymorphism in chronic pancreatitis.

PubMed

Manjari, K Sri; Jyothy, A; Kumar, P Shravan; Prabhakar, B; Nallari, Pratibha; Venkateshwari, A

2014-11-01

Chronic pancreatitis is progressive and irreversible destruction of the pancreas. Matrix metalloproteinase-7 (MMP-7) is a secreted matrilysin, which contributes to angiogenesis and breakdown of basement membranes of pancreatic tissues. The present study was aimed to investigate the association of MMP-7 -181A/G (rs11568818) gene promoter polymorphism in patients with chronic pancreatitis. A total of 100 chronic pancreatitis patients and 150 unrelated healthy individuals were included in this case control study. The genotyping of the MMP-7 gene (- 181 A/G) (rs11568818) was carried out based on PCR-RFLP. The serum levels of MMP-7 were determined by ELISA. Association between genotypes and chronic pancreatitis was examined by odds ratio (OR) with 95% confidence interval (CI). The frequencies of the genotypes in promoter of MMP-7 were AA 49 per cent, AG 25 per cent and GG 26 per cent in chronic pancreatitis patients and AA 53 per cent, AG 38 per cent and GG 9 per cent in control subjects. Frequency of MMP-7 -181GG genotype and - 181G allele was significantly associated with chronic pancreatitis compared to healthy subjects [OR = 1.58 (95% CI: 1.06 -2.36), p =0.019]. There was no significant difference in the serum MMP-7 levels in the patients compared to control subjects. The present study revealed a significant association of MMP-7 -181A/G (rs11568818) GG genotype with chronic pancreatitis patients, indicating its possible association with the disease.

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.

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.

Optical polarimetry of KIC 8462852 in 2017 May-August

NASA Astrophysics Data System (ADS)

Steele, I. A.; Copperwheat, C. M.; Jermak, H. E.; Kennedy, G. M.; Lamb, G. P.

2018-01-01

We present optical polarimetry in the period of 2017 May-August of the enigmatic `dipping' star KIC 8462852. During that period, three ˜1 per cent photometric dips were reported by other observers. We measured the average absolute polarization of the source, and find no excess or unusual polarization compared to a nearby comparison star. We place tight upper limits on any change in the degree of polarization of the source between epochs in-dip and out-of-dip of <0.1 per cent (8500 Å) and <0.2 per cent (7050 Å and 5300 Å). How our limits are interpreted depends on the specific model being considered. If the whole stellar disc were covered by material with an optical depth of ˜0.01, then the fractional polarization introduced by this material must be less than 10-20 per cent. While our non-detection does not constrain the comet scenario, it predicts that even modest amounts of dust that have properties similar to Solar system comets may be detectable. We note that the sensitivity of our method scales with the depth of the dip. Should a future ˜20 per cent photometric dip be observed (as was previously detected by Kepler), our method would constrain any induced polarization associated with any occulting material to 0.5-1.0 per cent.

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.

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.

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…

Limits on radio emission from meteors using the MWA

NASA Astrophysics Data System (ADS)

Zhang, X.; Hancock, P.; Devillepoix, H. A. R.; Wayth, R. B.; Beardsley, A.; Crosse, B.; Emrich, D.; Franzen, T. M. O.; Gaensler, B. M.; Horsley, L.; Johnston-Hollitt, M.; Kaplan, D. L.; Kenney, D.; Morales, M. F.; Pallot, D.; Steele, K.; Tingay, S. J.; Trott, C. M.; Walker, M.; Williams, A.; Wu, C.; Ji, Jianghui; Ma, Yuehua

2018-07-01

Recently, low-frequency, broad-band radio emission has been observed accompanying bright meteors by the Long Wavelength Array (LWA). The broad-band spectra between 20 and 60 MHz were captured for several events, while the spectral index (dependence of flux density on frequency, with Sν ∝ να) was estimated to be -4 ± 1 during the peak of meteor afterglows. Here we present a survey of meteor emission and other transient events using the Murchison Wide Field Array (MWA) at 72-103 MHz. In our 322 h survey, down to a 5σ detection threshold of 3.5 Jy beam-1, no transient candidates were identified as intrinsic emission from meteors. We derived an upper limit of -3.7 (95 per cent confidence limit) on the spectral index in our frequency range. We also report detections of other transient events, such as reflected FM broadcast signals from small satellites, conclusively demonstrating the ability of the MWA to detect and track space debris on scales as small as 0.1 m in low Earth orbits.

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.

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.

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.

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.

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.

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.

Experimental investigation of geologically produced antineutrinos with KamLAND.

PubMed

Araki, T; Enomoto, S; Furuno, K; Gando, Y; Ichimura, K; Ikeda, H; Inoue, K; Kishimoto, Y; Koga, M; Koseki, Y; Maeda, T; Mitsui, T; Motoki, M; Nakajima, K; Ogawa, H; Ogawa, M; Owada, K; Ricol, J-S; Shimizu, I; Shirai, J; Suekane, F; Suzuki, A; Tada, K; Takeuchi, S; Tamae, K; Tsuda, Y; Watanabe, H; Busenitz, J; Classen, T; Djurcic, Z; Keefer, G; Leonard, D; Piepke, A; Yakushev, E; Berger, B E; Chan, Y D; Decowski, M P; Dwyer, D A; Freedman, S J; Fujikawa, B K; Goldman, J; Gray, F; Heeger, K M; Hsu, L; Lesko, K T; Luk, K-B; Murayama, H; O'Donnell, T; Poon, A W P; Steiner, H M; Winslow, L A; Mauger, C; McKeown, R D; Vogel, P; Lane, C E; Miletic, T; Guillian, G; Learned, J G; Maricic, J; Matsuno, S; Pakvasa, S; Horton-Smith, G A; Dazeley, S; Hatakeyama, S; Rojas, A; Svoboda, R; Dieterle, B D; Detwiler, J; Gratta, G; Ishii, K; Tolich, N; Uchida, Y; Batygov, M; Bugg, W; Efremenko, Y; Kamyshkov, Y; Kozlov, A; Nakamura, Y; Karwowski, H J; Markoff, D M; Nakamura, K; Rohm, R M; Tornow, W; Wendell, R; Chen, M-J; Wang, Y-F; Piquemal, F

2005-07-28

The detection of electron antineutrinos produced by natural radioactivity in the Earth could yield important geophysical information. The Kamioka liquid scintillator antineutrino detector (KamLAND) has the sensitivity to detect electron antineutrinos produced by the decay of 238U and 232Th within the Earth. Earth composition models suggest that the radiogenic power from these isotope decays is 16 TW, approximately half of the total measured heat dissipation rate from the Earth. Here we present results from a search for geoneutrinos with KamLAND. Assuming a Th/U mass concentration ratio of 3.9, the 90 per cent confidence interval for the total number of geoneutrinos detected is 4.5 to 54.2. This result is consistent with the central value of 19 predicted by geophysical models. Although our present data have limited statistical power, they nevertheless provide by direct means an upper limit (60 TW) for the radiogenic power of U and Th in the Earth, a quantity that is currently poorly constrained.

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.

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.

Does dental undergraduate education and postgraduate training enable intention to provide inhalation sedation in primary dental care? A path analytical exploration.

PubMed

Yuan, S; J Carson, S; Rooksby, M; McKerrow, J; Lush, C; Humphris, G; Freeman, R

2017-08-01

To examine how quality standards of dental undergraduate education, postgraduate training and qualifications together with confidence and barriers could be utilised to predict intention to provide inhalation sedation. All 202 dentists working within primary dental care in NHS Highland were invited to participate. The measures in the questionnaire survey included demographic information, undergraduate education and postgraduate qualifications, current provision and access to sedation service, attitudes towards confidence, barriers and intention to provide inhalation sedation. A path analytical approach was employed to investigate the fit of collected data to the proposed mediational model. One hundred and nine dentists who completed the entire questionnaire participated (response rate of 54%). Seventy-six per cent of dentists reported receiving lectures in conscious sedation during their undergraduate education. Statistically significantly more Public Dental Service dentists compared with General Dental Service (GDS) dentists had postgraduate qualification and Continuing Professional Development training experience in conscious sedation. Only twenty-four per cent of the participants stated that they provided inhalation sedation to their patients. The findings indicated that PDS dentists had higher attitudinal scores towards inhalation sedation than GDS practitioners. The proposed model showed an excellent level of fit. A multigroup comparison test confirmed that the level of association between confidence in providing inhalation sedation and intention varied by group (GDS vs. PDS respondents). Public Dental Service respondents who showed extensive postgraduate training experience in inhalation sedation were more confident and likely to provide this service. The quality standards of dental undergraduate education, postgraduate qualifications and training together with improved confidence predicted primary care dentists' intention to provide inhalation sedation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

Holliday, B.

Information that would allow an assessment of the standard of radiological protection in the United Kingdom is very limited. The Radiological Protection Service (now the National Radiological Protection Board) has provided a monitoring and advisory service to dentists for many years but very limited use has been made of this service. In a recent survey a total of 114 dentists was visited in representative practices in South East England and it was established that only 6.5 per cent of dentists in general practice do not use radiography as an adjunct to their practice (Smith, 1969). In the 88 x-ray setsmore » which were examined, 24 per cent had less than the recommended thickness of aluminium filtration, while 25 per cent had a fixed field size which was larger than necessary for dental radiography, in addition 27 per cent of the timers were found to have an error of greater than 20 per cent in repetition of the pre-set exposure time. These figures are consistent with the results of surveys performed by the National Radiological ProteCtion Board at the request of dentists, but the sample has been small, i.e., a few per cent of dentists in general practice. It is also possible that these results are not typical as the dentist requesting such a survey may have a greater awareness than others of the need for protection.« less

Stellar binary black holes in the LISA band: a new class of standard sirens

NASA Astrophysics Data System (ADS)

Del Pozzo, Walter; Sesana, Alberto; Klein, Antoine

2018-04-01

The recent Advanced LIGO detections of coalescing black hole binaries (BHBs) imply a large population of such systems emitting at milli-Hz frequencies, accessible to the Laser Interferometer Space Antenna (LISA). We show that these systems provide a new class of cosmological standard sirens. Direct LISA luminosity distance - Dl - measurements, combined with the inhomogeneous redshift - z - distribution of possible host galaxies provide an effective way to populate the Dl-z diagram at z < 0.1, thus allowing a precise local measurement of the Hubble expansion rate. To be effective, the method requires a sufficiently precise LISA distance determination and sky localization of a sizeable number of BHBs, which is best achieved for a six-link detector configuration. We find that, for a BHB population consistent with current fiducial LIGO rates, the Hubble constant H0 can be determined at the ˜5 per cent and ˜2 per cent level (68 per cent confidence), assuming two and five million kilometre arm-length, respectively.

The angular velocity of Nubia relative to Somalia and the location of the Nubia-Somalia-Antarctica triple junction

NASA Astrophysics Data System (ADS)

Horner-Johnson, Benjamin C.; Gordon, Richard G.; Cowles, Sara M.; Argus, Donald F.

2005-07-01

A new analysis of geologically current plate motion across the Southwest Indian ridge (SWIR) and of the current location of the Nubia-Antarctica-Somalia triple junction is presented. Spreading rates averaged over the past 3.2 Myr are estimated from 103 well-distributed, nearly ridge-perpendicular profiles that cross the SWIR. All available bathymetric data are evaluated to estimate the azimuths and uncertainties of transform faults; six are estimated from multibeam data and 12 from precision depth recorder (PDR) data. If both the Nubian and Somalian component plates are internally rigid near the SWIR and if the Nubia-Somalia boundary is narrow where it intersects the SWIR, that intersection lies between ~26°E and ~32°E. Thus, the boundary is either along the spreading ridge segment just west of the Andrew Bain transform fault complex (ABTFC) or along some of the transform fault complex itself. These limits are narrower than and contained within limits of ~24°E to ~33°E previously found by Lemaux et al. from an analysis of the locations of magnetic anomaly 5. The data are consistent with a narrow boundary, but also consistent with a diffuse boundary as wide as ~700 km. The new Nubia-Somalia pole of rotation lies ~10° north of the Bouvet triple junction, which places it far to the southwest of southern Africa. The new angular velocity determined only from data along the SWIR indicates displacement rates of Somalia relative to Nubia of 3.6 +/- 0.5 mm yr-1 (95 per cent confidence limits) towards 176° (S04° E) between Somalia and Nubia near the SWIR, and of 8.3 +/- 1.9 mm yr-1 (95 per cent confidence limits) towards 121° (S59° E) near Afar. The new Nubia-Somalia angular velocity differs significantly from the Nubia-Somalia angular velocity estimated from Gulf of Aden and Red sea data. This significant difference has three main alternative explanations: (i) that the plate motion data have substantial unmodelled systematic errors, (ii) that the Nubian component plate is not a single rigid plate, or (iii) that the Somalian component plate is not a single rigid plate. We tentatively prefer the third explanation given the geographical distribution of earthquakes within the African composite plate relative to the inferred location of the Nubia-Somalia boundary along the SWIR.

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.

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.

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.

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.

Assessing the cost of laparotomy at a rural district hospital in Rwanda using time‐driven activity‐based costing

PubMed Central

Odhiambo, J.; Riviello, R.; Lin, Y.; Nkurunziza, T.; Shrime, M.; Maine, R.; Omondi, J. M.; Mpirimbanyi, C.; de la Paix Sebakarane, J.; Hagugimana, P.; Rusangwa, C.; Hedt‐Gauthier, B.

2018-01-01

Background In low‐ and middle‐income countries, the majority of patients lack access to surgical care due to limited personnel and infrastructure. The Lancet Commission on Global Surgery recommended laparotomy for district hospitals. However, little is known about the cost of laparotomy and associated clinical care in these settings. Methods This costing study included patients with acute abdominal conditions at three rural district hospitals in 2015 in Rwanda, and used a time‐driven activity‐based costing methodology. Capacity cost rates were calculated for personnel, location and hospital indirect costs, and multiplied by time estimates to obtain allocated costs. Costs of medications and supplies were based on purchase prices. Results Of 51 patients with an acute abdominal condition, 19 (37 per cent) had a laparotomy; full costing data were available for 17 of these patients, who were included in the costing analysis. The total cost of an entire care cycle for laparotomy was US$1023·40, which included intraoperative costs of US$427·15 (41·7 per cent) and preoperative and postoperative costs of US$596·25 (58·3 per cent). The cost of medicines was US$358·78 (35·1 per cent), supplies US$342·15 (33·4 per cent), personnel US$150·39 (14·7 per cent), location US$89·20 (8·7 per cent) and hospital indirect cost US$82·88 (8·1 per cent). Conclusion The intraoperative cost of laparotomy was similar to previous estimates, but any plan to scale‐up laparotomy capacity at district hospitals should consider the sizeable preoperative and postoperative costs. Although lack of personnel and limited infrastructure are commonly cited surgical barriers at district hospitals, personnel and location costs were among the lowest cost contributors; similar location‐related expenses at tertiary hospitals might be higher than at district hospitals, providing further support for decentralization of these services.

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.

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.

Variables influencing condom use in a cohort of gay and bisexual men.

PubMed

Valdiserri, R O; Lyter, D; Leviton, L C; Callahan, C M; Kingsley, L A; Rinaldo, C R

1988-07-01

Nine hundred fifty-five of 1,384 (69 per cent) gay and bisexual men enrolled in a prospective study of the natural history of human immunodeficiency virus (HIV) infection who reported engaging in anal intercourse in the past six months were surveyed about condom use practices for both insertive (IAI) and receptive anal intercourse (RAI). The following results were obtained: 23 per cent of the men reported that they always used condoms for IAI and 21 per cent for RAI; 32 per cent sometimes used condoms for IAI; 28 per cent sometimes used condoms for RAI; 45 per cent never used condoms for IAI; and 50 per cent never used condoms for RAI. Multiple logistic regression analysis revealed that the following variables were associated with both insertive and receptive condom use: condom acceptability; a history of multiple and/or anonymous partners in the past six months, and the number of partners with whom one is "high" (drugs/alcohol) during sex. Knowledge of positive HIV serostatus was more strongly associated with receptive than with insertive use. Condom use is a relatively complex health-related behavior, and condom promotion programs should not limit themselves to stressing the dangers of unprotected intercourse.

Common cent$ 1: One-armed economists and the invisible hand.

PubMed

Wilkinson, I

2001-01-01

This article is the first in a series called Common Cent$. There is a need for leaders and managers to have a basic understanding--Common Cent$--of elementary economics. The limited, retrospective view of the accountant must be supplemented by the broader, prospective view of the economist. The limits and scope of economics are defined. The First and Second Fundamental Theorems of Welfare Economics are introduced. The mythology behind the mechanism of action of Adam Smith's Invisible Hand is dissected, and the mechanism of the free market is explained in terms of the effect of marginal cost on net market efficiency. The apparently simple case of the effect of legislating a minimum wage on a free market is discussed. This provides an example of the real-world complexity of economies and of applying economic concepts to the business world.

The Australia Telescope search for cosmic microwave background anisotropy

NASA Astrophysics Data System (ADS)

Subrahmanyan, Ravi; Kesteven, Michael J.; Ekers, Ronald D.; Sinclair, Malcolm; Silk, Joseph

1998-08-01

In an attempt to detect cosmic microwave background (CMB) anisotropy on arcmin scales, we have made an 8.7-GHz image of a sky region with a resolution of 2 arcmin and high surface brightness sensitivity using the Australia Telescope Compact Array (ATCA) in an ultracompact configuration. The foreground discrete-source confusion was estimated from observations with higher resolution at the same frequency and in a scaled array at a lower frequency. Following the subtraction of the foreground confusion, the field shows no features in excess of the instrument noise. This limits the CMB anisotropy flat-band power to Q_flat<23.6muK with 95 per cent confidence; the ATCA filter function (which is available at the website www.atnf.csiro.au/Research/cmbr/cmbr_atca.html) F_l in multipole l-space peaks at l_eff=4700 and has half-maximum values at l=3350 and 6050.

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

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.

Lameness scoring system for dairy cows using force plates and artificial intelligence.

PubMed

Ghotoorlar, S Mokaram; Ghamsari, S Mehdi; Nowrouzian, I; Ghotoorlar, S Mokaram; Ghidary, S Shiry

2012-02-04

Lameness scoring is a routine procedure in dairy industry to screen the herds for new cases of lameness. Subjective lameness scoring, which is the most popular lameness detection and screening method in dairy herds, has several limitations. They include low intra-observer and inter-observer agreement and the discrete nature of the scores which limits its usage in monitoring the lameness. The aim of this study is to develop an automated lameness scoring system comparable with conventional subjective lameness scoring by means of artificial neural networks. The system is composed of four balanced force plates installed in a hoof-trimming box. A group of 105 dairy cows was used for the study. Twenty-three features extracted from ground reaction force (GRF) data were used in a computer training process which was performed on 60 per cent of the data. The remaining 40 per cent of the data were used to test the trained system. Repeatability of the lameness scoring system was determined by GRF samples from 25 cows, captured at two different times from the same animals. The mean sd was 0.31 and the mean coefficient of variation was 14.55 per cent, which represents a high repeatability in comparison with subjective vision-based scoring methods. Although the highest sensitivity and specificity values were seen in locomotion score groups 1 and 4, the automatic lameness system was both sensitive and specific in all groups. The sensitivity and specificity were higher than 72 per cent in locomotion score groups 1 to 4, and it was 100 per cent specific and 50 per cent sensitive for group 5.

The water, deuterium, gas and uranium content of tektites

USGS Publications Warehouse

Friedman, I.

1958-01-01

The water content, deuterium concentration of the water, total gas and uranium contents were determined on tektite samples and other glass samples from Texas, Australia, Philippine Islands, Java, French Indo-China, Czechoslovakia, Libyan Desert, Billiton Island, Thailand, French West Africa, Peru, and New Mexico. The water content ranges from 0.24 per cent for the Peru tektite, to 0.0002 per cent for a moldavite. The majority of the tektites have less than 0.05 per cent water, and average 0.005 per cent H2O by weight. No other gases were detected, the lower detection limit being about 1 p.p.m. by weight. The deuterium content of the water in tektites is in the same range as that in terrestrial waters, and varies from 0.010 mole per cent to 0.0166 mole per cent deuterium. The uranium content is about from 1 to 3 p.p.m. The possible origin of tektites is discussed. The experimental data presented favour their being originally terrestrial, but produced by some catastrophic event. An extra-terrestrial source is not ruled out. ?? 1958.

H0LiCOW VIII. A weak-lensing measurement of the external convergence in the field of the lensed quasar HE 0435-1223

NASA Astrophysics Data System (ADS)

Tihhonova, O.; Courbin, F.; Harvey, D.; Hilbert, S.; Rusu, C. E.; Fassnacht, C. D.; Bonvin, V.; Marshall, P. J.; Meylan, G.; Sluse, D.; Suyu, S. H.; Treu, T.; Wong, K. C.

2018-07-01

We present a weak gravitational lensing measurement of the external convergence along the line of sight to the quadruply lensed quasar HE 0435-1223. Using deep r-band images from Subaru Suprime Cam, we observe galaxies down to a 3σ limiting magnitude of ˜26 mag resulting in a source galaxy density of 14 galaxies per square arcminute after redshift-based cuts. Using an inpainting technique and multiscale entropy filtering algorithm, we find that the region in close proximity to the lens has an estimated external convergence of κ =-0.012^{+0.020}_{-0.013} and is hence marginally underdense. We also rule out the presence of any halo with a mass greater than Mvir = 1.6 × 1014h-1M⊙ (68 per cent confidence limit). Our results, consistent with previous studies of this lens, confirm that the intervening mass along the line of sight to HE 0435-1223 does not affect significantly the cosmological results inferred from the time-delay measurements of that specific object.

GERIATRIC PATIENTS IN A MENTAL HOSPITAL

PubMed Central

Ernst, Franklin H.; Oliver, W. A.; Simon, Alexander; Malamud, Nathan

1956-01-01

An intensive study was made of men 55 years of age and over admitted to Napa State Hospital with either senile or arteriosclerotic brain disease. A ward treatment program, combining both the medical and psychiatric approaches, was applied to one-half of such patients admitted to a state hospital, with the aim of determining what, if any, effect this program would have on the course of the illnesses. Special laboratory studies showed: (a) Serial electroencephalograms and hospital adjustment ratings appeared to be positively correlated with the patients' clinical course; (b) In 35 per cent of cases the electrocardiographic tracings at the time of admittance were within normal limits; (c) A “pathological level” of blood bromides was found in only one of 340 consecutive admissions in this age group. Sociopsychiatric study of 100 consecutively admitted patients revealed that: (a) 35 per cent of the patients were from the middle, and 65 per cent from the lower classes of society; (b) Only 59 per cent were admitted because of activities specifically psychotic. (c) 63 per cent needed admittance to this state hospital for observation and diagnosis, but only 44 per cent needed to stay for care and treatment; (d) In 88 per cent, specific emotional stresses were present just preceding and coincident with the clinical appearance of the organic brain syndrome. PMID:13304672

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.

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.

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.

Factors affecting high-density lipoprotein cholesterol in HIV-infected patients on nevirapine-based antiretroviral therapy

PubMed Central

Padmapriyadarsini, C.; Ramesh, K.; Sekar, L.; Ramachandran, Geetha; Reddy, Devaraj; Narendran, G.; Sekar, S.; Chandrasekar, C.; Anbarasu, D.; Wanke, Christine; Swaminathan, Soumya

2017-01-01

Background & objectives: Cardiovascular disease (CVD) risk with low high-density lipoprotein cholesterol (HDL-C) and high triglycerides is common in the general population in India. As nevirapine (NVP)-based antiretroviral therapy (ART) tends to increase HDL-C, gene polymorphisms associated with HDL-C metabolism in HIV-infected adults on stable NVP-based ART were studied. Methods: A cross-sectional study was conducted between January 2013 and July 2014 among adults receiving NVP-based ART for 12-15 months. Blood lipids were estimated and gene polymorphisms in apolipoprotein C3 (APOC3), cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genes were analyzed by real-time polymerase chain reaction. Framingham's 10-yr CVD risk score was estimated. Logistic regression was done to show factors related to low HDL-C levels. Results: Of the 300 patients included (mean age: 38.6±8.7 yr; mean CD4 count 449±210 cell/μl), total cholesterol (TC) >200 mg/dl was observed in 116 (39%) patients. Thirty nine per cent males and 47 per cent females had HDL-C levels below normal while 32 per cent males and 37 per cent females had TC/HDL ratio of 4.5 and 4.0, respectively. Body mass index [adjusted odds ratio (aOR)=1.70, 95% confidence interval (CI) 1.01-2.84, P=0.04] and viral load (aOR=3.39, 95% CI: 1.52-7.52, P=0.003) were negatively associated with serum HDL-C levels. The 10-yr risk score of developing CVD was 11-20 per cent in 3 per cent patients. Allelic variants of APOC3 showed a trend towards low HDL-C. Interpretation & conclusions: High-risk lipid profiles for atherosclerosis and cardiovascular disease were common among HIV-infected individuals, even after 12 months of NVP-based ART. Targeted interventions to address these factors should be recommended in the national ART programmes. PMID:28948955

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.

Health survey of 167 pet rabbits (Oryctolagus cuniculus) in Finland.

PubMed

Mäkitaipale, J; Harcourt-Brown, F M; Laitinen-Vapaavuori, O

2015-10-24

Only a limited amount of information is available about health status of pet rabbits. The aim of this study was to obtain data about the health status of pet rabbits considered healthy by the owners in Finland. Physical examination and lateral abdominal and lateral skull radiography were performed on 167 pet rabbits of which 118 (70.7 per cent) had abnormal findings in at least one examination. The most common findings were acquired dental disease (n=67, 40.1 per cent), vertebral column deformities and degenerative lesions (n=52, 31.1 per cent), skin disorders (n=28, 16.8 per cent) and eye disorders (n=12, 7.2 per cent). Vertebral column angulating deformities were significantly more common in dwarf lop rabbits (P≤0.001). The prevalence of health disorders was significantly higher in rabbits over three years of age of which 51 (82.3 per cent) had findings in at least one examination (P<0.05). Rabbits as prey animals hide their illness, which cause difficulties to owners to recognise health problems. Because of the high prevalence of clinical and radiological findings in apparently healthy pet rabbits, regular physical examinations are advised, especially for animals over three years old. British Veterinary Association.

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.

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.

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.

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.

Visual defects in Nepalese children with Down syndrome.

PubMed

Paudel, Nabin; Leat, Susan J; Adhikari, Prakash; Woodhouse, J Margaret; Shrestha, Jyoti Baba

2010-03-01

Down syndrome (DS) is a common chromosomal anomaly. People with this syndrome have recognisable physical characteristics and limited intellectual abilities. The aim of this study was to determine visual defects, especially refractive error and binocular anomalies, in a sample of Nepalese children with DS. Thirty-six children with DS (19 boys and 17 girls) from the Kathmandu valley, aged from four months to 18 years, underwent detailed optometric examination. Cycloplegic refraction was performed on all subjects. Vision on presentation of all the children was assessed with preferential looking cards, the Kay picture cards, the Bailey-Lovie logMAR chart or the Snellen chart. Binocular function was assessed with cover test, Hirschberg or Bruckner test. Cycloplegic refraction of the children revealed that 80 per cent of the children had significant refractive error. Most of them had hyperopia (55 per cent), followed by astigmatism (44 per cent), myopia (25 per cent) and anisometropia (19 per cent). Only two (5.6 per cent) children were strabismic and both of them were alternating esotropes. Nystagmus was present in 10 (28 per cent). Other ocular findings were upward slanting palpebral fissures, blepharitis, congenital nasolacrimal duct obstruction, blepharoconjunctivitis, chalazion and lenticular opacities. Nepalese children with DS have a high prevalence of refractive error and nystagmus. Regular eye examinations are indicated for these children to enable early diagnosis and appropriate management of ocular disorders to improve their vision and quality of life.

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.…

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.

Enhanced recovery protocol: implementation at a county institution with limited resources.

PubMed

Rona, Kais; Choi, J; Sigle, G; Kidd, S; Ault, G; Senagore, A J

2012-10-01

The benefits of an enhanced recovery protocol (ERP) in colorectal surgery have been well described; however, data on the implementation process is minimal, especially in a resource-limited institution. The purpose of this study was to evaluate outcomes during implementation of a physician-driven ERP at a public-funded institution. We retrospectively reviewed all elective colorectal surgery during a transition from standard care to an ERP (implemented via a standard order sheet). Data regarding use of care plan, length of stay (LOS), and rates of postoperative complications and readmission were recorded. One hundred eleven patients were included in the study; however, complete use of the ERP after its introduction occurred in a total of 50 patients for a compliance rate of 60 per cent (95% confidence interval [CI], 49 to 70). Late implementation of ERP diet, analgesics, and activity were the most common process errors. Full application of the ERP reduced mean LOS by 3 days (P=0.002), and there was a trend toward decreased postoperative morbidity without an increase in readmission rate (P=0.61). Full implementation of an ERP for colorectal surgery faces many challenges in a resource-limited county institution; however, when fully applied, the ERP safely reduced overall LOS, which is important in cost containment.

The evaluation of web-based data collection for enhanced surveillance of cryptosporidiosis.

PubMed

Viney, Kerri A; McAnulty, Jeremy M

2008-01-01

Following an increase in the number of people diagnosed with cryptosporidiosis in November 2005, the Communicable Diseases Branch initiated enhanced surveillance using a developmental version of NetEpi Collection, an open-source, web-based data collection tool. We evaluated the usefulness of NetEpi Collection for enhanced surveillance, using the Centers for Disease Control and Prevention's Updated Guidelines for Evaluating Public Health Surveillance Systems as a guide. Most staff (73 per cent) who used NetEpi Collection found it easy to use. Although ongoing support was thought to be adequate by 82 per cent of respondents who used NetEpi Collection, 36 per cent reported that training was limited and 27 per cent reported technical problems such as internet, server and password problems. In order to improve its usefulness in enhanced surveillance, training in NetEpi Collection should be enhanced and the stability of the system improved.

Survey of UK horse owners' knowledge of equine arboviruses and disease vectors.

PubMed

Chapman, Gail Elaine; Baylis, Matthew; Archer, Debra C

2018-05-15

Increased globalisation and climate change have led to concern about the increasing risk of arthropod-borne virus (arbovirus) outbreaks globally. An outbreak of equine arboviral disease in northern Europe could impact significantly on equine welfare, and result in economic losses. Early identification of arboviral disease by horse owners may help limit disease spread. In order to determine what horse owners understand about arboviral diseases of horses and their vectors, the authors undertook an open, cross-sectional online survey of UK horse owners. The questionnaire was distributed using social media and a press release and was active between May and July 2016. There were 466 respondents, of whom 327 completed the survey in full. High proportions of respondents correctly identified photographic images of biting midges (71.2 per cent) and mosquitoes (65.4 per cent), yet few were aware that they transmit equine infectious diseases (31.4 per cent and 35.9 per cent, respectively). Of the total number of respondents, only 7.4 per cent and 16.2 per cent correctly named a disease transmitted by biting midges and mosquitoes, respectively. Only 13.1 per cent and 12.5 per cent of participants identified specific clinical signs of African horse sickness (AHS) and West Nile virus (WNV), respectively. This study demonstrates that in the event of heightened disease risk educational campaigns directed towards horse owners need to be implemented, focussing on disease awareness, clinical signs and effective disease prevention strategies. © 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.

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.

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.

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'

Jeans that fit: weighing the mass of the Milky Way analogues in the ΛCDM universe

NASA Astrophysics Data System (ADS)

Kafle, Prajwal R.; Sharma, Sanjib; Robotham, Aaron S. G.; Elahi, Pascal J.; Driver, Simon P.

2018-04-01

The spherical Jeans equation is a widely used tool for dynamical study of gravitating systems in astronomy. Here, we test its efficacy in robustly weighing the mass of Milky Way analogues, given they need not be in equilibrium or even spherical. Utilizing Milky Way stellar haloes simulated in accordance with Λ cold dark matter (ΛCDM) cosmology by Bullock and Johnston and analysing them under the Jeans formalism, we recover the underlying mass distribution of the parent galaxy, within distance r/kpc ∈ [10, 100], with a bias of ˜ 12 per cent and a dispersion of ˜ 14 per cent. Additionally, the mass profiles of triaxial dark matter haloes taken from the SURFS simulation, within scaled radius 0.2 < r/rmax < 3, are measured with a bias of ˜ - 2.4 per cent and a dispersion of ˜ 10 per cent. The obtained dispersion is not because of Poisson noise due to small particle numbers as it is twice the later. We interpret the dispersion to be due to the inherent nature of the ΛCDM haloes, for example being aspherical and out-of-equilibrium. Hence, the dispersion obtained for stellar haloes sets a limit of about 12 per cent (after adjusting for random uncertainty) on the accuracy with which the mass profiles of the Milky Way-like galaxies can be reconstructed using the spherical Jeans equation. This limit is independent of the quantity and quality of the observational data. The reason for a non-zero bias is not clear, hence its interpretation is not obvious at this stage.

