Probability of Future Observations Exceeding One-Sided, Normal, Upper Tolerance Limits

DOE PAGES

Edwards, Timothy S.

2014-10-29

Normal tolerance limits are frequently used in dynamic environments specifications of aerospace systems as a method to account for aleatory variability in the environments. Upper tolerance limits, when used in this way, are computed from records of the environment and used to enforce conservatism in the specification by describing upper extreme values the environment may take in the future. Components and systems are designed to withstand these extreme loads to ensure they do not fail under normal use conditions. The degree of conservatism in the upper tolerance limits is controlled by specifying the coverage and confidence level (usually written inmore » “coverage/confidence” form). Moreover, in high-consequence systems it is common to specify tolerance limits at 95% or 99% coverage and confidence at the 50% or 90% level. Despite the ubiquity of upper tolerance limits in the aerospace community, analysts and decision-makers frequently misinterpret their meaning. The misinterpretation extends into the standards that govern much of the acceptance and qualification of commercial and government aerospace systems. As a result, the risk of a future observation of the environment exceeding the upper tolerance limit is sometimes significantly underestimated by decision makers. This note explains the meaning of upper tolerance limits and a related measure, the upper prediction limit. So, the objective of this work is to clarify the probability of exceeding these limits in flight so that decision-makers can better understand the risk associated with exceeding design and test levels during flight and balance the cost of design and development with that of mission failure.« less

Complications after common sheath reimplantation in pediatric patients with complicated duplex system.

PubMed

Lee, Yong Seung; Im, Young Jae; Shin, Sang Hee; Bascuna, Rosito T; Ha, Ji Yong; Han, Sang Won

2015-02-01

To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3%). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9%). Postoperative incontinence developed in 3 patients (7.7%). Median preoperative DRF was significantly lower in the postoperative incontinence group (P = .004). DRF decreased postoperatively in 5 of 36 patients (13.9%). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications. Copyright © 2015 Elsevier Inc. All rights reserved.

Specialized connective tissue: bone, the structural framework of the upper extremity

PubMed Central

Weatherholt, Alyssa M.; Fuchs, Robyn K.; Warden, Stuart J.

2011-01-01

Bone is a connective tissue containing cells, fibers and ground substance. There are many functions in the body in which the bone participates, such as storing minerals, providing internal support, protecting vital organs, enabling movement, and providing attachment sites for muscles and tendons. Bone is unique because its collagen framework absorbs energy, while the mineral encased within the matrix allows bone to resist deformation. This article provides an overview of the structure and function of bone tissue from a macroscopic to microscopic level and discusses the physiological processes contributing to upper extremity bone health. It concludes by discussing common conditions influencing upper extremity bone health. PMID:22047807

Evaluation of Future Fuels in a High Pressure Common Rail System. Part 3. John Deere 4.5L Powertech Plus

DTIC Science & Technology

2013-01-01

within the fuel injectors regardless of viscosity or lubricity levels. 15. SUBJECT TERMS Fuel Lubricity, Viscosity, HPCR, Synthetic Jet Fuel, Denso... injectors regardless of viscosity or lubricity levels. UNCLASSIFIED v UNCLASSIFIED FOREWORD/ACKNOWLEDGMENTS The U.S. Army TARDEC...40 3.10 UPPER INJECTOR CONNECTING PIN

Prevalence of upper extremity symptoms and disorders among dental and dental hygiene students.

PubMed

Werner, Robert A; Franzblau, Alfred; Gell, Nancy; Hamann, Curt; Rodgers, Pamela A; Caruso, Timothy J; Perry, Frank; Lamb, Courtney; Beaver, Shirley; Hinkamp, David; Eklund, Kathy; Klausner, Christine P

2005-02-01

Upper extremity musculoskeletal disorders are common among dental professionals. The natural history of these disorders is not well-understood. These disorders are more common in older workers, but the prevalence among younger workers has not been well-studied. The objective of this study was to determine if dental/dental hygiene students had a similar prevalence of upper extremity musculoskeletal disorders compared to age-matched clerical workers. We hypothesize students will have a lower prevalence of upper extremity musculoskeletal disorders compared to clerical workers. This was a cross-sectional design. Dental and dental hygiene students from three schools were compared to clerical workers from three locations (an insurance company and two data processing plants). There were 343 dental and dental hygiene students and 164 age-matched clerical workers. Regional discomfort was the primary outcome. The secondary health outcomes were diagnoses of carpal tunnel syndrome and upper extremity tendinitis. Clerical workers had a higher prevalence of hand symptoms (62 percent vs. 20 percent), elbow symptoms (34 percent vs. 6 percent) and shoulder/neck symptoms (48 percent vs. 16 percent) and a higher prevalence of carpal tunnel syndrome (2.5 percent vs. .6 percent) and upper extremity tendinitis (12 percent vs. 5 percent). The clerical workers were more obese, smoked more, exercised less frequently, and had lower educational levels and less control of their work environment. Dental and dental hygiene students have a very low prevalence of upper extremity musculoskeletal disorders. A longitudinal study is necessary to evaluate ergonomic and personal risk factors.

[Primary upper urinary tract tumors and subsequent location in the bladder].

PubMed

Azémar, M-D; Audouin, M; Revaux, A; Misraï, V; Comperat, E; Bitker, M-O; Chartier-Kastler, E; Richard, F; Cussenot, O; Rouprêt, M

2009-10-01

The urothelium is the epithelium that lines the upper and lower urinary tract. Over 95% of urothelial carcinomas are derived from urothelium. They can be located in the lower tract (bladder, urethra) or upper tract (pyelocaliceal cavities, ureter). Urothelial carcinomas are the fourth most common tumours after prostate (or breast) cancer, lung cancer and colorectal cancer. On one hand, bladder tumours account for 90-95% of urothelial carcinomas. It is the most common malignancy of the urinary tract and the second most common malignancy of the urogenital tract after prostate cancer. It accounts for 5-10% of all cancers diagnosed each year in Europe. On the other hand, upper urinary tract urothelial cell carcinomas (UUT-UCC) are scarce and account for only 5-10% of urothelial carcinomas. Recurrence in the bladder after primary UUT-UCC occurs in 15-50% of UUT-UCC. Differences in treatment modalities of the primary UUT-UCC do not play a key role in the subsequent appearance of a bladder recurrence. However, others factors have been described such as stage and location in the upper tract of the primary tumour or upper tract tumour multifocality. Previous history of bladder tumour is also associated with the risk that another tumour arises in the bladder subsequently. However, it becomes difficult to distinguish between natural history of bladder tumour and evolution of UUT-UCC in these cases. In most cases, bladder cancer occurs in the first two years after UUT-UCC management. Surveillance protocol is based on cystoscopy and on urinary cytology during at least every three months for two years. Current surveillance regimen have a low level of evidence considering the paucity of UUT-UCC.

Assessing the Transition between School and University: Differences in Assessment between A Level and University in English

ERIC Educational Resources Information Center

Wilson, Frances; Child, Simon; Suto, Irenka

2017-01-01

High stakes assessments are commonly used at the end of secondary school to select students for higher education. However, growing concerns about the preparedness of new undergraduates for university study have led to an increased focus on the form of assessments used at upper secondary level. This study compared the structure and format of…

Epidemiology of traumatic upper limb amputations.

PubMed

Pomares, G; Coudane, H; Dap, F; Dautel, G

2018-04-01

While published data on functional outcomes after upper limb amputations are plentiful, epidemiology data are relatively rare. This led us to performing an epidemiology study of traumatic upper limb amputations at our facility. This retrospective study spanned a 10-year period of cases seen at the SOS Main (Hand emergency center) of the Nancy University Hospital in France. Patients who suffered traumatic amputation of the upper limb were identified and divided into two groups: replantation and surgical amputation. All anatomical amputation levels were retained. Non-traumatic amputations were excluded. Epidemiology data (sex, age, dominant side, injured side) was collected along with the specific anatomical level of the injury, the injury mechanism and whether it was work-related. We also looked at the success rate of microsurgery and whether multi-finger amputations were partial or complete. In parallel, the annual incidence of amputations seen at the SOS Main over this period was calculated. Over the 10-year period, 1715 traumatic upper-limb amputations were identified, which was 3% of all cases seen at the SOS Main. Most of the cases involved middle-aged men. Revascularization was attempted in one-third of cases and microsurgery was successful in 70% of cases. The surgical amputation group consisted of 1132 patients with a mean age of 59 years, while the replantation group consisted of 583 patients with a mean age of 48 years. The primary mechanism of injury was a table saw. This injury, which must be addressed urgently, is not very common in everyday practice. This is contrary to lower limb amputations, which are more common and occur in the context of micro- and macroangiopathy in older patients. The success rate of microsurgery in this cohort must be placed in the context of age, amputation level and mechanism. The functional outcomes are not always as good as the vascular outcomes. This data is invaluable as it fills a gap in our knowledge about amputations. IV. Copyright © 2018. Published by Elsevier Masson SAS.

The Place of Rock and Mineral Identification in Geoscience Programs

NASA Astrophysics Data System (ADS)

Nicholls, J.

2011-12-01

Geoscience programs traditionally required a significant amount of class and laboratory time for students to learn to identify Earth materials: minerals, rocks, soils, and fossils. Two decades ago, courses devoted to the mineral sciences, mineralogy and petrology, constituted approximately 20% of a geoscience program. Today, they make up between 5% and 10% of the courses in such a program. Two decades ago students spent their laboratory time learning to identify Earth materials. Today, they do the same thing, even though the time set aside for students to achieve proficiency is limited. A typical learning objective for a geoscience program reads: Identify common Earth materials and interpret their composition, origin and uses. The three underlined words convey the essence of the objective: We ask students to identify and interpret common Earth materials, which begs the questions: Do the common Earth materials provide adequate information for interpreting the composition, origin, and use of Earth materials? Do modern curricula contain enough laboratory time for students to learn to identify Earth materials? Do all geoscientists need to be able to identify Earth materials? The assemblage kyanite plus sillimanite is crucial for interpreting metamorphic history yet they are not common minerals. The IUGS classification contains 179 rock names yet we expect students to identify only a handful of them. The upper mantle is dominated by peridotite yet do geophysicists need to be able to identify peridotite in order to study the upper mantle? All geoscientists should be able to interpret Earth materials, at least at some level, and deduce the information Earth materials provide about Earth history and processes. Only a subset of geoscientists needs to learn how to identify them. Identification skills can be learned in upper level courses designed for those who will become mineral scientists. Many of the interpretations derived from Earth materials can be learned in the lower level courses required of all geoscience students.

Survey of upper extremity injuries among martial arts participants.