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.

Fire frequency drives decadal changes in soil carbon and nitrogen and ecosystem productivity

NASA Astrophysics Data System (ADS)

Pellegrini, Adam F. A.; Ahlström, Anders; Hobbie, Sarah E.; Reich, Peter B.; Nieradzik, Lars P.; Staver, A. Carla; Scharenbroch, Bryant C.; Jumpponen, Ari; Anderegg, William R. L.; Randerson, James T.; Jackson, Robert B.

2018-01-01

Fire frequency is changing globally and is projected to affect the global carbon cycle and climate. However, uncertainty about how ecosystems respond to decadal changes in fire frequency makes it difficult to predict the effects of altered fire regimes on the carbon cycle; for instance, we do not fully understand the long-term effects of fire on soil carbon and nutrient storage, or whether fire-driven nutrient losses limit plant productivity. Here we analyse data from 48 sites in savanna grasslands, broadleaf forests and needleleaf forests spanning up to 65 years, during which time the frequency of fires was altered at each site. We find that frequently burned plots experienced a decline in surface soil carbon and nitrogen that was non-saturating through time, having 36 per cent (±13 per cent) less carbon and 38 per cent (±16 per cent) less nitrogen after 64 years than plots that were protected from fire. Fire-driven carbon and nitrogen losses were substantial in savanna grasslands and broadleaf forests, but not in temperate and boreal needleleaf forests. We also observe comparable soil carbon and nitrogen losses in an independent field dataset and in dynamic model simulations of global vegetation. The model study predicts that the long-term losses of soil nitrogen that result from more frequent burning may in turn decrease the carbon that is sequestered by net primary productivity by about 20 per cent of the total carbon that is emitted from burning biomass over the same period. Furthermore, we estimate that the effects of changes in fire frequency on ecosystem carbon storage may be 30 per cent too low if they do not include multidecadal changes in soil carbon, especially in drier savanna grasslands. Future changes in fire frequency may shift ecosystem carbon storage by changing soil carbon pools and nitrogen limitations on plant growth, altering the carbon sink capacity of frequently burning savanna grasslands and broadleaf forests.

Fire frequency drives decadal changes in soil carbon and nitrogen and ecosystem productivity.

PubMed

Pellegrini, Adam F A; Ahlström, Anders; Hobbie, Sarah E; Reich, Peter B; Nieradzik, Lars P; Staver, A Carla; Scharenbroch, Bryant C; Jumpponen, Ari; Anderegg, William R L; Randerson, James T; Jackson, Robert B

2018-01-11

Fire frequency is changing globally and is projected to affect the global carbon cycle and climate. However, uncertainty about how ecosystems respond to decadal changes in fire frequency makes it difficult to predict the effects of altered fire regimes on the carbon cycle; for instance, we do not fully understand the long-term effects of fire on soil carbon and nutrient storage, or whether fire-driven nutrient losses limit plant productivity. Here we analyse data from 48 sites in savanna grasslands, broadleaf forests and needleleaf forests spanning up to 65 years, during which time the frequency of fires was altered at each site. We find that frequently burned plots experienced a decline in surface soil carbon and nitrogen that was non-saturating through time, having 36 per cent (±13 per cent) less carbon and 38 per cent (±16 per cent) less nitrogen after 64 years than plots that were protected from fire. Fire-driven carbon and nitrogen losses were substantial in savanna grasslands and broadleaf forests, but not in temperate and boreal needleleaf forests. We also observe comparable soil carbon and nitrogen losses in an independent field dataset and in dynamic model simulations of global vegetation. The model study predicts that the long-term losses of soil nitrogen that result from more frequent burning may in turn decrease the carbon that is sequestered by net primary productivity by about 20 per cent of the total carbon that is emitted from burning biomass over the same period. Furthermore, we estimate that the effects of changes in fire frequency on ecosystem carbon storage may be 30 per cent too low if they do not include multidecadal changes in soil carbon, especially in drier savanna grasslands. Future changes in fire frequency may shift ecosystem carbon storage by changing soil carbon pools and nitrogen limitations on plant growth, altering the carbon sink capacity of frequently burning savanna grasslands and broadleaf forests.

DA white dwarfs in Sloan Digital Sky Survey Data Release 7 and a search for infrared excess emission

NASA Astrophysics Data System (ADS)

Girven, J.; Gänsicke, B. T.; Steeghs, D.; Koester, D.

2011-10-01

We present a method which uses colour-colour cuts on the Sloan Digital Sky Survey (SDSS) photometry to select white dwarfs with hydrogen-rich (DA) atmospheres without the recourse to spectroscopy. This method results in a sample of DA white dwarfs that is 95 per cent complete at an efficiency of returning a true DA white dwarf of 62 per cent. The approach was applied to SDSS Data Release 7 for objects with and without SDSS spectroscopy. This led to 4636 spectroscopicially confirmed DA white dwarfs with g≤ 19; a ˜70 per cent increase compared to Eisenstein et al.'s 2006 sample. Including the photometric-only objects, we estimate a factor of 3 increase in DA white dwarfs. We find that the SDSS spectroscopic follow-up is 44 per cent complete for DA white dwarfs with Teff≳ 8000 K. We further cross-correlated the SDSS sample with Data Release 8 of the UKIRT (United Kingdom Infrared Telescope) Infrared Deep Sky Survey (UKIDSS) Large Area Survey. The spectral energy distributions (SED) of both subsets, with and without SDSS spectroscopy, were fitted with white dwarf models to determine the fraction of DA white dwarfs with low-mass stellar companions or dusty debris discs via the detection of excess near-infrared emission. From the spectroscopic sample we find that 2.0 per cent of white dwarfs have an excess consistent with a brown dwarf type companion, with a firm lower limit of 0.8 per cent. From the white dwarfs with photometry only, we find that 1.8 per cent are candidates for having brown dwarf companions. Similarly, both samples show that ˜1 per cent of white dwarfs are candidates for having a dusty debris disc.

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.

A study of bereavement in general practice

PubMed Central

Levy, B.; Sclare, A. Balfour

1976-01-01

Forty six bereaved relatives were assessed by a general practitioner four to eight weeks after the bereavement. In 36 (78·3 per cent) the immediate reaction to bereavement was one of numbness or stupefaction; in seven (15·2 per cent) emotional relief occurred; and in three cases (6·5 per cent) there was no obvious immediate reaction. The numbness reaction was limited in duration to a week or less in 31 of the 36 instances. At four to eight weeks after bereavement 29 (63·0 per cent) of the subjects continued to experience difficulty in coming to terms with their loss. Twenty subjects reported guilt feelings and a similar number expressed aggressive reactions. The bereaved subjects tended to increase their consumption of cigarettes and alcohol, while their appetite and weight tended to be reduced. Thirty six (78·3 per cent) of the subjects reported physical symptoms, notably headache, dizziness, generalised aches, and abdominal complaints. The most prominent psychological features of bereavement were found to be: preoccupation with thoughts of the deceased, idealisation of the lost person, depressive mood, and loneliness. The findings are discussed and reference made to the role of the family doctor in the management of bereavement reactions. PMID:957295

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.

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.

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.

Acceptance and effects of a therapeutic renal food in pet cats with chronic kidney disease

PubMed Central

Fritsch, Dale A; Jewell, Dennis E

2015-01-01

Introduction Renal foods are used to manage chronic kidney disease (CKD) in dogs and cats, but their effectiveness may be limited by the ability to transition animals to them. Material and Methods In a prospective study, pet cats with previously undiagnosed kidney disease (20 International Renal Interest Society (IRIS) 1, 61 IRIS 2, 14 IRIS 3/4, 33 at risk for CKD) were transitioned to a renal food. Markers of renal function were measured and owners answered questionnaires about their pet over one year. Results All but eight cats (120/128; 94 per cent) successfully transitioned to the renal food. Most of the time, cats moderately or extremely liked the food (89 per cent), ate at least half (73 per cent) and were moderately or extremely enthusiastic while eating (68 per cent). Cats rarely disliked the food (2 per cent) or refused to eat it (1 per cent). Markers of renal function were unchanged in IRIS 1 and 2 cats and changed little in IRIS 3/4 cats. In all groups, owner-assessed quality of life improved initially and then remained stable. Mean bodyweight did not change in cats with CKD. Conclusions Most cats with CKD successfully transitioned to the renal food. The results also support previous studies that the renal food can help stabilise cats with CKD. PMID:26587240

Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013).

PubMed

Bartholomew, K A; Stover, K E; Olby, N J; Moore, S A

2016-12-24

Fibrocartilaginous embolic myelopathy (FCE) is common in dogs; however, there is conflicting information in the veterinary literature regarding clinical characteristics and data on recovery in severe cases is sparse. A systematic review of canine FCE was performed to delineate the natural history of this disease. 322 previously reported cases and 71 previously unreported cases were identified for inclusion. Source publications were identified via PubMed central search and by references from review articles. Previously unreported cases were identified via computerised medical records search at two veterinary institutions. FCE was most common in middle-aged large breed dogs (30 per cent); however, the miniature schnauzer was the most frequently reported individual breed and small breeds comprised 24 per cent of all reported cases. The most common neuroanatomical localisation was a T3-L3 myelopathy (33.1 per cent). Prognosis for recovery of ambulation was good to excellent with 85 per cent of cases regaining the ability to walk unassisted, most within 3 weeks. Persistent neurological deficits were common in patients that recovered ambulation (49.1 per cent). When nociception was absent in the affected limbs at initial presentation, rate of recovery was lower (10 per cent); however, this data is likely biased by limited follow-up in more severe cases. Future prospective studies should evaluate prognosis for more severely affected patients. British Veterinary Association.

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.

Limited impact on decadal-scale climate change from increased use of natural gas.

PubMed

McJeon, Haewon; Edmonds, Jae; Bauer, Nico; Clarke, Leon; Fisher, Brian; Flannery, Brian P; Hilaire, Jérôme; Krey, Volker; Marangoni, Giacomo; Mi, Raymond; Riahi, Keywan; Rogner, Holger; Tavoni, Massimo

2014-10-23

The most important energy development of the past decade has been the wide deployment of hydraulic fracturing technologies that enable the production of previously uneconomic shale gas resources in North America. If these advanced gas production technologies were to be deployed globally, the energy market could see a large influx of economically competitive unconventional gas resources. The climate implications of such abundant natural gas have been hotly debated. Some researchers have observed that abundant natural gas substituting for coal could reduce carbon dioxide (CO2) emissions. Others have reported that the non-CO2 greenhouse gas emissions associated with shale gas production make its lifecycle emissions higher than those of coal. Assessment of the full impact of abundant gas on climate change requires an integrated approach to the global energy-economy-climate systems, but the literature has been limited in either its geographic scope or its coverage of greenhouse gases. Here we show that market-driven increases in global supplies of unconventional natural gas do not discernibly reduce the trajectory of greenhouse gas emissions or climate forcing. Our results, based on simulations from five state-of-the-art integrated assessment models of energy-economy-climate systems independently forced by an abundant gas scenario, project large additional natural gas consumption of up to +170 per cent by 2050. The impact on CO2 emissions, however, is found to be much smaller (from -2 per cent to +11 per cent), and a majority of the models reported a small increase in climate forcing (from -0.3 per cent to +7 per cent) associated with the increased use of abundant gas. Our results show that although market penetration of globally abundant gas may substantially change the future energy system, it is not necessarily an effective substitute for climate change mitigation policy.

Personal satisfaction and mentorship are critical factors for today's resident surgeons to seek surgical training.

PubMed

Lukish, Jeffrey; Cruess, David

2005-11-01

The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.

Development & validation of a quantitative anti-protective antigen IgG enzyme linked immunosorbent assay for serodiagnosis of cutaneous anthrax.

PubMed

Ghosh, N; Gunti, D; Lukka, H; Reddy, B R; Padmaja, Jyothi; Goel, A K

2015-08-01

Anthrax caused by Bacillus anthracis is primarily a disease of herbivorous animals, although several mammals are vulnerable to it. ELISA is the most widely accepted serodiagnostic assay for large scale surveillance of cutaneous anthrax. The aims of this study were to develop and evaluate a quantitative ELISA for determination of IgG antibodies against B. anthracis protective antigen (PA) in human cutaneous anthrax cases. Quantitative ELISA was developed using the recombinant PA for coating and standard reference serum AVR801 for quantification. A total of 116 human test and control serum samples were used in the study. The assay was evaluated for its precision, accuracy and linearity. The minimum detection limit and lower limit of quantification of the assay for anti-PA IgG were 3.2 and 4 µg/ml, respectively. The serum samples collected from the anthrax infected patients were found to have anti-PA IgG concentrations of 5.2 to 166.3 µg/ml. The intra-assay precision per cent CV within an assay and within an operator ranged from 0.99 to 7.4 per cent and 1.7 to 3.9 per cent, respectively. The accuracy of the assay was high with a per cent error of 6.5 - 24.1 per cent. The described assay was found to be linear between the range of 4 to 80 ng/ml (R [2] = 0.9982; slope = 0.9186; intercept = 0.1108). The results suggested that the developed assay could be a useful tool for quantification of anti-PA IgG response in human after anthrax infection or vaccination.

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.

Binary neutron star merger rate via the luminosity function of short gamma-ray bursts

NASA Astrophysics Data System (ADS)

Paul, Debdutta

2018-07-01

The luminosity function of short gamma ray bursts (GRBs) is modelled by using the available catalogue data of all short GRBs (sGRBs) detected till 2017 October. The luminosities are estimated via the `pseudo-redshifts' obtained from the `Yonetoku correlation', assuming a standard delay distribution between the cosmic star formation rate and the production rate of their progenitors. While the simple power law is ruled out to high confidence, the data is fit well both by exponential cutoff power law and broken power law models. Using the derived parameters of these models along with conservative values in the jet opening angles seen from afterglow observations, the true rate of sGRBs is derived. Assuming a sGRB is produced from each binary neutron star merger (BNSM), the rate of gravitational wave (GW) detections from these mergers are derived for the past, present, and future configurations of the GW detector networks. Stringent lower limits of 1.87 { yr^{-1}} for the aLIGO-VIRGO, and 3.11 { yr^{-1}} for the upcoming aLIGO-VIRGO-KAGRA-LIGO/India configurations are thus derived for the BNSM rate at 68 per cent confidence. The BNSM rates calculated from this work and that independently inferred from the observation of the only confirmed BNSM observed till date are shown to have a mild tension; however, the scenario that all BNSMs produce sGRBs cannot be ruled out.

A global survey of HIV-positive people's attitudes towards cure research.

PubMed

Simmons, R; Kall, M; Collins, S; Cairns, G; Taylor, S; Nelson, M; Fidler, S; Porter, K; Fox, J

2017-02-01

Involvement of people living with HIV (PLHIV) in the design of HIV cure studies is important, given the potential risks to participants. We present results of an international survey of PLHIV to define these issues and inform cure research. PLHIV were recruited in June-November 2014 through HIV websites, advocacy forums, social media and 12 UK HIV clinics. The survey included questions concerning demographics, HIV disease history, the desirability of types of cure and the patient's willingness to accept potential toxicity and treatment interruption (TI). We examined factors associated with TI and willingness to accept substantial risks. A total of 982 PLHIV completed the survey; 87% were male, 79% white and 81% men who have sex with men (MSM). Fifty-one per cent were aged 25-44 years and 69% were UK residents. The median time since diagnosis was 7 years [interquartile range (IQR) 2-17 years]. Eighty-eight per cent were receiving antiretrovirals (91% reported undetectable viral load). Health/wellbeing improvements (96%) and an inability to transmit HIV (90%) were more desirable cure characteristics than testing HIV-negative (69%). Ninety-five per cent were interested in participating in cure studies, and 59% were willing to accept substantial risks. PLHIV with a low CD4 count [201-350 cells/μL vs. ≥ 350 cells/μL; odds ratio (OR) 2.11; 95% confidence interval (CI) 1.11-4.00] were more likely to accept risks, whereas those with limited knowledge of HIV treatments vs. excellent/good knowledge and those aged ≥ 65 years vs. 45-64 years were less likely to accept risks [OR 0.58 (95% CI 0.37-0.90) and OR 0.18 (95% CI 0.07-0.45), respectively]. TI was acceptable for 62% of participants, with the main concerns being becoming unwell (82%), becoming infectious (76%) and HIV spreading through the body (76%). Cure research was highly acceptable to the PLHIV surveyed. Most individuals would accept risks, including TI, even in the absence of personal benefit. An optimal cure would improve health and minimize onward transmission risk. © 2016 British HIV Association.

Volumetric upper airway changes after rapid maxillary expansion: a systematic review and meta-analysis.

PubMed

Buck, Lloyd M; Dalci, Oyku; Darendeliler, M Ali; Papageorgiou, Spyridon N; Papadopoulou, Alexandra K

2017-10-01

Although Rapid Maxillary Expansion (RME) has been used for over a century, its effect on upper airways has not yet adequately been assessed in an evidence-based manner. To investigate the volumetric changes in the upper airway spaces following RME in growing subjects by means of acoustic rhinometry, three-dimensional radiography and digital photogrammetry. Literature search of electronic databases and additional manual searches up to February 2016. Randomized clinical trials, prospective or retrospective controlled clinical trials and cohort clinical studies of at least eight patients, where the RME appliance was left in place for retention, and a maximum follow-up of 8 months post-expansion. After duplicate data extraction and assessment of the risk of bias, the mean differences and 95 per cent confidence intervals (CIs) of upper airway volume changes were calculated with random-effects meta-analyses, followed by subgroup analyses, meta-regressions, and sensitivity analyses. Twenty studies were eligible for qualitative synthesis, of which 17 (3 controlled clinical studies and 14 cohort studies) were used in quantitative analysis. As far as total airway volume is concerned patients treated with RME showed a significant increase post-expansion (5 studies; increase from baseline: 1218.3mm3; 95 per cent CI: 702.0 to 1734.6mm3), which did not seem to considerably diminish after the retention period (11 studies; increase from baseline: 1143.9mm3; 95 per cent CI: 696.9 to 1590.9mm3). However, the overall quality of evidence was judged as very low, due to methodological limitations of the included studies, absence of untreated control groups, and inconsistency among studies. RME seems to be associated with an increase in the nasal cavity volume in the short and in the long term. However, additional well-conducted prospective controlled clinical studies are needed to confirm the present findings. None. Australian Society of Orthodontics Foundation for Research and Education Inc. © 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

HPV self-sampling in Japanese women: A feasibility study in a population with limited experience of tampon use.

PubMed

Hanley, Sharon Jb; Fujita, Hiromasa; Yokoyama, Susumu; Kunisawa, Shiori; Tamakoshi, Akiko; Dong, Peixin; Kobayashi, Noriko; Watari, Hidemichi; Kudo, Masataka; Sakuragi, Noriaki

2016-09-01

Cervical cancer incidence and mortality is increasing in Japanese women under age 50. Screening uptake is low and proactive recommendations for human papillomavirus vaccination have been suspended. Other cervical cancer prevention initiatives are urgently needed. We assessed whether human papillomavirus self-sampling might be an acceptable alternative to physician-led screening, particularly in women with limited experience of tampon use. We also sought to identify any practical, logistical, or safety issues in women already attending for screening, before carrying out further large-scale studies in non-responders. In total, 203 women aged 20-49 attending their annual workplace healthcheck in Sapporo, northern Japan, performed unsupervised human papillomavirus self-sampling before undergoing a physician-led cervical smear and human papillomavirus test, and completing a measure of acceptability for both tests. Ninety per cent of participants stated they would use self-sampling again. They found instructions easy to follow and reported no issues with the usability of the self-sampling device. Compared with physician-led testing, women found self-sampling significantly less painful, less embarrassing and could relax more (p < 0.001), regardless of history of tampon use, which was associated with negative experiences in physician sampling (p = 0.034). Women lacked confidence the test had been performed correctly, despite no unsatisfactory samples. No safety issues were reported. Self-sampling was highly acceptable in this population of women. They could perform the test safely unsupervised, but lacked confidence the test has been carried out correctly. Japanese women need to be educated about the accuracy of human papillomavirus self-sampling and further large-scale studies are necessary in non-responders. © The Author(s) 2016.

New Zealand optometrists 2006: demographics, working arrangements and hours worked.

PubMed

Frederikson, Lesley G; Chamberlain, Kerry; Sangster, Andrew J

2008-07-01

Optometry is a regulated health profession in NZ, with limited student places. With 650 registered optometrists in 2005, the optometrist to population ratio was 1 : 6,291 with no apparent national shortage. If optometrists registered in NZ do not actually live there, a workforce shortage is possible. This paper presents findings from the New Zealand Association of Optometrists 2006 workforce survey of members, which aimed to profile the NZ optometric workforce and to explore factors relating to workforce capacity, job stress and future planning. A questionnaire was developed to collect information on employment status, hours worked and gender distribution of optometrists in New Zealand. It was circulated to 530 active members of the NZ Association of Optometrists representing 86 per cent of the available optometrists. Direct comparisons with the Australian optometric workforce numbers were also undertaken. Of the 243 respondents, 129 (53 per cent) were male. The median age of all respondents was 39 years (46 for males and 34 for females) and 75 per cent of the respondents were aged younger than 50 years. Fifty per cent had practised 15 years or less. Ten per cent of respondents had 'time-out' during their career and this was significantly more likely for females. Nearly half the respondents were self-employed (46 per cent) and eight per cent worked as locums. Part-time employees were more likely to be female and males were more likely to be in full-time self-employment. Half the group was under 40 (51 per cent), which accounted for 86 per cent of the full-time salaried arrangements. Those aged 30 to 39 included 52 per cent of the total part-time salaried workers. The average working week was 34 hours for women and 39 hours for men; the median was 40 hours for both groups. In the typical working week, 80 per cent of an optometrist's time was spent consulting with patients and five per cent was patient-related paperwork. The distribution of work arrangements was remarkably similar among New Zealand optometrists, New Zealand GPs and Australian optometrists. In 2006, there were 619 optometrists assessed as working in New Zealand. This equated to 544 EFTOs and a ratio of EFTO to population of 1 : 7,517. The New Zealand optometric workforce in 2006 was sufficient to meet the overall population needs. One-third of optometrists chose to work part-time and the proportion of female optometrists has increased over the past 15 years. In the face of expected increasing demand for optometric services, a targeted expansion of the workforce appears desirable.

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.

Predictors for people's response to a tornado warning: Arkansas, 1 March 1997.

PubMed

Balluz, L; Schieve, L; Holmes, T; Kiezak, S; Malilay, J

2000-03-01

On 1 March 1997, powerful tornadoes touched down in Arkansas (USA) on a Saturday afternoon. Twenty-six fatalities and 400 non-fatal injuries were reported. We performed a population-based cross-sectional study to determine factors associated with appropriate responses to tornado warnings. Of 146 survey participants, 140 (96 per cent) knew the difference between 'tornado watch' and 'tornado warning' and were aware of when the warning was announced. Of those 140 participants, 64 (45.7 per cent) responded to the warning by seeking shelter, and 58 (90.6 per cent) of those 64 acted within five minutes of hearing the warning. Four factors were positively associated with those seeking shelter: having graduated from high school (OR = 4.2, 95 per cent CI = 1.1-15.5); having a basement in one's house (OR = 3.8, 95 per cent exact CI = 1.1-17.1); hearing a siren (OR = 4.4, 95 per cent CI = 1.3-18.9); and having prepared a household plan of response when tornadoes occur (OR = 2.6, 95 per cent CI = 1.1-6.3). On the basis of these findings, we recommend: first, that people who live in tornadoprone areas have a personal plan of action to help them respond immediately to warnings; second, public-health education officials in areas with frequent tornadic activity should do more to educate the public about what they can do to protect themselves from a tornado; and third, that emergency-management officials planning protection measures for vulnerable communities should consider that most people have limited time (our study documented five minutes) in which to respond to a tornado warning. Thus, shelters in tornado-prone areas should be quickly accessible by residents.

Topical isotretinoin for melasma in Thai patients: a vehicle-controlled clinical trial.

PubMed

Leenutaphong, V; Nettakul, A; Rattanasuwon, P

1999-09-01

Melasma is an acquired hyperpigmentary disorder commonly seen in Orientals. Recently it has been demonstrated that tretinoin (all-trans-retinoic acid) can produce significant clinical improvement of melasma. However, moderate cutaneous side effects (retinoid dermatitis) occurred in a number of patients. To investigate the efficacy of topical 0.05 per cent isotretinoin gel (Isotrex) in the treatment of melasma in Thai patients. Thirty patients with moderate to severe melasma entered a 40-week, randomized, vehicle-controlled clinical trial in which they applied either 0.05 per cent isotretinoin gel, or its vehicle base together with a broad spectrum sunscreen (SPF 28) daily to the entire face. They were evaluated clinically (using Melasma Area and Severity Index), and colorimetrically (using our Melasma Area and Melanin Index). After 40 weeks, the average MASI and MAMI scores of the isotretinoin-treated group decreased by 68.2 per cent and 47 per cent respectively, while the corresponding control scores declined 60 per cent and 34 per cent. There was no statistically significant difference between the isotretinoin and vehicle groups. When the MASI and MAMI scores of each visit were compared to their baseline data, a statistically significant reduction of the score was first noted at weeks 4 and 12 respectively. Lightening of melasma, as determined clinically (MASI score), correlated well with pigmentation measurements (MAMI score). Side effects were limited to a mild transient "retinoid dermatitis" occurring in 27 per cent of isotretinoin-treated patients. Daily use of broad spectrum sunscreen has a significant lightening effect on melasma in Thai patients. However, there was no statistically significant difference between the isotretinoin and vehicle-treated group.

The association between high-risk behavior and central nervous system injuries: analysis of traffic-related fatalities in a large coroner's series.

PubMed

Pakula, Andrea; Shaker, Adel; Martin, Maureen; Skinner, Ruby

2013-10-01

High-risk behaviors leading to traffic fatalities are often a result of severe traumatic brain and spine injuries. The objective of the study was to analyze patterns of behavior in drivers and motorcyclists that are associated with central nervous system (CNS)-related prehospital deaths that may serve as a basis for future prevention initiatives. Our study group comprised 514 fatalities with severe CNS injuries documented at autopsy. The majority (n = 491) was the result of motor vehicle collisions (MVCs). In this group, male drivers predominated and the majority, 80 per cent, wore seatbelts. Toxicology analysis revealed 53 per cent of drivers with a mean concentration of ethanol above the legal limit. Texting while driving comprised 45 per cent of the study group. Less than 5 per cent of the fatalities were the result of road or weather conditions. In the motorcycle group (n = 23), 100 per cent of the victims were unhelmeted. We report a large autopsy series of CNS-related deaths with analysis of behavioral factors associated with the fatalities. Substance abuse and distracted driving are dominant patterns of high-risk behavior in MVCs and not wearing a motorcycle helmet is deadly for victims of motorcycle crashes.

A systematic review of the impact of volume of surgery and specialization on patient outcome.

PubMed

Chowdhury, M M; Dagash, H; Pierro, A

2007-02-01

Volume of surgery and specialization may affect patient outcome. Articles examining the effects of one or more of three variables (hospital volume of surgery, surgeon volume and specialization) on outcome (measured by length of hospital stay, mortality and complication rate) were analysed. Reviews, opinion articles and observational studies were excluded. The methodological quality of each study was assessed, a correlation between the variables analysed and the outcome accepted if it was significant. The search identified 55,391 articles published between 1957 and 2002; 1075 were relevant to the study, of which 163 (9,904,850 patients) fulfilled the entry criteria. These 163 examined 42 different surgical procedures, spanning 13 surgical specialities. None were randomized and 40 investigated more than one variable. Hospital volume was reported in 127 studies; high-volume hospitals had significantly better outcomes in 74.2 per cent of studies, but this effect was limited in prospective studies (40 per cent). Surgeon volume was reported in 58 studies; high-volume surgeons had significantly better outcomes in 74 per cent of studies. Specialization was reported in 22 studies; specialist surgeons had significantly better outcomes than general surgeons in 91 per cent of studies. The benefit of high surgeon volume and specialization varied in magnitude between specialities. High surgeon volume and specialization are associated with improved patient outcome, while high hospital volume is of limited benefit. Copyright (c) 2007 British Journal of Surgery Society Ltd.

Can you refuse these discounts? An evaluation of the use and price discount impact of price-related promotions among US adult smokers by cigarette manufacturers.

PubMed

Caraballo, Ralph S; Wang, Xu; Xu, Xin

2014-06-04

The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23-34% of adult smokers in the US use cheaper brands, and 18-55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. An analysis based on the cross-sectional 2009-2010 National Adult Tobacco Survey (NATS). 11 766 current smokers aged 18 or above in the USA. Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. The use of price-related discounts and associated price impact vary widely by cigarette manufacturer and brand. Approximately one of three Camel, one of four Marlboro and one of eight Newport smokers used price-related discounts on their latest cigarette purchases. The average price reductions of discounts offered by Philip Morris (PM) or R.J. Reynolds (RJR) were around 29 cents per pack while that of Lorillard (Newport only) was 24 cents per pack. Cigarette brands that provided significant per pack price reductions include: PM Marlboro (28 cents), RJR brand Camel (41 cents), Doral (50 cents), Kool (73 cents) and Salem (80 cents), and Lorillard Newport (24 cents). Policies that decrease price-minimisation strategies will benefit public health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Efficacy of three formulations of diflubenzuron, an insect growth regulator, against Culex quinquefasciatus Say, the vector of Bancroftian filariasis in India

PubMed Central

Sadanandane, C.; Doss, P. S. Boopathi; Jambulingam, P.

2012-01-01

Background & objectives: Insect growth regulators (IGRs) offer alternatives to conventional chemical larvicides that pose problem of resistance and environmental safety. However, only a limited number of IGRs have been approved for use in mosquito control. In the present study, two new formulations of the IGR diflubenzuron, 2 per cent granular (GR) and 2 per cent tablet (DT) were tested for its efficacy against Culex quinquefasciatus, in comparison to its 25 per cent wettable powder (WP) formulation. Methods: The WP, GR and DT formulations were tested in cesspits, street drains and abandoned wells each at four dosages, 25, 50, 75 and 100 g ai/ha. Additionally, the DT formulation was tested at a higher dosage of 1 tablet/m2 (equal to 400 g ai/ha). Results: The WP and GR formulations yielded >80 per cent inhibition of adult emergence (IE) for 7-10 days in cesspits, 4-7 days in street drains and 7-21 days in abandoned wells at all dosages tested. The DT formulation was effective only at higher dosage 100 g ai/ha and or 1 tablet/m2 for 7-15 days at all habitats. Interpretation & conclusions: The trial showed that the dosage 25 g ai/ha of 25 per cent WP could be the field dosage for cesspits and wells, and 50 g ai/ha for drains, to be applied at weekly intervals. The dosages 25, 50 and 100 g ai/ha of 2 per cent GR could be the field dosages for application in cesspits at weekly intervals, in abandoned wells every three weeks and in drains at weekly intervals, respectively. Diflubenzuron 25 per cent WP and 2 per cent GR could be used for larval control of Cx. quinquefasciatus under integrated vector management programme. PMID:23287125

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.

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.

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.

A randomized evaluation of a computer-based physician's workstation: design considerations and baseline results.

PubMed Central

Rotman, B. L.; Sullivan, A. N.; McDonald, T.; DeSmedt, P.; Goodnature, D.; Higgins, M.; Suermondt, H. J.; Young, C. Y.; Owens, D. K.

1995-01-01

We are performing a randomized, controlled trial of a Physician's Workstation (PWS), an ambulatory care information system, developed for use in the General Medical Clinic (GMC) of the Palo Alto VA. Goals for the project include selecting appropriate outcome variables and developing a statistically powerful experimental design with a limited number of subjects. As PWS provides real-time drug-ordering advice, we retrospectively examined drug costs and drug-drug interactions in order to select outcome variables sensitive to our short-term intervention as well as to estimate the statistical efficiency of alternative design possibilities. Drug cost data revealed the mean daily cost per physician per patient was 99.3 cents +/- 13.4 cents, with a range from 0.77 cent to 1.37 cents. The rate of major interactions per prescription for each physician was 2.9% +/- 1%, with a range from 1.5% to 4.8%. Based on these baseline analyses, we selected a two-period parallel design for the evaluation, which maximized statistical power while minimizing sources of bias. PMID:8563376

Prescription compliance in ophthalmic lenses.

PubMed

Yuen, Gloria S-C; Chou, B Ralph; Ngo, Thao Pt; Cheng, Brian B; Dain, Stephen J

2011-07-01

Tolerances required for ophthalmic lenses are set down in national and international standards. It appears that the compliance of manufactured lenses has not been reported previously. Assembling a statistical quantity of lenses of a single prescription is usually an expensive process. It was, secondary to a lens impact study, possible to assemble a large number of plano lenses. In the assessment of the fracture velocity of lenses approximately 20 plano lenses of each material and thickness are required. Prior to using lenses for the impact study, they were checked for prescription. The results of the prescription measurements are reported here and the results of the impact study are reported in a separate paper. Using an automated focimeter, 679 plano lenses in stock thickness, typical occupational eye protector thickness and up to 3.5 mm thick were measured. There were 21 combinations of material/thickness/coating from seven suppliers. The power was evaluated against Australian Standard 2228.1-1992, as the lenses were supplied in Australia. The permitted tolerances are ±0.09 D sphere and ±0.06 D cylinder. When assessed for material/thickness/coating combination, failure rates varied from <0.0001 per cent to 77.5 per cent (with a further 17.3 per cent classified as borderline, because they were within the uncertainty of measurement of the required limit). Grouped by supplier, the failure rates ranged from <0.0001 per cent to 7.6 per cent (with a further 12.3 per cent borderline). To improve understanding of the result, it may be easier to quote the figures without considering uncertainties. When assessed by supplier, the failure rate varies from <0.0001 per cent to 12.6 per cent. Compliance of plano lenses should be among the easiest of tasks for a laboratory. While we know of no defined or required acceptance rates for prescription lenses, a failure rate for a laboratory of 12.6 per cent, which includes a failure rate of 88 per cent in 2.8 mm thick refractive index = 1.53 hard coated lenses (n = 20) cannot be considered satisfactory and is a strong indication of a failure to check lenses before they leave the laboratory. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

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.

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.

Assessing primary care data quality.

PubMed

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

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.

22 CFR 303.13 - Fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... educational or non-commercial scientific institution, fees shall be limited to reasonable standard charges for...) Duplication by paper copy: 15 cents per page; (4) Duplication by other methods: Actual costs as incurred; (5... within 45 business days. (m) The Peace Corps reserves the right to limit the number of copies of any...

Cosmological parameter forecasts for H I intensity mapping experiments using the angular power spectrum

NASA Astrophysics Data System (ADS)

Olivari, L. C.; Dickinson, C.; Battye, R. A.; Ma, Y.-Z.; Costa, A. A.; Remazeilles, M.; Harper, S.

2018-01-01

H I intensity mapping is a new observational technique to survey the large-scale structure of matter using the 21 cm emission line of atomic hydrogen (H I). In this work, we simulate BINGO (BAO from Integrated Neutral Gas Observations) and SKA (Square Kilometre Array) phase-1 dish array operating in autocorrelation mode. For the optimal case of BINGO with no foregrounds, the combination of the H I angular power spectra with Planck results allows w to be measured with a precision of 4 per cent, while the combination of the BAO acoustic scale with Planck gives a precision of 7 per cent. We consider a number of potentially complicating effects, including foregrounds and redshift-dependent bias, which increase the uncertainty on w but not dramatically; in all cases, the final uncertainty is found to be Δw < 8 per cent for BINGO. For the combination of SKA-MID in autocorrelation mode with Planck, we find that, in ideal conditions, w can be measured with a precision of 4 per cent for the redshift range 0.35 < z < 3 (350-1050 MHz) and 2 per cent for 0 < z < 0.49 (950-1421 MHz). Extending the model to include the sum of neutrino masses yields a 95 per cent upper limit of ∑mν < 0.24 eV for BINGO and ∑mν < 0.08 eV for SKA phase 1, competitive with the current best constraints in the case of BINGO and significantly better than them in the case of SKA.

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.

On the contribution of height to predict lung volumes, capacities and diffusion in healthy school children of 10-17 years.

PubMed

Gupta, C K; Mishra, G; Mehta, S C; Prasad, J

1993-01-01

Lung volumes, capacities, diffusion and alveolar volumes with physical characteristics (age, height and weight) were recorded for 186 healthy school children (96 boys and 90 girls) of 10-17 years age group. The objective was to study the relative importance of physical characteristics as regressor variables in regression models to estimate lung functions. We observed that height is best correlated with all the lung functions. Inclusion of all physical characteristics in the models have little gain compared to the ones having just height as regressor variable. We also find that exponential models were not only statistically valid but fared better compared to the linear ones. We conclude that lung functions covary with height and other physical characteristics but do not depend upon them. The rate of increase in the functions depend upon initial lung functions. Further, we propose models and provide ready reckoners to give estimates of lung functions with 95 per cent confidence limits based on heights from 125 to 170 cm for the age group of 10 to 17 years.

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.

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.

Per cent emphysema is associated with respiratory and lung cancer mortality in the general population: a cohort study.

PubMed

Oelsner, Elizabeth C; Carr, J Jeffrey; Enright, Paul L; Hoffman, Eric A; Folsom, Aaron R; Kawut, Steven M; Kronmal, Richard A; Lederer, David J; Lima, Joao A C; Lovasi, Gina S; Smith, Benjamin M; Shea, Steven J; Barr, R Graham

2016-07-01

Emphysema on CT is a risk factor for all-cause mortality in persons with and without airflow obstruction; however, causes of death associated with emphysema remain uncertain, particularly in the general population. To test associations between quantitatively assessed emphysema on CT and cause of death in persons with and without a substantial smoking history. The Multi-Ethnic Study of Atherosclerosis recruited 6814 participants, aged 45-84 years and without clinical cardiovascular disease, in 2000-2002. Per cent emphysema was defined on cardiac CT as per cent of lung voxels less than -950 Hounsfield units; emphysema on CT was defined as per cent emphysema above the upper limit of normal. Cause of death was classified by administrative codes. Proportional-hazards models were adjusted for age, race/ethnicity, gender, body mass index, smoking status, pack-years, coronary artery calcium, site and education. Additional adjustment for lung function was made in a subset with spirometry from 2004 to 2006. There were 1091 deaths over 12 years median follow-up. Emphysema on CT was strongly associated with increased mortality due to respiratory diseases (adjusted HR 2.94, 95% CI 1.68 to 5.15), particularly chronic lower respiratory diseases (adjusted HR 9.54, 95% CI 4.70 to 19.35), and lung cancer (adjusted HR 1.84, 95% CI 1.09 to 3.12), but not cardiovascular disease. Associations persisted among participants with fewer than 10 pack-years and those without physician-diagnosed respiratory disease, and were similar after adjustment for airflow measures and in persons without airflow limitation. Quantitatively assessed emphysema on CT is associated with greater respiratory disease and lung cancer mortality, even among persons without traditional risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A 20 GHz bright sample for δ > 72° - II. Multifrequency follow-up

NASA Astrophysics Data System (ADS)

Ricci, R.; Righini, S.; Verma, R.; Prandoni, I.; Carretti, E.; Mack, K.-H.; Massardi, M.; Procopio, P.; Zanichelli, A.; Gregorini, L.; Mantovani, F.; Gawroński, M. P.; Peel, M. W.

2013-11-01

We present follow-up observations at 5, 8 and 30 GHz of the K-band Northern Wide Survey (KNoWS) 20 GHz Bright Sample, performed with the 32-m Medicina radio telescope and the 32-m Toruń radio telescope. The KNoWS sources were selected in the Northern Polar Cap (δ > 72°) and have a flux density limit S20 GHz = 115 mJy. We include NRAO-VLA Sky Survey 1.4 GHz measurements to derive the source radio spectra between 1.4 and 30 GHz. Based on optical identifications, 68 per cent of the sources are quasars and 27 per cent are radio galaxies. A redshift measurement is available for 58 per cent of the sources. The radio spectral properties of the different source populations are found to be in agreement with those of other high-frequency-selected samples.

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

40 CFR 420.13 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... exceed 13.3 per cent of the above limitations, shall be provided for process wastewaters from coke oven... (except those from coal charging and coke pushing emission controls), coal tar processing operations and coke plant groundwater remediation systems, but only to the extent such systems generate process...

40 CFR 420.13 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... exceed 13.3 per cent of the above limitations, shall be provided for process wastewaters from coke oven... (except those from coal charging and coke pushing emission controls), coal tar processing operations and coke plant groundwater remediation systems, but only to the extent such systems generate process...

Interseismic Strain Accumulation Across Metropolitan Los Angeles: Puente Hills Thrust

NASA Astrophysics Data System (ADS)

Argus, D.; Liu, Z.; Heflin, M. B.; Moore, A. W.; Owen, S. E.; Lundgren, P.; Drake, V. G.; Rodriguez, I. I.

2012-12-01

Twelve years of observation of the Southern California Integrated GPS Network (SCIGN) are tightly constraining the distribution of shortening across metropolitan Los Angeles, providing information on strain accumulation across blind thrust faults. Synthetic Aperture Radar Interferometry (InSAR) and water well records are allowing the effects of water and oil management to be distinguished. The Mojave segment of the San Andreas fault is at a 25° angle to Pacific-North America plate motion. GPS shows that NNE-SSW shortening due to this big restraining bend is fastest not immediately south of the San Andreas fault across the San Gabriel mountains, but rather 50 km south of the fault in northern metropolitan Los Angeles. The GPS results we quote next are for a NNE profile through downtown Los Angeles. Just 2 mm/yr of shortening is being taken up across the San Gabriel mountains, 40 km wide (0.05 micro strain/yr); 4 mm/yr of shortening is being taken up between the Sierra Madre fault, at the southern front of the San Gabriel mountains, and South Central Los Angeles, also 40 km wide (0.10 micro strain/yr). We find shortening to be more evenly distributed across metropolitan Los Angeles than we found before [Argus et al. 2005], though within the 95% confidence limits. An elastic models of interseismic strain accumulation is fit to the GPS observations using the Back Slip model of Savage [1983]. Rheology differences between crystalline basement and sedimentary basin rocks are incorporated using the EDGRN/EDCMP algorithm of Wang et al. [2003]. We attempt to place the Back Slip model into the context of the Elastic Subducting Plate Model of Kanda and Simons [2010]. We find, along the NNE profile through downtown, that: (1) The deep Sierra Madre Thrust cannot be slipping faster than 2 mm/yr, and (2) The Puente Hills Thrust and nearby thrust faults (such as the upper Elysian Park Thrust) are slipping at 9 ±2 mm/yr beneath a locking depth of 12 ±5 km (95% confidence limits). Incorporating sedimentary basin rock either reduces the slip rate by 10 per cent or increases the locking rate by 20 per cent. The 9 mm/yr rate for the Puente Hills Thrust and nearby faults exceeds the cumulative 3-5 mm/yr rate estimated using paleoseismology along the Puente Hills Thrust (1.2-1.6 mm/yr, Dolan et al. 2003), upper Elysian Park Thrust (0.6-2.2 mm/yr, Oskin et al. 2000), and western Compton Thrust (1.2 mm/yr, Leon et al. 2009], though all the paleoseismic estimates are minimums. We infer that M 7 earthquakes in northern metropolitan Los Angeles may occur more frequently that previously thought.

Improving Tanzanian childbirth service quality.

PubMed

Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

2018-04-16

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

Academic poster design at a national conference: a need for standardised guidance?

PubMed

Gopal, Alan; Redman, Melody; Cox, David; Foreman, David; Elsey, Elizabeth; Fleming, Simon

2017-10-01

Academic posters are a common means of disseminating information at conferences. Presentation at conferences is frequently given weight in postgraduate training programme recruitment. Some conferences provide guidance for visual presentation of posters. For the Association of the Study of Medical Education (ASME) Annual Scientific Meeting (ASM) 2015, poster abstract guidance was provided; however, the guidance on poster design was limited to size and orientation. The aim of this study was to investigate academic poster quality at a national medical education conference to identify where standards could be promoted and improved. Presentation at conferences is frequently given weight in postgraduate training programme recruitment METHODS: Six auditors assessed all posters displayed at the ASME ASM (15-17 July 2015) using guidelines based upon a modified checklist for academic posters. Ten criteria were agreed as assessment standards for poster design quality. One-hundred-and-eighty posters were assessed: 29 per cent had appropriate copyright for the materials displayed (n = 52); 41 per cent included suitable contact details (n = 73); 48 per cent (n = 87) had a text to graphic ratio of 50 : 50; 72 per cent (n = 130) met ASME guidance for layout and orientation; 76 per cent (n = 137) had appropriate referencing; 78 per cent showed evidence of proofreading for grammar and spelling (n = 140); 79 per cent (n = 142) were readable at a distance of 2 metres; and 87 per cent used appropriate academic logos (n = 156). There was variability in design quality as assessed by these criteria. We recommend that detailed guidance should be produced and disseminated by the organising conference. This may improve poster quality and aid in the communication of presented material. We aim to re-audit following the production and dissemination of poster presentation guidance. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

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.

Abundant molecular oxygen in the coma of comet 67P/Churyumov-Gerasimenko.

PubMed

Bieler, A; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J-J; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; van Dishoeck, E F; Fiethe, B; Fuselier, S A; Gasc, S; Gombosi, T I; Hansen, K C; Hässig, M; Jäckel, A; Kopp, E; Korth, A; Le Roy, L; Mall, U; Maggiolo, R; Marty, B; Mousis, O; Owen, T; Rème, H; Rubin, M; Sémon, T; Tzou, C-Y; Waite, J H; Walsh, C; Wurz, P

2015-10-29

The composition of the neutral gas comas of most comets is dominated by H2O, CO and CO2, typically comprising as much as 95 per cent of the total gas density. In addition, cometary comas have been found to contain a rich array of other molecules, including sulfuric compounds and complex hydrocarbons. Molecular oxygen (O2), however, despite its detection on other icy bodies such as the moons of Jupiter and Saturn, has remained undetected in cometary comas. Here we report in situ measurement of O2 in the coma of comet 67P/Churyumov-Gerasimenko, with local abundances ranging from one per cent to ten per cent relative to H2O and with a mean value of 3.80 ± 0.85 per cent. Our observations indicate that the O2/H2O ratio is isotropic in the coma and does not change systematically with heliocentric distance. This suggests that primordial O2 was incorporated into the nucleus during the comet's formation, which is unexpected given the low upper limits from remote sensing observations. Current Solar System formation models do not predict conditions that would allow this to occur.

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.

Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa.

PubMed

van Gend, Christine L; Haadsma, Maaike L; Sauer, Pieter J J; Schoeman, Cornelius J

2003-06-01

The WHO clinical case definition for pediatric HIV infection has been designed to be used in countries where diagnostic laboratory resources are limited. We evaluated the WHO case definition to determine whether it is a useful instrument to discriminate between HIV-positive and HIV-negative children. In addition, clinical features not included in this case definition were recorded. We recorded clinical data from 300 consecutively admitted children in a state hospital in Bloemfontein, South Africa, and tested these children for HIV infection. A total of 222 children were included in the study; 69 children (31.1 per cent) were HIV positive. The sensitivity of the WHO case definition in this study was 14.5 per cent, the specificity was 98.6 per cent. Apart from weight loss and generalized dermatitis, the signs of the WHO case definition were significantly more often seen in HIV-positive than in HIV-negative children. Of the clinical signs not included in the WHO case definition, marasmus and hepatosplenomegaly especially occurred more frequently in HIV-positive children. Based on these findings we composed a new case definition consisting of four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. HIV infection is suspected in a child presenting with at least two of these four signs. The sensitivity of this case definition was 63.2 per cent, the specificity was 96.0 per cent. We conclude that in this study the WHO case definition was not a useful instrument to discriminate between HIV-positive and HIV-negative children, mainly because its sensitivity was strikingly low. The simplified case definition we propose, proved to be more sensitive than the WHO case definition (63.2 vs. 14.5 per cent), whilst its specificity remained high.

Effect of material variation on the biomechanical behaviour of orthodontic fixed appliances: a finite element analysis

PubMed Central

Papageorgiou, Spyridon N.; Keilig, Ludger; Hasan, Istabrak; Jäger, Andreas

2016-01-01

Summary Introduction: Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. Methods: A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. Results: The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). Limitations: The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. Conclusion: According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement. PMID:26174769

Telephone follow-up for cataract surgery: feasibility and patient satisfaction study.

PubMed

Hoffman, Jeremy J S L; Pelosini, Lucia

2016-05-09

Purpose - The purpose of this paper is to investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach - Prospective, non-randomised cohort study. A ten-point subjective ophthalmic assessment questionnaire and a six-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at two to three weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of post-operative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings - Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66 per cent second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) post-operatively. Subjective visual acuity was graded as good by 92 per cent of patients; 72 per cent patients reported no pain and 20 per cent reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6 per cent defined TFU as convenient and 75.5 per cent of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications - Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications - Post-operative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value - This is the first study reporting TFU results and patient satisfaction to the usual alternative two-week outpatient review.

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.

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.

Maximizing and stabilizing luminescence from halide perovskites with potassium passivation

NASA Astrophysics Data System (ADS)

Abdi-Jalebi, Mojtaba; Andaji-Garmaroudi, Zahra; Cacovich, Stefania; Stavrakas, Camille; Philippe, Bertrand; Richter, Johannes M.; Alsari, Mejd; Booker, Edward P.; Hutter, Eline M.; Pearson, Andrew J.; Lilliu, Samuele; Savenije, Tom J.; Rensmo, Håkan; Divitini, Giorgio; Ducati, Caterina; Friend, Richard H.; Stranks, Samuel D.

2018-03-01

Metal halide perovskites are of great interest for various high-performance optoelectronic applications. The ability to tune the perovskite bandgap continuously by modifying the chemical composition opens up applications for perovskites as coloured emitters, in building-integrated photovoltaics, and as components of tandem photovoltaics to increase the power conversion efficiency. Nevertheless, performance is limited by non-radiative losses, with luminescence yields in state-of-the-art perovskite solar cells still far from 100 per cent under standard solar illumination conditions. Furthermore, in mixed halide perovskite systems designed for continuous bandgap tunability (bandgaps of approximately 1.7 to 1.9 electronvolts), photoinduced ion segregation leads to bandgap instabilities. Here we demonstrate substantial mitigation of both non-radiative losses and photoinduced ion migration in perovskite films and interfaces by decorating the surfaces and grain boundaries with passivating potassium halide layers. We demonstrate external photoluminescence quantum yields of 66 per cent, which translate to internal yields that exceed 95 per cent. The high luminescence yields are achieved while maintaining high mobilities of more than 40 square centimetres per volt per second, providing the elusive combination of both high luminescence and excellent charge transport. When interfaced with electrodes in a solar cell device stack, the external luminescence yield—a quantity that must be maximized to obtain high efficiency—remains as high as 15 per cent, indicating very clean interfaces. We also demonstrate the inhibition of transient photoinduced ion-migration processes across a wide range of mixed halide perovskite bandgaps in materials that exhibit bandgap instabilities when unpassivated. We validate these results in fully operating solar cells. Our work represents an important advance in the construction of tunable metal halide perovskite films and interfaces that can approach the efficiency limits in tandem solar cells, coloured-light-emitting diodes and other optoelectronic applications.

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

The burden of antenatal heart disease in South Africa: a systematic review

PubMed Central

2012-01-01

Background Maternal mortality in South Africa is rising, and heart conditions currently account for 41 per cent of indirect causes of deaths. Little is known about the burden of heart disease in pregnant South Africans. Methods We systematically reviewed the contemporary epidemiology and peripartum outcomes of heart disease in South African women attending antenatal care. Searches were performed in PubMed, ISI Web of Science, the EBSCO Africa-Wide database, the South African Union Catalogue, and the Current and Completed Research database (South Africa). References of included articles were also hand-searched. Studies reporting epidemiologic data on antenatal heart disease in South Africa were included. Data on morbidity and mortality were also collected. Results Seven studies were included in the systematic review. The prevalence of heart disease ranged from 123 to 943 per 100,000 deliveries, with a median prevalence of 616 per 100,000. Rheumatic valvular lesions were the commonest abnormalities, although cardiomyopathies were disproportionately high in comparison with other developing countries. Peripartum case-fatality rates were as high as 9.5 per cent in areas with limited access to care. The most frequent complications were pulmonary oedema, thromboembolism, and major bleeding with warfarin use. Perinatal mortality ranged from 8.9 to 23.8 per cent, whilst mitral lesions were associated with low birth weight. Meta-analysis could not be performed due to clinical and statistical heterogeneity of the included studies. Conclusion Approximately 0.6 per cent of pregnant South Africans have pre-existing cardiac abnormalities, with rheumatic lesions being the commonest. Maternal and perinatal morbidity and mortality continue to be very high. We conclude this review by summarising limitations of the current literature and recommending standard reporting criteria for future reports. PMID:22463484

Maximizing and stabilizing luminescence from halide perovskites with potassium passivation.

PubMed

Abdi-Jalebi, Mojtaba; Andaji-Garmaroudi, Zahra; Cacovich, Stefania; Stavrakas, Camille; Philippe, Bertrand; Richter, Johannes M; Alsari, Mejd; Booker, Edward P; Hutter, Eline M; Pearson, Andrew J; Lilliu, Samuele; Savenije, Tom J; Rensmo, Håkan; Divitini, Giorgio; Ducati, Caterina; Friend, Richard H; Stranks, Samuel D

2018-03-21

Metal halide perovskites are of great interest for various high-performance optoelectronic applications. The ability to tune the perovskite bandgap continuously by modifying the chemical composition opens up applications for perovskites as coloured emitters, in building-integrated photovoltaics, and as components of tandem photovoltaics to increase the power conversion efficiency. Nevertheless, performance is limited by non-radiative losses, with luminescence yields in state-of-the-art perovskite solar cells still far from 100 per cent under standard solar illumination conditions. Furthermore, in mixed halide perovskite systems designed for continuous bandgap tunability (bandgaps of approximately 1.7 to 1.9 electronvolts), photoinduced ion segregation leads to bandgap instabilities. Here we demonstrate substantial mitigation of both non-radiative losses and photoinduced ion migration in perovskite films and interfaces by decorating the surfaces and grain boundaries with passivating potassium halide layers. We demonstrate external photoluminescence quantum yields of 66 per cent, which translate to internal yields that exceed 95 per cent. The high luminescence yields are achieved while maintaining high mobilities of more than 40 square centimetres per volt per second, providing the elusive combination of both high luminescence and excellent charge transport. When interfaced with electrodes in a solar cell device stack, the external luminescence yield-a quantity that must be maximized to obtain high efficiency-remains as high as 15 per cent, indicating very clean interfaces. We also demonstrate the inhibition of transient photoinduced ion-migration processes across a wide range of mixed halide perovskite bandgaps in materials that exhibit bandgap instabilities when unpassivated. We validate these results in fully operating solar cells. Our work represents an important advance in the construction of tunable metal halide perovskite films and interfaces that can approach the efficiency limits in tandem solar cells, coloured-light-emitting diodes and other optoelectronic applications.

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)

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.

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 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.

How well does the Friends-of-Friends algorithm recover group properties from galaxy catalogues limited in both distance and luminosity?

NASA Astrophysics Data System (ADS)

Duarte, Manuel; Mamon, Gary A.

2014-05-01

The specific star formation rates of galaxies are influenced both by their mass and by their environment. Moreover, the mass function of groups and clusters serves as a powerful cosmological tool. It is thus important to quantify the accuracy to which group properties are extracted from redshift surveys. We test here the Friends-of-Friends (FoF) grouping algorithm, which depends on two linking lengths (LLs), plane-of-sky and line-of-sight (LOS), normalized to the mean nearest neighbour separation of field galaxies. We argue, on theoretical grounds, that LLs should be b⊥ ≃ 0.11, and b∥ ≈ 1.3 to recover 95 per cent of all galaxies with projected radii within the virial radius r200 and 95 per cent of the galaxies along the LOS. We then predict that 80 to 90 per cent of the galaxies in FoF groups should lie within their parent real-space groups (RSGs), defined within their virial spheres. We test the FoF extraction for 16 × 16 pairs of LLs, using subsamples of galaxies, doubly complete in distance and luminosity, of a flux-limited mock Sloan Digital Sky Survey (SDSS) galaxy catalogue. We find that massive RSGs are more prone to fragmentation, while the fragments typically have low estimated mass, with typically 30 per cent of groups of low and intermediate estimated mass being fragments. Group merging rises drastically with estimated mass. For groups of three or more galaxies, galaxy completeness and reliability are both typically better than 80 per cent (after discarding the fragments). Estimated masses of extracted groups are biased low, by up to a factor 4 at low richness, while the inefficiency of mass estimation improves from 0.85 dex to 0.2 dex when moving from low to high multiplicity groups. The optimal LLs depend on the scientific goal for the group catalogue. We propose b⊥ ≃ 0.07, with b∥ ≃ 1.1 for studies of environmental effects, b∥ ≃ 2.5 for cosmographic studies and b∥ ≃ 5 for followups of individual groups.

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).

The Nature of the Unresolved Extragalactic Cosmic Soft X-Ray Background

NASA Technical Reports Server (NTRS)

Cappelluti, N.; Ranalli, P.; Roncarelli, M.; Arevalo, P.; Zamorani, G.; Comastri, A.; Gilli, R.; Rovilos, E.; Vignali, C.; Allevato, V.;

Unmet need for contraception among married women in an urban area of Puducherry, India.

PubMed

Sulthana, Bahiya; Shewade, Hemant Deepak; Sunderamurthy, Bhuvaneswary; Manoharan, Keerthana; Subramanian, Manimozhi

2015-01-01

Unmet need for contraception remains a national problem. The study was conducted in an urban area of Puducherry, India, among the eligible couples to assess the unmet need for contraception and to determine the awareness and pattern of use of contraceptives along with the socio-demographic factors associated with the unmet needs for contraception. This cross-sectional study included eligible couples with married women in age group of 15-45 yr as the study population (n=267). Probability proportional to size sampling followed by systematic random sampling was used. A pre-tested questionnaire was administered to collect data from the respondents. Double data entry and validation of data was done. Unmet need for contraception was 27.3 per cent (95% CI: 22.3-33); unmet need for spacing and limiting was 4.9 and 22.5 per cent, respectively. Among those with unmet need (n=73), 50 per cent reported client related factors (lack of knowledge, shyness, etc.); and 37 per cent reported contraception related factors (availability, accessibility, affordability, side effects) as a cause for unmet need. Our study showed a high unmet need for contraception in the study area indicating towards a necessity to address user perspective to meet the contraception needs.

Testing Models of Stellar Structure and Evolution I. Comparison with Detached Eclipsing Binaries

NASA Astrophysics Data System (ADS)

del Burgo, C.; Allende Prieto, C.

2018-05-01

We present the results of an analysis aimed at testing the accuracy and precision of the PARSEC v1.2S library of stellar evolution models, combined with a Bayesian approach, to infer stellar parameters. We mainly employ the online DEBCat catalogue by Southworth, a compilation of detached eclipsing binary systems with published measurements of masses and radii to ˜ 2 per cent precision. We select a sample of 318 binary components, with masses between 0.10 and 14.5 solar units, and distances between 1.3 pc and ˜ 8 kpc for Galactic objects and ˜ 44-68 kpc for the extragalactic ones. The Bayesian analysis applied takes on input effective temperature, radius, and [Fe/H], and their uncertainties, returning theoretical predictions for other stellar parameters. From the comparison with dynamical masses, we conclude inferred masses are precisely derived for stars on the main-sequence and in the core-helium-burning phase, with respective uncertainties of 4 per cent and 7 per cent, on average. Subgiants and red giants masses are predicted within 14 per cent, and early asymptotic giant branch stars within 24 per cent. These results are helpful to further improve the models, in particular for advanced evolutionary stages for which our understanding is limited. We obtain distances and ages for the binary systems and compare them, whenever possible, with precise literature estimates, finding excellent agreement. We discuss evolutionary effects and the challenges associated with the inference of stellar ages from evolutionary models. We also provide useful polynomial fittings to theoretical zero-age main-sequence relations.

Appointment standardization evaluation in a primary care facility.

PubMed

Huang, Yu-Li

2016-07-11

Purpose - The purpose of this paper is to evaluate the performance on standardizing appointment slot length in a primary care clinic to understand the impact of providers' preferences and practice differences. Design/methodology/approach - The treatment time data were collected for each provider. There were six patient types: emergency/urgent care (ER/UC), follow-up patient (FU), new patient, office visit (OV), physical exam, and well-child care. Simulation model was developed to capture patient flow and measure patient wait time, provider idle time, cost, overtime, finish time, and the number of patients scheduled. Four scheduling scenarios were compared: scheduled all patients at 20 minutes; scheduled ER/UC, FU, OV at 20 minutes and others at 40 minutes; scheduled patient types on individual provider preference; and scheduled patient types on combined provider preference. Findings - Standardized scheduling among providers increase cost by 57 per cent, patient wait time by 83 per cent, provider idle time by five minutes per patient, overtime by 22 minutes, finish time by 30 minutes, and decrease patient access to care by approximately 11 per cent. An individualized scheduling approach could save as much as 14 per cent on cost and schedule 1.5 more patients. The combined preference method could save about 8 per cent while the number of patients scheduled remained the same. Research limitations/implications - The challenge is to actually disseminate the findings to medical providers and adjust scheduling systems accordingly. Originality/value - This paper concluded standardization of providers' clinic preference and practice negatively impact clinic service quality and access to care.

Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis.

PubMed

Fong, E; Garcia, M; Woods, C M; Ooi, E

2017-01-01

Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery. Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes. Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37-0.72). Hyaluronic acid use was not associated with any significant adverse events. Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.

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.

Velocity variations and uncertainty from transdimensional P-wave tomography of North America

NASA Astrophysics Data System (ADS)

Burdick, Scott; Lekić, Vedran

2017-05-01

High-resolution models of seismic velocity variations constructed using body-wave tomography inform the study of the origin, fate and thermochemical state of mantle domains. In order to reliably relate these variations to material properties including temperature, composition and volatile content, we must accurately retrieve both the patterns and amplitudes of variations and quantify the uncertainty associated with the estimates of each. For these reasons, we image the mantle beneath North America with P-wave traveltimes from USArray using a novel method for 3-D probabilistic body-wave tomography. The method uses a Transdimensional Hierarchical Bayesian framework with a reversible-jump Markov Chain Monte Carlo algorithm in order to generate an ensemble of possible velocity models. We analyse this ensemble solution to obtain the posterior probability distribution of velocities, thereby yielding error bars and enabling rigorous hypothesis testing. Overall, we determine that the average uncertainty (1σ) of compressional wave velocity estimates beneath North America is ∼0.25 per cent dVP/VP, increasing with proximity to complex structure and decreasing with depth. The addition of USArray data reduces the uncertainty beneath the Eastern US by over 50 per cent in the upper mantle and 25-40 per cent below the transition zone and ∼30 per cent throughout the mantle beneath the Western US. In the absence of damping and smoothing, we recover amplitudes of variations 10-80 per cent higher than a standard inversion approach. Accounting for differences in data coverage, we infer that the length scale of heterogeneity is ∼50 per cent longer at shallow depths beneath the continental platform than beneath tectonically active regions. We illustrate the model trade-off analysis for the Cascadia slab and the New Madrid Seismic Zone, where we find that smearing due to the limitations of the illumination is relatively minor.

The origins of post-starburst galaxies at z < 0.05

NASA Astrophysics Data System (ADS)

Pawlik, M. M.; Taj Aldeen, L.; Wild, V.; Mendez-Abreu, J.; Lahén, N.; Johansson, P. H.; Jimenez, N.; Lucas, W.; Zheng, Y.; Walcher, C. J.; Rowlands, K.

2018-06-01

Post-starburst galaxies can be identified via the presence of prominent Hydrogen Balmer absorption lines in their spectra. We present a comprehensive study of the origin of strong Balmer lines in a volume-limited sample of 189 galaxies with 0.01 < z < 0.05, log ({M}_{\\star }/{M}_{⊙})>9.5 and projected axial ratio b/a > 0.32. We explore their structural properties, environments, emission lines, and star formation histories, and compare them to control samples of star-forming and quiescent galaxies, and simulated galaxy mergers. Excluding contaminants, in which the strong Balmer lines are most likely caused by dust-star geometry, we find evidence for three different pathways through the post-starburst phase, with most events occurring in intermediate-density environments: (1) a significant disruptive event, such as a gas-rich major merger, causing a starburst and growth of a spheroidal component, followed by quenching of the star formation (70 per cent of post-starburst galaxies at 9.5< log ({M}_{\\star}/{M}_{⊙})<10.5 and 60 per cent at log ({M}_{\\star}/{M}_{⊙})>10.5); (2) at 9.5< log ({M}_{\\star}/{M}_{⊙})<10.5, stochastic star formation in blue-sequence galaxies, causing a weak burst and subsequent return to the blue sequence (30 per cent); (3) at log ({M}_{\\star}/{M}_{⊙})>10.5, cyclic evolution of quiescent galaxies which gradually move towards the high-mass end of the red sequence through weak starbursts, possibly as a result of a merger with a smaller gas-rich companion (40 per cent). Our analysis suggests that active galactic nuclei (AGNs) are 'on' for 50 per cent of the duration of the post-starburst phase, meaning that traditional samples of post-starburst galaxies with strict emission-line cuts will be at least 50 per cent incomplete due to the exclusion of narrow-line AGNs.