PubMed

Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

2013-01-01

To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

Universal Common Communication Substrate (UCCS) Specification; Universal Common Communication Substrate (UCCS) Implementation

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

Universal Common Communication Substrate (UCCS) is a low-level communication substrate that exposes high-performance communication primitives, while providing network interoperability. It is intended to support multiple upper layer protocol (ULPs) or programming models including SHMEM,UPC,Titanium,Co-Array Fortran,Global Arrays,MPI,GASNet, and File I/O. it provides various communication operations including one-sided and two-sided point-to-point, collectives, and remote atomic operations. In addition to operations for ULPs, it provides an out-of-band communication channel required typically required to wire-up communication libraries.

Impact of Cabin Ozone Concentrations on Passenger Reported Symptoms in Commercial Aircraft

PubMed Central

Bekö, Gabriel; Allen, Joseph G.; Weschler, Charles J.; Vallarino, Jose; Spengler, John D.

2015-01-01

Due to elevated ozone concentrations at high altitudes, the adverse effect of ozone on air quality, human perception and health may be more pronounced in aircraft cabins. The association between ozone and passenger-reported symptoms has not been investigated under real conditions since smoking was banned on aircraft and ozone converters became more common. Indoor environmental parameters were measured at cruising altitude on 83 US domestic and international flights. Passengers completed a questionnaire about symptoms and satisfaction with the indoor air quality. Average ozone concentrations were relatively low (median: 9.5 ppb). On thirteen flights (16%) ozone levels exceeded 60 ppb, while the highest peak level reached 256 ppb for a single flight. The most commonly reported symptoms were dry mouth or lips (26%), dry eyes (22.1%) and nasal stuffiness (18.9%). 46% of passengers reported at least one symptom related to the eyes or mouth. A third of the passengers reported at least one upper respiratory symptom. Using multivariate logistic (individual symptoms) and linear (aggregated continuous symptom variables) regression, ozone was consistently associated with symptoms related to the eyes and certain upper respiratory endpoints. A concentration-response relationship was observed for nasal stuffiness and eye and upper respiratory symptom indicators. Average ozone levels, as opposed to peak concentrations, exhibited slightly weaker associations. Medium and long duration flights were significantly associated with more symptoms compared to short flights. The relationship between ultrafine particles and ozone on flights without meal service was indicative of ozone-initiated chemistry. PMID:26011001

A prospective study of neck, shoulder, and upper back pain among technical school students entering working life.

PubMed

Hanvold, Therese N; Veiersted, Kaj B; Waersted, Morten

2010-05-01

The aim of this prospective study was to relate the prevalence of neck, shoulder, and upper back pain to occupational and individual risk factors among a population of technical school students in their transition from school to working life. In addition, we wanted to assess the changes in pain prevalence during follow-up. A cohort consisting of 173 technical school students was followed up during a 3-year period, from their last year of school through their first years of working life. Data on self-reported neck, shoulder, and upper back pain and factors such as mechanical exposure, perceived stress, and physical activity in leisure time were collected. A high prevalence of pain in the neck, shoulder, and upper back among the technical school students was found. There were however few students reporting severe pain. Reporting pain at baseline gave over three times higher risk of reporting it at follow-up. A high level of physical activity outside working hours gave a lower risk of reporting neck, shoulder, and upper back pain at follow-up. High and moderate levels of mechanical exposure and high stress level were not found to be risk factors for pain after entering working life. Neck, shoulder, and upper back pain are common among adolescents and may persist into working life. These results may give potential for preventive efforts at a young age. There is still much uncertainty about the factors leading to musculoskeletal pain, and more research is needed on this topic. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.

Designing Polymerase Chain Reaction (PCR) Primer Multiplexes in the Forensic Laboratory

ERIC Educational Resources Information Center

Elkins, Kelly M.

2011-01-01

The polymerase chain reaction (PCR) is a common experiment in upper-level undergraduate biochemistry, molecular biology, and forensic laboratory courses as reagents and thermocyclers have become more affordable for institutions. Typically, instructors design PCR primers to amplify the region of interest and the students prepare their samples for…

American English Dialogues; Exercises in Colloquial Idiom.

ERIC Educational Resources Information Center

Nakajima, Fumio; And Others

The material in this volume is designed especially for university-level, adult Japanese speakers studying upper-intermediate or advanced conversational English. Each of the 60 lessons presents several common American English idioms in a set of three dialogs. Each idiom appears in various contexts, which are of particular interest to Japanese…

Novel Sensor Technology To Assess Independence and Limb-Use Laterality in Cervical Spinal Cord Injury.

PubMed

Brogioli, Michael; Popp, Werner L; Albisser, Urs; Brust, Anne K; Frotzler, Angela; Gassert, Roger; Curt, Armin; Starkey, Michelle L

2016-11-01

After spinal cord injury (SCI), levels of independence are commonly assessed with standardized clinical assessments. However, such tests do not provide information about the actual extent of upper limb activities or the impact on independence of bi- versus unilateral usage throughout daily life following cervical SCI. The objective of this study was to correlate activity intensity and laterality of upper extremity activity measured by body-fixed inertial measurement units (IMUs) with clinical assessment scores of independence. Limb-use intensity and laterality of activities performed by the upper extremities was measured in 12 subjects with cervical SCI using four IMUs (positioned on both wrists, on the chest, and on one wheel of the wheelchair). Algorithms capable of reliably detecting self-propulsion and arm activity in a clinical environment were applied to rate functional outcome levels, and were related to clinical independence measures during inpatient rehabilitation. Measures of intensity of upper extremity activity during self-propulsion positively correlated (p < 0.05, r = 0.643) with independence measures related to mobility. Clinical measures of laterality were positively correlated (p < 0.01, r = 0.900) with laterality as measured by IMUs during "daily life," and increased laterality was negatively correlated (p < 0.01, r = -0.739) with independence. IMU sensor technology is sensitive in assessing and quantifying upper limb-use intensity and laterality in human cervical SCI. Continuous and objective movement data of distinct daily activities (i.e., mobility and day-to-day activities) can be related to levels of independence. Therefore, IMU sensor technology is suitable not only for monitoring activity levels during rehabilitation (including during clinical trials) but could also be used to assess levels of participation after discharge.

A retrospective photometric study of 82 published reports of mastopexy and breast reduction.

PubMed

Swanson, Eric

2011-12-01

Numerous publications claim to improve breast projection and upper pole fullness after mastopexy or breast reduction. Fascial sutures and "autoaugmentation" with local flaps are advocated. However, there is no objective evidence that these efforts are effective. The author has proposed a measuring system to quantitate results. Not only is this system useful for assessing one's own results, but it may also be used to assess and compare results in published studies. Eighty-two international publications on mastopexies and breast reductions were analyzed. The studies were grouped by technique: inverted-T (superior/medial, central, and inferior pedicles), vertical, periareolar, inframammary, lateral, and "other." Measurements were made using the definitions and terminology reported separately and included breast projection, upper pole projection, lower pole level, nipple level, breast convexity, breast parenchymal ratio, and lower pole ratio. Areola shape was assessed. Breast projection and upper pole projection were not increased significantly by any of the mastopexy/reduction procedures or by the use of fascial sutures or autoaugmentation techniques. Nipple overelevation was common (41.9 percent). The incidence of the teardrop areola deformity (53.8 percent) was significantly higher (p < 0.001) in patients treated with the open technique of nipple placement. There was no significant difference in results when compared by follow-up times, resection weights, year of publication, or geographic region. Existing mastopexy/reduction techniques do not significantly increase breast projection or upper pole projection. Fascial sutures and autoaugmentation techniques are ineffective. Nipple overelevation and the teardrop areola deformity are common problems and should be avoided.

Less common upper limb mononeuropathies.

PubMed

Williams, Faren H; Kumiga, Bryan

2013-05-01

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Comparison the Serum STREM1 Levels Between Children with Upper and Lower UTI.

PubMed

Ehsanipour, Fahime; Noorbakhsh, Samileh; Zarabi, Vida; Movahedi, Zahra; Rahimzadeh, Nahid

2017-01-01

Pyelonephritis is the most common and important infection among Iranian pediatric population. Differentiation between upper and lower Urinary Tract Infection (UTI) is often difficult based on clinical data. Therefore, definite diagnosis is helpful for choosing appropriate antibiotic and decision for hospital admission. The main purpose of this study was todetermine the diagnostic value of serum STREM-1 level in children suspicious to UTI and differentiation of upper UTI and lower UTI. This prospective cross sectional study (2010-2011) was performed to evaluate and compare the serum level of STREM- 1 (pg. /ml) in 36 diagnosed UTI patients (24 upper and 12 lower UTI) with 25 normal children (without UTI) in Rasoul Akram hospital, Tehran, Iran. The mean age of studied children was 3.64 years; 24 male and 37 female. Urinary analysis and urine culture were performed for all UTI cases and only the positive cultured cases with the same microorganism were enrolled in the study. Distinguishing the upper from lower UTI was done on the basis of clinical manifestation and laboratory tests and confirmed by Imaging studies (ultra sonography /or DMSA scan). Blood sampling was taken from all children and centrifuged .The level of STREM-1 (pg /ml) in all sera was determined by Enzyme immunoassay technique (Human TREM-1 immunoassay Sandwich test, Quantikine, R&D systems, Minneapolis; USA). Cut-off levels for STREM-1 were illustrated by ROC curve. The p<0.05 was considered as significant for differences between groups. The mean of STREM -1level had significant difference between overall cases of UTI (427.72pg/ml) and controls (124.24 pg. /ml; P =0.000) ; with cutoff point 111.5 pg./ml ; it had 83.3% sensitivity; and 60 % specificity to distinguish UTI from control. Serum STREM -1 level had no significantly difference between the upper and lower UTI (500pg/ml vs. 283 pg. /ml, P value=0.1) with cutoff point 132 pg./ml it had 83.3% sensitivity ; and 60 % specificity to distinguish upper UTI from lower UTI. Our study demonstrates that even low amount of serum STREM-1 (111.5 pg./ml) has 83.3% sensitivity ; and 60 % specificity to distinguish the UTI from normal cases (P value =0.000) but higher level (132 pg./ml) was needed for definite diagnosis (83.3% sensitivity; 60 % specificity) of upper and lower UTI. It is concluded that serum STREM-1 level test is a valuable tool for early diagnosis of the normal cases with false positive urine culture, or in highly suspicious upper UTI cases with false negative urine culture. Indeed higher titer of this biomarker could be helpful for discriminating the upper from lower UTI. Therefore adding this new biologic marker (STREM-1) to previous ones (CRP, PCT) is suggested to prevent the unnecessary hospital admission and empiric antibiotic therapy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Introductory Bioinformatics Exercises Utilizing Hemoglobin and Chymotrypsin to Reinforce the Protein Sequence-Structure-Function Relationship

ERIC Educational Resources Information Center

Inlow, Jennifer K.; Miller, Paige; Pittman, Bethany

2007-01-01

We describe two bioinformatics exercises intended for use in a computer laboratory setting in an upper-level undergraduate biochemistry course. To introduce students to bioinformatics, the exercises incorporate several commonly used bioinformatics tools, including BLAST, that are freely available online. The exercises build upon the students'…

Upper limit on the inner radiation belt MeV electron intensity.