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)

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.

Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 4: clinical factor.

PubMed

Alexander, G; Hopcraft, M S; Tyas, M J; Wong, Rhk

2017-09-01

The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury-containing products and processes, including a phase-down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists' decision-making which may be of use when determining the impact of any change. An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed. There were 408 respondents to the survey. Eighty-seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty-three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place. There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non-users of amalgam with respect to these findings. © 2017 Australian Dental Association.

Spring clip sterilization: one-year follow-up of 1,079 cases.

PubMed

Hulka, J F; Mercer, J P; Fishburne, J I; Kumarasamy, T; Omran, K F; Phillips, J M; Lefler, H T; Lieberman, B; Lean, T H; Pai, D N; Koetsawang, S; Castro, M V

1976-08-15

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

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.

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.

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.

Pharmacokinetics of ivermectin in llamas (Lama glama).

PubMed

Jarvinen, J A; Miller, J A; Oehler, D D

2002-03-16

The pharmacokinetic behaviour of ivermectin was investigated in adult llamas (Lama glama) by using high performance liquid chromatography with a lower limit of quantification of 2 ng/ml to measure its concentration in serum. Llamas were treated with one of three commercial formulations (injectable, pour-on or oral paste) at dosages recommended by the manufacturer, or with an experimental injectable sustained-release formulation. In five llamas given 1 per cent ivermectin subcutaneously at 200 microg/kg, the median peak serum concentration (Cmax) was 3 ng/ml and the area under the serum concentration-time curve (AUC) was 13.5 ng x day/ml. In six llamas treated topically with 0.5 per cent ivermedin pour-on at 500 microg/kg, Cmax was 2.5 ng/ml or less and the AUC was 7.75 ng x day/ml or less. In seven llamas with measurable concentrations of ivermedin, the median times to peak serum concentration (tmax) were six days after subcutaneous injection and seven days after treatment with the pour-on formulation. In six llamas, the serum concentration of ivermectin remained less than 2 ng/ml for 124 hours after treatment with a 1.87 per cent oral paste at 200 microg/kg. In five llamas treated subcutaneously with 25 per cent ivermectin sustained-release microspheres at 1500 microg/kg, the median Cmax was 5 ng/ml and the median AUC was 224 ng x day/ml.

Environmental health survey in asbestos cement sheets manufacturing industry.

PubMed

Ansari, F A; Bihari, V; Rastogi, S K; Ashquin, M; Ahmad, I

2007-01-01

About 673 small-scale asbestos mining and milling facilities and 33 large - scale asbestos manufacturing plants, (17 asbestos-cement product manufacturing plants and 16 other than asbestos-cement product plants) are situated in India. The present study reveals the exposure of commercial asbestos (chrysotile) in the occupational as well as ambient air environment of the asbestos-cement (AC) sheets industry using membrane filter method of Bureau of Indian Standards (BIS). The fibre concentrations in 15 samples collected in the occupational environment at ingredient feeding site, sheet-producing site, fibre godown were 0.079, 0.057 and 0.078 f/cc, respectively and in five samples from surrounding ambient air at factory gate resulted fibre concentration of 0.071 f/cc. All the samples have shown fibre concentration lower than the threshold limit values (TLVs) prescribed by BIS. Morphological analysis of samples, further under phase contrast and polarized microscopy indicates the presence of chrysotile asbestos, which acts as carcinogen as well as co-carcinogen. A clinical examination of exposed subjects reveals that there was no case of clubbing, crepitation, ronchi and dyspnea on exertion; however, obstruction and restriction were 10.9 per cent and 25 per cent in exposed subjects, respectively while in control there were 12 per cent and 28 per cent, respectively. The study revealed that chrysotile asbestos is emitted in the occupational as well as ambient environment that may cause adverse health impact.

Evaluation of serum free thyroxine and thyrotropin concentrations in the diagnosis of canine hypothyroidism.

PubMed

Dixon, R M; Mooney, C T

1999-02-01

Canine thyroid-stimulating hormone (cTSH), total thyroxine (T4) and free T4 by equilibrium dialysis (fT4d) were measured in serum samples from 107 dogs with clinical signs suggestive of hypothyroidism in which the diagnosis was either confirmed (n = 30) or excluded (n = 77) by exogenous TSH response testing. Median serum total T4 and fT4d concentrations were significantly lower and cTSH significantly higher (P < 0.001) in hypothyroid compared with euthyroid dogs. Differential positive rate analysis determined optimal cut-off values of less than 14.9 nmol/litre (total T4), less than 5.42 pmol/litre (fT4d), greater than 0.68 ng/ml (cTSH), less than 17.3 (T4 to cTSH ratio), and less than 7.5 (fT4d to cTSH ratio) for hypothyroidism. These had a sensitivity and specificity of 100 and 75.3 per cent, 80 and 93.5 per cent, 86.7 and 81.8 per cent, 86.7 and 92.2 per cent, and 80 and 97.4 per cent, respectively, for diagnosing hypothyroidism. Corresponding areas under the receiver operating characteristic curves were 0.92, 0.93, 0.87, 0.93 and 0.93. Unexpectedly low cTSH values in hypothyroid dogs may have resulted from concurrent non-thyroidal illness. Unexpectedly high serum cTSH values in the euthyroid dogs might have resulted from recovery from illness or concurrent potentiated sulphonamide therapy. Measurement of endogenous cTSH concentration is a valuable diagnostic tool for canine hypothyroidism if used in association with assessment of T4. Estimation of fT4d added only limited additional information over total T4 measurement.

The Large Area Radio Galaxy Evolution Spectroscopic Survey (LARGESS): survey design, data catalogue and GAMA/WiggleZ spectroscopy

NASA Astrophysics Data System (ADS)

Ching, John H. Y.; Sadler, Elaine M.; Croom, Scott M.; Johnston, Helen M.; Pracy, Michael B.; Couch, Warrick J.; Hopkins, A. M.; Jurek, Russell J.; Pimbblet, K. A.

2017-01-01

We present the Large Area Radio Galaxy Evolution Spectroscopic Survey (LARGESS), a spectroscopic catalogue of radio sources designed to include the full range of radio AGN populations out to redshift z ˜ 0.8. The catalogue covers ˜800 deg2 of sky, and provides optical identifications for 19 179 radio sources from the 1.4 GHz Faint Images of the Radio Sky at Twenty-cm (FIRST) survey down to an optical magnitude limit of Imod < 20.5 in Sloan Digital Sky Survey (SDSS) images. Both galaxies and point-like objects are included, and no colour cuts are applied. In collaboration with the WiggleZ and Galaxy And Mass Assembly (GAMA) spectroscopic survey teams, we have obtained new spectra for over 5000 objects in the LARGESS sample. Combining these new spectra with data from earlier surveys provides spectroscopic data for 12 329 radio sources in the survey area, of which 10 856 have reliable redshifts. 85 per cent of the LARGESS spectroscopic sample are radio AGN (median redshift z = 0.44), and 15 per cent are nearby star-forming galaxies (median z = 0.08). Low-excitation radio galaxies (LERGs) comprise the majority (83 per cent) of LARGESS radio AGN at z < 0.8, with 12 per cent being high-excitation radio galaxies (HERGs) and 5 per cent radio-loud QSOs. Unlike the more homogeneous LERG and QSO sub-populations, HERGs are a heterogeneous class of objects with relatively blue optical colours and a wide dispersion in mid-infrared colours. This is consistent with a picture in which most HERGs are hosted by galaxies with recent or ongoing star formation as well as a classical accretion disc.

The JCMT Plane Survey: first complete data release - emission maps and compact source catalogue

NASA Astrophysics Data System (ADS)

Eden, D. J.; Moore, T. J. T.; Plume, R.; Urquhart, J. S.; Thompson, M. A.; Parsons, H.; Dempsey, J. T.; Rigby, A. J.; Morgan, L. K.; Thomas, H. S.; Berry, D.; Buckle, J.; Brunt, C. M.; Butner, H. M.; Carretero, D.; Chrysostomou, A.; Currie, M. J.; deVilliers, H. M.; Fich, M.; Gibb, A. G.; Hoare, M. G.; Jenness, T.; Manser, G.; Mottram, J. C.; Natario, C.; Olguin, F.; Peretto, N.; Pestalozzi, M.; Polychroni, D.; Redman, R. O.; Salji, C.; Summers, L. J.; Tahani, K.; Traficante, A.; diFrancesco, J.; Evans, A.; Fuller, G. A.; Johnstone, D.; Joncas, G.; Longmore, S. N.; Martin, P. G.; Richer, J. S.; Weferling, B.; White, G. J.; Zhu, M.

2017-08-01

We present the first data release of the James Clerk Maxwell Telescope Plane Survey (JPS), the JPS Public Release 1. JPS is an 850-μm continuum survey of six fields in the northern inner Galactic plane in a longitude range of ℓ = 7°-63°, made with the Submillimetre Common-User Bolometer Array 2. This first data release consists of emission maps of the six JPS regions with an average pixel-to-pixel noise of 7.19 mJy beam-1, when smoothed over the beam, and a compact source catalogue containing 7813 sources. The 95 per cent completeness limits of the catalogue are estimated at 0.04 Jy beam-1 and 0.3 Jy for the peak and integrated flux densities, respectively. The emission contained in the compact source catalogue is 42 ± 5 per cent of the total and, apart from the large-scale (greater than 8 arcmin) emission, there is excellent correspondence with features in the 500-μm Herschel maps. We find that, with two-dimensional matching, 98 ± 2 per cent of sources within the fields centred at ℓ = 20°, 30°, 40° and 50° are associated with molecular clouds, with 91 ± 3 per cent of the ℓ = 30° and 40° sources associated with dense molecular clumps. Matching the JPS catalogue to Herschel 70-μm sources, we find that 38 ± 1 per cent of sources show evidence of ongoing star formation. The JPS Public Release 1 images and catalogue will be a valuable resource for studies of star formation in the Galaxy and the role of environment and spiral arms in the star formation process.

An evaluation of bubble-CPAP in a neonatal unit in a developing country: effective respiratory support that can be applied by nurses.

PubMed

Koyamaibole, Lanieta; Kado, Joseph; Qovu, Josaia D; Colquhoun, Samantha; Duke, Trevor

2006-08-01

To describe the implementation of bubble-CPAP in a referral hospital in a developing country and to investigate: the feasibility of nurses implementing bubble-CPAP and the impact of bubble-CPAP on need for mechanical ventilation and mortality. Retrospective evaluation of prospectively collected data from two time periods: 18 months before and 18 months after the introduction of bubble-CPAP. The introduction of bubble-CPAP was associated with a 50 per cent reduction in the need for mechanical ventilation; from 113 of 1,106 (10.2 per cent) prior to bubble-CPAP to 70 of 1,382 (5.1%) after introduction of CPAP (chi2, p<0.001). In the 18 months prior to bubble-CPAP there were 79 deaths (case fatality of 7.1 per cent). In the 18 months after bubble-CPAP there were 74 deaths (CF 5.4 per cent), relative risk: 0.75 (0.55-1.02, chi2, p=0.065). Nurses could safely apply bubble-CPAP after 1-2 months of on-the-job training. Equipment for Bubble-CPAP cost 15 per cent of the cost of the cheapest mechanical ventilator. The introduction of bubble-CPAP substantially reduced the need for mechanical ventilation, with no difference in mortality. In models of neonatal care for resource-limited countries, bubble-CPAP may be the first type of ventilatory support that is recommended. Its low cost and safety when administered by nurses makes it ideal for this purpose. Bubble-CPAP has the potential for being available at even lower cost than the current commercially available bubble systems used in this study.

Treatment of ocean tide aliasing in the context of a next generation gravity field mission

NASA Astrophysics Data System (ADS)

Hauk, Markus; Pail, Roland

2018-04-01

Current temporal gravity field solutions from GRACE suffer from temporal aliasing errors due to under-sampling of signal to be recovered (e.g. hydrology), uncertainties in the de-aliasing models (usually atmosphere and ocean), and imperfect ocean tide models. Especially the latter will be one of the most limiting factors in determining high resolution temporal gravity fields from future gravity missions such as GRACE Follow-on and Next-Generation Gravity Missions (NGGM). In this paper a method to co-parameterize ocean tide parameters of the 8 main tidal constituents over time spans of several years is analysed and assessed. Numerical closed-loop simulations of low-low satellite-to-satellite-tracking missions for a single polar pair and a double pair Bender-type formation are performed, using time variable geophysical background models and noise assumptions for new generation instrument technology. Compared to the single pair mission, results show a reduction of tide model errors up to 70 per cent for dedicated tidal constituents due to an enhanced spatial and temporal sampling and error isotropy for the double pair constellation. Extending the observation period from one to three years leads to a further reduction of tidal errors up to 60 per cent for certain constituents, and considering non-tidal mass changes during the estimation process leads to reductions of tidal errors between 20 per cent and 80 per cent. As part of a two-step approach, the estimated tide model is used for de-aliasing during gravity field retrieval in a second iteration, resulting in more than 50 per cent reduction of ocean tide aliasing errors for a NGGM Bender-type formation.

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

Combining Dark Energy Survey Science Verification data with near-infrared data from the ESO VISTA Hemisphere Survey

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

Banerji, M.; Jouvel, S.; Lin, H.

2014-11-25

We present the combination of optical data from the Science Verification phase of the Dark Energy Survey (DES) with near-infrared (NIR) data from the European Southern Observatory VISTA Hemisphere Survey (VHS). The deep optical detections from DES are used to extract fluxes and associated errors from the shallower VHS data. Joint seven-band ( grizYJK) photometric catalogues are produced in a single 3 sq-deg dedicated camera field centred at 02h26m-04d36m where the availability of ancillary multiwavelength photometry and spectroscopy allows us to test the data quality. Dual photometry increases the number of DES galaxies with measured VHS fluxes by a factormore » of ~4.5 relative to a simple catalogue level matching and results in a ~1.5 mag increase in the 80 per cent completeness limit of the NIR data. Almost 70 per cent of DES sources have useful NIR flux measurements in this initial catalogue. Photometric redshifts are estimated for a subset of galaxies with spectroscopic redshifts and initial results, although currently limited by small number statistics, indicate that the VHS data can help reduce the photometric redshift scatter at both z < 0.5 and z > 1. We present example DES+VHS colour selection criteria for high-redshift luminous red galaxies (LRGs) at z ~ 0.7 as well as luminous quasars. Using spectroscopic observations in this field we show that the additional VHS fluxes enable a cleaner selection of both populations with <10 per cent contamination from galactic stars in the case of spectroscopically confirmed quasars and <0.5 per cent contamination from galactic stars in the case of spectroscopically confirmed LRGs. The combined DES+VHS data set, which will eventually cover almost 5000 sq-deg, will therefore enable a range of new science and be ideally suited for target selection for future wide-field spectroscopic surveys.« less

Combining Dark Energy Survey Science Verification data with near-infrared data from the ESO VISTA Hemisphere Survey

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

Banerji, M.; Jouvel, S.; Lin, H.

2014-11-25

We present the combination of optical data from the Science Verification phase of the Dark Energy Survey (DES) with near-infrared (NIR) data from the European Southern Observatory VISTA Hemisphere Survey (VHS). The deep optical detections from DES are used to extract fluxes and associated errors from the shallower VHS data. Joint seven-band (grizYJK) photometric catalogues are produced in a single 3 sq-deg dedicated camera field centred at 02h26m-04d36m where the availability of ancillary multiwavelength photometry and spectroscopy allows us to test the data quality. Dual photometry increases the number of DES galaxies with measured VHS fluxes by a factor ofmore » similar to 4.5 relative to a simple catalogue level matching and results in a similar to 1.5 mag increase in the 80 per cent completeness limit of the NIR data. Almost 70 per cent of DES sources have useful NIR flux measurements in this initial catalogue. Photometric redshifts are estimated for a subset of galaxies with spectroscopic redshifts and initial results, although currently limited by small number statistics, indicate that the VHS data can help reduce the photometric redshift scatter at both z < 0.5 and z > 1. We present example DES VHS colour selection criteria for high-redshift luminous red galaxies (LRGs) at z similar to 0.7 as well as luminous quasars. Using spectroscopic observations in this field we show that the additional VHS fluxes enable a cleaner selection of both populations with <10 per cent contamination from galactic stars in the case of spectroscopically confirmed quasars and <0.5 per cent contamination from galactic stars in the case of spectroscopically confirmed LRGs. The combined DES+VHS data set, which will eventually cover almost 5000 sq-deg, will therefore enable a range of new science and be ideally suited for target selection for future wide-field spectroscopic surveys.« less

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.

Search for Majorana neutrinos with the first two years of EXO-200 data

NASA Astrophysics Data System (ADS)

The Exo-200 Collaboration; Albert, J. B.; Auty, D. J.; Barbeau, P. S.; Beauchamp, E.; Beck, D.; Belov, V.; Benitez-Medina, C.; Bonatt, J.; Breidenbach, M.; Brunner, T.; Burenkov, A.; Cao, G. F.; Chambers, C.; Chaves, J.; Cleveland, B.; Coon, M.; Craycraft, A.; Daniels, T.; Danilov, M.; Daugherty, S. J.; Davis, C. G.; Davis, J.; Devoe, R.; Delaquis, S.; Didberidze, T.; Dolgolenko, A.; Dolinski, M. J.; Dunford, M.; Fairbank, W., Jr.; Farine, J.; Feldmeier, W.; Fierlinger, P.; Fudenberg, D.; Giroux, G.; Gornea, R.; Graham, K.; Gratta, G.; Hall, C.; Herrin, S.; Hughes, M.; Jewell, M. J.; Jiang, X. S.; Johnson, A.; Johnson, T. N.; Johnston, S.; Karelin, A.; Kaufman, L. J.; Killick, R.; Koffas, T.; Kravitz, S.; Kuchenkov, A.; Kumar, K. S.; Leonard, D. S.; Leonard, F.; Licciardi, C.; Lin, Y. H.; MacLellan, R.; Marino, M. G.; Mong, B.; Moore, D.; Nelson, R.; Odian, A.; Ostrovskiy, I.; Ouellet, C.; Piepke, A.; Pocar, A.; Prescott, C. Y.; Rivas, A.; Rowson, P. C.; Rozo, M. P.; Russell, J. J.; Schubert, A.; Sinclair, D.; Slutsky, S.; Smith, E.; Stekhanov, V.; Tarka, M.; Tolba, T.; Tosi, D.; Twelker, K.; Vogel, P.; Vuilleumier, J.-L.; Waite, A.; Walton, J.; Walton, T.; Weber, M.; Wen, L. J.; Wichoski, U.; Wright, J. D.; Yang, L.; Yen, Y.-R.; Ya. Zeldovich, O.; Zhao, Y. B.

2014-06-01

Many extensions of the standard model of particle physics suggest that neutrinos should be Majorana-type fermions--that is, that neutrinos are their own anti-particles--but this assumption is difficult to confirm. Observation of neutrinoless double-β decay (0νββ), a spontaneous transition that may occur in several candidate nuclei, would verify the Majorana nature of the neutrino and constrain the absolute scale of the neutrino mass spectrum. Recent searches carried out with 76Ge (the GERDA experiment) and 136Xe (the KamLAND-Zen and EXO (Enriched Xenon Observatory)-200 experiments) have established the lifetime of this decay to be longer than 1025 years, corresponding to a limit on the neutrino mass of 0.2-0.4 electronvolts. Here we report new results from EXO-200 based on a large 136Xe exposure that represents an almost fourfold increase from our earlier published data sets. We have improved the detector resolution and revised the data analysis. The half-life sensitivity we obtain is 1.9 × 1025 years, an improvement by a factor of 2.7 on previous EXO-200 results. We find no statistically significant evidence for 0νββ decay and set a half-life limit of 1.1 × 1025 years at the 90 per cent confidence level. The high sensitivity holds promise for further running of the EXO-200 detector and future 0νββ decay searches with an improved Xe-based experiment, nEXO.

Supernova progenitors, their variability and the Type IIP Supernova ASASSN-16fq in M66

NASA Astrophysics Data System (ADS)

Kochanek, C. S.; Fraser, M.; Adams, S. M.; Sukhbold, T.; Prieto, J. L.; Müller, T.; Bock, G.; Brown, J. S.; Dong, Subo; Holoien, T. W.-S.; Khan, R.; Shappee, B. J.; Stanek, K. Z.

2017-05-01

We identify a pre-explosion counterpart to the nearby Type IIP supernova ASASSN-16fq (SN 2016cok) in archival Hubble Space Telescope data. The source appears to be a blend of several stars that prevents obtaining accurate photometry. However, with reasonable assumptions about the stellar temperature and extinction, the progenitor almost certainly had an initial mass M* ≲ 17 M⊙, and was most likely in the mass range of M* = 8-12 M⊙. Observations once ASASSN-16fq has faded will have no difficulty accurately determining the properties of the progenitor. In 8 yr of Large Binocular Telescope (LBT) data, no significant progenitor variability is detected to rms limits of roughly 0.03 mag. Of the six nearby supernova (SN) with constraints on the low-level variability, SN 1987A, SN 1993J, SN 2008cn, SN 2011dh, SN 2013ej and ASASSN-16fq, only the slowly fading progenitor of SN 2011dh showed clear evidence of variability. Excluding SN 1987A, the 90 per cent confidence limit implied by these sources on the number of outbursts over the last decade before the SN that last longer than 0.1 yr (full width at half-maximum) and are brighter than MR < -8 mag is approximately Nout ≲ 3. Our continuing LBT monitoring programme will steadily improve constraints on pre-SN progenitor variability at amplitudes far lower than achievable by SN surveys.

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.

Impacts and mitigation of excess diesel-related NOx emissions in 11 major vehicle markets

NASA Astrophysics Data System (ADS)

Anenberg, Susan C.; Miller, Joshua; Minjares, Ray; Du, Li; Henze, Daven K.; Lacey, Forrest; Malley, Christopher S.; Emberson, Lisa; Franco, Vicente; Klimont, Zbigniew; Heyes, Chris

2017-05-01

Vehicle emissions contribute to fine particulate matter (PM2.5) and tropospheric ozone air pollution, affecting human health, crop yields and climate worldwide. On-road diesel vehicles produce approximately 20 per cent of global anthropogenic emissions of nitrogen oxides (NOx), which are key PM2.5 and ozone precursors. Regulated NOx emission limits in leading markets have been progressively tightened, but current diesel vehicles emit far more NOx under real-world operating conditions than during laboratory certification testing. Here we show that across 11 markets, representing approximately 80 per cent of global diesel vehicle sales, nearly one-third of on-road heavy-duty diesel vehicle emissions and over half of on-road light-duty diesel vehicle emissions are in excess of certification limits. These excess emissions (totalling 4.6 million tons) are associated with about 38,000 PM2.5- and ozone-related premature deaths globally in 2015, including about 10 per cent of all ozone-related premature deaths in the 28 European Union member states. Heavy-duty vehicles are the dominant contributor to excess diesel NOx emissions and associated health impacts in almost all regions. Adopting and enforcing next-generation standards (more stringent than Euro 6/VI) could nearly eliminate real-world diesel-related NOx emissions in these markets, avoiding approximately 174,000 global PM2.5- and ozone-related premature deaths in 2040. Most of these benefits can be achieved by implementing Euro VI standards where they have not yet been adopted for heavy-duty vehicles.

The 2-24 μm source counts from the AKARI North Ecliptic Pole survey

NASA Astrophysics Data System (ADS)

Murata, K.; Pearson, C. P.; Goto, T.; Kim, S. J.; Matsuhara, H.; Wada, T.

2014-11-01

We present herein galaxy number counts of the nine bands in the 2-24 μm range on the basis of the AKARI North Ecliptic Pole (NEP) surveys. The number counts are derived from NEP-deep and NEP-wide surveys, which cover areas of 0.5 and 5.8 deg2, respectively. To produce reliable number counts, the sources were extracted from recently updated images. Completeness and difference between observed and intrinsic magnitudes were corrected by Monte Carlo simulation. Stellar counts were subtracted by using the stellar fraction estimated from optical data. The resultant source counts are given down to the 80 per cent completeness limit; 0.18, 0.16, 0.10, 0.05, 0.06, 0.10, 0.15, 0.16 and 0.44 mJy in the 2.4, 3.2, 4.1, 7, 9, 11, 15, 18 and 24 μm bands, respectively. On the bright side of all bands, the count distribution is flat, consistent with the Euclidean universe, while on the faint side, the counts deviate, suggesting that the galaxy population of the distant universe is evolving. These results are generally consistent with previous galaxy counts in similar wavebands. We also compare our counts with evolutionary models and find them in good agreement. By integrating the models down to the 80 per cent completeness limits, we calculate that the AKARI NEP survey revolves 20-50 per cent of the cosmic infrared background, depending on the wavebands.

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

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.

Array automated assembly task, phase 2. Low cost silicon solar array project

NASA Technical Reports Server (NTRS)

Rhee, S. S.; Jones, G. T.; Allison, K. T.

1978-01-01

Several modifications instituted in the wafer surface preparation process served to significantly reduce the process cost to 1.55 cents per peak watt in 1975 cents. Performance verification tests of a laser scanning system showed a limited capability to detect hidden cracks or defects, but with potential equipment modifications this cost effective system could be rendered suitable for applications. Installation of electroless nickel plating system was completed along with an optimization of the wafer plating process. The solder coating and flux removal process verification test was completed. An optimum temperature range of 500-550 C was found to produce uniform solder coating with the restriction that a modified dipping procedure is utilized. Finally, the construction of the spray-on dopant equipment was completed.

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.

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.

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.

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

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.

Reducing the width of confidence intervals for the difference between two population means by inverting adaptive tests.

PubMed

O'Gorman, Thomas W

2018-05-01

In the last decade, it has been shown that an adaptive testing method could be used, along with the Robbins-Monro search procedure, to obtain confidence intervals that are often narrower than traditional confidence intervals. However, these confidence interval limits require a great deal of computation and some familiarity with stochastic search methods. We propose a method for estimating the limits of confidence intervals that uses only a few tests of significance. We compare these limits to those obtained by a lengthy Robbins-Monro stochastic search and find that the proposed method is nearly as accurate as the Robbins-Monro search. Adaptive confidence intervals that are produced by the proposed method are often narrower than traditional confidence intervals when the distributions are long-tailed, skewed, or bimodal. Moreover, the proposed method of estimating confidence interval limits is easy to understand, because it is based solely on the p-values from a few tests of significance.

Reclaiming "Sense" from "Cents" in Accounting Education

ERIC Educational Resources Information Center

Dellaportas, Steven

2015-01-01

This essay adopts an interpretive methodology of relevant literature to explore the limitations of accounting education when it is taught purely as a technical practice. The essay proceeds from the assumption that conventional accounting education is captured by a positivistic neo-classical model of decision-making that draws on economic rationale…

Mobility impairment is associated with urge but not stress urinary incontinence in community-dwelling older women: results from the Ossébo study.

PubMed

Fritel, X; Lachal, L; Cassou, B; Fauconnier, A; Dargent-Molina, P

2013-11-01

To assess the association between functional limitations related to mobility and urinary incontinence (UI) in elderly women. An observational cross-sectional study. Nine 'balance' workshops in France. A total of 1942 community-dwelling women aged 75-85 years, who were invited, based on voter registration lists, to a 'balance assessment'. Mobility and balance test results for incontinent women were compared with those for continent women according to the severity and type of incontinence. Data on UI were collected using a self-administered questionnaire (International Consultation on Incontinence Questionnaire-Short Form). Motor-related physical abilities were assessed using standardised balance and functional gait tests. Forty-two per cent of women had involuntary urine leakage, with daily leaks in 57% of them; 24% had stress UI, 31% had urge UI, and 37% had mixed UI. Results for each functional test were poorer for women with UI and the limitation was more pronounced when the incontinence was severe. Multivariate logistic regression analyses showed that balance and gait impairments were significantly and independently associated with urge UI (walking speed, lower versus higher quartile, odds ratio (OR) 2.2; 95% confidence interval (95% CI) 1.4-3.5; walking balance, unable versus able to do four tandem steps (OR 1.6; 95% CI 1.2-2.2) but not with stress UI. In this large population of older women living at home, there was a strong association between limitation of motor and balance skills and UI, which was proportional to the severity of incontinence and related specifically to urge incontinence. These results offer new perspectives on the prevention and treatment of urge incontinence in elderly women. © 2013 RCOG.

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.

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.

Two-way Coupling of a Process-Based Crop Growth Model (BioCro) and a Biogeochemistry Model (DayCent) and its Application to an Energy Crop Site in the mid-west USA

NASA Astrophysics Data System (ADS)

Jaiswal, D.; Long, S.; Parton, W. J.; Hartman, M.

2012-12-01

A coupled modeling system of crop growth model (BioCro) and biogeochemical model (DayCent) has been developed to assess the two-way interactions between plant growth and biogeochemistry. Crop growth in BioCro is simulated using a detailed mechanistic biochemical and biophysical multi-layer canopy model and partitioning of dry biomass into different plant organs according to phenological stages. Using hourly weather records, the model partitions light between dynamically changing sunlit and shaded portions of the canopy and computes carbon and water exchange with the atmosphere and through the canopy for each hour of the day, each day of the year. The model has been parameterized for the bioenergy crops sugarcane, Miscanthus and switchgrass, and validation has shown it to predict growth cycles and partitioning of biomass to a high degree of accuracy. As such it provides an ideal input for a soil biogeochemical model. DayCent is an established model for predicting long-term changes in soil C & N and soil-atmosphere exchanges of greenhouse gases. At present, DayCent uses a relatively simple productivity model. In this project BioCro has replaced this simple model to provide DayCent with a productivity and growth model equal in detail to its biogeochemistry. Dynamic coupling of these two models to produce CroCent allows for differential C: N ratios of litter fall (based on rates of senescence of different plant organs) and calibration of the model for realistic plant productivity in a mechanistic way. A process-based approach to modeling plant growth is needed for bioenergy crops because research on these crops (especially second generation feedstocks) has started only recently, and detailed agronomic information for growth, yield and management is too limited for effective empirical models. The coupled model provides means to test and improve the model against high resolution data, such as that obtained by eddy covariance and explore yield implications of different crop and soil management.

Reducing inappropriate non-steroidal anti-inflammatory prescription in primary care patients with chronic kidney disease.

PubMed

Keohane, David M; Dennehy, Thomas; Keohane, Kenneth P; Shanahan, Eamonn

2017-08-14

Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor. This group was refined to include those with an estimated glomerular filtration rate (eGFR)<60 ml/min per 1.73m2 (stage 3 CKD or greater). Phase one analysed how many prescriptions had occurred in this group over the preceding three months. The intervention involved creating an automated alert on at risk patient records if non-steroidal anti-inflammatories were prescribed and discussing the rationale with practice staff. The re-audit phase occurred three months' post intervention. Findings The study revealed 728/7,500 (9.7 per cent) patients at risk from CKD and 158 (2.1 per cent) who were subsequently found to have an eGFR<60 ml/min, indicating=stage 3 CKD. In phase one, 10.2 per cent of at risk patients had received a non-steroidal anti-inflammatory prescription in the preceding three months. Additionally, 6.2 per cent had received non-steroidal anti-inflammatories on repeat prescription. Phase two post intervention revealed a significant 75 per cent reduction in the total non-steroidal anti-inflammatories prescribed and a 90 per cent reduction in repeat non-steroidal anti-inflammatory prescriptions in those with CKD. Originality/value The study significantly reduced non-steroidal anti-inflammatory prescription in those with CKD in primary care settings. It also created a CKD register within the practice and an enduring medication alert system for individuals that risk nephrotoxic non-steroidal anti-inflammatory prescription. It established a safe, reliable and efficient process for reducing morbidity and mortality, improving quality of life and limiting the CKD associated health burden.

Ageing in India--an overview.

PubMed

Kumar, V

1997-10-01

Accelerated population ageing experienced in the last few decades is an unprecedented phenomenon. Currently, this is more in the developing countries. Soon three-fourths of the elderly will be in the developing world. From 1990 to 2025, the elderly population in Asia will rise from 50 per cent of the world's elderly to 58 per cent, in Africa and Latin America from 5 to 7 per cent, but in Europe the figure will drop from 19 to 12 per cent of the world's elderly. The life span has increased in India from 32 yr in 1947 to more than 62 yr now. From the morbidity point of view, almost 50 per cent of the Indian elderly have chronic diseases and 5 per cent suffer from immobility. There are several vulnerable groups and a big disadvantaged lot are elderly females who are one of the fastest growing segments, which will increase to become 4 times the current figure, by 2025. In spite of professional disinterest in the speciality, recent trends indicate the beginning of sensitization of medical teachers, advancing speciality of psychosocial gerontology and availability of some research funds. Importance of training of health professionals and priorities in gerontological research are also under consideration. Infections still take a heavy toll of our elderly population apart from well known degenerative disorders. Limitations of a developing country further influence the morbidity pattern in various ways. Nutritional deficiencies are common and often subclinical thus escaping the desired interventions. Coronary heart disease, hypertension, mental and many other disorders in the elderly have been reported as isolated observations highlighting differences from those made in the Western countries. Socio-economically, the traditional support of extended families is rapidly undergoing erosion making the elderly further vulnerable. This causes more emotional and psychological problems while the State finds itself helpless in providing a comprehensive care to its large chunk of elderly population. It will be important to surmise and predetermine the future factors that are going to modify the diverse patterns of morbidity, disability and mortality in regional context.

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

Quantifying lost information due to covariance matrix estimation in parameter inference

NASA Astrophysics Data System (ADS)

Sellentin, Elena; Heavens, Alan F.

2017-02-01

Parameter inference with an estimated covariance matrix systematically loses information due to the remaining uncertainty of the covariance matrix. Here, we quantify this loss of precision and develop a framework to hypothetically restore it, which allows to judge how far away a given analysis is from the ideal case of a known covariance matrix. We point out that it is insufficient to estimate this loss by debiasing the Fisher matrix as previously done, due to a fundamental inequality that describes how biases arise in non-linear functions. We therefore develop direct estimators for parameter credibility contours and the figure of merit, finding that significantly fewer simulations than previously thought are sufficient to reach satisfactory precisions. We apply our results to DES Science Verification weak lensing data, detecting a 10 per cent loss of information that increases their credibility contours. No significant loss of information is found for KiDS. For a Euclid-like survey, with about 10 nuisance parameters we find that 2900 simulations are sufficient to limit the systematically lost information to 1 per cent, with an additional uncertainty of about 2 per cent. Without any nuisance parameters, 1900 simulations are sufficient to only lose 1 per cent of information. We further derive estimators for all quantities needed for forecasting with estimated covariance matrices. Our formalism allows to determine the sweetspot between running sophisticated simulations to reduce the number of nuisance parameters, and running as many fast simulations as possible.

Multicentre observational study of outcomes after drainage of acute perianal abscess.

PubMed

Pearce, L; Newton, K; Smith, S R; Barrow, P; Smith, J; Hancock, L; Kirwan, C C; Hill, J

2016-07-01

Management of perianal abscesses has remained largely unchanged for over 50 years. The evidence for postoperative wound packing is limited and may expose patients to painful procedures with no clinical benefit and at considerable increased cost. Patients were recruited in 15 UK centres between December 2013 and October 2014. Outcome measures included number of dressing (pack) changes, healing, recurrence, return to work/normal function, postoperative fistula in ano and health utility scores (EQ-5D™). Pain was measured before, during and after dressing change on a visual analogue scale. Some 141 patients were recruited (median age 39 (range 18-86) years). The mean number of dressing changes in the first 3 weeks was 13 (range 0-21), equating to an annual cost to the National Health Service of €6 453 360 in England alone per annum. Some 43·8 per cent of wounds were healed by 8 weeks after surgery and 86 per cent of patients had returned to normal function. Some 7·6 per cent of abscesses had recurred and 26·7 per cent of patients developed a fistula in ano by 6 months following surgery. Patients reported a twofold to threefold increase in pain scores during and after dressing changes. Recurrent abscess is rare and fistula occurs in one-quarter of the patients. Packing is painful and costly. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

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.

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

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.

Likelihood-based confidence intervals for estimating floods with given return periods

NASA Astrophysics Data System (ADS)

Martins, Eduardo Sávio P. R.; Clarke, Robin T.

1993-06-01

This paper discusses aspects of the calculation of likelihood-based confidence intervals for T-year floods, with particular reference to (1) the two-parameter gamma distribution; (2) the Gumbel distribution; (3) the two-parameter log-normal distribution, and other distributions related to the normal by Box-Cox transformations. Calculation of the confidence limits is straightforward using the Nelder-Mead algorithm with a constraint incorporated, although care is necessary to ensure convergence either of the Nelder-Mead algorithm, or of the Newton-Raphson calculation of maximum-likelihood estimates. Methods are illustrated using records from 18 gauging stations in the basin of the River Itajai-Acu, State of Santa Catarina, southern Brazil. A small and restricted simulation compared likelihood-based confidence limits with those given by use of the central limit theorem; for the same confidence probability, the confidence limits of the simulation were wider than those of the central limit theorem, which failed more frequently to contain the true quantile being estimated. The paper discusses possible applications of likelihood-based confidence intervals in other areas of hydrological analysis.

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

Approximation of Confidence Limits on Sample Semivariograms From Single Realizations of Spatially Correlated Random Fields

NASA Astrophysics Data System (ADS)

Shafer, J. M.; Varljen, M. D.

1990-08-01

A fundamental requirement for geostatistical analyses of spatially correlated environmental data is the estimation of the sample semivariogram to characterize spatial correlation. Selecting an underlying theoretical semivariogram based on the sample semivariogram is an extremely important and difficult task that is subject to a great deal of uncertainty. Current standard practice does not involve consideration of the confidence associated with semivariogram estimates, largely because classical statistical theory does not provide the capability to construct confidence limits from single realizations of correlated data, and multiple realizations of environmental fields are not found in nature. The jackknife method is a nonparametric statistical technique for parameter estimation that may be used to estimate the semivariogram. When used in connection with standard confidence procedures, it allows for the calculation of closely approximate confidence limits on the semivariogram from single realizations of spatially correlated data. The accuracy and validity of this technique was verified using a Monte Carlo simulation approach which enabled confidence limits about the semivariogram estimate to be calculated from many synthetically generated realizations of a random field with a known correlation structure. The synthetically derived confidence limits were then compared to jackknife estimates from single realizations with favorable results. Finally, the methodology for applying the jackknife method to a real-world problem and an example of the utility of semivariogram confidence limits were demonstrated by constructing confidence limits on seasonal sample variograms of nitrate-nitrogen concentrations in shallow groundwater in an approximately 12-mi2 (˜30 km2) region in northern Illinois. In this application, the confidence limits on sample semivariograms from different time periods were used to evaluate the significance of temporal change in spatial correlation. This capability is quite important as it can indicate when a spatially optimized monitoring network would need to be reevaluated and thus lead to more robust monitoring strategies.

On the radio properties of the intermediate-mass black hole candidate ESO 243-49 HLX-1

NASA Astrophysics Data System (ADS)

Cseh, D.; Webb, N. A.; Godet, O.; Barret, D.; Corbel, S.; Coriat, M.; Falcke, H.; Farrell, S. A.; Körding, E.; Lenc, E.; Wrobel, J. M.

2015-02-01

We present follow-up radio observations of ESO 243-49 HLX-1 from 2012 using the Australia Telescope Compact Array (ATCA) and the Karl G. Jansky Very Large Array (VLA). We report the detection of radio emission at the location of HLX-1 during its hard X-ray state using the ATCA. Assuming that the `Fundamental Plane' of accreting black holes is applicable, we provide an independent estimate of the black hole mass of M_{BH}≤ 2.8^{+7.5}_{-2.1} × 106 M⊙ at 90 per cent confidence. However, we argue that the detected radio emission is likely to be Doppler-boosted and our mass estimate is an upper limit. We discuss other possible origins of the radio emission such as being due to a radio nebula, star formation, or later interaction of the flares with the large-scale environment. None of these were found adequate. The VLA observations were carried out during the X-ray outburst. However, no new radio flare was detected, possibly due to a sparse time sampling. The deepest, combined VLA data suggest a variable radio source and we briefly discuss the properties of the previously detected flares and compare them with microquasars and active galactic nuclei.

Access to dental care among adults with physical and intellectual disabilities: residence factors.

PubMed

Pradhan, A; Slade, G D; Spencer, A J

2009-09-01

There is limited information about access and barriers to dental care among adults with disabilities. A mailed questionnaire survey of carers of 18-44-year-old South Australians with physical and intellectual disabilities (care recipients; n = 485) in family homes, community housing and institutions. Bivariate associations were tested using chi-square tests. Odds ratios (ORs) and 95 per cent confidence intervals (CI) were estimated for irregular dental visits (IDV). Carers from family homes and community housing were more likely to report problems in obtaining dental care than those at institutions (p < 0.001). Lack of dentists with adequate skills in special needs dentistry (SND) was the most frequently reported problem for carers from family homes and community housing. IDV were less likely (p < 0.01) for care recipients in institutions and community housing than in family homes. After adjusting for care recipients' age, gender and disability, odds of IDV was lower in community housing (OR = 0.2, 95% CI = 0.1, 0.3) and in institutions (OR = 0.1, 95% CI = 0.04, 0.3) relative to family homes. Care recipients in institutions and community housing had better access to dental care than those at family homes. The shortage of dentists in SND and treatment costs needs to be addressed.

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

European Pulsar Timing Array limits on an isotropic stochastic gravitational-wave background

NASA Astrophysics Data System (ADS)

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

2015-11-01

We present new limits on an isotropic stochastic gravitational-wave background (GWB) using a six pulsar data set spanning 18 yr of observations from the 2015 European Pulsar Timing Array data release. Performing a Bayesian analysis, we fit simultaneously for the intrinsic noise parameters for each pulsar, along with common correlated signals including clock, and Solar system ephemeris errors, obtaining a robust 95 per cent upper limit on the dimensionless strain amplitude A of the background of A < 3.0 × 10-15 at a reference frequency of 1 yr-1 and a spectral index of 13/3, corresponding to a background from inspiralling supermassive black hole binaries, constraining the GW energy density to Ωgw(f)h2 < 1.1 × 10-9 at 2.8 nHz. We also present limits on the correlated power spectrum at a series of discrete frequencies, and show that our sensitivity to a fiducial isotropic GWB is highest at a frequency of ˜5 × 10-9 Hz. Finally, we discuss the implications of our analysis for the astrophysics of supermassive black hole binaries, and present 95 per cent upper limits on the string tension, Gμ/c2, characterizing a background produced by a cosmic string network for a set of possible scenarios, and for a stochastic relic GWB. For a Nambu-Goto field theory cosmic string network, we set a limit Gμ/c2 < 1.3 × 10-7, identical to that set by the Planck Collaboration, when combining Planck and high-ℓ cosmic microwave background data from other experiments. For a stochastic relic background, we set a limit of Ω ^relic_gw(f)h^2<1.2 × 10^{-9}, a factor of 9 improvement over the most stringent limits previously set by a pulsar timing array.

Impacts and mitigation of excess diesel-related NOx emissions in 11 major vehicle markets.

PubMed

Anenberg, Susan C; Miller, Joshua; Minjares, Ray; Du, Li; Henze, Daven K; Lacey, Forrest; Malley, Christopher S; Emberson, Lisa; Franco, Vicente; Klimont, Zbigniew; Heyes, Chris

2017-05-25

Vehicle emissions contribute to fine particulate matter (PM 2.5 ) and tropospheric ozone air pollution, affecting human health, crop yields and climate worldwide. On-road diesel vehicles produce approximately 20 per cent of global anthropogenic emissions of nitrogen oxides (NO x ), which are key PM 2.5 and ozone precursors. Regulated NO x emission limits in leading markets have been progressively tightened, but current diesel vehicles emit far more NO x under real-world operating conditions than during laboratory certification testing. Here we show that across 11 markets, representing approximately 80 per cent of global diesel vehicle sales, nearly one-third of on-road heavy-duty diesel vehicle emissions and over half of on-road light-duty diesel vehicle emissions are in excess of certification limits. These excess emissions (totalling 4.6 million tons) are associated with about 38,000 PM 2.5 - and ozone-related premature deaths globally in 2015, including about 10 per cent of all ozone-related premature deaths in the 28 European Union member states. Heavy-duty vehicles are the dominant contributor to excess diesel NO x emissions and associated health impacts in almost all regions. Adopting and enforcing next-generation standards (more stringent than Euro 6/VI) could nearly eliminate real-world diesel-related NO x emissions in these markets, avoiding approximately 174,000 global PM 2.5 - and ozone-related premature deaths in 2040. Most of these benefits can be achieved by implementing Euro VI standards where they have not yet been adopted for heavy-duty vehicles.

Galaxy clusters in simulations of the local Universe: a matter of constraints

NASA Astrophysics Data System (ADS)

Sorce, Jenny G.; Tempel, Elmo

2018-06-01

To study the full formation and evolution history of galaxy clusters and their population, high-resolution simulations of the latter are flourishing. However, comparing observed clusters to the simulated ones on a one-to-one basis to refine the models and theories down to the details is non-trivial. The large variety of clusters limits the comparisons between observed and numerical clusters. Simulations resembling the local Universe down to the cluster scales permit pushing the limit. Simulated and observed clusters can be matched on a one-to-one basis for direct comparisons provided that clusters are well reproduced besides being in the proper large-scale environment. Comparing random and local Universe-like simulations obtained with differently grouped observational catalogues of peculiar velocities, this paper shows that the grouping scheme used to remove non-linear motions in the catalogues that constrain the simulations affects the quality of the numerical clusters. With a less aggressive grouping scheme - galaxies still falling on to clusters are preserved - combined with a bias minimization scheme, the mass of the dark matter haloes, simulacra for five local clusters - Virgo, Centaurus, Coma, Hydra, and Perseus - is increased by 39 per cent closing the gap with observational mass estimates. Simulacra are found on average in 89 per cent of the simulations, an increase of 5 per cent with respect to the previous grouping scheme. The only exception is Perseus. Since the Perseus-Pisces region is not well covered by the used peculiar velocity catalogue, the latest release lets us foresee a better simulacrum for Perseus in a near future.

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 prevalence of dynamo-generated magnetic fields in the cores of intermediate-mass stars.

PubMed

Stello, Dennis; Cantiello, Matteo; Fuller, Jim; Huber, Daniel; García, Rafael A; Bedding, Timothy R; Bildsten, Lars; Aguirre, Victor Silva

2016-01-21

Magnetic fields play a part in almost all stages of stellar evolution. Most low-mass stars, including the Sun, show surface fields that are generated by dynamo processes in their convective envelopes. Intermediate-mass stars do not have deep convective envelopes, although 10 per cent exhibit strong surface fields that are presumed to be residuals from the star formation process. These stars do have convective cores that might produce internal magnetic fields, and these fields might survive into later stages of stellar evolution, but information has been limited by our inability to measure the fields below the stellar surface. Here we report the strength of dipolar oscillation modes for a sample of 3,600 red giant stars. About 20 per cent of our sample show mode suppression, by strong magnetic fields in the cores, but this fraction is a strong function of mass. Strong core fields occur only in red giants heavier than 1.1 solar masses, and the occurrence rate is at least 50 per cent for intermediate-mass stars (1.6-2.0 solar masses), indicating that powerful dynamos were very common in the previously convective cores of these stars.

DNA barcodes for 1/1000 of the animal kingdom.

PubMed

Hebert, Paul D N; Dewaard, Jeremy R; Landry, Jean-François

2010-06-23

This study reports DNA barcodes for more than 1300 Lepidoptera species from the eastern half of North America, establishing that 99.3 per cent of these species possess diagnostic barcode sequences. Intraspecific divergences averaged just 0.43 per cent among this assemblage, but most values were lower. The mean was elevated by deep barcode divergences (greater than 2%) in 5.1 per cent of the species, often involving the sympatric occurrence of two barcode clusters. A few of these cases have been analysed in detail, revealing species overlooked by the current taxonomic system. This study also provided a large-scale test of the extent of regional divergence in barcode sequences, indicating that geographical differentiation in the Lepidoptera of eastern North America is small, even when comparisons involve populations as much as 2800 km apart. The present results affirm that a highly effective system for the identification of Lepidoptera in this region can be built with few records per species because of the limited intra-specific variation. As most terrestrial and marine taxa are likely to possess a similar pattern of population structure, an effective DNA-based identification system can be developed with modest effort.

Bayesian evidence for the prevalence of waterworlds

NASA Astrophysics Data System (ADS)

Simpson, Fergus

2017-07-01

Should we expect most habitable planets to share the Earth's marbled appearance? For a planetary surface to boast extensive areas of both land and water, a delicate balance must be struck between the volume of water it retains and the capacity of its perturbations. These two quantities may show substantial variability across the full spectrum of water-bearing worlds. This would suggest that, barring strong feedback effects, most surfaces are heavily dominated by either water or land. Why is the Earth so finely poised? To address this question, we construct a simple model for the selection bias that would arise within an ensemble of surface conditions. Based on the Earth's ocean coverage of 71 per cent, we find substantial evidence (Bayes factor K ≃ 6) supporting the hypothesis that anthropic selection effects are at work. Furthermore, due to the Earth's proximity to the waterworld limit, this model predicts that most habitable planets are dominated by oceans spanning over 90 per cent of their surface area (95 per cent credible interval). This scenario, in which the Earth has a much greater land area than most habitable planets, is consistent with results from numerical simulations and could help explain the apparently low-mass transition in the mass-radius relation.

Long term results of surgery for non-acute anteromedial rotatory instability of the knee.

PubMed

Oretorp, N; Gillquist, J; Liljedahl, S O

1979-06-01

Seventy-eight patients treated by extraarticular reconstruction including pes anserinus transfer for anteromedial rotatory instability of the knee were reinvestigated 16--47 months (mean 28) after operation. Function before and after operation was assessed by means of a knee rating score. Of these patients, 94 per cent showed a higher score after operation. Twenty per cent showed full recovery with no limitation of knee function whatsoever. The follow-up score was higher with preserved medial meniscus function than when this structure had been removed. When not initially torn, the medial meniscus tended to become involved with time. Mild laxity in extension, possibly indicative of a posterior cruciate injury previously underestimated or not observed, was found in 15 per cent of the patients. No correlation was found between late knee function and the interval between injury and operation or the interval between operation and follow-up examination. The long term results were good. Extraarticular reconstruction is thus indicated in cases of chronic rotatory instability of the anteromedial type. Routine meniscectomy is not recommended in these patients, however. Signs possibly indicating posterior cruciate ligament involvement should be carefully looked for, as even minor posterior cruciate injury, easily overlooked, may influence the late results.

Evidence for halo kinematics among cool carbon-rich dwarfs

NASA Astrophysics Data System (ADS)

Farihi, J.; Arendt, A. R.; Machado, H. S.; Whitehouse, L. J.

2018-07-01

This paper reports preliminary, yet compelling, kinematical inferences for N≳ 600 carbon-rich dwarf stars that demonstrate around 30-60 per cent are members of the Galactic halo. The study uses a spectroscopically and non-kinematically selected sample of stars from the SDSS, and cross-correlates these data with three proper motion catalogues based on Gaia DR1 astrometry to generate estimates of their 3D space velocities. The fraction of stars with halo-like kinematics is roughly 30 per cent for distances based on a limited number of parallax measurements, with the remainder dominated by the thick disc, but close to 60 per cent of the sample lies below an old, metal-poor disc isochrone in reduced proper motion. An ancient population is consistent with an extrinsic origin for C/O >1 in cool dwarfs, where a fixed mass of carbon pollution more readily surmounts lower oxygen abundance and with a lack of detectable ultraviolet-blue flux from younger white dwarf companions. For an initial stellar mass function that favours low-mass stars as in the Galactic disc, the dC stars are likely to be the dominant source of carbon-enhanced, metal-poor stars in the Galaxy.

Demonstration of a small programmable quantum computer with atomic qubits.

PubMed

Debnath, S; Linke, N M; Figgatt, C; Landsman, K A; Wright, K; Monroe, C

2016-08-04

Quantum computers can solve certain problems more efficiently than any possible conventional computer. Small quantum algorithms have been demonstrated on multiple quantum computing platforms, many specifically tailored in hardware to implement a particular algorithm or execute a limited number of computational paths. Here we demonstrate a five-qubit trapped-ion quantum computer that can be programmed in software to implement arbitrary quantum algorithms by executing any sequence of universal quantum logic gates. We compile algorithms into a fully connected set of gate operations that are native to the hardware and have a mean fidelity of 98 per cent. Reconfiguring these gate sequences provides the flexibility to implement a variety of algorithms without altering the hardware. As examples, we implement the Deutsch-Jozsa and Bernstein-Vazirani algorithms with average success rates of 95 and 90 per cent, respectively. We also perform a coherent quantum Fourier transform on five trapped-ion qubits for phase estimation and period finding with average fidelities of 62 and 84 per cent, respectively. This small quantum computer can be scaled to larger numbers of qubits within a single register, and can be further expanded by connecting several such modules through ion shuttling or photonic quantum channels.

Demonstration of a small programmable quantum computer with atomic qubits

NASA Astrophysics Data System (ADS)

Debnath, S.; Linke, N. M.; Figgatt, C.; Landsman, K. A.; Wright, K.; Monroe, C.

2016-08-01

Quantum computers can solve certain problems more efficiently than any possible conventional computer. Small quantum algorithms have been demonstrated on multiple quantum computing platforms, many specifically tailored in hardware to implement a particular algorithm or execute a limited number of computational paths. Here we demonstrate a five-qubit trapped-ion quantum computer that can be programmed in software to implement arbitrary quantum algorithms by executing any sequence of universal quantum logic gates. We compile algorithms into a fully connected set of gate operations that are native to the hardware and have a mean fidelity of 98 per cent. Reconfiguring these gate sequences provides the flexibility to implement a variety of algorithms without altering the hardware. As examples, we implement the Deutsch-Jozsa and Bernstein-Vazirani algorithms with average success rates of 95 and 90 per cent, respectively. We also perform a coherent quantum Fourier transform on five trapped-ion qubits for phase estimation and period finding with average fidelities of 62 and 84 per cent, respectively. This small quantum computer can be scaled to larger numbers of qubits within a single register, and can be further expanded by connecting several such modules through ion shuttling or photonic quantum channels.

Sagacious, Sophisticated, and Sedulous: The Importance of Discussing 50-Cent Words with Preschoolers

ERIC Educational Resources Information Center

Collins, Molly F.

2012-01-01

Adults often use simple words instead of complex words when talking to young children. Reasons vary from teachers' beliefs that young children cannot understand sophisticated vocabulary because they are too young or have limited language skills, to teachers' unfamiliarity with complex words or with strategies for supporting vocabulary. As a…

Experimental Course Report/Grade Nine.

ERIC Educational Resources Information Center

Davis, Robert B.

Described is the development of an approach to the algebra of real numbers which includes three areas of mathematics not commonly found in grade 9--the theory of limits of infinite sequences, a frequent use of Cartesian co-ordinates, and algebra of matrices. Seventy per cent of the course is abstract axiomatic algebra and the remaining portion…

Dr. Penny. Teacher's Guide [and] Student Material.

ERIC Educational Resources Information Center

Butler, Della

This unit, which contains a teacher's guide and student materials, is designed for students with limited acquaintance with money (Grades K-1). Activities reinforce the basic concept of recognizing a penny, counting pennies, and associating monetary value with pennies from one to ten cents. These activities include listening to a taped read-along…

The regrets of procrastination in climate policy

NASA Astrophysics Data System (ADS)

Keller, Klaus; Robinson, Alexander; Bradford, David F.; Oppenheimer, Michael

2007-04-01

Anthropogenic carbon dioxide (CO2) emissions are projected to impose economic costs due to the associated climate change impacts. Climate change impacts can be reduced by abating CO2 emissions. What would be an economically optimal investment in abating CO2 emissions? Economic models typically suggest that reducing CO2 emissions by roughly ten to twenty per cent relative to business-as-usual would be an economically optimal strategy. The currently implemented CO2 abatement of a few per cent falls short of this benchmark. Hence, the global community may be procrastinating in implementing an economically optimal strategy. Here we use a simple economic model to estimate the regrets of this procrastination—the economic costs due to the suboptimal strategy choice. The regrets of procrastination can range from billions to trillions of US dollars. The regrets increase with increasing procrastination period and with decreasing limits on global mean temperature increase. Extended procrastination may close the window of opportunity to avoid crossing temperature limits interpreted by some as 'dangerous anthropogenic interference with the climate system' in the sense of Article 2 of the United Nations Framework Convention on Global Climate Change.

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.

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.

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.

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

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.

Lithium-ion battery structure that self-heats at low temperatures

NASA Astrophysics Data System (ADS)

Wang, Chao-Yang; Zhang, Guangsheng; Ge, Shanhai; Xu, Terrence; Ji, Yan; Yang, Xiao-Guang; Leng, Yongjun

2016-01-01

Lithium-ion batteries suffer severe power loss at temperatures below zero degrees Celsius, limiting their use in applications such as electric cars in cold climates and high-altitude drones. The practical consequences of such power loss are the need for larger, more expensive battery packs to perform engine cold cranking, slow charging in cold weather, restricted regenerative braking, and reduction of vehicle cruise range by as much as 40 per cent. Previous attempts to improve the low-temperature performance of lithium-ion batteries have focused on developing additives to improve the low-temperature behaviour of electrolytes, and on externally heating and insulating the cells. Here we report a lithium-ion battery structure, the ‘all-climate battery’ cell, that heats itself up from below zero degrees Celsius without requiring external heating devices or electrolyte additives. The self-heating mechanism creates an electrochemical interface that is favourable for high discharge/charge power. We show that the internal warm-up of such a cell to zero degrees Celsius occurs within 20 seconds at minus 20 degrees Celsius and within 30 seconds at minus 30 degrees Celsius, consuming only 3.8 per cent and 5.5 per cent of cell capacity, respectively. The self-heated all-climate battery cell yields a discharge/regeneration power of 1,061/1,425 watts per kilogram at a 50 per cent state of charge and at minus 30 degrees Celsius, delivering 6.4-12.3 times the power of state-of-the-art lithium-ion cells. We expect the all-climate battery to enable engine stop-start technology capable of saving 5-10 per cent of the fuel for 80 million new vehicles manufactured every year. Given that only a small fraction of the battery energy is used for self-heating, we envisage that the all-climate battery cell may also prove useful for plug-in electric vehicles, robotics and space exploration applications.

Long-term results after Russe bone-grafting: the effect of malunion of the scaphoid.

PubMed

Jiranek, W A; Ruby, L K; Millender, L B; Bankoff, M S; Newberg, A H

1992-09-01

Twenty-five patients had Russe anterior corticocancellous bone-grafting between 1973 and 1984 for twenty-six symptomatic established non-unions of the scaphoid. The mean duration of follow-up was eleven years (range, seven to eighteen years). Twenty-one (81 per cent) of the twenty-six scaphoid bones united. We developed two rating scales to evaluate the results of the operation. One scale, based on objective findings, included the radiographic appearance of the wrist, the range of motion, and strength; the other scale, based on subjective findings, comprised function, pain, perception of a decrease in performance because of limitation of motion or strength, and satisfaction. These scales were used to compare the objective and subjective results in patients who had a malunion of the scaphoid in which the lateral intrascaphoid angle was more than 45 degrees convex dorsally between the proximal and distal poles (a so-called flexion or humpback deformity, which results in extension of the proximal fragment of the scaphoid at the radiocarpal joint) with the results in patients who had no such deformity. The lateral intrascaphoid angle was more than 45 degrees in thirteen (50 per cent) of the twenty-six wrists. Although the difference in the objective results between the wrists that had a malunion and those that did not have a malunion was highly significant (p = 0.001), there was no significant difference in the subjective results between the two groups, including satisfaction of the patient (p = 0.39). Twenty-three patients (92 per cent) returned to full-time employment and twenty-two (88 per cent), to sports activities. Twenty-three patients (92 per cent) reported that they had pronounced relief of pain and that the procedure had improved their quality of life. The presence of this deformity of the scaphoid after bone-grafting for a symptomatic non-union was not predictive of a poor long-term subjective outcome.

Lithium-ion battery structure that self-heats at low temperatures.

PubMed

Wang, Chao-Yang; Zhang, Guangsheng; Ge, Shanhai; Xu, Terrence; Ji, Yan; Yang, Xiao-Guang; Leng, Yongjun

2016-01-28

Lithium-ion batteries suffer severe power loss at temperatures below zero degrees Celsius, limiting their use in applications such as electric cars in cold climates and high-altitude drones. The practical consequences of such power loss are the need for larger, more expensive battery packs to perform engine cold cranking, slow charging in cold weather, restricted regenerative braking, and reduction of vehicle cruise range by as much as 40 per cent. Previous attempts to improve the low-temperature performance of lithium-ion batteries have focused on developing additives to improve the low-temperature behaviour of electrolytes, and on externally heating and insulating the cells. Here we report a lithium-ion battery structure, the 'all-climate battery' cell, that heats itself up from below zero degrees Celsius without requiring external heating devices or electrolyte additives. The self-heating mechanism creates an electrochemical interface that is favourable for high discharge/charge power. We show that the internal warm-up of such a cell to zero degrees Celsius occurs within 20 seconds at minus 20 degrees Celsius and within 30 seconds at minus 30 degrees Celsius, consuming only 3.8 per cent and 5.5 per cent of cell capacity, respectively. The self-heated all-climate battery cell yields a discharge/regeneration power of 1,061/1,425 watts per kilogram at a 50 per cent state of charge and at minus 30 degrees Celsius, delivering 6.4-12.3 times the power of state-of-the-art lithium-ion cells. We expect the all-climate battery to enable engine stop-start technology capable of saving 5-10 per cent of the fuel for 80 million new vehicles manufactured every year. Given that only a small fraction of the battery energy is used for self-heating, we envisage that the all-climate battery cell may also prove useful for plug-in electric vehicles, robotics and space exploration applications.

Improving timing sensitivity in the microhertz frequency regime: limits from PSR J1713+0747 on gravitational waves produced by supermassive black hole binaries

NASA Astrophysics Data System (ADS)

Perera, B. B. P.; Stappers, B. W.; Babak, S.; Keith, M. J.; Antoniadis, J.; Bassa, C. G.; Caballero, R. N.; Champion, D. J.; Cognard, I.; Desvignes, G.; Graikou, E.; Guillemot, L.; Janssen, G. H.; Karuppusamy, R.; Kramer, M.; Lazarus, P.; Lentati, L.; Liu, K.; Lyne, A. G.; McKee, J. W.; Osłowski, S.; Perrodin, D.; Sanidas, S. A.; Sesana, A.; Shaifullah, G.; Theureau, G.; Verbiest, J. P. W.; Taylor, S. R.

2018-07-01

We search for continuous gravitational waves (CGWs) produced by individual supermassive black hole binaries in circular orbits using high-cadence timing observations of PSR J1713+0747. We observe this millisecond pulsar using the telescopes in the European Pulsar Timing Array with an average cadence of approximately 1.6 d over the period between 2011 April and 2015 July, including an approximately daily average between 2013 February and 2014 April. The high-cadence observations are used to improve the pulsar timing sensitivity across the gravitational wave frequency range of 0.008-5μHz. We use two algorithms in the analysis, including a spectral fitting method and a Bayesian approach. For an independent comparison, we also use a previously published Bayesian algorithm. We find that the Bayesian approaches provide optimal results and the timing observations of the pulsar place a 95 per cent upper limit on the sky-averaged strain amplitude of CGWs to be ≲3.5 × 10-13 at a reference frequency of 1 μHz. We also find a 95 per cent upper limit on the sky-averaged strain amplitude of low-frequency CGWs to be ≲1.4 × 10-14 at a reference frequency of 20 nHz.

Improving timing sensitivity in the microhertz frequency regime: limits from PSR J1713+0747 on gravitational waves produced by super-massive black-hole binaries

NASA Astrophysics Data System (ADS)

Perera, B. B. P.; Stappers, B. W.; Babak, S.; Keith, M. J.; Antoniadis, J.; Bassa, C. G.; Caballero, R. N.; Champion, D. J.; Cognard, I.; Desvignes, G.; Graikou, E.; Guillemot, L.; Janssen, G. H.; Karuppusamy, R.; Kramer, M.; Lazarus, P.; Lentati, L.; Liu, K.; Lyne, A. G.; McKee, J. W.; Osłowski, S.; Perrodin, D.; Sanidas, S. A.; Sesana, A.; Shaifullah, G.; Theureau, G.; Verbiest, J. P. W.; Taylor, S. R.