PubMed

Li, X; Selesnick, R S; Baker, D N; Jaynes, A N; Kanekal, S G; Schiller, Q; Blum, L; Fennell, J; Blake, J B

2015-02-01

No instruments in the inner radiation belt are immune from the unforgiving penetration of the highly energetic protons (tens of MeV to GeV). The inner belt proton flux level, however, is relatively stable; thus, for any given instrument, the proton contamination often leads to a certain background noise. Measurements from the Relativistic Electron and Proton Telescope integrated little experiment on board Colorado Student Space Weather Experiment CubeSat, in a low Earth orbit, clearly demonstrate that there exist sub-MeV electrons in the inner belt because their flux level is orders of magnitude higher than the background, while higher-energy electron (>1.6 MeV) measurements cannot be distinguished from the background. Detailed analysis of high-quality measurements from the Relativistic Electron and Proton Telescope on board Van Allen Probes, in a geo-transfer-like orbit, provides, for the first time, quantified upper limits on MeV electron fluxes in various energy ranges in the inner belt. These upper limits are rather different from flux levels in the AE8 and AE9 models, which were developed based on older data sources. For 1.7, 2.5, and 3.3 MeV electrons, the upper limits are about 1 order of magnitude lower than predicted model fluxes. The implication of this difference is profound in that unless there are extreme solar wind conditions, which have not happened yet since the launch of Van Allen Probes, significant enhancements of MeV electrons do not occur in the inner belt even though such enhancements are commonly seen in the outer belt. Quantified upper limit of MeV electrons in the inner beltActual MeV electron intensity likely much lower than the upper limitMore detailed understanding of relativistic electrons in the magnetosphere.

Upper limit on the inner radiation belt MeV electron intensity

PubMed Central

Li, X; Selesnick, RS; Baker, DN; Jaynes, AN; Kanekal, SG; Schiller, Q; Blum, L; Fennell, J; Blake, JB

2015-01-01

No instruments in the inner radiation belt are immune from the unforgiving penetration of the highly energetic protons (tens of MeV to GeV). The inner belt proton flux level, however, is relatively stable; thus, for any given instrument, the proton contamination often leads to a certain background noise. Measurements from the Relativistic Electron and Proton Telescope integrated little experiment on board Colorado Student Space Weather Experiment CubeSat, in a low Earth orbit, clearly demonstrate that there exist sub-MeV electrons in the inner belt because their flux level is orders of magnitude higher than the background, while higher-energy electron (>1.6 MeV) measurements cannot be distinguished from the background. Detailed analysis of high-quality measurements from the Relativistic Electron and Proton Telescope on board Van Allen Probes, in a geo-transfer-like orbit, provides, for the first time, quantified upper limits on MeV electron fluxes in various energy ranges in the inner belt. These upper limits are rather different from flux levels in the AE8 and AE9 models, which were developed based on older data sources. For 1.7, 2.5, and 3.3 MeV electrons, the upper limits are about 1 order of magnitude lower than predicted model fluxes. The implication of this difference is profound in that unless there are extreme solar wind conditions, which have not happened yet since the launch of Van Allen Probes, significant enhancements of MeV electrons do not occur in the inner belt even though such enhancements are commonly seen in the outer belt. Key Points Quantified upper limit of MeV electrons in the inner belt Actual MeV electron intensity likely much lower than the upper limit More detailed understanding of relativistic electrons in the magnetosphere PMID:26167446

Understanding Differences in Upper Stratospheric Ozone Response to Changes in Chlorine and Temperature as Computed Using CCMVal Models

NASA Technical Reports Server (NTRS)

Douglass, A. R.; Stolarski, R. S.; Strahan, S. E.; Oman, L. D.

2012-01-01

Projections of future ozone levels are made using models that couple a general circulation model with a representation of atmospheric photochemical processes, allowing interactions among photochemical processes, radiation, and dynamics. Such models are known as chemistry and climate models (CCMs). Although developed from common principles and subject to the same boundary conditions, simulated ozone time series vary for projections of changes in ozone depleting substances (ODSs) and greenhouse gases. In the upper stratosphere photochemical processes control ozone level, and ozone increases as ODSs decrease and temperature decreases due to greenhouse gas increase. Simulations agree broadly but there are quantitative differences in the sensitivity of ozone to chlorine and to temperature. We obtain insight into these differences in sensitivity by examining the relationship between the upper stratosphere annual cycle of ozone and temperature as produced by a suite of models. All simulations conform to expectation in that ozone is less sensitive to temperature when chlorine levels are highest because chlorine catalyzed loss is nearly independent of temperature. Differences in sensitivity are traced to differences in simulated temperature, ozone and reactive nitrogen when chlorine levels are close to background. This work shows that differences in the importance of specific processes underlie differences in simulated sensitivity of ozone to composition change. This suggests a) the multi-model mean is not a best estimate of the sensitivity of upper ozone to changes in ODSs and temperature; b) the spread of values is not an appropriate measure of uncertainty.

Upper Albian to Lower Turonian deposits and associated breccias along the Dahar cuestas (southeastern Tunisia): Origin and depositional environments

NASA Astrophysics Data System (ADS)

Krimi, Mabrouk; Ouaja, Mohamed; Zargouni, Fouad

2017-11-01

The carbonate Zebbag Formation of Upper Albian to Lower Turonian age which outcrops along the Dahar cuestas (south eastern Tunisia) includes several breccia intervals. The stratigraphic hierarchy of these breccia levels led to achieving a detailed sequential analysis within a spectrum of depositional environments extending from subtidal to inner to middle ramp settings. Six major transgressive/regressive sequences make up the stacking of the elementary sequences beginning with transgressive and/or storm wave breccias capped by desiccation and/or collapse breccias. The stratigraphic evolutionary history of the breccia facies are interpreted as the result of the interplay between eustatic and tectonic factors. This model is in accord with the tectonic activities common during Upper Albian-Lower Turonian responsible for the sequences onlapping.

Freedom and purpose in biology.

PubMed

McShea, Daniel W

2016-08-01

All seemingly teleological systems share a common hierarchical structure. They consist of a small entity moving or changing within a larger field that directs it from above (what I call "upper direction"). This is true for organisms seeking some external resource, for the organized behavior of cells and other parts in organismal development, and for lineages evolving by natural selection. In all cases, the lower-level entity is partly "free," tending to wander under the influence of purely local forces, and partly directed by a larger enveloping field. The persistent and plastic behavior that characterizes goal-directedness arises, I argue, at intermediate levels of freedom and upper direction, when the two are in a delicate balance. I tentatively extend the argument to human teleology (wants, purposes). Copyright © 2015 Elsevier Ltd. All rights reserved.

Social networking among upper extremity patients.

PubMed

Rozental, Tamara D; George, Tina M; Chacko, Aron T

2010-05-01

Despite their rising popularity, the health care profession has been slow to embrace social networking sites. These are Web-based initiatives, designed to bring people with common interests or activities under a common umbrella. The purpose of this study is to evaluate social networking patterns among upper extremity patients. A total of 742 anonymous questionnaires were distributed among upper extremity outpatients, with a 62% response rate (462 were completed). Demographic characteristics (gender, age, level of education, employment, type of health insurance, and income stratification) were defined, and data on computer ownership and frequency of social networking use were collected. Social network users and nonusers were compared according to their demographic and socioeconomic characteristics. Our patient cohort consisted of 450 patients. Of those 450 patients, 418 had a high school education or higher, and 293 reported a college or graduate degree. The majority of patients (282) were employed at the time of the survey, and income was evenly distributed among U.S. Census Bureau quintiles. A total of 349 patients reported computer ownership, and 170 reported using social networking sites. When compared to nonusers, social networking users were younger (p<.001), more educated (p<.001), and more likely to be employed (p = .013). Users also had higher income levels (p=0.028) and had high rates of computer ownership (p<.001). Multivariate regression revealed that younger age (p<.001), computer ownership (p<.001), and higher education (p<.001) were independent predictors of social networking use. Most users (n = 114) regularly visit a single site. Facebook was the most popular site visited (n=142), followed by MySpace (n=28) and Twitter (n=16). Of the 450 upper extremity patients in our sample, 170 use social networking sites. Younger age, higher level of education, and computer ownership were associated with social networking use. Physicians should consider expanding their use of social networking sites to reach their online patient populations. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The Impact of Child Safety Restraint Status and Age in Motor Vehicle Collisions in Predicting Type and Severity of Bone Fractures and Traumatic Injuries.

PubMed

Loftis, Christopher M; Sawyer, Jeffrey R; Eubanks, James W; Kelly, Derek M

2017-12-01

Although morbidity and mortality in children increases in motor vehicle collisions (MVC) if child restraints are not used, no data exist correlating specific injuries with proper or improper use of safety restraints or age. The purpose of this study was to evaluate correlations between childhood MVC injuries, age, and restraint status. A medical record search for pediatric patients involved in a MVC was conducted at a pediatric hospital (level 1 trauma). Charts were reviewed for demographics and injury-specific information. Patients were grouped by age, restraint use, and injuries. Nine hundred sixty-seven patients ≤12 years (average age 6.39 y) were identified. Being properly restrained was most common in all age groups except the 4- to 8-year age group in which being improperly restrained was most common. Unrestrained patients were most commonly found in the 9- to 12-year age group. A statistically significant difference was not observed for orthopaedic injuries among the restraint groups, but internal thoracic injuries, open head wound, and open upper extremity wounds were significantly more common in improperly or unrestrained patients. Improperly restrained infants had a significantly higher rate of intracranial bleeds and abrasions than those properly restrained. Unrestrained and improperly restrained 9- to 12-year olds had significantly more open head, open upper extremity, and vascular injuries. When comparing injury types with age groups, upper extremity fractures, femoral fractures, dislocations, and spinal fractures were found to be significantly higher in older children. Preventing orthopaedic injuries in older children may be accomplished by changes in regulations or automotive safety equipment. Rear-facing child safety seats could possibly be improved to prevent head trauma in the youngest patients. There is a continued need to reinforce the importance of proper use of child safety devices to parents. Knowledge of the patient's age, along with restraint status, might aid in diagnosis of less obvious MCV injuries. Level III.

Common Ice Hockey Injuries and Treatment: A Current Concepts Review.

PubMed

Mosenthal, William; Kim, Michael; Holzshu, Robert; Hanypsiak, Bryan; Athiviraham, Aravind

Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article. Lower-extremity injuries reviewed in this article include adductor strain, athletic pubalgia, femoroacetabular impingement, sports hernia, medial collateral and anterior cruciate ligament tears, skate bite, and ankle sprains. This review is intended to aid the sports medicine physician in providing optimal sports-specific care to allow their athlete to return to their preinjury level of performance.