2018-05-01

We search for continuous gravitational waves (CGWs) produced by individual super-massive black-hole binaries (SMBHBs) in circular orbits using high-cadence timing observations of PSR J1713+0747. We observe this millisecond pulsar using the telescopes in the European Pulsar Timing Array (EPTA) with an average cadence of approximately 1.6 days over the period between April 2011 and July 2015, including an approximately daily average between February 2013 and April 2014. The high-cadence observations are used to improve the pulsar timing sensitivity across the GW frequency range of 0.008 - 5 μHz. We use two algorithms in the analysis, including a spectral fitting method and a Bayesian approach. For an independent comparison, we also use a previously published Bayesian algorithm. We find that the Bayesian approaches provide optimal results and the timing observations of the pulsar place a 95 per cent upper limit on the sky-averaged strain amplitude of CGWs to be ≲ 3.5 × 10-13 at a reference frequency of 1 μHz. We also find a 95 per cent upper limit on the sky-averaged strain amplitude of low-frequency CGWs to be ≲ 1.4 × 10-14 at a reference frequency of 20 nHz.

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...

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.

Search for Majorana neutrinos with the first two years of EXO-200 data.

PubMed

2014-06-12

Many extensions of the standard model of particle physics suggest that neutrinos should be Majorana-type fermions-that is, that neutrinos are their own anti-particles-but this assumption is difficult to confirm. Observation of neutrinoless double-β decay (0νββ), a spontaneous transition that may occur in several candidate nuclei, would verify the Majorana nature of the neutrino and constrain the absolute scale of the neutrino mass spectrum. Recent searches carried out with (76)Ge (the GERDA experiment) and (136)Xe (the KamLAND-Zen and EXO (Enriched Xenon Observatory)-200 experiments) have established the lifetime of this decay to be longer than 10(25) years, corresponding to a limit on the neutrino mass of 0.2-0.4 electronvolts. Here we report new results from EXO-200 based on a large (136)Xe exposure that represents an almost fourfold increase from our earlier published data sets. We have improved the detector resolution and revised the data analysis. The half-life sensitivity we obtain is 1.9 × 10(25) years, an improvement by a factor of 2.7 on previous EXO-200 results. We find no statistically significant evidence for 0νββ decay and set a half-life limit of 1.1 × 10(25) years at the 90 per cent confidence level. The high sensitivity holds promise for further running of the EXO-200 detector and future 0νββ decay searches with an improved Xe-based experiment, nEXO.

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.

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.

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.

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.

Dark energy constraints from the thermal Sunyaev-Zeldovich power spectrum

NASA Astrophysics Data System (ADS)

Bolliet, Boris; Comis, Barbara; Komatsu, Eiichiro; Macías-Pérez, Juan Francisco

2018-07-01

We constrain the dark energy equation of state parameter, {w}, using the power spectrum of the thermal Sunyaev-Zeldovich (tSZ) effect. We improve upon previous analyses by taking into account the trispectrum in the covariance matrix and marginalizing over the foreground parameters, the correlated noise, the mass bias B in the Planck universal pressure profile, and all the relevant cosmological parameters (i.e. not just Ωm and σ8). We find that the amplitude of the tSZ power spectrum at ℓ ≲ 103 depends primarily on F ≡ σ8(Ωm/B)0.40h-0.21, where B is related to more commonly used variable b by B = (1 - b)-1. We measure this parameter with 2.6 per cent precision, F = 0.460 ± 0.012 (68 per cent CL). By fixing the bias to B = 1.25 and adding the local determination of the Hubble constant H0 and the amplitude of the primordial power spectrum constrained by the Planck cosmic microwave background (CMB) data, we find {w} = -1.10 ± 0.12, σ8 = 0.802 ± 0.037, and Ωm = 0.265 ± 0.022 (68 per cent CL). Our limit on {w} is consistent with and is as tight as that from the distance-alone constraint from the CMB and H0. Finally, by combining the tSZ power spectrum and the CMB data we find, in the Λ cold dark matter model, the mass bias of B = 1.71 ± 0.17, i.e. 1 - b = 0.58 ± 0.06 (68 per cent CL).

Deep ALMA photometry of distant X-ray AGN: improvements in star formation rate constraints, and AGN identification

NASA Astrophysics Data System (ADS)

Stanley, F.; Harrison, C. M.; Alexander, D. M.; Simpson, J.; Knudsen, K. K.; Mullaney, J. R.; Rosario, D. J.; Scholtz, J.

2018-05-01

We present the star formation rates (SFRs) of a sample of 109 galaxies with X-ray selected active galactic nuclei (AGN) with moderate to high X-ray luminosities (\\mathrel {L_2-8{keV}}= 10^{42} - 10^{45} \\mathrel {erg {} s^{-1}}), at redshifts 1 < z < 4.7, that were selected to be faint or undetected in the Herschel bands. We combine our deep ALMA continuum observations with deblended 8-500\\mathrel {μ m} photometry from Spitzer and Herschel, and use infrared (IR) SED fitting and AGN - star formation decomposition methods. The addition of the ALMA photometry results in an order of magnitude more X-ray AGN in our sample with a measured SFR (now 37 per cent). The remaining 63 per cent of the sources have SFR upper limits that are typically a factor of 2-10 times lower than the pre-ALMA constraints. With the improved constraints on the IR SEDs, we can now identify a mid-IR (MIR) AGN component in 50 per cent of our sample, compared to only ˜1 per cent previously. We further explore the F_{870\\mathrel {μ m}}/F_{24\\mathrel {μ m}}-redshift plane as a tool for the identification of MIR emitting AGN, for three different samples representing AGN dominated, star formation dominated, and composite sources. We demonstrate that the F_{870\\mathrel {μ m}}/F_{24\\mathrel {μ m}}-redshift plane can successfully split between AGN and star formation dominated sources, and can be used as an AGN identification method.

Prevalence of shigellosis in the U.S.: consistency with dose-response information.

PubMed

Crockett, C S; Haas, C N; Fazil, A; Rose, J B; Gerba, C P

1996-06-01

Every year there are estimated 300000 cases of Shigella in the United States (Bennett et al., 1987, Am. J. Prev. Med. 3, 102-114). A beta-poisson model was fit to human dose-response information on pathogenic Shigella using the Maximum Likelihood Estimation technique (Haas, 1983, Am. J. Epidemiol. 118, 573-582). Pooled and separate data sets for the Shigella species were fit to the beta-Poisson model and 95% confidence limits and regions were calculated. Shigella dysentariae and Shigella flexneri confidence regions and limits overlapped with each other and with the pooled data set, suggesting that this model can describe Shigella in general. The pooled Shigella model as well as the upper and lower confidence limits of the three data sets showed average exposures based on the estimated U.S. caseload of pathogenic Shigella of 0.01 to 0.014 organisms (confidence limits 0.001-0.05) for a 7-day per annum period of exposure and ranges from 0.07 to 0.1 organisms (confidence limits 0.006-0.4). for a 1-day per annum period of exposure. The plausibility of the pooled dose-response model was then evaluated by comparison with two known cruise ship outbreaks. The pooled model estimated that the two outbreaks studied could have been due to ingestion of 344 (confidence limits 72-915) Shigella cells per meal and 10.5-12 (confidence limits 1-44) Shigella cells per glass of water by passengers.

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.

[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.

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.

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.

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.

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.

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.

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2013 CFR

2013-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2010 CFR

2010-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the LCL approach follows: 4.3A source conducts an initial series of at least three runs. The owner... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2012 CFR

2012-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

Developing Confidence Limits For Reliability Of Software

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.

1991-01-01

Technique developed for estimating reliability of software by use of Moranda geometric de-eutrophication model. Pivotal method enables straightforward construction of exact bounds with associated degree of statistical confidence about reliability of software. Confidence limits thus derived provide precise means of assessing quality of software. Limits take into account number of bugs found while testing and effects of sampling variation associated with random order of discovering bugs.

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.

11 CFR 9035.1 - Campaign expenditure limitation; compliance and fundraising exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the greater of: 16 cents (as adjusted under 2 U.S.C. 441a(c)) multiplied by the voting age population...: (i) Coordinated expenditures under 11 CFR 109.20; (ii) Coordinated communications under 11 CFR 109.21... coordinated communications pursuant to 11 CFR 109.37 that are in-kind contributions received or accepted by...

The Dollars and Cents of Conventional Processing of Standard-Size Blanks

Treesearch

Philip A. Araman; Bruce G. Hansen

1983-01-01

Manufacturers of furniture and cabinets normally use over 2 billion board feet of hardwood lumber or about one-third of all hardwood lumber demanded each year. Although the current market for hardwood lumber reflects the overall economic downturn, competition for limited better grade hardwood resources will intensify when the economy improves. So, we need to improve...

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.

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.

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.

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

Cost analysis of DAWT innovative wind energy systems

NASA Astrophysics Data System (ADS)

Foreman, K. M.

The results of a diffuser augmented wind turbine (DAWT) preliminary design study of three constructional material approaches and cost analysis of DAWT electrical energy generation are presented. Costs are estimated assuming a limited production run (100 to 500 units) of factory-built subassemblies and on-site final assembly and erection within 200 miles of regional production centers. It is concluded that with the DAWT the (busbar) cost of electricity (COE) can range between 2.0 and 3.5 cents/kW-hr for farm and REA cooperative end users, for sites with annual average wind speeds of 16 and 12 mph respectively, and 150 kW rated units. No tax credit incentives are included in these figures. For commercial end users of the same units and site characteristics, the COE ranges between 4.0 and 6.5 cents/kW-hr.

Preliminary design and economic investigations of Diffuser Augmented Wind Turbines (DAWT)

NASA Astrophysics Data System (ADS)

Foreman, K. M.

1981-12-01

A preferred design and configuration approach for the diffuser augmented wind turbines (DAWT) innovative wind energy conversion system is proposed. A preliminary economic assessment for limited production rates of units between 5 and 150 kw rated output was made. It is estimated that for farm and REA cooperative end users, the COE can range between 2 and 3.5 cents/kWh for sites with annual average wind speeds of 16 and 12 mph respectively and 150 kW rated units. No tax credits are included in these COE figures. For commercial end users of these 150 kW units the COE ranges between 4.0 and 6.5 cents/kWh for 16 and 12 mph sites. These estimates in 1979 dollars are lower than DOE goals set in 1978 for the rating size and end applications.

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.

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.

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.

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.

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.

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.

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.

[Study of the labor market for dentists who recieved Norwegian authorization during 1972-1975. I. Waiting time and alternative employment before the 1st relevant job].

PubMed

Haugejorden, O

1977-07-01

The purpose of the investigation was to monitor changes in the labour market situation for dentists who received authorization to practise dentistry in Norway during the years 1972-1975. Data was collected by postal questionnaire during April/May of the year following authorization, except for the 1972 cohort, which was contacted the second year after authorization. A 92-95 per cent response rate was achieved using one follow-up (Table 1). The percentage of respondents who waited 8 weeks or more to acquire a job in dentistry increased from 15 for those authorized in 1972 to 36 for the 1975 group (Table 3). The proportion of dentists who took paid employment other than dentistry, increased from just over 3 per cent for the 1973 to 14 per cent for the 1975 cohort (Table 4). This development has occured despite a decrease in the number of dentists receiving authorization each year and has resulted in a limited emigration of dentists. It is suggested that the favourable supply of dentists in relation to existing demand for dental services presents an ideal opportunity for attempting to solve dental health problems which have received inadequate attention in the past.

[Normal microflora of the pharyngeal mucosa].

PubMed

Kolotilova, L V; Akishina, T M; Zargarian, O P; Lomnitskaia, V B; Pruzhniak, O V; Lutsik, T S

1989-10-01

Aerobic microflora of the throat mucosa was studied in 518 healthy persons aged 1 to 50 years. On the basis of the study results, criteria for estimating microbiocenoses of the upper respiratory tracts were defined. It was shown that the throat symbiotic flora included three groups of microorganisms playing different roles in the development of microbiocenosis. The indigenous group consisted of representatives of Streptococcus and Neisseria and was characterized by permanent (90-100 per cent) and intensive (3-8 lg CFU/ml) colonization, broad species spectrum, associations of 2-3 and more species and no significant influence of sociological, age and season factors. The representatives of the facultative group i.e. bacteria belonging to Staphylococcus, Corynebacterium and Haemophilus were less frequent (25-50 per cent). The intensity of their isolation was lower (1-4 lg CFU/ml) and their species spectrum was narrow. The microorganisms of the transitory group were characterized by low frequency (5-20 per cent) and insignificant contamination of the throat mucosa (1-2 lg CFU/ml). The nature of the colonization was monospecific. The group was more numerous by generic composition (Candida, Escherichia, Klebsiella, Citrobacter, Enterobacter, Pseudomonas, Branhamella, Moraxella and Micrococcus). However, it was generally limited by one colonization type. The facultative and transitory groups were subject to age and season variation. They were also different in urban and rural populations.

Toward eliminating blindness due to uncorrected refractive errors: assessment of refractive services in the northern and central regions of Ghana.

PubMed

Ntodie, Michael; Danquah, Lisa; Kandel, Himal; Abokyi, Samuel

2014-11-01

This study sought to document current refractive services in the northern and central regions of Ghana as a first step toward evidence-based planning of refractive services. A descriptive cross-sectional survey was carried out in health facilities in the northern and central regions of Ghana, which provided eye-care services. A semi-structured questionnaire was administered to gather information on each facility type, human resources providing refractive services, assessment of refraction and spectacle dispensing output and provider barriers to the services. Current outputs of refraction in the northern and central regions were 0.5 and 1.2 per cent of the estimated refractive needs, respectively. Spectacle dispensing services were below the outputs of refraction. Lack of equipment (36.8 per cent) and cost of providing spectacles frames (31.6 per cent), were identified as the main barriers to providing refractive services. The provision of refractive services in the study regions was inadequate. Lack of infrastructure and inadequate human resource were the major reasons for the limited service provision. This should be considered for planning refractive services in the study regions and Ghana as a whole. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

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.;

VizieR Online Data Catalog: KIC 10670103 frequency spectrum (Reed+, 2014)

NASA Astrophysics Data System (ADS)

Reed, M. D.; Foster, H.; Telting, J. H.; Ostensen, R. H.; Farris, L. H.; Oreiro, R.; Baran, A. S.

2017-05-01

From 33 months of nearly continuous Kepler data, we have detected 278 periodicities in KIC 10670103, making it the richest sdBV star observed, so far. The 93.8 per cent duty cycle provided excellent data with a 5σ detection limit of 0.1ppt and a resolution of 0.017uHz. (1 data file).

The European Working Time Directive and training in cardiothoracic surgery in the United Kingdom.

PubMed

West, D; Codispoti, M; Graham, T

2007-04-01

The European Working Time Directive (EWTD) limited average working hours for junior doctors to 58 per week in 2004. The Cardiothoracic Specialty Advisory Board conducted postal and email surveys of cardiothoracic trainees' work patterns and attitudes in 2003 and 2005-6. The results reveal an increase in shift-based working from 15% to 58% of respondents. One hundred per cent of respondents felt that the EWTD had had a negative impact on training, and only 30% were satisfied with their training to date. Satisfied trainees were more likely to work in larger units as assessed by ITU beds (20.6 vs. 8.9, p < 0.001) and cardiac cases/year (1586.2 vs. 828.4, p < 0.001). They had performed more cardiac cases than their peers (72.7 vs. 26.7, p = 0.005). Fifty-two per cent thought that their quality of life improved after EWTD implementation. The EWTD is unpopular amongst cardiothoracic trainees, who perceive it as harming training. Overall trainee satisfaction is low. Larger units and increased personal operative experience are associated with trainee satisfaction. Training programmes must act vigorously to safeguard training quality before implementation of the 48-hour limit in 2009.

A Detection of the Baryon Acoustic Oscillation Features in the SDSS BOSS DR12 Galaxy Bispectrum

NASA Astrophysics Data System (ADS)

Pearson, David W.; Samushia, Lado

2018-05-01

We present the first high significance detection (4.1σ) of the Baryon Acoustic Oscillations (BAO) feature in the galaxy bispectrum of the twelfth data release (DR12) of the Baryon Oscillation Spectroscopic Survey (BOSS) CMASS sample (0.43 ≤ z ≤ 0.7). We measured the scale dilation parameter, α, using the power spectrum, bispectrum, and both simultaneously for DR12, plus 2048 MultiDark-PATCHY mocks in the North and South Galactic Caps (NGC and SGC, respectively), and the volume weighted averages of those two samples (N+SGC). The fitting to the mocks validated our analysis pipeline, yielding values consistent with the mock cosmology. By fitting to the power spectrum and bispectrum separately, we tested the robustness of our results, finding consistent values from the NGC, SGC and N+SGC in all cases. We found DV = 2032 ± 24(stat.) ± 15(sys.) Mpc, DV = 2038 ± 55(stat.) ± 15(sys.) Mpc, and DV = 2031 ± 22(stat.) ± 10(sys.) Mpc from the N+SGC power spectrum, bispectrum and simultaneous fitting, respectively. Our bispectrum measurement precision was mainly limited by the size of the covariance matrix. Based on the fits to the mocks, we showed that if a less noisy estimator of the covariance were available, from either a theoretical computation or a larger suite of mocks, the constraints from the bispectrum and simultaneous fits would improve to 1.1 per cent (1.3 per cent with systematics) and 0.7 per cent (0.9 per cent with systematics), respectively, with the latter being slightly more precise than the power spectrum only constraints from the reconstructed field.

Cobalt carbide nanoprisms for direct production of lower olefins from syngas

NASA Astrophysics Data System (ADS)

Zhong, Liangshu; Yu, Fei; An, Yunlei; Zhao, Yonghui; Sun, Yuhan; Li, Zhengjia; Lin, Tiejun; Lin, Yanjun; Qi, Xingzhen; Dai, Yuanyuan; Gu, Lin; Hu, Jinsong; Jin, Shifeng; Shen, Qun; Wang, Hui

2016-10-01

Lower olefins—generally referring to ethylene, propylene and butylene—are basic carbon-based building blocks that are widely used in the chemical industry, and are traditionally produced through thermal or catalytic cracking of a range of hydrocarbon feedstocks, such as naphtha, gas oil, condensates and light alkanes. With the rapid depletion of the limited petroleum reserves that serve as the source of these hydrocarbons, there is an urgent need for processes that can produce lower olefins from alternative feedstocks. The ‘Fischer-Tropsch to olefins’ (FTO) process has long offered a way of producing lower olefins directly from syngas—a mixture of hydrogen and carbon monoxide that is readily derived from coal, biomass and natural gas. But the hydrocarbons obtained with the FTO process typically follow the so-called Anderson-Schulz-Flory distribution, which is characterized by a maximum C2-C4 hydrocarbon fraction of about 56.7 per cent and an undesired methane fraction of about 29.2 per cent (refs 1, 10, 11, 12). Here we show that, under mild reaction conditions, cobalt carbide quadrangular nanoprisms catalyse the FTO conversion of syngas with high selectivity for the production of lower olefins (constituting around 60.8 per cent of the carbon products), while generating little methane (about 5.0 per cent), with the ratio of desired unsaturated hydrocarbons to less valuable saturated hydrocarbons amongst the C2-C4 products being as high as 30. Detailed catalyst characterization during the initial reaction stage and theoretical calculations indicate that preferentially exposed {101} and {020} facets play a pivotal role during syngas conversion, in that they favour olefin production and inhibit methane formation, and thereby render cobalt carbide nanoprisms a promising new catalyst system for directly converting syngas into lower olefins.

The SuperCOSMOS all-sky galaxy catalogue

NASA Astrophysics Data System (ADS)

Peacock, J. A.; Hambly, N. C.; Bilicki, M.; MacGillivray, H. T.; Miller, L.; Read, M. A.; Tritton, S. B.

2016-10-01

We describe the construction of an all-sky galaxy catalogue, using SuperCOSMOS scans of Schmidt photographic plates from the UK Schmidt Telescope and Second Palomar Observatory Sky Survey. The photographic photometry is calibrated using Sloan Digital Sky Survey data, with results that are linear to 2 per cent or better. All-sky photometric uniformity is achieved by matching plate overlaps and also by requiring homogeneity in optical-to-2MASS colours, yielding zero-points that are uniform to 0.03 mag or better. The typical AB depths achieved are BJ < 21, RF < 19.5 and IN < 18.5, with little difference between hemispheres. In practice, the IN plates are shallower than the BJ and RF plates, so for most purposes we advocate the use of a catalogue selected in these two latter bands. At high Galactic latitudes, this catalogue is approximately 90 per cent complete with 5 per cent stellar contamination; we quantify how the quality degrades towards the Galactic plane. At low latitudes, there are many spurious galaxy candidates resulting from stellar blends: these approximately match the surface density of true galaxies at |b| = 30°. Above this latitude, the catalogue limited in BJ and RF contains in total about 20 million galaxy candidates, of which 75 per cent are real. This contamination can be removed, and the sky coverage extended, by matching with additional data sets. This SuperCOSMOS catalogue has been matched with 2MASS and with WISE, yielding quasi-all-sky samples of respectively 1.5 million and 18.5 million galaxies, to median redshifts of 0.08 and 0.20. This legacy data set thus continues to offer a valuable resource for large-angle cosmological investigations.

Treatment of ocean tide aliasing in the context of a next generation gravity field mission

NASA Astrophysics Data System (ADS)

Hauk, Markus; Pail, Roland

2018-07-01

Current temporal gravity field solutions from Gravity Recovery and Climate Experiment (GRACE) suffer from temporal aliasing errors due to undersampling of signal to be recovered (e.g. hydrology), uncertainties in the de-aliasing models (usually atmosphere and ocean) and imperfect ocean tide models. Especially the latter will be one of the most limiting factors in determining high-resolution temporal gravity fields from future gravity missions such as GRACE Follow-On and Next-Generation Gravity Missions (NGGM). In this paper a method to co-parametrize ocean tide parameters of the eight main tidal constituents over time spans of several years is analysed and assessed. Numerical closed-loop simulations of low-low satellite-to-satellite-tracking missions for a single polar pair and a double pair Bender-type formation are performed, using time variable geophysical background models and noise assumptions for new generation instrument technology. Compared to the single pair mission, results show a reduction of tide model errors up to 70 per cent for dedicated tidal constituents due to an enhanced spatial and temporal sampling and error isotropy for the double pair constellation. Extending the observation period from 1 to 3 yr leads to a further reduction of tidal errors up to 60 per cent for certain constituents, and considering non-tidal mass changes during the estimation process leads to reductions of tidal errors between 20 and 80 per cent. As part of a two-step approach, the estimated tide model is used for de-aliasing during gravity field retrieval in a second iteration, resulting in more than 50 per cent reduction of ocean tide aliasing errors for a NGGM Bender-type formation.

Homelessness as viewed by incarcerated women: participatory research.

PubMed

Martin, Ruth Elwood; Hanson, Debra; Hemingway, Christine; Ramsden, Vivian; Buxton, Jane; Granger-Brown, Alison; Condello, Lara-Lisa; Macaulay, Ann; Janssen, Patti; Hislop, T Gregory

2012-01-01

The purpose of this paper is to describe the development, by incarcerated women who were members of a prison participatory health research team, of a survey tool regarding homelessness and housing, the survey findings and recommendations for policy. A survey was developed by incarcerated women in a minimum/medium security women's prison in Canada. Associations were examined between socio-demographic factors and reports of difficulty finding housing upon release, homelessness contributing to a return to crime, and a desire for relocation to another city upon release. Open-ended questions were examined to look for recurrent themes and to illuminate the survey findings. In total, 83 women completed the survey, a 72 per cent response rate. Of the 71 who were previously incarcerated, 56 per cent stated that homelessness contributed to their return to crime. Finding housing upon release was a problem for 63 per cent and 34 per cent desired relocation to another city upon release. Women indicated that a successful housing plan should incorporate flexible progressive staged housing. The present study focuses only on incarcerated women but could be expanded in future to include men. Incarcerated women used the findings to create a housing proposal for prison leavers and created a resource database of the limited housing resources for women prison leavers. Lack of suitable housing is a major factor leading to recidivism. This study highlights the reality of the cycle of homelessness, poverty, crime for survival, street-life leading to drug use and barriers to health, education and employment that incarcerated women face. Housing is a recognized basic determinant of health. No previous studies have used participatory research to address homelessness in a prison population.

Physical health of patients with severe mental illness: an intervention on medium secure forensic unit.

PubMed

Vasudev, Kamini; Thakkar, Pratish B; Mitcheson, Nicola

2012-01-01

Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side-effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year. A physical health monitoring sheet was introduced in all the patients' records on a 15-bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re-audit were compared. At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re-audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status. This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward. There is a need for improved access to physical health care in long-stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients. Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.

Two Decades of WRF/CMAQ simulations over the continental United States: New approaches for performing dynamic model evaluation and determining confidence limits for ozone exceedances

EPA Science Inventory

Confidence in the application of models for forecasting and regulatory assessments is furthered by conducting four types of model evaluation: operational, dynamic, diagnostic, and probabilistic. Operational model evaluation alone does not reveal the confidence limits that can be ...

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.

Closed-form confidence intervals for functions of the normal mean and standard deviation.

PubMed

Donner, Allan; Zou, G Y

2012-08-01

Confidence interval methods for a normal mean and standard deviation are well known and simple to apply. However, the same cannot be said for important functions of these parameters. These functions include the normal distribution percentiles, the Bland-Altman limits of agreement, the coefficient of variation and Cohen's effect size. We present a simple approach to this problem by using variance estimates recovered from confidence limits computed for the mean and standard deviation separately. All resulting confidence intervals have closed forms. Simulation results demonstrate that this approach performs very well for limits of agreement, coefficients of variation and their differences.

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.

Aircraft MSS data registration and vegetation classification of wetland change detection

USGS Publications Warehouse

Christensen, E.J.; Jensen, J.R.; Ramsey, Elijah W.; Mackey, H.E.

1988-01-01

Portions of the Savannah River floodplain swamp were evaluated for vegetation change using high resolution (5a??6 m) aircraft multispectral scanner (MSS) data. Image distortion from aircraft movement prevented precise image-to-image registration in some areas. However, when small scenes were used (200-250 ha), a first-order linear transformation provided registration accuracies of less than or equal to one pixel. A larger area was registered using a piecewise linear method. Five major wetland classes were identified and evaluated for change. Phenological differences and the variable distribution of vegetation limited wetland type discrimination. Using unsupervised methods and ground-collected vegetation data, overall classification accuracies ranged from 84 per cent to 87 per cent for each scene. Results suggest that high-resolution aircraft MSS data can be precisely registered, if small areas are used, and that wetland vegetation change can be accurately detected and monitored.

Was there significant tax evasion after the 1999 50 cent per pack cigarette tax increase in California?

PubMed Central

Emery, S; White, M; Gilpin, E; Pierce, J

2002-01-01

Objectives: Several states, including California, have implemented large cigarette excise tax increases, which may encourage smokers to purchase their cigarettes in other lower taxed states, or from other lower or non-taxed sources. Such tax evasion thwarts tobacco control objectives and may cost the state substantial tax revenues. Thus, this study investigates the extent of tax evasion in the 6–12 months after the implementation of California's $0.50/pack excise tax increase. Design and setting: Retrospective data analysis from the 1999 California Tobacco Surveys (CTS), a random digit dialled telephone survey of California households. Main outcome measures: Sources of cigarettes, average daily cigarette consumption, and reported price paid. Results: Very few (5.1 (0.7)% (±95% confidence limits)) of California smokers avoided the excise tax by usually purchasing cigarettes from non- or lower taxed sources, such as out-of-state outlets, military commissaries, or the internet. The vast majority of smokers purchased their cigarettes from the most convenient and expensive sources: convenience stores/gas (petrol) stations (45.0 (1.9)%), liquor/drug stores (16.4 (1.6)%), and supermarkets (8.8 (1.2)%). Conclusions: Despite the potential savings, tax evasion by individual smokers does not appear to pose a serious threat to California's excise tax revenues or its tobacco control objectives. PMID:12035006

Random numbers certified by Bell's theorem.

PubMed

Pironio, S; Acín, A; Massar, S; de la Giroday, A Boyer; Matsukevich, D N; Maunz, P; Olmschenk, S; Hayes, D; Luo, L; Manning, T A; Monroe, C

2010-04-15

Randomness is a fundamental feature of nature and a valuable resource for applications ranging from cryptography and gambling to numerical simulation of physical and biological systems. Random numbers, however, are difficult to characterize mathematically, and their generation must rely on an unpredictable physical process. Inaccuracies in the theoretical modelling of such processes or failures of the devices, possibly due to adversarial attacks, limit the reliability of random number generators in ways that are difficult to control and detect. Here, inspired by earlier work on non-locality-based and device-independent quantum information processing, we show that the non-local correlations of entangled quantum particles can be used to certify the presence of genuine randomness. It is thereby possible to design a cryptographically secure random number generator that does not require any assumption about the internal working of the device. Such a strong form of randomness generation is impossible classically and possible in quantum systems only if certified by a Bell inequality violation. We carry out a proof-of-concept demonstration of this proposal in a system of two entangled atoms separated by approximately one metre. The observed Bell inequality violation, featuring near perfect detection efficiency, guarantees that 42 new random numbers are generated with 99 per cent confidence. Our results lay the groundwork for future device-independent quantum information experiments and for addressing fundamental issues raised by the intrinsic randomness of quantum theory.

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...

Use of sentinel node mapping for cancer of the colon: 'to map or not to map".

PubMed

Thomas, Kristen A; Lechner, Jonathan; Shen, Perry; Waters, Gregory S; Geisinger, Kim R; Levine, Edward A

2006-07-01

Sentinel lymph node (SLN) mapping has become a cornerstone of oncologic surgery because it is a proven method for identifying nodal disease in melanoma and breast cancer. In addition, it can ameliorate the surgical morbidity secondary to lymphadenectomy. However, experience with SLN mapping for carcinoma of the colon and other visceral malignancies is limited. This study represents an update to our initial pilot experience with SLN mapping for carcinoma of the colon. Consenting patients over the age of 18 diagnosed with adenocarcinoma of the colon were included in this study. At the time of operation, 1 to 2 mL of isosulfan blue was injected with a 25-gauge needle into the subserosa at 4 sites around the edge of the palpable tumor. The SLN was identified visually and excised followed by a standard lymphadenectomy and surgical resection. SLNs were evaluated by standard hematoxylin and eosin (H&E) evaluation as well as immunohistochemical (IHC) techniques for carcinoembryonic antigen and cytokeratin if the H&E was negative. Sixty-nine patients underwent SLN mapping. A SLN was identified in 93 per cent (64 of 69) of patients. Nodal metastases were identified in 38 per cent (26 of 69) of patients overall. In 5 patients, the only positive node identified was the SLN, 2 of which were positive by IHC criteria alone. Therefore, 3 per cent (2 of 69) of patients were upstaged by SLN mapping. This technique was 100 per cent specific while being 46 per cent sensitive. Fourteen patients had false-negative SLNs. Metastasis to regional lymph nodes remains the key prognostic factor for colon cancer. SLN mapping is feasible for colon cancer and can identify a subset of patients who could benefit from adjuvant chemotherapy. Although SLN mapping did not alter the surgical management of colon cancer, it does make possible a more focused and cost-effective pathologic evaluation of nodal disease. We do not suggest routine utilization of SLN mapping for colon cancer, but we believe that the data supports proceeding with a national trial.

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

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.

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.

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.

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

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.

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.