Fusariotoxicosis from barley in British Columbia. I. Natural occurrence and diagnosis.

PubMed

Greenway, J A; Puls, R

1976-01-01

Clinical sickness was observed in domestic ducks, geese, horses and swine during October 1973. All species showed upper alimentary distress with mortalities occurring in the geese. Barley derived from a common source had been fed. Examination of the barley revealed invasion by Fusarium spp and detection of a high level of dermatitic fusariotoxins.

Teaching of Chemical Bonding: A Study of Swedish and South African Students' Conceptions of Bonding

ERIC Educational Resources Information Center

Nimmermark, Anders; Ohrstrom, Lars; Mårtensson, Jerker; Davidowitz, Bette

2016-01-01

Almost 700 Swedish and South African students from the upper secondary school and first-term chemistry university level responded to our survey on concepts of chemical bonding. The national secondary school curricula and most common textbooks for both countries were also surveyed and compared for their content on chemical bonding. Notable…

Conversation and Control: Emergent Progressive Pedagogy in the Last of Nebraska's One-Teacher Schools

ERIC Educational Resources Information Center

Swidler, Stephen A.

2005-01-01

This article describes the teaching practices at Upper Rill School, a 1-teacher school in rural Nebraska. With its 8 students, grades 1 through 8, the teacher considers the school?s size and continuity of student enrollment flexible and generative. Subject matter and grade levels are regularly integrated though common curricula. Instruction is…

Assembly of a Modular Fluorimeter and Associated Software: Using LabVIEW in an Advanced Undergraduate Analytical Chemistry Laboratory

ERIC Educational Resources Information Center

Algar, W. Russ; Massey, Melissa; Krull, Ulrich J.

2009-01-01

A laboratory activity for an upper-level undergraduate course in instrumental analysis has been created around LabVIEW. Students learn rudimentary programming and interfacing skills during the construction of a fluorimeter assembled from common modular components. The fluorimeter consists of an inexpensive data acquisition module, LED light…

The Use of Demonstrative Pronoun and Demonstrative Determiner "This" in Upper-Level Student Writing: A Case Study

ERIC Educational Resources Information Center

Rustipa, Katharina

2015-01-01

Demonstrative "this" is worthy to investigate because of the role of "this" as a common cohesive device in academic writing. This study attempted to find out the variables underlying the realization of demonstrative "this" in graduate-student writing of Semarang State University, Indonesia. The data of the study were…

Assessment of Selected Aspects of Teaching Programming in SK and CZ

ERIC Educational Resources Information Center

Záhorec, Jan; Hašková, Alena; Munk, Michal

2014-01-01

Authors of this paper carried out a broader international research aimed at assessing the computer science education at upper secondary level of education--ISCED 3A. The assessed school subjects were informatics and programming as the most common school subjects taught at secondary schools within computer sciences. The assessment was based on the…

Neck Dissection Technique Commonality and Variance: A Survey on Neck Dissection Technique Preferences among Head and Neck Oncologic Surgeons in the American Head and Neck Society

PubMed Central

Hemmat, Shirin M.; Wang, Steven J.; Ryan, William R.

2016-01-01

Introduction Neck dissection (ND) technique preferences are not well reported. Objective The objective of this study is to educate practitioners and trainees about surgical technique commonality and variance used by head and neck oncologic surgeons when performing a ND. Methods Online survey of surgeon members of the American Head and Neck Society (AHNS). Survey investigated respondents' demographic information, degree of surgical experience, ND technique preferences. Results In our study, 283 out of 1,010 (28%) AHNS surgeon members with a mean age of 50.3 years (range 32–77 years) completed surveys from 41 states and 24 countries. We found that 205 (72.4%) had completed a fellowship in head and neck surgical oncology. Also, 225 (79.5%) respondents reported completing more than 25 NDs per year. ND technique commonalities (>66% respondents) included: preserving level 5 (unless with suspicious lymph nodes (LN)), only excising the portion of sternocleidomastoid muscle involved with tumor, resecting lymphatic tissue en bloc, preservation of cervical sensory rootlets, not performing submandibular gland (SMG) transfer, placing one drain for unilateral selective NDs, and performing a ND after parotidectomy and thyroidectomy and before transcervical approaches to upper aerodigestive tract primary site. Variability existed in the sequence of LN levels excised, instrument preferences, criteria for drain removal, the timing of a ND with transoral upper aerodigestive tract primary site resections, and submandibular gland preservation. Results showed that 122 (43.1%) surgeons reported that they preserve the submandibular gland during the level 1b portion of a ND. Conclusions The commonalities and variances reported for the ND technique may help put individual preferences into context. PMID:28050201

Progress on the J-2X Upper Stage Engine for the Ares I Crew Launch Vehicle and the Ares V Cargo Launch Vehicle

NASA Technical Reports Server (NTRS)

Byrd, Thomas D.; Kynard, Michael .

2007-01-01

NASA's Vision for Exploration requires a safe, reliable, affordable upper stage engine to power the Ares I Crew Launch Vehicle (CLV) and the Ares V Cargo Launch Vehicle. The J-2X engine is being developed for that purpose, epitomizing NASA's philosophy of employing legacy knowledge, heritage hardware, and commonality to carry the next generation of explorers into low-Earth orbit and out into the solar system This presentation gives top-level details on accomplishments to date and discusses forward work necessary to bring the J-2X engine to the launch pad.

Adult obstructive sleep apnoea

PubMed Central

Jordan, Amy S.; McSharry, David G.; Malhotra, Atul

2013-01-01

Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, which leads to oxygen desaturation and disrupted sleep. Symptoms include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60–70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss. PMID:23910433

ASSESSMENT OF UPPER EXTREMITY IMPAIRMENT, FUNCTION, AND ACTIVITY FOLLOWING STROKE: FOUNDATIONS FOR CLINICAL DECISION MAKING

PubMed Central

Lang, Catherine E.; Bland, Marghuretta D.; Bailey, Ryan R.; Schaefer, Sydney Y.; Birkenmeier, Rebecca L.

2012-01-01

The purpose of this review is to provide a comprehensive approach for assessing the upper extremity (UE) after stroke. First, common upper extremity impairments and how to assess them are briefly discussed. While multiple UE impairments are typically present after stroke, the severity of one impairment, paresis, is the primary determinant of UE functional loss. Second, UE function is operationally defined and a number of clinical measures are discussed. It is important to consider how impairment and loss of function affect UE activity outside of the clinical environment. Thus, this review also identifies accelerometry as an objective method for assessing UE activity in daily life. Finally, the role that each of these levels of assessment should play in clinical decision making is discussed in order to optimize the provision of stroke rehabilitation services. PMID:22975740

Common drive to the upper airway muscle genioglossus during inspiratory loading

PubMed Central

Woods, Michael J.; Nicholas, Christian L.; Semmler, John G.; Chan, Julia K. M.; Jordan, Amy S.

2015-01-01

Common drive is thought to constitute a central mechanism by which the efficiency of a motor neuron pool is increased. This study tested the hypothesis that common drive to the upper airway muscle genioglossus (GG) would increase with increased respiratory drive in response to an inspiratory load. Respiration, GG electromyographic (EMG) activity, single-motor unit activity, and coherence in the 0–5 Hz range between pairs of GG motor units were assessed for the 30 s before an inspiratory load, the first and second 30 s of the load, and the 30 s after the load. Twelve of twenty young, healthy male subjects provided usable data, yielding 77 pairs of motor units: 2 Inspiratory Phasic, 39 Inspiratory Tonic, 15 Expiratory Tonic, and 21 Tonic. Respiratory and GG inspiratory activity significantly increased during the loads and returned to preload levels during the postload periods (all showed significant quadratic functions over load trials, P < 0.05). As hypothesized, common drive increased during the load in inspiratory modulated motor units to a greater extent than in expiratory/tonic motor units (significant load × discharge pattern interaction, P < 0.05). Furthermore, this effect persisted during the postload period. In conclusion, common drive to inspiratory modulated motor units was elevated in response to increased respiratory drive. The postload elevation in common drive was suggestive of a poststimulus activation effect. PMID:26378207

Arousal from sleep does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals.

PubMed

Jordan, Amy S; Cori, Jennifer M; Dawson, Andrew; Nicholas, Christian L; O'Donoghue, Fergal J; Catcheside, Peter G; Eckert, Danny J; McEvoy, R Doug; Trinder, John

2015-01-01

To compare changes in end-tidal CO2, genioglossus muscle activity and upper airway resistance following tone-induced arousal and the return to sleep in healthy individuals with small and large ventilatory responses to arousal. Observational study. Two sleep physiology laboratories. 35 men and 25 women with no medical or sleep disorders. Auditory tones to induce 3-s to 15-s cortical arousals from sleep. During arousal from sleep, subjects with large ventilatory responses to arousal had higher ventilation (by analytical design) and tidal volume, and more marked reductions in the partial pressure of end-tidal CO2 compared to subjects with small ventilatory responses to arousal. However, following the return to sleep, ventilation, genioglossus muscle activity, and upper airway resistance did not differ between high and low ventilatory response groups (Breath 1 on return to sleep: ventilation 6.7±0.4 and 5.5±0.3 L/min, peak genioglossus activity 3.4%±1.0% and 4.8%±1.0% maximum, upper airway resistance 4.7±0.7 and 5.5±1.0 cm H2O/L/s, respectively). Furthermore, dilator muscle activity did not fall below the pre-arousal sleeping level and upper airway resistance did not rise above the pre-arousal sleeping level in either group for 10 breaths following the return to sleep. Regardless of the magnitude of the ventilatory response to arousal from sleep and subsequent reduction in PETCO2, healthy individuals did not develop reduced dilator muscle activity nor increased upper airway resistance, indicative of partial airway collapse, on the return to sleep. These findings challenge the commonly stated notion that arousals predispose to upper airway obstruction. © 2014 Associated Professional Sleep Societies, LLC.