Search for extended γ-ray emission around AGN with H.E.S.S. and Fermi-LAT

NASA Astrophysics Data System (ADS)

H. E. S. S. Collaboration; Abramowski, A.; Aharonian, F.; Ait Benkhali, F.; Akhperjanian, A. G.; Angüner, E.; Anton, G.; Backes, M.; Balenderan, S.; Balzer, A.; Barnacka, A.; Becherini, Y.; Becker Tjus, J.; Bernlöhr, K.; Birsin, E.; Bissaldi, E.; Biteau, J.; Böttcher, M.; Boisson, C.; Bolmont, J.; Bordas, P.; Brucker, J.; Brun, F.; Brun, P.; Bulik, T.; Carrigan, S.; Casanova, S.; Chadwick, P. M.; Chalme-Calvet, R.; Chaves, R. C. G.; Cheesebrough, A.; Chrétien, M.; Colafrancesco, S.; Cologna, G.; Conrad, J.; Couturier, C.; Cui, Y.; Dalton, M.; Daniel, M. K.; Davids, I. D.; Degrange, B.; Deil, C.; deWilt, P.; Dickinson, H. J.; Djannati-Atäı, A.; Domainko, W.; Drury, L. O'C.; Dubus, G.; Dutson, K.; Dyks, J.; Dyrda, M.; Edwards, T.; Egberts, K.; Eger, P.; Espigat, P.; Farnier, C.; Fegan, S.; Feinstein, F.; Fernandes, M. V.; Fernandez, D.; Fiasson, A.; Fontaine, G.; Förster, A.; Füßling, M.; Gajdus, M.; Gallant, Y. A.; Garrigoux, T.; Giavitto, G.; Giebels, B.; Glicenstein, J. F.; Grondin, M.-H.; Grudzińska, M.; Häffner, S.; Hahn, J.; Harris, J.; Heinzelmann, G.; Henri, G.; Hermann, G.; Hervet, O.; Hillert, A.; Hinton, J. A.; Hofmann, W.; Hofverberg, P.; Holler, M.; Horns, D.; Jacholkowska, A.; Jahn, C.; Jamrozy, M.; Janiak, M.; Jankowsky, F.; Jung, I.; Kastendieck, M. A.; Katarzyński, K.; Katz, U.; Kaufmann, S.; Khélifi, B.; Kieffer, M.; Klepser, S.; Klochkov, D.; Kluźniak, W.; Kneiske, T.; Kolitzus, D.; Komin, Nu.; Kosack, K.; Krakau, S.; Krayzel, F.; Krüger, P. P.; Laffon, H.; Lamanna, G.; Lefaucheur, J.; Lemie`re, A.; Lemoine-Goumard, M.; Lenain, J.-P.; Lohse, T.; Lopatin, A.; Lu, C.-C.; Marandon, V.; Marcowith, A.; Marx, R.; Maurin, G.; Maxted, N.; Mayer, M.; McComb, T. J. L.; Méhault, J.; Meintjes, P. J.; Menzler, U.; Meyer, M.; Moderski, R.; Mohamed, M.; Moulin, E.; Murach, T.; Naumann, C. L.; de Naurois, M.; Niemiec, J.; Nolan, S. J.; Oakes, L.; Odaka, H.; Ohm, S.; de Oña Wilhelmi, E.; Opitz, B.; Ostrowski, M.; Oya, I.; Panter, M.; Parsons, R. D.; Paz Arribas, M.; Pekeur, N. W.; Pelletier, G.; Perez, J.; Petrucci, P.-O.; Peyaud, B.; Pita, S.; Poon, H.; Pühlhofer, G.; Punch, M.; Quirrenbach, A.; Raab, S.; Raue, M.; Reichardt, I.; Reimer, A.; Reimer, O.; Renaud, M.; de los Reyes, R.; Rieger, F.; Rob, L.; Romoli, C.; Rosier-Lees, S.; Rowell, G.; Rudak, B.; Rulten, C. B.; Sahakian, V.; Sanchez, D. A.; Santangelo, A.; Schlickeiser, R.; Schüssler, F.; Schulz, A.; Schwanke, U.; Schwarzburg, S.; Schwemmer, S.; Sol, H.; 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.; Tluczykont, M.; Trichard, C.; Valerius, K.; van Eldik, C.; van Soelen, B.; Vasileiadis, G.; Venter, C.; Viana, A.; Vincent, P.; Völk, H. J.; Volpe, F.; Vorster, M.; Vuillaume, T.; Wagner, S. J.; Wagner, P.; Wagner, R. M.; Ward, M.; Weidinger, M.; Weitzel, Q.; White, R.; Wierzcholska, A.; Willmann, P.; Wörnlein, A.; Wouters, D.; Yang, R.; Zabalza, V.; Zacharias, M.; Zdziarski, A. A.; Zech, A.; Zechlin, H.-S.; Malyshev, D.

2014-02-01

Context. Very-high-energy (VHE; E > 100 GeV) γ-ray emission from blazars inevitably gives rise to electron-positron pair production through the interaction of these γ-rays with the extragalactic background light (EBL). Depending on the magnetic fields in the proximity of the source, the cascade initiated from pair production can result in either an isotropic halo around an initially beamed source or a magnetically broadened cascade flux. Aims: Both extended pair-halo (PH) and magnetically broadened cascade (MBC) emission from regions surrounding the blazars 1ES 1101-232, 1ES 0229+200, and PKS 2155-304 were searched for using VHE γ-ray data taken with the High Energy Stereoscopic System (H.E.S.S.) and high-energy (HE; 100 MeV < E < 100 GeV) γ-ray data with the Fermi Large Area Telescope (LAT). Methods: By comparing the angular distributions of the reconstructed γ-ray events to the angular profiles calculated from detailed theoretical models, the presence of PH and MBC was investigated. Results: Upper limits on the extended emission around 1ES 1101-232, 1ES 0229+200, and PKS 2155-304 are found to be at a level of a few per cent of the Crab nebula flux above 1 TeV, depending on the assumed photon index of the cascade emission. Assuming strong extra-Galactic magnetic field (EGMF) values, >10-12 G, this limits the production of pair haloes developing from electromagnetic cascades. For weaker magnetic fields, in which electromagnetic cascades would result in MBCs, EGMF strengths in the range (0.3-3)× 10-15 G were excluded for PKS 2155-304 at the 99% confidence level, under the assumption of a 1 Mpc coherence length.

A randomized trial of adjunct testosterone for cancer‐related muscle loss in men and women

PubMed Central

Wright, Traver J.; Dillon, E. Lichar; Durham, William J.; Chamberlain, Albert; Randolph, Kathleen M.; Danesi, Christopher; Horstman, Astrid M.; Gilkison, Charles R.; Willis, Maurice; Richardson, Gwyn; Hatch, Sandra S.; Jupiter, Daniel C.; McCammon, Susan; Urban, Randall J.

2018-01-01

Abstract Background Cancer cachexia negatively impacts cancer‐related treatment options, quality of life, morbidity, and mortality, yet no established therapies exist. We investigated the anabolic properties of testosterone to limit the loss of body mass in late stage cancer patients undergoing standard of care cancer treatment. Methods A randomized, double‐blind, placebo‐controlled phase II clinical trial was undertaken to assess the potential therapeutic role of adjunct testosterone to limit loss of body mass in patients with squamous cell carcinoma of the cervix or head and neck undergoing standard of care treatment including chemotherapy and chemoradiation. Patients were randomly assigned in blocks to receive weekly injections of either 100 mg testosterone enanthate or placebo for 7 weeks. The primary outcome was per cent change in lean body mass, and secondary outcomes included assessment of quality of life, tests of physical performance, muscle strength, daily activity levels, resting energy expenditure, nutritional intake, and overall survival. Results A total of 28 patients were enrolled, 22 patients were studied to completion, and 21 patients were included in the final analysis (12 placebo, nine testosterone). Adjunct testosterone increased lean body mass by 3.2% (95% confidence interval [CI], 0–7%) whereas those receiving placebo lost 3.3% (95% CI, −7% to 1%, P = 0.015). Although testosterone patients maintained more favourable body condition, sustained daily activity levels, and showed meaningful improvements in quality of life and physical performance, overall survival was similar in both treatment groups. Conclusions In patients with advanced cancer undergoing the early phase of standard of care therapy, adjunct testosterone improved lean body mass and was also associated with increased quality of life, and physical activity compared with placebo. PMID:29654645

The ATLAS3D project - I. A volume-limited sample of 260 nearby early-type galaxies: science goals and selection criteria

NASA Astrophysics Data System (ADS)

Cappellari, Michele; Emsellem, Eric; Krajnović, Davor; McDermid, Richard M.; Scott, Nicholas; Verdoes Kleijn, G. A.; Young, Lisa M.; Alatalo, Katherine; Bacon, R.; Blitz, Leo; Bois, Maxime; Bournaud, Frédéric; Bureau, M.; Davies, Roger L.; Davis, Timothy A.; de Zeeuw, P. T.; Duc, Pierre-Alain; Khochfar, Sadegh; Kuntschner, Harald; Lablanche, Pierre-Yves; Morganti, Raffaella; Naab, Thorsten; Oosterloo, Tom; Sarzi, Marc; Serra, Paolo; Weijmans, Anne-Marie

2011-05-01

The ATLAS3D project is a multiwavelength survey combined with a theoretical modelling effort. The observations span from the radio to the millimetre and optical, and provide multicolour imaging, two-dimensional kinematics of the atomic (H I), molecular (CO) and ionized gas (Hβ, [O III] and [N I]), together with the kinematics and population of the stars (Hβ, Fe5015 and Mg b), for a carefully selected, volume-limited (1.16 × 105 Mpc3) sample of 260 early-type (elliptical E and lenticular S0) galaxies (ETGs). The models include semi-analytic, N-body binary mergers and cosmological simulations of galaxy formation. Here we present the science goals for the project and introduce the galaxy sample and the selection criteria. The sample consists of nearby (D < 42 Mpc, |δ- 29°| < 35°, |b| > 15°) morphologically selected ETGs extracted from a parent sample of 871 galaxies (8 per cent E, 22 per cent S0 and 70 per cent spirals) brighter than MK < -21.5 mag (stellar mass M★≳ 6 ×109 M⊙). We analyse possible selection biases and we conclude that the parent sample is essentially complete and statistically representative of the nearby galaxy population. We present the size-luminosity relation for the spirals and ETGs and show that the ETGs in the ATLAS3D sample define a tight red sequence in a colour-magnitude diagram, with few objects in the transition from the blue cloud. We describe the strategy of the SAURON integral field observations and the extraction of the stellar kinematics with the pPXF method. We find typical 1σ errors of ΔV≈ 6 km s-1, Δσ≈ 7 km s-1, Δh3≈Δh4≈ 0.03 in the mean velocity, the velocity dispersion and Gauss-Hermite (GH) moments for galaxies with effective dispersion σe≳ 120 km s-1. For galaxies with lower σe (≈40 per cent of the sample) the GH moments are gradually penalized by pPXF towards zero to suppress the noise produced by the spectral undersampling and only V and σ can be measured. We give an overview of the characteristics of the other main data sets already available for our sample and of the ongoing modelling projects.

Seizing opportunities for change at the operational level.

PubMed

Restrepo, Diana; Charron-Latour, Julie; Pourmonet, Hugo; Bassetto, Samuel

2016-04-18

Purpose - This paper presents a method for handling everyday opportunities for improvement, led by floor staff in healthcare institutions. More than 400,000 incidents and accidents were recorded in Quebec healthcare institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose of this paper is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement. Design/methodology/approach - Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l'Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature. Findings - The proposed method presents a 68 per cent increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41 per cent better (lower) than in the reference case. Research limitations/implications - The test lasted 15 weeks; a longer test is needed to collect more data. Practical implications - The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed: first, the operational nature of the proposal (empowerment of the work team); second, the operationalization of continuous improvement (71 per cent of ideas were finalized while the initiative was monitored); third, the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90 per cent of cases); and fourth, a shared feeling that intra- and inter-team communication had been strengthened. Originality/value - The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.

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.

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.

Immediate public health concerns and actions in volcanic eruptions: lessons from the Mount St. Helens eruptions, May 18-October 18, 1980.

PubMed Central

Bernstein, R S; Baxter, P J; Falk, H; Ing, R; Foster, L; Frost, F

1986-01-01

A comprehensive epidemiological evaluation of mortality and short-term morbidity associated with explosive volcanic activity was carried out by the Centers for Disease Control in collaboration with affected state and local health departments, clinicians, and private institutions. Following the May 18, 1980 eruption of Mount St. Helens, a series of public health actions were rapidly instituted to develop accurate information about volcanic hazards and to recommend methods for prevention or control of adverse effects on safety and health. These public health actions included: establishing a system of active surveillance of cause-specific emergency room (ER) visits and hospital admissions in affected and unaffected communities for comparison; assessing the causes of death and factors associated with survival or death among persons located near the crater; analyzing the mineralogy and toxicology of sedimented ash and the airborne concentration of resuspended dusts; investigating reported excesses of ash-related adverse respiratory effects by epidemiological methods such as cross-sectional and case-control studies; and controlling rumors and disseminating accurate, timely information about volcanic hazards and recommended preventive or control measures by means of press briefings and health bulletins. Surveillance and observational studies indicated that: excess in morbidity were limited to transient increases in ER visits and hospital admissions for traumatic injuries and respiratory problems (but not for communicable disease or mental health problems) which were associated in time, place, and person with exposures to volcanic ash; excessive mortality due to suffocation (76 per cent), thermal injuries (12 per cent), or trauma (12 per cent) by ash and other volcanic hazards was directly proportional to the degree of environmental damage--that is, it was more pronounced among those persons (48/65, or about 74 per cent) who, at the time of the eruption, were residing, camping, or sightseeing (despite restrictions) or working (with permission) closer to the crater in areas affected by the explosive blast, pyroclastic and mud flows, and heavy ashfall; and de novo appearance of ash-related asthma was not observed, but transient excesses in adverse respiratory effects occurred in two high-risk groups--hypersusceptibles (with preexisting asthma or chronic bronchitis) and heavily exposed workers. Laboratory and field studies indicated that: volcanic ash had mild to moderate fibrogenic potential, consisting of greater than 90 per cent (by count) respirable size particles which contained 4-7 per cent (by weight) crystalline free silica (SiO2).(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3946727

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.

European Pulsar Timing Array limits on continuous gravitational waves from individual supermassive black hole binaries

NASA Astrophysics Data System (ADS)

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

2016-01-01

We have searched for continuous gravitational wave (CGW) signals produced by individually resolvable, circular supermassive black hole binaries (SMBHBs) in the latest European Pulsar Timing Array (EPTA) data set, which consists of ultraprecise timing data on 41-ms pulsars. We develop frequentist and Bayesian detection algorithms to search both for monochromatic and frequency-evolving systems. None of the adopted algorithms show evidence for the presence of such a CGW signal, indicating that the data are best described by pulsar and radiometer noise only. Depending on the adopted detection algorithm, the 95 per cent upper limit on the sky-averaged strain amplitude lies in the range 6 × 10-15 < A < 1.5 × 10-14 at 5 nHz < f < 7 nHz. This limit varies by a factor of five, depending on the assumed source position and the most constraining limit is achieved towards the positions of the most sensitive pulsars in the timing array. The most robust upper limit - obtained via a full Bayesian analysis searching simultaneously over the signal and pulsar noise on the subset of ours six best pulsars - is A ≈ 10-14. These limits, the most stringent to date at f < 10 nHz, exclude the presence of sub-centiparsec binaries with chirp mass M_c>10^9 M_{⊙} out to a distance of about 25 Mpc, and with M_c>10^{10} M_{⊙} out to a distance of about 1Gpc (z ≈ 0.2). We show that state-of-the-art SMBHB population models predict <1 per cent probability of detecting a CGW with the current EPTA data set, consistent with the reported non-detection. We stress, however, that PTA limits on individual CGW have improved by almost an order of magnitude in the last five years. The continuing advances in pulsar timing data acquisition and analysis techniques will allow for strong astrophysical constraints on the population of nearby SMBHBs in the coming years.

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.

Development of confidence limits by pivotal functions for estimating software reliability

NASA Technical Reports Server (NTRS)

Dotson, Kelly J.

1987-01-01

The utility of pivotal functions is established for assessing software reliability. Based on the Moranda geometric de-eutrophication model of reliability growth, confidence limits for attained reliability and prediction limits for the time to the next failure are derived using a pivotal function approach. Asymptotic approximations to the confidence and prediction limits are considered and are shown to be inadequate in cases where only a few bugs are found in the software. Departures from the assumed exponentially distributed interfailure times in the model are also investigated. The effect of these departures is discussed relative to restricting the use of the Moranda model.

A radio spectral index map and catalogue at 147-1400 MHz covering 80 per cent of the sky

NASA Astrophysics Data System (ADS)

de Gasperin, F.; Intema, H. T.; Frail, D. A.

2018-03-01

The radio spectral index is a powerful probe for classifying cosmic radio sources and understanding the origin of the radio emission. Combining data at 147 MHz and 1.4 GHz from the TIFR GMRT Sky Survey (TGSS) and the NRAO VLA Sky Survey (NVSS), we produced a large-area radio spectral index map of ˜80 per cent of the sky (Dec. > - 40 deg), as well as a radio spectral index catalogue containing 1396 515 sources, of which 503 647 are not upper or lower limits. Almost every TGSS source has a detected counterpart, while this is true only for 36 per cent of NVSS sources. We released both the map and the catalogue to the astronomical community. The catalogue is analysed to discover systematic behaviours in the cosmic radio population. We find a differential spectral behaviour between faint and bright sources as well as between compact and extended sources. These trends are explained in terms of radio galaxy evolution. We also confirm earlier reports of an excess of steep-spectrum sources along the galactic plane. This corresponds to 86 compact and steep-spectrum source in excess compared to expectations. The properties of this excess are consistent with normal non-recycled pulsars, which may have been missed by pulsation searches due to larger than average scattering along the line of sight.

Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective

PubMed Central

Carrasco, Luis R.; Lee, Vernon J.; Chen, Mark I.; Matchar, David B.; Thompson, James P.; Cook, Alex R.

2011-01-01

Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic–economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, Guatemala, India, Indonesia, New Zealand, Singapore, the UK, the USA and Zimbabwe. In the model, antivirals stockpiling considerably reduced mortality. There was greater potential avoidance of expected costs in the higher resourced countries (e.g. from $55 billion to $27 billion over a 30 year time horizon for the USA) and large avoidance of fatalities in those less resourced (e.g. from 11.4 to 2.3 million in Indonesia). Under perfect allocation, higher resourced countries should aim to store antiviral stockpiles able to cover at least 15 per cent of their population, rising to 25 per cent with 30 per cent misallocation, to minimize fatalities and economic costs. Stockpiling is estimated not to be cost-effective for two-thirds of the world's population under current antivirals pricing. Lower prices and international cooperation are necessary to make the life-saving potential of antivirals cost-effective in resource-limited countries. PMID:21296791

Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective.

PubMed

Carrasco, Luis R; Lee, Vernon J; Chen, Mark I; Matchar, David B; Thompson, James P; Cook, Alex R

2011-09-07

Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic-economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, Guatemala, India, Indonesia, New Zealand, Singapore, the UK, the USA and Zimbabwe. In the model, antivirals stockpiling considerably reduced mortality. There was greater potential avoidance of expected costs in the higher resourced countries (e.g. from $55 billion to $27 billion over a 30 year time horizon for the USA) and large avoidance of fatalities in those less resourced (e.g. from 11.4 to 2.3 million in Indonesia). Under perfect allocation, higher resourced countries should aim to store antiviral stockpiles able to cover at least 15 per cent of their population, rising to 25 per cent with 30 per cent misallocation, to minimize fatalities and economic costs. Stockpiling is estimated not to be cost-effective for two-thirds of the world's population under current antivirals pricing. Lower prices and international cooperation are necessary to make the life-saving potential of antivirals cost-effective in resource-limited countries.

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

Synthetic Stellar Photometry - II. Testing the bolometric flux scale and tables of bolometric corrections for the Hipparcos/Tycho, Pan-STARRS1, SkyMapper, and JWST systems

NASA Astrophysics Data System (ADS)

Casagrande, L.; VandenBerg, Don A.

2018-04-01

We use MARCS model atmosphere fluxes to compute synthetic colours, bolometric corrections and reddening coefficients for the Hipparcos/Tycho, Pan-STARRS1, SkyMapper, and JWST systems. Tables and interpolation subroutines are provided to transform isochrones from the theoretical to various observational planes, to derive bolometric corrections, synthetic colours and colour-temperature relations at nearly any given point of the HR diagram for 2600 K ≤ Teff ≤ 8000 K, and different values of reddening in 85 photometric filters. We use absolute spectrophotometry from the CALSPEC library to show that bolometric fluxes can be recovered to ˜2 per cent from bolometric corrections in a single band, when input stellar parameters are well known for FG dwarfs at various metallicities. This sole source of uncertainty impacts interferometric Teff to ≃0.5 per cent (or 30 K at the solar temperature). Uncertainties are halved when combining bolometric corrections in more bands, and limited by the fundamental uncertainty of the current absolute flux scale at 1 per cent. Stars in the RAVE DR5 catalogue are used to validate the quality of our MARCS synthetic photometry in selected filters across the optical and infrared range. This investigation shows that extant MARCS synthetic fluxes are able to reproduce the main features observed in stellar populations across the Galactic disc.

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.

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.

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

Therapeutic ultrasound for acute ankle sprains.

PubMed

van den Bekerom, Michel Pj; van der Windt, Daniëlle Awm; Ter Riet, Gerben; van der Heijden, Geert J; Bouter, Lex M

2011-06-15

Ultrasound is used in the treatment of a wide variety of musculoskeletal disorders, which include acute ankle sprains. This is an update of a Cochrane review first published in 1999, and previously updated in 2004. To evaluate the effects of ultrasound therapy in the treatment of acute ankle sprains. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 3), MEDLINE (1966 to September 2010), EMBASE (1983 to September 2010), CINAHL (1982 to 2004), and PEDro - the Physiotherapy Evidence Database (accessed 01/06/09). We also searched the Cochrane Rehabilitation and Related Therapies Field database, reference lists of articles, and contacted colleagues.The WHO International Clinical Trials Registry Platform was searched for ongoing trials. Randomised or quasi-randomised trials were included if the following conditions were met: at least one study group was treated with therapeutic ultrasound; participants had acute lateral ankle sprains; and outcome measures included general improvement, pain, swelling, functional disability, or range of motion. Two authors independently performed study selection, and assessed the risk of bias and extracted data. Risk ratios and risk differences together with 95% confidence intervals were calculated for dichotomous outcomes and mean differences together with 95% confidence intervals for continuous outcome measures. Limited pooling of data was undertaken where there was clinical homogeneity in terms of participants, treatments, outcomes, and follow-up time points. Six trials were included, involving 606 participants. Five trials included comparisons of ultrasound therapy with sham ultrasound; and three trials included single comparisons of ultrasound with three other treatments. The assessment of risk of bias was hampered by poor reporting of trial methods and results. None of the five placebo-controlled trials (sham ultrasound) demonstrated statistically significant differences between true and sham ultrasound therapy for any outcome measure at one to four weeks of follow-up. The pooled risk ratio for general improvement at one week was 1.04 (random-effects model, 95% confidence interval 0.92 to 1.17) for active versus sham ultrasound. The differences between intervention groups were generally small, between zero and six per cent, for most dichotomous outcomes. The evidence from the five small placebo-controlled trials included in this review does not support the use of ultrasound in the treatment of acute ankle sprains. The potential treatment effects of ultrasound appear to be generally small and of probably of limited clinical importance, especially in the context of the usually short-term recovery period for these injuries. However, the available evidence is insufficient to rule out the possibility that there is an optimal dosage schedule for ultrasound therapy that may be of benefit.

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.

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.

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

Meta‐analysis of antibiotics versus appendicectomy for non‐perforated acute appendicitis

PubMed Central

Sallinen, V.; Akl, E. A.; You, J. J.; Agarwal, A.; Shoucair, S.; Vandvik, P. O.; Agoritsas, T.; Heels‐Ansdell, D.; Guyatt, G. H.

2016-01-01

Abstract Background For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non‐perforated appendicitis. Methods A comprehensive search was conducted for randomized trials comparing antibiotic therapy with appendicectomy in patients with non‐perforated appendicitis. Key outcomes were analysed using random‐effects meta‐analysis, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Five studies including 1116 patients reported major complications in 25 (4·9 per cent) of 510 patients in the antibiotic and 41 (8·4 per cent) of 489 in the appendicectomy group: risk difference −2·6 (95 per cent c.i. –6·3 to 1·1) per cent (low‐quality evidence). Minor complications occurred in 11 (2·2 per cent) of 510 and 61 (12·5 per cent) of 489 patients respectively: risk difference −7·2 (−18·1 to 3·8) per cent (very low‐quality evidence). Of 550 patients in the antibiotic group, 47 underwent appendicectomy within 1 month: pooled estimate 8·2 (95 per cent c.i. 5·2 to 11·8) per cent (high‐quality evidence). Within 1 year, appendicitis recurred in 114 of 510 patients in the antibiotic group: pooled estimate 22·6 (15·6 to 30·4) per cent (high‐quality evidence). For every 100 patients with non‐perforated appendicitis, initial antibiotic therapy compared with prompt appendicectomy may result in 92 fewer patients receiving surgery within the first month, and 23 more experiencing recurrent appendicitis within the first year. Conclusion The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value‐ and preference‐dependent, suggesting a change in practice towards shared decision‐making is necessary. PMID:26990957

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.

Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis.

PubMed

Sallinen, V; Akl, E A; You, J J; Agarwal, A; Shoucair, S; Vandvik, P O; Agoritsas, T; Heels-Ansdell, D; Guyatt, G H; Tikkinen, K A O

2016-05-01

For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non-perforated appendicitis. A comprehensive search was conducted for randomized trials comparing antibiotic therapy with appendicectomy in patients with non-perforated appendicitis. Key outcomes were analysed using random-effects meta-analysis, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Five studies including 1116 patients reported major complications in 25 (4·9 per cent) of 510 patients in the antibiotic and 41 (8·4 per cent) of 489 in the appendicectomy group: risk difference -2·6 (95 per cent c.i. -6·3 to 1·1) per cent (low-quality evidence). Minor complications occurred in 11 (2·2 per cent) of 510 and 61 (12·5 per cent) of 489 patients respectively: risk difference -7·2 (-18·1 to 3·8) per cent (very low-quality evidence). Of 550 patients in the antibiotic group, 47 underwent appendicectomy within 1 month: pooled estimate 8·2 (95 per cent c.i. 5·2 to 11·8) per cent (high-quality evidence). Within 1 year, appendicitis recurred in 114 of 510 patients in the antibiotic group: pooled estimate 22·6 (15·6 to 30·4) per cent (high-quality evidence). For every 100 patients with non-perforated appendicitis, initial antibiotic therapy compared with prompt appendicectomy may result in 92 fewer patients receiving surgery within the first month, and 23 more experiencing recurrent appendicitis within the first year. The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value- and preference-dependent, suggesting a change in practice towards shared decision-making is necessary. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Feline hyperthyroidism reported in primary-care veterinary practices in England: prevalence, associated factors and spatial distribution.

PubMed

Stephens, M J; O'Neill, D G; Church, D B; McGreevy, P D; Thomson, P C; Brodbelt, D C

2014-11-08

Feline hyperthyroidism is a commonly diagnosed endocrinopathy that can have a substantial deleterious impact on the welfare of affected cats. This study aimed to estimate the prevalence, associated factors and geographical distribution for feline hyperthyroidism in England, using primary-care veterinary practice clinical data from the VetCompass Animal Surveillance Project. Prevalence was estimated from the overall cat cohort. Associated factor analysis used an age-matched, nested, case-control design with multivariable logistic regression. There were 2,276 cases of feline hyperthyroidism identified from 95,629 cats attending 84 practices from September 2009 to December 2011. Cases were aged 6-25 years. 3.7 per cent of cases and 9.9 per cent of controls were purebred, 56.4 per cent of cases and 56.5 per cent of controls were female, and 88.1 per cent of cases and 86.0 per cent of controls were neutered. The apparent prevalence was 2.4 per cent (95% CI 2.3 to 2.5 per cent) overall, and 8.7 per cent (95% CI 8.3 to 9.0 per cent) in cats aged 10 years or above. Burmese (OR 0.15, 95% CI 0.07 to 0.32, P<0.0001), Persian (OR 0.17, 95% CI 0.08 to 0.33, P<0.0001), Siamese (OR 0.4, 95% CI 0.21 to 0.75, P=0.004) and purebred cats overall (OR 0.33, 95% CI 0.25 to 0.42, P< 0.0001) had lower odds of feline hyperthyroidism than non-purebred cats. Insured cats had increased odds (OR 1.78, 95% CI 1.56 to 2.03, P< 0.001). There was little evidence of spatial variation. This study highlights feline hyperthyroidism as a high-prevalence disease in England, and reports reduced odds of diagnosis in certain breeds and purebred cats overall. British Veterinary Association.

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.

The perceived and actual diagnostic utility of veterinary cytological samples.

PubMed

Skeldon, N; Dewhurst, E

2009-04-01

To establish the proportion of cytology samples sent to a commercial veterinary laboratory that yields diagnostically useful information in the context of current use and perceptions of cytology. Nine hundred and forty-five cytology submissions were retrospectively collected and categorised according to diagnostic utility. A survey into the use and perceptions of cytology was distributed at the British Small Animal Veterinary Association Congress 2008. A specific diagnosis was reached in 23.1 per cent of samples and a cytological diagnosis in 35.3 per cent. 22.4 per cent of samples yielded some useful information, but 19.2 per cent were unacceptable. Seventy-four participants in the survey took an average of 3.9 cytological samples per week, of which they examined 27.0 per cent in-house only, 21.6 per cent in-house before sending to an external laboratory and 51.4 per cent were sent externally without prior examination. "To obtain a definitive diagnosis" was the principal reason cited for performing cytology. Results suggest that cytology is underused and may be applied in an inappropriate context in the UK. It is hoped that illustrating the diagnostic outcome of samples received by a commercial laboratory will encourage increased, appropriate use of cytology.

[Metastatic breast cancers: comparison of the prognostic significance and the sensitivity to chemotherapy according to the presence of estradiol and progesterone receptors].

PubMed

Pouillart, P; Madgelenat, H; Jouve, M; Palangie, T; Garcia-Giralt, E; Bretaudeau, B; Polijcak, M; Asselain, B

1982-01-01

102 patients with disseminated breast cancer entered this retrospective study. An estrogen receptor (ER) assay was realized in 91 patients and a progesterone receptor (PgR) assay in 90 cases; 44 per cent of the patients were considered as ER+ and 29 per cent as PgR+; 56 per cent were considered as ER- PgR-. The objective response rate to cytotoxic chemotherapy after 4 months of treatment was 66 per cent for ER-, 73 per cent for ER+, 67 per cent for PgR- and 74 per cent for PgR+. However, the mean duration of response was significantly shorter for ER- patients, and no difference appeared between PgR+ and PgR- patients. The acturial survival curves demonstrated a favorable prognostic significance of ER+ as compared to ER- p = 0,03), but the difference was slightly more significant for PgR+ as compared to PgR- (p = 0,008). The prognostic significance of PgR in patients with advanced breast cancer treated with cytotoxic chemotherapy does not appear to be related to the sensitivity to this treatment.

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.

Confidence limit variation for a single IMRT system following the TG119 protocol.

PubMed

Gordon, J D; Krafft, S P; Jang, S; Smith-Raymond, L; Stevie, M Y; Hamilton, R J

2011-03-01

To evaluate the robustness of TG119-based quality assurance metrics for an IMRT system. Four planners constructed treatment plans for the five IMRT test cases described in TG119. All plans were delivered to a 30 cm x 30 cm x 15 cm solid water phantom in one treatment session in order to minimize session-dependent variation from phantom setup, film quality, machine performance, etc. Composite measurements utilized film and an ionization chamber. Per-field measurements were collected using a diode array device at an effective depth of 5 cm. All data collected were analyzed using the TG119 specifications to determine the confidence limit values for each planner separately and then compared. The mean variance of ion chamber measurements for each planner was within 1.7% of the planned dose. The resulting confidence limits were 3.13%, 1.98%, 3.65%, and 4.39%. Confidence limit values determined by composite film analysis were 8.06%, 13.4%, 9.30%, and 16.5%. Confidence limits from per-field measurements were 1.55%, 0.00%, 0.00%, and 2.89%. For a single IMRT system, the accuracy assessment provided by TG119-based quality assurance metrics showed significant variations in the confidence limits between planners across all composite and per-field evaluations. This observed variation is likely due to the different levels of modulation between each planner's set of plans. Performing the TG119 evaluation using plans produced by a single planner may not provide an adequate estimation of IMRT system accuracy.

Confidence in Altman-Bland plots: a critical review of the method of differences.

PubMed

Ludbrook, John

2010-02-01

1. Altman and Bland argue that the virtue of plotting differences against averages in method-comparison studies is that 95% confidence limits for the differences can be constructed. These allow authors and readers to judge whether one method of measurement could be substituted for another. 2. The technique is often misused. So I have set out, by statistical argument and worked examples, to advise pharmacologists and physiologists how best to construct these limits. 3. First, construct a scattergram of differences on averages, then calculate the line of best fit for the linear regression of differences on averages. If the slope of the regression is shown to differ from zero, there is proportional bias. 4. If there is no proportional bias and if the scatter of differences is uniform (homoscedasticity), construct 'classical' 95% confidence limits. 5. If there is proportional bias yet homoscedasticity, construct hyperbolic 95% confidence limits (prediction interval) around the line of best fit. 6. If there is proportional bias and the scatter of values for differences increases progressively as the average values increase (heteroscedasticity), log-transform the raw values from the two methods and replot differences against averages. If this eliminates proportional bias and heteroscedasticity, construct 'classical' 95% confidence limits. Otherwise, construct horizontal V-shaped 95% confidence limits around the line of best fit of differences on averages or around the weighted least products line of best fit to the original data. 7. In designing a method-comparison study, consult a qualified biostatistician, obey the rules of randomization and make replicate observations.