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

Matthias C. M. Troffaes; Gero Walter; Dana Kelly

In a standard Bayesian approach to the alpha-factor model for common-cause failure, a precise Dirichlet prior distribution models epistemic uncertainty in the alpha-factors. This Dirichlet prior is then updated with observed data to obtain a posterior distribution, which forms the basis for further inferences. In this paper, we adapt the imprecise Dirichlet model of Walley to represent epistemic uncertainty in the alpha-factors. In this approach, epistemic uncertainty is expressed more cautiously via lower and upper expectations for each alpha-factor, along with a learning parameter which determines how quickly the model learns from observed data. For this application, we focus onmore » elicitation of the learning parameter, and find that values in the range of 1 to 10 seem reasonable. The approach is compared with Kelly and Atwood's minimally informative Dirichlet prior for the alpha-factor model, which incorporated precise mean values for the alpha-factors, but which was otherwise quite diffuse. Next, we explore the use of a set of Gamma priors to model epistemic uncertainty in the marginal failure rate, expressed via a lower and upper expectation for this rate, again along with a learning parameter. As zero counts are generally less of an issue here, we find that the choice of this learning parameter is less crucial. Finally, we demonstrate how both epistemic uncertainty models can be combined to arrive at lower and upper expectations for all common-cause failure rates. Thereby, we effectively provide a full sensitivity analysis of common-cause failure rates, properly reflecting epistemic uncertainty of the analyst on all levels of the common-cause failure model.« less

Environmental regulation of plant gene expression: an RT-qPCR laboratory project for an upper-level undergraduate biochemistry or molecular biology course.

PubMed

Eickelberg, Garrett J; Fisher, Alison J

2013-01-01

We present a novel laboratory project employing "real-time" RT-qPCR to measure the effect of environment on the expression of the FLOWERING LOCUS C gene, a key regulator of floral timing in Arabidopsis thaliana plants. The project requires four 3-hr laboratory sessions and is aimed at upper-level undergraduate students in biochemistry or molecular biology courses. The project provides students with hands-on experience with RT-qPCR, the current "gold standard" for gene expression analysis, including detailed data analysis using the common 2-ΔΔCT method. Moreover, it provides a convenient starting point for many inquiry-driven projects addressing diverse questions concerning ecological biochemistry, naturally occurring genetic variation, developmental biology, and the regulation of gene expression in nature. Copyright © 2013 Wiley Periodicals, Inc.

Stress fractures of the ribs and upper extremities: causation, evaluation, and management.

PubMed

Miller, Timothy L; Harris, Joshua D; Kaeding, Christopher C

2013-08-01

Stress fractures are common troublesome injuries in athletes and non-athletes. Historically, stress fractures have been thought to predominate in the lower extremities secondary to the repetitive stresses of impact loading. Stress injuries of the ribs and upper extremities are much less common and often unrecognized. Consequently, these injuries are often omitted from the differential diagnosis of rib or upper extremity pain. Given the infrequency of this diagnosis, few case reports or case series have reported on their precipitating activities and common locations. Appropriate evaluation for these injuries requires a thorough history and physical examination. Radiographs may be negative early, requiring bone scintigraphy or MRI to confirm the diagnosis. Nonoperative and operative treatment recommendations are made based on location, injury classification, and causative activity. An understanding of the most common locations of upper extremity stress fractures and their associated causative activities is essential for prompt diagnosis and optimal treatment.

Ecological Effects of Rubble Weir Jetty Construction at Murrells Inlet, South Carolina. Volume 2. Changes in Macrobenthic Communities of Sandy Beach and Nearshore ENvironments.

DTIC Science & Technology

1984-06-01

species were not commonly observed, and oligochaetes and nematodes were abundant in the area. Rany of these differences were attributed to normal...1977-78 (Table 3). Subtidally, amphipods and pelecypods were most abundant in 1982, while oligochaetes and nematodes largely dominated the intertidal...generally restricted to that level and the highest intertidal level (Table 10). Nematodes were also abundant in the upper intertidal zone, with greatest

PROPOSED PROCEDURE FOR DERIVATION OF REGULATORY VALUES FOR CARCINOGENIC AIRBORNE POLYCYCLIC AROMATIC HYDROCARBONS (PAHS) BASED ON COAL TAR PITCH (CTP) VOLATILES

EPA Science Inventory

A procedure for estimating upper bound lifetime human cancer risk from air levels of 6 common carcinogenic PAHs, termed "PAHs of concern", is proposed. These PAHs are benzo(a)pyrene, benz(a)anathracene, benzo(k)flouranthene, indeno(1,2,3-c,d)pyrene and chrysene. In application,...

Etiological and Endoscopic Profile of Middle Aged and Elderly Patients with Upper Gastrointestinal Bleeding in a Tertiary Care Hospital in North India: A Retrospective Analysis.

PubMed

Mahajan, Pranav; Chandail, Vijant Singh

2017-01-01

Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease. This study aims to study the clinical and endoscopic profile of middle aged and elderly patients suffering from upper GI bleed to know the etiology of the disease and outcome of the intervention. Out of a total of 1790 patients who presented to the hospital from May 2015 to August 2017 with upper GI bleed, and underwent upper GI endoscopy, data of 1270 patients, aged 40 years and above, was compiled and analyzed retrospectively. All the patients included in the study were above 40 years of age. Majority of the patients were males, with a male to female ratio of 1.6:1. The most common causes of upper GI bleed in these patients were portal hypertension-related (esophageal, gastric and duodenal varices, portal hypertensive gastropathy, and gastric antral vascular ectasia GAVE), seen in 53.62% of patients, followed by peptic ulcer disease (gastric and duodenal ulcers) seen in 17.56% of patients. Gastric erosions/gastritis accounted for 15.20%, and duodenal erosions were seen in 5.8% of upper GI bleeds. The in-hospital mortality rate in our study population was 5.83%. The present study reported portal hypertension as the most common cause of upper GI bleeding, while the most common endoscopic lesions reported were esophageal varices, followed by gastric erosion/gastritis, and duodenal ulcer.

An efficient and accurate solution methodology for bilevel multi-objective programming problems using a hybrid evolutionary-local-search algorithm.

PubMed

Deb, Kalyanmoy; Sinha, Ankur

2010-01-01

Bilevel optimization problems involve two optimization tasks (upper and lower level), in which every feasible upper level solution must correspond to an optimal solution to a lower level optimization problem. These problems commonly appear in many practical problem solving tasks including optimal control, process optimization, game-playing strategy developments, transportation problems, and others. However, they are commonly converted into a single level optimization problem by using an approximate solution procedure to replace the lower level optimization task. Although there exist a number of theoretical, numerical, and evolutionary optimization studies involving single-objective bilevel programming problems, not many studies look at the context of multiple conflicting objectives in each level of a bilevel programming problem. In this paper, we address certain intricate issues related to solving multi-objective bilevel programming problems, present challenging test problems, and propose a viable and hybrid evolutionary-cum-local-search based algorithm as a solution methodology. The hybrid approach performs better than a number of existing methodologies and scales well up to 40-variable difficult test problems used in this study. The population sizing and termination criteria are made self-adaptive, so that no additional parameters need to be supplied by the user. The study indicates a clear niche of evolutionary algorithms in solving such difficult problems of practical importance compared to their usual solution by a computationally expensive nested procedure. The study opens up many issues related to multi-objective bilevel programming and hopefully this study will motivate EMO and other researchers to pay more attention to this important and difficult problem solving activity.

ENDOSCOPIC FINDINGS OF UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH LIVER CIRROSIS.

PubMed

Hadayat, Rania; Jehangiri, Attique-ur-Rehman; Gul, Rahid; Khan, Adil Naseer; Said, Khalid; Gandapur, Asadullah

2015-01-01

Acute upper gastrointestinal (GI) bleeding is a common medical emergency. A common risk factor of upper GI bleeding is cirrhosis of liver, which can lead to variceal haemorrhage. 30-40% of cirrhotic patients who bleed may have non-variceal upper GI bleeding and it is frequently caused by peptic ulcers, portal gastropathy, Mallory-Weiss tear, and gastroduodenal erosions. The objective of this study was to determine the frequency of upper gastrointestinal endoscopic findings among patients presenting with upper gastrointestinal bleeding with liver cirrhosis. This descriptive cross-sectional study was carried out in Gastroenterology & Hepatology Department of Ayub Teaching Hospital, Abbottabad from February 2012 to June 2013. 252 patients diagnosed with cirrhosis, presenting with upper GI bleed, age 50 years of either gender, and were included in the study. Non-probability consecutive sampling was used, Endoscopy was performed on each patient and the findings documented. The mean age was 57.84 +/- 6.29 years. There were 158 (62.7%) males and 94 (37.3%) females. The most common endoscopic finding was oesophageal varices (92.9%, n=234) followed by portal hypertensive gastropathy (38.9%, n=98) with almost equal distribution among males and females. Gastric varices were found in 33.3% of patients (n=84). Among other non-variceal lesions, peptic ulcer disease was seen in 26 patients (10.3%) while gastric erosions were found in 8 patients (3.2%). In patients with acute upper GI bleeding and liver cirrhosis, the most common endoscopic finding is oesophageal varices, with a substantially higher value in our part of the country, apart from other non-variceal causes.

Micronutrients decrease incidence of common infections in type 2 diabetic outpatients.

PubMed

Liu, Yinghua; Jing, Hongjiang; Wang, Jin; Zhang, Rongxin; Zhang, Yuehong; Zhang, Yong; Xu, Qing; Yu, Xiaoming; Xue, Changyong

2011-01-01

A randomized, double-blind, placebo-controlled trial was carried out to investigate the effects of micronutrients supplementation on immunity and the incidence of common infections in type 2 diabetic outpatients. A total of 196 type 2 diabetic outpatients were randomized to receive tablets of micronutrients (n=97) or placebo (n=99) for 6 months. Individualized dietary energy intake and daily physical activity were recommended. Anthropometric measurements, blood biochemical variables and the incidence of common infections were measured at baseline and at 6 months. Data on diet, exercise and infection (upper respiratory tract infection, skin infection, urinary and genital tract infections, other infections) were recorded 1 month before the study and every month during the study. Blood concentrations of total protein, iron (Fe), folic acid and hemoglobin increased and unsaturated iron-binding capacity(UIBC) levels were decreased in the micronutrients supplementation group compared to the placebo group at 6 months. Moreover, at 6 months, compared to the placebo group, the blood concentrations of IgE, CD4+, CD4+/CD8+, WBC, lymphocyte counts, basophilic leukocyte increased and CD8+ count decreased in the supplementation group, and the levels of IgA, IgM, IgG and complements C3 and C4 did not differ. The incidence of upper respiratory infection, whitlow, dermapostasis, vaginitis, urinary tract infection, gingivitis and dental ulcer were lower and body temperature and duration of fever greatly improved in the supplementation than the placebo group. These data indicated that supplementation of micronutrients might increase immune function and reduce the incidence of common infections in type 2 diabetic outpatients.

Examining Predictive Validity of Oral Reading Fluency Slope in Upper Elementary Grades Using Quantile Regression.

PubMed

Cho, Eunsoo; Capin, Philip; Roberts, Greg; Vaughn, Sharon

2017-07-01

Within multitiered instructional delivery models, progress monitoring is a key mechanism for determining whether a child demonstrates an adequate response to instruction. One measure commonly used to monitor the reading progress of students is oral reading fluency (ORF). This study examined the extent to which ORF slope predicts reading comprehension outcomes for fifth-grade struggling readers ( n = 102) participating in an intensive reading intervention. Quantile regression models showed that ORF slope significantly predicted performance on a sentence-level fluency and comprehension assessment, regardless of the students' reading skills, controlling for initial ORF performance. However, ORF slope was differentially predictive of a passage-level comprehension assessment based on students' reading skills when controlling for initial ORF status. Results showed that ORF explained unique variance for struggling readers whose posttest performance was at the upper quantiles at the end of the reading intervention, but slope was not a significant predictor of passage-level comprehension for students whose reading problems were the most difficult to remediate.

Adult obstructive sleep apnoea.

PubMed

Jordan, Amy S; McSharry, David G; Malhotra, Atul

2014-02-22

Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, leading to oxygen desaturation and disrupted sleep. Features include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60-70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss. Copyright © 2014 Elsevier Ltd. All rights reserved.

Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014.

PubMed

Baidwan, N K; Naranje, S M

2017-01-01

Fractures in geriatric age group (over 65 years of age) are an important public health issue and frequent causes of emergency room visits. The purpose of this descriptive epidemiological study was to present the epidemiology of geriatric fractures and their trends in the USA using National Electronic Injury Surveillance System (NEISS) database from year 2004-2014. National Electronic Injury Surveillance System (NEISS) Database was queried for all fracture injuries from 2004 to 2014 for ages 65 years and above. The proportions of fractures based on NEISS national estimates were calculated and their trends using linear regression over last 11 years were studied. Lower trunk (pelvis, hip and lower spine) fractures were the most common (34% for year 2014) type of fractures in this age group. Upper trunk (upper spine, clavicle and ribs) fractures were the second most common type of fractures (13% for year 2014). Other body parts commonly fractured involved the upper arm and wrist with an average of 7% fractures in both during the study period. About 5% of geriatric fractures pertained to shoulder and upper leg. Although less common, there was also about 2% increase in fractures to face and neck in 2014 as compared to about 3.2% and 1% respectively in 2004. Fractures to other body parts were less common with no major variations during the study period. Overall, lower trunk (hip, pelvic and lower spine) fractures were the most common geriatric fractures followed by upper trunk (upper spine, clavicle and rib) fractures. We suggest that there were decreasing trends for incidence of lower trunk, wrist and upper body fractures over the last 11 years (2004-2014). Approximately half of the geriatric fractures presenting to Emergency Department needed hospitalizations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[Bacterial culture and drug sensitivity analysis of upper urinary tract calculi complicating with infection].

PubMed

Wang, Shu; Shi, Yong-kang; Huang, Xiao-bo; Ma, Kai; Xu, Qing-quan; Xiong, Lin-lin; Li, Jian-xing; Wang, Xia-feng

2014-10-18

To investigate the bacteriology and drug sensitivity of upper urinary tract calculi patients, and to provide information for choosing suitable antibiotics. In the study, 21 patients who suffered from lithiasis in upper urinary tract and required an emergency drainage for acute obstruction and infection were the "acute group"; 64 patients with calculi in upper urinary tract and accompanied with no infectious symptoms were the "common group". The bacteriology and drug sensitivity of the two groups were investigated. Gram-negative bacteria infected the most common of upper urinary tract calculi patients with infection, accounting for 71.4% in the acute group and 65.7% in the common group, among which Escherichia coli were the predominant ones (35.7% in the acute group and 32.9% in the common group). No difference was found between these two groups in bacterial distribution (P>0.05). Although the average drug resistance rate of Gram-negative bacteria in the acute group was higher than that in the common group, it revealed no significant difference (P>0.05). The drug resistance rate to semisynthetic penicillin, cefuroxime and ceftriaxone were more than 50%, 60%, and 50%, respectively. Quinolones, such as ciprofloxacin and levofloxacin, got a 45% drug resistance. Aminoglycoside, carbapenema were sensitive to Gram-negative bacteria. Cefoperazone/sulbactam and piperacillin/tazobactam were more effective than ceftriaxone and piperacillin, respectively. There was no significant difference between upper urinary tract calculi patients with acute infection and common infection in bacteriology and drug sensitivity. Semisynthetic penicillin, the second generation of cephalosporin and quinolone were no longer the good choices of empirical use. Antibiotics combined with β-lactamase inhibitors would be an ideal empirical therapeutic choice.

The Relationship between Grandiose and Vulnerable (Hypersensitive) Narcissism

PubMed Central

Jauk, Emanuel; Weigle, Elena; Lehmann, Konrad; Benedek, Mathias; Neubauer, Aljoscha C.

2017-01-01

Narcissistic grandiosity is characterized by overt expressions of feelings of superiority and entitlement, while narcissistic vulnerability reflects hypersensitivity and introversive self-absorbedness. Clinical evidence suggests that grandiosity is accompanied by vulnerable aspects, pointing to a common foundation. Subclinical personality research, however, views grandiose and vulnerable narcissism as independent traits. Grandiose narcissism displays substantial correlation with extraversion, while vulnerable narcissism correlates highly with introversion. We investigated if (1) controlling for intro-/extraversion might reveal a “common core” of grandiose and vulnerable narcissism, and if (2) the correlation between both aspects might be higher at higher levels of narcissism. Latent variable structural equation modeling and segmented regression analysis confirmed these hypotheses in a large non-clinical sample (N = 1,006). Interindividual differences in intro-/extraversion mask the common core of grandiose and vulnerable narcissism. The association between both aspects increases at high levels (upper 10%) of grandiose narcissism, which suggests a possible transition to clinically relevant (pathological) narcissism. PMID:28955288

Atmospheric products from the Upper Atmosphere Research Satellite (UARS)

NASA Technical Reports Server (NTRS)

Ahmad, Suraiya P.; Johnson, James E.; Jackman, Charles H.

2003-01-01

This paper provides information on the products available at the NASA Goddard Earth Sciences (GES) Distributed Active Archive Center (DAAC) from the Upper Atmosphere Research Satellite (UARS) mission. The GES DAAC provides measurements from the primary UARS mission, which extended from launch in September 1991 through September 2001. The ten instruments aboard UARS provide measurements of atmospheric trace gas species, dynamical variables, solar irradiance input, and particle energy flux. All standard Level 3 UARS products from all ten instruments are offered free to the public and science user community. The Level 3 data are geophysical parameters, which have been transformed into a common format and equally spaced along the measurement trajectory. The UARS data have been reprocessed several times over the years following improvements to the processing algorithms. The UARS data offered from the GES DAAC are the latest versions of each instrument. The UARS data may be accessed through the GES DAAC website at

Forearm Muscle Oxygenation Decreases During Low Levels of Brief, Isometric Contraction

NASA Technical Reports Server (NTRS)

Murthy Gita; Kahan, N. J.; Hargens, Alan R.; Rempel, D. M.; Hargens, Murthy G. (Technical Monitor)

1997-01-01

Regional muscle pain syndromes can be caused by repeated and sustained exertion of a specific muscle. Such exertion may elevate local tissue fluid pressure, reduce blood flow and tissue oxygenation (TO2), and cause fatigue, pain and functional deficits of the Involved muscle. Low levels (less than 20% maximum voluntary contraction (MVC)) of prolonged static contraction of the upper extremity are common In many occupational settings and May cause fatigue. The purpose of our Investigation was to determine whether TO2 decreases significantly at low levels of static contraction of the extensor carpi radialis brevis (ECRB).

Introducing Students to Gas Chromatography-Mass Spectrometry Analysis and Determination of Kerosene Components in a Complex Mixture

ERIC Educational Resources Information Center

Pacot, Giselle Mae M.; Lee, Lyn May; Chin, Sung-Tong; Marriott, Philip J.

2016-01-01

Gas chromatography-mass spectrometry (GC-MS) and GC-tandem MS (GC-MS/MS) are useful in many separation and characterization procedures. GC-MS is now a common tool in industry and research, and increasingly, GC-MS/MS is applied to the measurement of trace components in complex mixtures. This report describes an upper-level undergraduate experiment…

Laser isotope separation of erbium and other isotopes

DOEpatents

Haynam, Christopher A.; Worden, Earl F.

1995-01-01

Laser isotope separation is accomplished using at least two photoionization pathways of an isotope simultaneously, where each pathway comprises two or more transition steps. This separation method has been applied to the selective photoionization of erbium isotopes, particularly for the enrichment of .sup.167 Er. The hyperfine structure of .sup.167 Er was used to find two three-step photoionization pathways having a common upper energy level.

Epidemiology of fishing related upper extremity injuries presenting to the emergency department in the United States.

PubMed

Gil, Joseph A; Elia, Gregory; Shah, Kalpit N; Owens, Brett D; Got, Christopher

2018-04-16

Fishing injuries commonly affect the hands. The goal of this study was to quantify the incidence of fishing-related upper extremity injuries that present to emergency departments in the United States. We examined the reported cases of fishing-related upper extremity injuries in the National Electronic Injury Surveillance System database. Analysis was performed based on age, sex and the type of injury reported. The national incidence of fishing-related upper extremity injuries was 119.6 per 1 million person-years in 2014. The most common anatomic site for injury was the finger (63.3%), followed by the hand (20.3%). The most common type of injury in the upper extremity was the presence of a foreign body (70.4%). The incidence of fishing-related upper extremity injuries in males was 200 per 1 million person-years, which was significantly higher than the incidence in females (41 per 1 million person-years). The incidence of fishing-related upper extremity injuries that present to the Emergency Department was 120 per 1 million person-years. The incidence was significantly higher in males. With the widespread popularity of the activity, it is important for Emergency Physicians and Hand Surgeons to understand how to properly evaluate and manage these injuries.

Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects.

PubMed

Dominguez, Mariana Chiaradia; Alvares, Beatriz Regina

2018-01-01

To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition.

Prolonged partial upper airway obstruction during sleep – an underdiagnosed phenotype of sleep-disordered breathing

PubMed Central

Anttalainen, Ulla; Tenhunen, Mirja; Rimpilä, Ville; Polo, Olli; Rauhala, Esa; Himanen, Sari-Leena; Saaresranta, Tarja

2016-01-01

Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea–hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals. There is also a growing body of evidence that prolonged partial obstruction is a clinically significant form of SDB, which is associated with symptoms and co-morbidities which may partially differ from those associated with OSAS. Partial upper airway obstruction is most prevalent in women, and it is treatable with the nasal continuous positive pressure device with good adherence to therapy. This review describes the characteristics of prolonged partial upper airway obstruction during sleep in terms of diagnostics, pathophysiology, clinical presentation, and comorbidity to improve recognition of this phenotype and its timely and appropriate treatment. PMID:27608271

Contamination of food crops grown on soils with elevated heavy metals content.