The final stages of the global eradication of poliomyelitis.

PubMed

Grassly, Nicholas C

2013-08-05

The global incidence of poliomyelitis has dropped by more than 99 per cent since the governments of the world committed to eradication in 1988. One of the three serotypes of wild poliovirus has been eradicated and the remaining two serotypes are limited to just a small number of endemic regions. However, the Global Polio Eradication Initiative (GPEI) has faced a number of challenges in eradicating the last 1 per cent of wild-virus transmission. The polio endgame has also been complicated by the recognition that vaccination with the oral poliovirus vaccine (OPV) must eventually cease because of the risk of outbreaks of vaccine-derived polioviruses. I describe the major challenges to wild poliovirus eradication, focusing on the poor immunogenicity of OPV in lower-income countries, the inherent limitations to the sensitivity and specificity of surveillance, the international spread of poliovirus and resulting outbreaks, and the potential significance of waning intestinal immunity induced by OPV. I then focus on the challenges to eradicating all polioviruses, the problem of vaccine-derived polioviruses and the risk of wild-type or vaccine-derived poliovirus re-emergence after the cessation of oral vaccination. I document the role of research in the GPEI's response to these challenges and ultimately the feasibility of achieving a world without poliomyelitis.

Capability of detecting ultraviolet counterparts of gravitational waves with GLUV

NASA Astrophysics Data System (ADS)

Ridden-Harper, Ryan; Tucker, B. E.; Sharp, R.; Gilbert, J.; Petkovic, M.

2017-12-01

With the discovery of gravitational waves (GWs), attention has turned towards detecting counterparts to these sources. In discussions on counterpart signatures and multimessenger follow-up strategies to the GW detections, ultraviolet (UV) signatures have largely been neglected, due to UV facilities being limited to SWIFT, which lacks high-cadence UV survey capabilities. In this paper, we examine the UV signatures from merger models for the major GW sources, highlighting the need for further modelling, while presenting requirements and a design for an effective UV survey telescope. Using the u΄-band models as an analogue, we find that a UV survey telescope requires a limiting magnitude of m_{u^' }}(AB)≈ 24 to fully complement the aLIGO range and sky localization. We show that a network of small, balloon-based UV telescopes with a primary mirror diameter of 30 cm could be capable of covering the aLIGO detection distance from ∼60 to 100 per cent for BNS events and ∼40 per cent for the black hole and a neutron star events. The sensitivity of UV emission to initial conditions suggests that a UV survey telescope would provide a unique data set, which can act as an effective diagnostic to discriminate between models.

The final stages of the global eradication of poliomyelitis

PubMed Central

Grassly, Nicholas C.

2013-01-01

The global incidence of poliomyelitis has dropped by more than 99 per cent since the governments of the world committed to eradication in 1988. One of the three serotypes of wild poliovirus has been eradicated and the remaining two serotypes are limited to just a small number of endemic regions. However, the Global Polio Eradication Initiative (GPEI) has faced a number of challenges in eradicating the last 1 per cent of wild-virus transmission. The polio endgame has also been complicated by the recognition that vaccination with the oral poliovirus vaccine (OPV) must eventually cease because of the risk of outbreaks of vaccine-derived polioviruses. I describe the major challenges to wild poliovirus eradication, focusing on the poor immunogenicity of OPV in lower-income countries, the inherent limitations to the sensitivity and specificity of surveillance, the international spread of poliovirus and resulting outbreaks, and the potential significance of waning intestinal immunity induced by OPV. I then focus on the challenges to eradicating all polioviruses, the problem of vaccine-derived polioviruses and the risk of wild-type or vaccine-derived poliovirus re-emergence after the cessation of oral vaccination. I document the role of research in the GPEI's response to these challenges and ultimately the feasibility of achieving a world without poliomyelitis. PMID:23798688

A Survey on Renewable Energy Development in Malaysia: Current Status, Problems and Prospects

NASA Astrophysics Data System (ADS)

Alam, Syed Shah; Nor, Nor Fariza Mohd; Ahmad, Maisarah; Hashim, Nik Hazrul Nik

2016-05-01

Energy demand in Malaysia is increasing over seven per cent a year, while forty per cent of the energy is supplied from conventional fossil fuel. However, a number of social barriers have mired the social acceptance of renewable energy among the users. This study investigates the current status of renewable energy, problems and future outlook of renewable energy in Malaysia. A total of 200 respondents were surveyed from Klang Valley in Malaysia. Majority of the respondents use energy to generate electricity. Although some respondents reported using solar energy, there is lack of retail availability for solar energy. The findings show that limited information on renewable energy technologies, lack of awareness, and limited private sector engagement emerged as major barriers to sustainable renewable energy development. In addition, the respondents suggest for increasing policy support from the government to make information more accessible to mass users, provide economic incentives to investors and users, and promote small-community based renewable energy projects. The study suggests that the government begin small scale projects to build awareness on renewable energy, while academically, higher learning institutions include renewable energy syllabus in their academic curriculum. The study concluded that to have sustainable renewable energy development, government's initiative, private sector engagement and users awareness must be given priority.

Claw length recommendations for dairy cow foot trimming

PubMed Central

Archer, S. C.; Newsome, R.; Dibble, H.; Sturrock, C. J.; Chagunda, M. G. G.; Mason, C. S.; Huxley, J. N.

2015-01-01

The aim was to describe variation in length of the dorsal hoof wall in contact with the dermis for cows on a single farm, and hence, derive minimum appropriate claw lengths for routine foot trimming. The hind feet of 68 Holstein-Friesian dairy cows were collected post mortem, and the internal structures were visualised using x-ray µCT. The internal distance from the proximal limit of the wall horn to the distal tip of the dermis was measured from cross-sectional sagittal images. A constant was added to allow for a minimum sole thickness of 5 mm and an average wall thickness of 8 mm. Data were evaluated using descriptive statistics and two-level linear regression models with claw nested within cow. Based on 219 claws, the recommended dorsal wall length from the proximal limit of hoof horn was up to 90 mm for 96 per cent of claws, and the median value was 83 mm. Dorsal wall length increased by 1 mm per year of age, yet 85 per cent of the null model variance remained unexplained. Overtrimming can have severe consequences; the authors propose that the minimum recommended claw length stated in training materials for all Holstein-Friesian cows should be increased to 90 mm. PMID:26220848

Preoperative imaging and prediction of oesophageal conduit necrosis after oesophagectomy for cancer.

PubMed

Lainas, P; Fuks, D; Gaujoux, S; Machroub, Z; Fregeville, A; Perniceni, T; Mal, F; Dousset, B; Gayet, B

2017-09-01

Oesophageal conduit necrosis following oesophagectomy is a rare but life-threatening complication. The present study aimed to assess the impact of coeliac axis stenosis on outcomes after oesophagectomy for cancer. The study included consecutive patients who had an Ivor Lewis procedure with curative intent for middle- and lower-third oesophageal cancer at two tertiary referral centres. All patients underwent preoperative multidetector CT with arterial phase to detect coeliac axis stenosis. The coeliac artery was classified as normal, with extrinsic stenosis due to a median arcuate ligament or with intrinsic stenosis caused by atherosclerosis. Some 481 patients underwent an Ivor Lewis procedure. Of these, ten (2·1 per cent) developed oesophageal conduit necrosis after surgery. Coeliac artery evaluation revealed a completely normal artery in 431 patients (91·5 per cent) in the group without conduit necrosis and in one (10 per cent) with necrosis (P < 0·001). Extrinsic stenosis of the coeliac artery due to a median arcuate ligament was found in two patients (0·4 per cent) without conduit necrosis and five (50 per cent) with necrosis (P < 0·001). Intrinsic stenosis of the coeliac artery was found in 11 (2·3 per cent) and eight (80 per cent) patients respectively (P < 0·001). Eight patients without (1·7 per cent) and five (50 per cent) with conduit necrosis had a single and thin left gastric artery (P < 0·001). This study suggests that oesophageal conduit necrosis after oesophagectomy for cancer may be due to pre-existing coeliac axis stenosis. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Prognostic markers in feline hepatic lipidosis: a retrospective study of 71 cats.

PubMed

Kuzi, Sharon; Segev, Gilad; Kedar, Shay; Yas, Einat; Aroch, Itamar

2017-11-11

Feline hepatic lipidosis (HL) is a common, potentially life-threatening disease resulting from prolonged anorexia and increased catabolism. This retrospective study included cats diagnosed with HL based on liver cytology or histopathology (years 2004-2015), and aimed to identify clinical and laboratory parameters associated with mortality. The study included 71 cats (47 females and 24 males) and 85 control cats with non-HL diseases. Most HL cats (90 per cent) were mixed breed, neutered (70; 99 per cent), female (47; 66 per cent), indoor cats (56; 79 per cent), fed dry commercial diets (44 cats; 62 per cent), and with a median age of 7.5 years (range 1.5-16.0). Common primary conditions included gastrointestinal diseases, pancreatitis and cholangiohepatitis (31 cats; 44 per cent) and stressful events (14; 20 per cent). HL was idiopathic in 20 cats (28 per cent). The overall mortality was 38 per cent (27/71 cats). Older age, as well as dullness, weakness, ptyalism, hypoproteinaemia, hypoalbuminaemia, increased serum creatine kinase activity, hypocholesterolaemia and hepatic failure at presentation were significantly (P≤0.033) associated with mortality. The primary disease was unassociated with mortality. Worsening hypoalbuminaemia, hyperammonaemia, hyperbilirubinaemia, electrolyte disorders, and occurrence of cavitary effusions or hypotension during hospitalisation were significantly (P≤0.045) associated with mortality. A decrease of serum β-hydroxybutyrate during hospitalisation was significantly (P=0.01) associated with survival, likely reflecting improvement in the catabolic state. The identified risk factors may be therapeutic targets. © 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.

Compliance and use of the World Health Organization checklist in U.K. operating theatres.

PubMed

Pickering, S P; Robertson, E R; Griffin, D; Hadi, M; Morgan, L J; Catchpole, K C; New, S; Collins, G; McCulloch, P

2013-11-01

The World Health Organization (WHO) Surgical Safety Checklist is reported to reduce surgical morbidity and mortality, and is mandatory in the U.K. National Health Service. Hospital audit data show high compliance rates, but direct observation suggests that actual performance may be suboptimal. For each observed operation, WHO time-out and sign-out attempts were recorded, and the quality of the time-out was evaluated using three measures: all information points communicated, all personnel present and active participation. Observation of WHO checklist performance was conducted for 294 operations, in five hospitals and four surgical specialties. Time-out was attempted in 257 operations (87.4 per cent) and sign-out in 26 (8.8 per cent). Within time-out, all information was communicated in 141 (54.9 per cent), the whole team was present in 199 (77.4 per cent) and active participation was observed in 187 (72.8 per cent) operations. Surgical specialty did not affect time-out or sign-out attempt frequency (P = 0.453). Time-out attempt frequency (range 42-100 per cent) as well as all information communicated (15-83 per cent), all team present (35-90 per cent) and active participation (15-93 per cent) varied between hospitals (P < 0.001 for all). Meaningful compliance with the WHO Surgical Safety Checklist is much lower than indicated by administrative data. Sign-out compliance is generally poor, suggesting incompatibility with normal theatre work practices. There is variation between hospitals, but consistency across studied specialties, suggesting a need to address organizational culture issues. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

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.

Dogs attending primary-care practice in England with clinical signs suggestive of Chiari-like malformation/syringomyelia.

PubMed

Sanchis-Mora, S; Pelligand, L; Thomas, C L; Volk, H A; Abeyesinghe, S M; Brodbelt, D C; Church, D B; Thomson, P C; McGreevy, P D; O'Neill, D G

2016-10-29

Chiari-like malformation/syringomyelia (CM/SM) in dogs describes a developmental disorder that can cause pain and reduced quality of life. This retrospective study aimed to report the period prevalence, clinical signs and risk factors for diagnosis of symptomatic CM/SM in the veterinary primary-care setting using a cross-sectional design. The study population included all dogs within the VetCompass Programme (September 1, 2009-June 13, 2014). Overall, the period prevalence of symptomatic CM/SM was 0.05 per cent (95 per cent CI 0.04 per cent to 0.06 per cent) for all breeds. The period prevalence in the Cavalier King Charles Spaniel (CKCS) was 1.6 per cent (95 per cent CI 1.2 to 2.06). Other breeds at increased odds included the King Charles Spaniel (KCS), Affenpinscher, Chihuahua and Pomeranian. Insured dogs had 4.6 times the odds (95 per cent CI 2.95 to 7.17) of having a diagnosis of CM/SM compared with uninsured dogs. Pain was the most commonly associated clinical sign (67 dogs, 72 per cent). Analgesics were prescribed to 72 (77.4 per cent) of the symptomatic dogs. Despite its low overall period prevalence, the high proportion of affected dogs identified with chronic pain suggests a significant welfare issue. Financial implications could impede the diagnostic process and lead to underestimation of the true prevalence. This study may help to inform clinicians about the clinical relevance and the need for improved awareness of clinical signs, particularly in high-risk breeds, to optimise the management of CM/SM in primary-care practice. British Veterinary Association.

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.

Extended family households among children in the United States: Differences by race/ethnicity and socio-economic status.

PubMed

Cross, Christina J

2018-07-01

This study uses nationally representative longitudinal data from the Panel Study of Income Dynamics, to examine the prevalence and predictors of extended family households among children in the United States and to explore variation by race/ethnicity and socio-economic status (SES). Findings suggest that extended family households are a common living arrangement for children, with 35 per cent of youth experiencing this family structure before age 18. Racial/ethnic and SES differences are substantial: 57 per cent of Black and 35 per cent of Hispanic children ever live in an extended family, compared with 20 per cent of White children. Further, 47 per cent of children whose parents did not finish high school spend time in an extended family, relative to 17 per cent of children whose parents earned a bachelor's degree or higher. Models of predictors show that transitions into extended families are largely a response to social and economic needs.

Motor vehicle-related burns: a review of 107 cases.

PubMed

Papaevangelou, J; Batchelor, J S; Roberts, A H

1995-02-01

Motor vehicles are a major cause of morbidity and mortality. Burn injuries sustained from motor vehicles form a small but important subgroup. The authors have reviewed the case notes of 107 patients with motor vehicle-related burns over a 13-year period. The age ranged from 18 months to 65 years and the male to female ratio was 4:1. The mechanisms of injury were variable, although four major categories could be identified. These accounted for 83 per cent of the cases. Car fires following road traffic accidents was the largest group accounting for 48.5 per cent of cases. The remaining three groups were: motorcycle-related burns following road traffic accidents (6.5 per cent of cases), garage fire-related burns (15 per cent of cases) and car radiator-related burns (13 per cent of cases). Garage fire-related burns had the highest mortality of the four groups (25 per cent). This study demonstrated that garage fire burns are an important subgroup of motor vehicle-related burns.

Genetic influence on age at first birth of female twins born in the UK, 1919-68.

PubMed

Tropf, Felix C; Barban, Nicola; Mills, Melinda C; Snieder, Harold; Mandemakers, Jornt J

2015-01-01

Using a sample of monozygotic (945, 42 per cent) and dizygotic (1,329, 58 per cent) twin pairs born 1919-68 in the UK, we applied innovative tobit models to investigate genetic and environmental influences on age at first birth (AFB). We found that a substantial part (40 per cent) of the variation in AFB is caused by latent family characteristics. Genetic dispositions (26 per cent) play a more important role than the shared environment of siblings (14 per cent), with the non-shared environment/measurement error having the strongest influence (60 per cent). Like previous studies, this study reveals marked changes in estimates over time, and supports the idea that environmental constraints (war or economic crisis) suppress and normative freedom (sexual revolution) promotes the activation of genetic predispositions that affect fertility. We show that the exclusion of censored information (i.e., on the childless) by previous studies biased their results.

[Reappearance of soft chancre: comments on the current epidemic in Paris (author's transl)].

PubMed

Civatte, J; Belaich, S; Bonvalet, D; Vallet, C; Broissin, M

1980-01-01

A total of 678 cases of soft chancre were treated in one hospital between 1973 and 1979. The majority of the patients were males (97 p. cent), and most of them came originally from Maghreb or Black Africa. Contamination was from prostitution (61 p. cent) or chance acquaintances (29 p. cent). The genital ulceration was often clinically atypical, frequently syphiloid; pain was present in only 59 p. cent of cases, and adenopathy, noted in 63 p. cent of patients, had the appearance of an inflammatory bubo in only 23 p. cent. The present high frequency of soft chancres, and their misleading clinical characteristics, makes it sometimes difficult to establish the clinical differential diagnosis from syphilitic chancre, but confirmation of the latter is supplied by direct examination and culture to search for Ducreys bacillus, this being indispensable for establishing the correct diagnosis. Treatment with sulfamethoxazole trimethopin or streptomycin prevents complications and cures the affection in one or two weeks.

Evaluation of cervical spine fracture in the elderly: can we trust our physical examination?

PubMed

Goode, Terral; Young, Andrew; Wilson, Sean P; Katzen, Judith; Wolfe, Luke G; Duane, Therese M

2014-02-01

The purpose of this trial was to compare National Emergency X-Radiography Utilization Study (NEXUS) criteria (NC) with computed tomography (CT) as the gold standard to evaluate cervical spine (C-spine) fractures in elderly blunt trauma patients. We prospectively compared adult blunt trauma patients 65 years or older (E) with younger than 65 years (NE), evaluating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of NC compared with CT in these two cohorts. A total of 2785 blunt trauma patients were included of whom 320 were E (average age, 75 years) and 2465 were NE (average age, 36 years). Incidence of C-spine fracture was 12.8 per cent (E) versus 7.4 per cent (NE) (P = 0.002). Age was an independent predictor of fracture (P = 0.01). NC had a sensitivity of 65.9 per cent in E and PPV of 19.3 per cent in E (P = 0.001) versus a sensitivity of 84.2 per cent in NE and PPV of 10.6 per cent (P < 0.0001). The specificity was 59.5 per cent for E versus 42.6 per cent for NE (NPV, 92.2% E vs 97.1% NE). This study suggests that NEXUS criteria are not an appropriate assessment tool when applied to severe blunt trauma patients, particularly in the elderly population who had more missed injures than their younger counterparts. CT should be used in all blunt trauma patients regardless of whether they meet NEXUS criteria.

Infant mortality and undernutrition in the squatter settlements of Karachi.

PubMed

Thaver, I H; Ebrahim, G J; Richardson, R

1990-06-01

The socio-demographic and biological processes contributing to infant mortality and undernourishment were studied in five urban squatter settlements of Karachi. All those families who had experienced an infant death in the past 2 years (N = 106) were recruited into the study. Comparative children were selected by random numbers with geographical matching from families with at least one live infant and without a history of infant deaths in the past 2 years. The comparison children were weighed and those found underweight (27 per cent) were studied for the presence of risk factors. Forty-one per cent of all deaths were in the neonatal period, and in 47 per cent of cases deaths had occurred in infants with a birth order of 5 and above. Age, duration of breast feeding, birth interval, and the live/dead status of the previous sibling were significant biological variables accounting for 23 per cent of the variance for survival. Socio-economic status accounted for 22 per cent of the variance and health-seeking behaviour (antenatal care, immunization, etc.) for 28 per cent. Sixty-eight per cent of those underweight were more than 6 months old. Age, female sex, birth interval less than 24 months, duration of breast feeding, adolescent mother, alive/dead status of the previous child were significant influences accounting for 12 per cent of the variance. Socio-economic status and health seeking behaviour were also important determinants, but not to the same extent as in the case of infant death.

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.

Zoonotic bacteria and parasites found in raw meat-based diets for cats and dogs.

PubMed

van Bree, Freek P J; Bokken, Gertie C A M; Mineur, Robin; Franssen, Frits; Opsteegh, Marieke; van der Giessen, Joke W B; Lipman, Len J A; Overgaauw, Paul A M

2018-01-13

Feeding raw meat-based diets (RMBDs) to companion animals has become increasingly popular. Since these diets may be contaminated with bacteria and parasites, they may pose a risk to both animal and human health. The purpose of this study was to test for the presence of zoonotic bacterial and parasitic pathogens in Dutch commercial RMBDs. We analysed 35 commercial frozen RMBDs from eight different brands. Escherichia coli serotype O157:H7 was isolated from eight products (23 per cent) and extended-spectrum beta-lactamases-producing E coli was found in 28 products (80 per cent). Listeria monocytogenes was present in 19 products (54 per cent), other Listeria species in 15 products (43 per cent) and Salmonella species in seven products (20 per cent). Concerning parasites, four products (11 per cent) contained Sarcocystis cruzi and another four (11 per cent) S tenella In two products (6 per cent) Toxoplasma gondii was found. The results of this study demonstrate the presence of potential zoonotic pathogens in frozen RMBDs that may be a possible source of bacterial infections in pet animals and if transmitted pose a risk for human beings. If non-frozen meat is fed, parasitic infections are also possible. Pet owners should therefore be informed about the risks associated with feeding their animals RMBDs. © 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.

Variations in locoregional therapy in postmenopausal patients with early breast cancer treated in different countries.

PubMed

van Nes, J G H; Seynaeve, C; Jones, S; Markopoulos, C; Putter, H; van de Velde, C J H; Hasenburg, A; Rea, D W; Vannetzel, J-M; Dirix, L; Hozumi, Y; Kerin, M J; Kieback, D G; Meershoek-Klein Kranenbarg, W M; Hille, E T M; Nortier, J W R

2010-05-01

The Tamoxifen and Exemestane Adjuvant Multinational (TEAM) trial is an international randomized trial evaluating the efficacy and safety of exemestane, alone or following tamoxifen. The large number of patients already recruited offered the opportunity to explore locoregional treatment practices between countries. Patients were enrolled in Belgium, France, Germany, Greece, Ireland, Japan, the Netherlands, the UK and the USA. The core protocol had minor differences in eligibility criteria between countries, reflecting variations in national guidelines and practice regarding adjuvant endocrine therapy. Between 2001 and 2006, 9779 patients of mean(s.d.) age 64(9) years were randomized. Some 58.4 per cent had T1 tumours (range between countries 36.8-75.9 per cent; P < 0.001) and 47.3 per cent were axillary node positive (range 25.9-84.6 per cent; P < 0.001). Independent factors for type of breast surgery were country, age, tumour status and calendar year of surgery. After breast-conserving surgery, radiotherapy was given to 93.2 per cent of patients, 86.0 per cent in the USA and 100 per cent in France. Axillary lymph node dissection was performed in 82.0 (range 74.6-99.1) per cent. Despite international consensus guidelines, wide global variations were observed in treatment practices of early breast cancer. There should be further efforts to optimize locoregional treatment for breast cancer worldwide. Copyright 2010 British Journal of Surgery Society Ltd.

A survey of Campylobacter and other bacterial contaminants of pre-market chicken and retail poultry and meats, King County, Washington.

PubMed Central

Harris, N V; Thompson, D; Martin, D C; Nolan, C M

1986-01-01

As part of a larger study to determine the flow of Campylobacter and Salmonella from food animals to humans during 1982-83, 1,936 swabs were collected for bacteriologic study from pre-market chickens, retail poultry, and other retail meats as well as from equipment and work surfaces used to process such foods. Of the 297 samples collected in a poultry processing plant, 56.6 per cent were positive for Campylobacter jejuni/coli (CJC), as were 23.1 per cent of the 862 retail chicken, and 17.2 per cent of the 29 retail game hen samples. CJC was found infrequently in retail turkey, pork, and beef samples. Contamination of retail and pre-market chicken with CJC appeared to increase as the week progressed, and in pre-market chicken, later in the day. Less than 5 per cent of the retail samples of poultry, beef, and pork were found to contain Yersinia or Salmonella. However, Salmonella was cultured from 14.8 per cent of the swabs taken from the processing plant with 68 per cent of 44 Salmonellas being isolated concurrently with CJC. Tetracycline resistance which was plasmid-mediated was the most common antibiotic resistance observed, and was carried by 23.8 per cent of all CJC isolates. Overall, 38.8 per cent of all CJC isolates were resistant to ampicillin, erythromycin, streptomycin, or tetracycline, either singly or in combination. PMID:3953916

The nature of assembly bias - III. Observational properties

NASA Astrophysics Data System (ADS)

Lacerna, Ivan; Padilla, Nelson; Stasyszyn, Federico

2014-10-01

We analyse galaxies in groups in the Sloan Digital Sky Survey (SDSS) and find a weak but significant assembly-type bias, where old central galaxies have a higher clustering amplitude (61 ± 9 per cent) at scales >1 h-1 Mpc than young central galaxies of equal host halo mass (Mh ˜ 1011.8 h- 1 M⊙). The observational sample is volume limited out to z = 0.1 with Mr - 5 log (h) ≤ -19.6. We construct a mock catalogue of galaxies that shows a similar signal of assembly bias (46 ± 9 per cent) at the same halo mass. We then adapt the model presented by Lacerna & Padilla (Paper I) to redefine the overdensity peak height, which traces the assembly bias such that galaxies in equal density peaks show the same clustering regardless of their stellar age, but this time using observational features such as a flux limit. The proxy for peak height, which is proposed as a better alternative than the virial mass, consists in the total mass given by the mass of neighbour host haloes in cylinders centred at each central galaxy. The radius of the cylinder is parameterized as a function of stellar age and virial mass. The best-fitting sets of parameters that make the assembly bias signal lower than 5-15 per cent for both SDSS and mock central galaxies are similar. The idea behind the parameterization is not to minimize the bias, but it is to use this method to understand the physical features that produce the assembly bias effect. Even though the tracers of the density field used here differ significantly from those used in Paper I, our analysis of the simulated catalogue indicates that the different tracers produce correlated proxies, and therefore the reason behind assembly bias is the crowding of peaks in both simulations and the SDSS.

Supervised machine learning on a network scale: application to seismic event classification and detection

NASA Astrophysics Data System (ADS)

Reynen, Andrew; Audet, Pascal

2017-09-01

A new method using a machine learning technique is applied to event classification and detection at seismic networks. This method is applicable to a variety of network sizes and settings. The algorithm makes use of a small catalogue of known observations across the entire network. Two attributes, the polarization and frequency content, are used as input to regression. These attributes are extracted at predicted arrival times for P and S waves using only an approximate velocity model, as attributes are calculated over large time spans. This method of waveform characterization is shown to be able to distinguish between blasts and earthquakes with 99 per cent accuracy using a network of 13 stations located in Southern California. The combination of machine learning with generalized waveform features is further applied to event detection in Oklahoma, United States. The event detection algorithm makes use of a pair of unique seismic phases to locate events, with a precision directly related to the sampling rate of the generalized waveform features. Over a week of data from 30 stations in Oklahoma, United States are used to automatically detect 25 times more events than the catalogue of the local geological survey, with a false detection rate of less than 2 per cent. This method provides a highly confident way of detecting and locating events. Furthermore, a large number of seismic events can be automatically detected with low false alarm, allowing for a larger automatic event catalogue with a high degree of trust.

Using gamification to develop academic writing skills in dental undergraduate students.

PubMed

El Tantawi, Maha; Sadaf, Shazia; AlHumaid, Jehan

2018-02-01

To assess the satisfaction of first-year dental students with gamification and its effect on perceived and actual improvement of academic writing. Two first-year classes of dental undergraduate students were recruited for the study which extended over 4 months and ended in January 2015. A pre-intervention assessment of students' academic writing skills was performed using criteria to evaluate writing. The same criteria were used to evaluate the final writing assignment after the intervention. Students' satisfaction with game aspects was assessed. The per cent change in writing score was regressed on scores of satisfaction with game aspects controlling for gender. Perceived improvement in writing was also assessed. Data from 87 (94.6%) students were available for analysis. Students' overall satisfaction with the gamified experience was modest [mean (SD) = 5.9 (2.1)] and so was their overall perception of improvement in writing [mean (SD) = 6.0 (2.2)]. The per cent score of the first assignment was 35.6 which improved to 80 in the last assignment. Satisfaction with playing the game was significantly associated with higher percentage of improvement in actual writing skills [regression coefficient (95% confidence interval) = 21.1 (1.9, 40.2)]. Using gamification in an obligatory course for first-year dental students was associated with an improvement in academic writing skills although students' satisfaction with game aspects was modest and their willingness to use gamification in future courses was minimal. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The dynamics of the Local Group as a probe of dark energy and modified gravity

NASA Astrophysics Data System (ADS)

Carlesi, Edoardo; Mota, David F.; Winther, Hans A.

2017-04-01

In this work, we study the dynamics of the Local Group (LG) within the context of cosmological models beyond General Relativity (GR). Using observable kinematic quantities to identify candidate pairs, we build up samples of simulated LG-like objects drawing from f(R), symmetron, Dvali, Gabadadze & Porrati and quintessence N-body simulations together with their Λ cold dark matter (ΛCDM) counterparts featuring the same initial random phase realizations. The variables and intervals used to define LG-like objects are referred to as LG model; different models are used throughout this work and adapted to study their dynamical and kinematic properties. The aim is to determine how well the observed LG dynamics can be reproduced within cosmological theories beyond GR, We compute kinematic properties of samples drawn from alternative theories and ΛCDM and compare them to actual observations of the LG mass, velocity and position. As a consequence of the additional pull, pairwise tangential and radial velocities are enhanced in modified gravity and coupled dark energy with respect to ΛCDM inducing significant changes to the total angular momentum and energy of the LG. For example, in models such as f(R) and the symmetron this increase can be as large as 60 per cent, peaking well outside of the 95 per cent confidence region allowed by the data. This shows how simple considerations about the LG dynamics can lead to clear small-scale observational signatures for alternative scenarios, without the need of expensive high-resolution simulations.

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.

A hip wear simulator with 100 test stations.

PubMed

Saikko, V

2005-09-01

A novel high-capacity hip wear simulator of the pin-on-disc type was designed, built, and validated. This so-called Super-CTPOD (circularly translating pin-on-disc) device has as many as 100 separate test stations, being an advanced version of the previously validated 12-station CTPOD. A validity test was done so that in all stations the specimens and the test conditions were as similar as possible. Hence, for the first time in this field, an adequate number of similar tests was done for a proper statistical analysis of wear data. The pins were conventional, gamma-sterilized ultra-high molecular weight polyethylene, and the discs were polished CoCr. The lubricant was diluted calf serum and the test length 3 million cycles. In the course of the test, the pins became highly polished, whereas the discs remained practically unchanged. The majority of the polyethylene wear particles were rounded, with a mean diameter of 0.25 microm. The 100 wear factor values computed from the 100 steady state wear rate values of the pins were normally distributed, the mean +/- 95 per cent confidence interval being 1.63 +/- 0.017 x 10(-6) mm3 /N m. The standard deviation was 5.4 per cent of the mean. There were no outliers. The wear mechanisms and the wear factor agreed well with clinical findings. Altogether, the Super-CTPOD test system was shown to be a unique combination of validity, low variation, capacity, efficiency, reliability, productivity, economy, ease of operation, and compact size.

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.

The geographical distribution of fossil fuels unused when limiting global warming to 2 °C.

PubMed

McGlade, Christophe; Ekins, Paul

2015-01-08

Policy makers have generally agreed that the average global temperature rise caused by greenhouse gas emissions should not exceed 2 °C above the average global temperature of pre-industrial times. It has been estimated that to have at least a 50 per cent chance of keeping warming below 2 °C throughout the twenty-first century, the cumulative carbon emissions between 2011 and 2050 need to be limited to around 1,100 gigatonnes of carbon dioxide (Gt CO2). However, the greenhouse gas emissions contained in present estimates of global fossil fuel reserves are around three times higher than this, and so the unabated use of all current fossil fuel reserves is incompatible with a warming limit of 2 °C. Here we use a single integrated assessment model that contains estimates of the quantities, locations and nature of the world's oil, gas and coal reserves and resources, and which is shown to be consistent with a wide variety of modelling approaches with different assumptions, to explore the implications of this emissions limit for fossil fuel production in different regions. Our results suggest that, globally, a third of oil reserves, half of gas reserves and over 80 per cent of current coal reserves should remain unused from 2010 to 2050 in order to meet the target of 2 °C. We show that development of resources in the Arctic and any increase in unconventional oil production are incommensurate with efforts to limit average global warming to 2 °C. Our results show that policy makers' instincts to exploit rapidly and completely their territorial fossil fuels are, in aggregate, inconsistent with their commitments to this temperature limit. Implementation of this policy commitment would also render unnecessary continued substantial expenditure on fossil fuel exploration, because any new discoveries could not lead to increased aggregate production.

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.