PubMed

Dziubanek, Grzegorz; Piekut, Agata; Rusin, Monika; Baranowska, Renata; Hajok, Ilona

2015-08-01

The exposure of inhabitants from 13 cities of The Upper Silesia Industrial Region to cadmium and lead has been estimated on the basis of heavy metals content in commonly consumed vegetables. The samples were collected from agricultural fields, allotments and home gardens in these cities. Cadmium and lead concentrations in samples of soil and vegetables - cabbage, carrots and potatoes were determined. High content of heavy metals in the arable layer of soil in Upper Silesia (max. 48.8 and 2470mgkg(-1) d.w. for Cd and Pb, respectively) explained high Cd and Pb concentrations in locally cultivated vegetables which are well above the permissible level. Three exposure scenarios with different concentrations of Pb and Cd in vegetables were taken into consideration. In the Scenario I where the content of heavy metals was equal to maximum permissible level, the value of hazard quotient (HQ) for Pb and Cd was 0.530 and 0.704, respectively. In the scenarios where were assumed consumption of contaminated vegetables from Upper Silesia the value of hazard quotient (HQ) for Pb and Cd was 0.755 and 1.337 for Scenario II and 1.806 and 4.542 for Scenario III. The study showed that consumption of vegetables cultivated in Upper Silesia Region on the agricultural fields, allotments and in home gardens may pose a significant health risk. Copyright © 2015 Elsevier Inc. All rights reserved.

Liquid level controller

DOEpatents

Mangus, J.D.; Redding, A.H.

1975-07-15

A system for maintaining two distinct sodium levels within the shell of a heat exchanger having a plurality of J-shaped modular tube bundles each enclosed in a separate shell which extends from a common base portion. A lower liquid level is maintained in the base portion and an upper liquid level is maintained in the shell enwrapping the long stem of the J-shaped tube bundles by utilizing standpipes with a notch at the lower end which decreases in open area the distance from the end of the stand pipe increases and a supply of inert gas fed at a constant rate to produce liquid levels, which will remain generally constant as the flow of liquid through the vessel varies. (auth)

Upper limit on the inner radiation belt MeV electron intensity

NASA Astrophysics Data System (ADS)

Li, X.; Selesnick, R. S.; Baker, D. N.; Jaynes, A. N.; Kanekal, S. G.; Schiller, Q.; Blum, L.; Fennell, J.; Blake, J. B.

2015-02-01

No instruments in the inner radiation belt are immune from the unforgiving penetration of the highly energetic protons (tens of MeV to GeV). The inner belt proton flux level, however, is relatively stable; thus, for any given instrument, the proton contamination often leads to a certain background noise. Measurements from the Relativistic Electron and Proton Telescope integrated little experiment on board Colorado Student Space Weather Experiment CubeSat, in a low Earth orbit, clearly demonstrate that there exist sub-MeV electrons in the inner belt because their flux level is orders of magnitude higher than the background, while higher-energy electron (>1.6 MeV) measurements cannot be distinguished from the background. Detailed analysis of high-quality measurements from the Relativistic Electron and Proton Telescope on board Van Allen Probes, in a geo-transfer-like orbit, provides, for the first time, quantified upper limits on MeV electron fluxes in various energy ranges in the inner belt. These upper limits are rather different from flux levels in the AE8 and AE9 models, which were developed based on older data sources. For 1.7, 2.5, and 3.3 MeV electrons, the upper limits are about 1 order of magnitude lower than predicted model fluxes. The implication of this difference is profound in that unless there are extreme solar wind conditions, which have not happened yet since the launch of Van Allen Probes, significant enhancements of MeV electrons do not occur in the inner belt even though such enhancements are commonly seen in the outer belt.

Determinants of climate change awareness level in upper Nyakach Division, Kisumu County, Kenya.

PubMed

Ajuang, Chadwick O; Abuom, Paul O; Bosire, Esna K; Dida, Gabriel O; Anyona, Douglas N

2016-01-01

Improving the understanding of climate change awareness is one of the top priorities in climate change research. While the African continent is among the regions with the highest vulnerability to climate change, research on climate knowledge and awareness is lacking. Kenya is already grappling with the impacts of climate change, which are projected to increase in a non-linear and non-predictable manner. This study sought to determine climate change awareness levels among households residing in Upper Nyakach Division, Kisumu County, Kenya using common climate change markers viz heavy rainfall, floods, droughts and temperature. A cross-sectional survey design was adopted in which 384 household heads were selected as respondents from 11 sub-locations; all located within Upper Nyakach Division. A questionnaire was used to collect data. Most (90.9 %) respondents had observed changes in the overall climate. Awareness level of climate change varied significantly across the 11 sub-locations. To further gain insight unto which variables were the most significant determinant of climate change awareness in upper Nyakach division, Kisumu county, a Generalized Linear Model (GLM) with Poisson error distribution was built. The model indicated that sex of the household head, education level and age significantly influenced respondents' awareness to climate change markers. Most (87 %) households reported rising temperatures over the past 20 years. Over half (55.2 %) the respondents had observed declining rains, with significant differences being observed across age groups. Up to 75 % of the respondents reported increased droughts frequency over the last 20 years, with significant differences observed across gender. Most (86.7 %) respondents reported having observed changes in water sources with significant differences reported across age groups. The respondents reported an increased prevalence of malaria with significant differences being observed among the education levels and households' main livelihoods. The general population of the Upper Nyakach Divison is aware of changing global climate. However, more effort is required in mitigating climate change as per the local settings. Awareness campaign aimed at increasing knowledge of climate change markers among community members is recommended.

Neogene stratigraphy, foraminifera, diatoms, and depositional history of Maria Madre Island, Mexico: Evidence of early Neogene marine conditions in the southern Gulf of California

USGS Publications Warehouse

McCloy, C.; Ingle, J.C.; Barron, J.A.

1988-01-01

Foraminifera and diatoms have been analyzed from an upper Miocene through Pleistocene(?) sequence of marine sediments exposed on Maria Madre Island, largest of the Tre??s Marias Islands off the Pacific coast of Mexico. The Neogene stratigraphic sequence exposed on Maria Madre Island includes a mid-Miocene(?) non-marine and/or shallow marine sandstone unconformably overlain by a lower upper Miocene to uppermost Miocene upper to middle bathyal laminated and massive diatomite, mudstone, and siltstone unit. This unit is unconformably overlain by lower Pliocene middle to lower bathyal sandstones and siltstones which, in turn, are unconformably overlain by upper Pliocene through Pleistocene(?) upper bathyal to upper middle bathyal foraminiferal limestones and siltstones. These beds are unconformably capped by Pleistocene terrace deposits. Basement rocks on the island include Cretaceous granite and granodiorite, and Tertiary(?) andesites and rhyolites. The upper Miocene diatomaceous unit contains a low diversity foraminiferal fauna dominated by species of Bolivina indicating low oxygen conditions in the proto-Gulf Maria Madre basin. The diatomaceous unit grades into a mudstone that contains a latest Miocene upper to middle bathyal biofacies characterized by Baggina californica and Uvigerina hootsi along with displaced neritic taxa. An angular unconformity separates the upper Miocene middle bathyal sediments from overlying lower Pliocene siltstones and mudstones that contain a middle to lower bathyal biofacies and abundant planktonic species including Neogloboquadrina acostaensis and Pulleniatina primalis indicating an early Pliocene age. Significantly, this Pliocene unit contains common occurrences of benthic species restricted to Miocene sediments in California including Bulimina uvigerinaformis. Pliocene to Pleistocene(?) foraminiferal limestones and siltstones characterize submarine bank accumulations formed during uplift of the Tre??s Marias Island area, and include abundant planktonic foraminifera such as Pulleniatina obliquiloculata and Neogloboquadrina duterteri. Common benthic foraminifera in this unit are indicative of upper bathyal water depths. The Neogene depositional history recorded on Maria Madre Island involves an early late Miocene subsidence event marking formation of the Tre??s Marias Basin with relatively undiluted diatomaceous sediment deposited in a low oxygen setting. Subsidence and deepening of the basin continued into the early Pliocene along with rapid deposition of terrigenous clastics. Uplift of the basinal sequence began in late Pliocene time accompanied by deposition of upper Pliocene-Pleistocene foraminiferal limestones on a rising submarine bank. Continued episodic uplift of the Neogene deposits brought the island above sea level by late Pleistocene time. ?? 1988.

Analysis of stand basal area development of thinned and unthinned Acer rubrum forests in the upper Great Lakes region, USA

Treesearch

Justin L. Pszwaro; Anthony W. D' Amato; Thomas E. Burk; Matthew B. Russell; Brian J. Palik; Terry F. Strong

2016-01-01

Red maple (Acer rubrum L.), historically a common but not abundant tree species in North America, has increased in abundance throughout its range over the last several decades; however, it has received little attention in growth and yield studies. The objectives of this study were to (i) evaluate the effects of stocking level and stand density on...

Laser isotope separation of erbium and other isotopes

DOEpatents

Haynam, C.A.; Worden, E.F.

1995-08-22

Laser isotope separation is accomplished using at least two photoionization pathways of an isotope simultaneously, where each pathway comprises two or more transition steps. This separation method has been applied to the selective photoionization of erbium isotopes, particularly for the enrichment of {sup 167}Er. The hyperfine structure of {sup 167}Er was used to find two three-step photoionization pathways having a common upper energy level. 3 figs.

Roller skating injuries in children.

PubMed

Inkelis, S H; Stroberg, A J; Keller, E L; Christenson, P D

1988-06-01

Many children who roller skate sustain injuries. To determine the type and severity of these mishaps, the medical records of 76 children less than 16 years of age with roller skating injuries presenting to two pediatric emergency departments were reviewed. Seventy-five percent were girls, and 25% were boys. The upper extremity was the most common body part injured (74%) (P less than 0.0001). Lower extremity injuries occurred in 12%, head and face injuries in 10%, and chest injuries in 4%. The most common type of injury was a fracture (69%), with the wrist and forearm being most frequently fractured (53%). Hospitalization and long-term sequelae were infrequent. Younger children (less than or equal to 9) had an increased frequency of fracture injury (P less than 0.02). This is most likely because maturation of lower and upper extremity speed, strength, agility, coordination, balance, and reaction time and morphologically stronger bones combine to afford relative protection to the older child. Physicians and parents need to be aware of a child's skill level before the child is encouraged to roller skate. Measures which may decrease the likelihood of injury include protective gear, instruction in roller skating technique, learning to skate in an uncongested area on level, familiar terrain, and learning to fall properly.

Bayesian Hierarchical Random Intercept Model Based on Three Parameter Gamma Distribution

NASA Astrophysics Data System (ADS)

Wirawati, Ika; Iriawan, Nur; Irhamah

2017-06-01

Hierarchical data structures are common throughout many areas of research. Beforehand, the existence of this type of data was less noticed in the analysis. The appropriate statistical analysis to handle this type of data is the hierarchical linear model (HLM). This article will focus only on random intercept model (RIM), as a subclass of HLM. This model assumes that the intercept of models in the lowest level are varied among those models, and their slopes are fixed. The differences of intercepts were suspected affected by some variables in the upper level. These intercepts, therefore, are regressed against those upper level variables as predictors. The purpose of this paper would demonstrate a proven work of the proposed two level RIM of the modeling on per capita household expenditure in Maluku Utara, which has five characteristics in the first level and three characteristics of districts/cities in the second level. The per capita household expenditure data in the first level were captured by the three parameters Gamma distribution. The model, therefore, would be more complex due to interaction of many parameters for representing the hierarchical structure and distribution pattern of the data. To simplify the estimation processes of parameters, the computational Bayesian method couple with Markov Chain Monte Carlo (MCMC) algorithm and its Gibbs Sampling are employed.

Global outcome, productivity and epilepsy 3--8 years after severe head injury. The impact of injury severity.

PubMed

Skandsen, Toril; Ivar Lund, Tom; Fredriksli, Oddrun; Vik, Anne

2008-07-01

To assess long-term outcome in survivors after severe head injury and relate outcome to injury severity. Follow-up 3-8 years post injury in a retrospectively collected sample. A neurosurgical department in a regional trauma centre. Of 146 individuals admitted, 135 were actively treated. Twenty-four per cent of these died within six months. Ninety-three of the 94 (aged 1-88 years) who survived more than three years were included in the follow-up. They were separated into groups based on their level of consciousness at four weeks post injury: oriented (n = 39), confused (n = 22) or in a minimally conscious/vegetative state (MCS/VS) (n = 26) and not possible to assess (n = 6). Glasgow Outcome Scale Extended (GOSE), participation in work/education (productivity) and posttraumatic epilepsy. GOSE scores were: vegetative state: 3%, severe disability: 28% (22% lower level, 6% upper level), moderate disability: 39% (22% lower level, 17% upper level) and good recovery: 27% (10% lower level, 17% upper level). Productivity was 34% (aged 7-64 years). The three severity groups had different GOSE scores (P<0.001) and different proportion of productive individuals (P<0.001). Twenty-three per cent experienced posttraumatic epilepsy and this was significantly associated with the highest injury severity (P<0.001) and intracranial surgery (P = 0.01). Being independent in daily life but unable to work was the typical long-term outcome. Stratifying the patients based on consciousness at four weeks we found different outcomes. Among oriented patients, almost all regained independency, whereas in the most severe group, poor outcomes and posttraumatic epilepsy was common.

THE ETIOLOGY OF ACUTE UPPER RESPIRATORY INFECTION (COMMON COLD)

PubMed Central

Long, Perrin H.; Doull, James A.; Bourn, Janet M.; McComb, Emily

1931-01-01

Experimental upper respiratory infections similar to "common colds" were transmitted singly and in series through two and four passages in nine out of fifteen persons, by intransal inoculations with bacteria-free filtrates of nasopharyngeal washings obtained from individuals ill with natural "colds." These observations conform with those reported by previous workers and lend further support to the view that the incitant of the "common cold" is a filtrable virus. PMID:19869857

Shoulder injuries from alpine skiing and snowboarding. Aetiology, treatment and prevention.

PubMed

Kocher, M S; Dupré, M M; Feagin, J A

1998-03-01

There has been a decrease in the overall injury rate and the rate of lower extremity injuries for alpine skiing, with a resultant increase in the ratio of upper extremity to lower extremity injuries. Upper extremity injuries account for 20 to 35% of all injuries during alpine skiing and nearly 50% of all injuries during snowboarding. The most common upper extremity injuries during skiing are sprain of the thumb metacarpal-phalangeal joint ulnar collateral ligament, and the most common in snowboarding is wrist fracture. Shoulder injuries from skiing and snowboarding have been less well characterised. With the increased ratio of upper to lower extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries will be seen with increasing frequency by those who care for alpine sport injuries. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper extremity injuries. The rate of shoulder injuries during alpine skiing is 0.2 to 0.5 injuries per thousand skier-days. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are glenohumeral instability, rotator cuff strains, acromioclavicular separations and clavicle fractures. Less common shoulder injuries include greater tuberosity fractures, trapezius strains, proximal humerus fractures, biceps strains, glenoid fractures, scapula fractures, humeral head fractures, sterno-clavicular separations, acromion fractures and biceps tendon dislocation. Prevention of shoulder injuries during skiing and snowboarding may be possible through interventions in education and technique, conditioning and equipment and environment.

Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

PubMed

Demers, Marika; Levin, Mindy F

2017-07-01

Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

Upper extremity transplantation: current concepts and challenges in an emerging field.

PubMed

Elliott, River M; Tintle, Scott M; Levin, L Scott

2014-03-01

Loss of an isolated upper limb is an emotionally and physically devastating event that results in significant impairment. Patients who lose both upper extremities experience profound disability that affects nearly every aspect of their lives. While prosthetics and surgery can eventually provide the single limb amputee with a suitable assisting hand, limited utility, minimal haptic feedback, weight, and discomfort are persistent problems with these techniques that contribute to high rates of prosthetic rejection. Moreover, despite ongoing advances in prosthetic technology, bilateral amputees continue to experience high levels of dependency, disability, and distress. Hand and upper extremity transplantation holds several advantages over prosthetic rehabilitation. The missing limb is replaced with one of similar skin color and size. Sensibility, voluntary motor control, and proprioception are restored to a greater degree, and afford better dexterity and function than prosthetics. The main shortcomings of transplantation include the hazards of immunosuppression, the complications of rejection and its treatment, and high cost. Hand and upper limb transplantation represents the most commonly performed surgery in the growing field of Vascularized Composite Allotransplantation (VCA). As upper limb transplantation and VCA have become more widespread, several important challenges and controversies have emerged. These include: refining indications for transplantation, optimizing immunosuppression, establishing reliable criteria for monitoring, diagnosing, and treating rejection, and standardizing outcome measures. This article will summarize the historical background of hand transplantation and review the current literature and concepts surrounding it.

Role of upper-level wind shear on the structure and maintenance of derecho-producing convective systems

NASA Astrophysics Data System (ADS)

Coniglio, Michael Charles

Common large-scale environments associated with the development of derecho-producing convective systems from a large number of events are identified using statistical clustering of the 500-mb geopotential heights as guidance. The majority of the events (72%) fall into three main patterns that include a well-defined upstream trough (40%), a ridge (20%), and a zonal, low-amplitude flow (12%), which is defined as an additional warm-season pattern that is not identified in past studies of derecho environments. Through an analysis of proximity soundings, discrepancies are found in both low-level and deep-tropospheric shear parameters between observations and the shear profiles considered favorable for strong, long-lived convective systems in idealized simulations. To explore the role of upper-level shear in derecho environments, a set of two-dimensional simulations of density currents within a dry, neutrally stable environment are used to examine the ability of a cold pool to lift environmental air within a vertically sheared flow. The results confirm that the addition of upper-level shear to a wind profile with weak to moderate low-level shear increases the vertical displacement of low-level parcels despite a decrease in the vertical velocity along the cold pool interface, as suggested by previous studies. Parcels that are elevated above the surface (1-2 km) overturn and are responsible for the deep lifting in the deep-shear environments. This deep overturning caused by the upper-level shear helps to maintain the tilt of the convective systems in more complex two-dimensional and three dimensional simulations. The overturning also is shown to greatly increase the size of the convective systems in the three-dimensional simulations by facilitating the initiation and maintenance of convective cells along the cold pool. When combined with estimates of the cold pool motion and the storm-relative hodograph, these results may best be used for the prediction of the demise of strong, linear mesoscale convective systems (MCSs) and may provide a conceptual model for the persistence of strong MCSs above a surface nocturnal inversion in situations that are not forced by a low-level jet.

The need for a reassessment of the safe upper limit of selenium in drinking water.

PubMed

Vinceti, Marco; Crespi, Catherine M; Bonvicini, Francesca; Malagoli, Carlotta; Ferrante, Margherita; Marmiroli, Sandra; Stranges, Saverio

2013-01-15

Results of recent epidemiologic studies suggest the need to reassess the safe upper limit in drinking water of selenium, a metalloid with both toxicological and nutritional properties. Observational and experimental human studies on health effects of organic selenium compounds consumed through diet or supplements, and of inorganic selenium consumed through drinking water, have shown that human toxicity may occur at much lower levels than previously surmised. Evidence indicates that the chemical form of selenium strongly influences its toxicity, and that its biological activity may differ in different species, emphasizing the importance of the few human studies on health effects of the specific selenium compounds found in drinking water. Epidemiologic studies that investigated the effects of selenate, an inorganic selenium species commonly found in drinking water, together with evidence of toxicity of inorganic selenium at low levels in from in vitro and animal studies, indicate that health risks may occur at exposures below the current European Union and World Health Organization upper limit and guideline of 10 and 40 μg/l, respectively, and suggest reduction to 1 μg/l in order to adequately protect human health. Although few drinking waters are currently known to have selenium concentrations exceeding this level, the public health importance of this issue should not be overlooked, and further epidemiologic research is critically needed in this area. Copyright © 2012 Elsevier B.V. All rights reserved.

Infectious mononucleosis presenting as upper airway obstruction.

PubMed

Jain, Vivek; Singhi, Sunit; Desai, Ravi V

2003-01-01

Upper airway obstruction though a common complication of infectious mononucleosis is rarely considered in differential diagnosis of stridor. We report a three-year-old child who had upper airway obstruction due to infectious mononucleosis, managed conservatively with oxygen, intravenous fluids and steroids.

Knowledge, Attitude, and Practice of Upper-middle Class toward the Importance of a Pediatric Dentist.

PubMed

Sadana, Gunmeen; Walia, Satinder; Rai, Hashmit Kaur; Aggarwal, Neha; Bhargava, Ankita

2017-10-01

This study was carried out to assess the knowledge, attitude, and practice of upper middle class toward the importance of a pediatric dentist in the city of Amritsar, Punjab. A cross-sectional study was carried out among the parents of children belonging to upper middle class in the city of Amritsar. This proposed study was assessed by the Institutional Ethical Committee (531/IDSR/2016) and their clearance was attained. A total of 950 parents were selected using a convenient sampling technique, and a self-made questionnaire was presented to them. Responses from the parents were evaluated in terms of numbers and percentages and were statistically analyzed using SPSS for Windows release 14.0 (SPSS Inc., Chicago, IL, USA). Differences at the 5% level were accepted as being statistically significant. The results of the study show limited knowledge about a pediatric dentist among the well-educated, well-placed, and economically sound citizens of Amritsar city. Consequently, the attitude and practices among this socioeconomic group are unconstructive and unprepared, respectively. Although the importance of taking a child to a pediatrician is a common practice among the upper and upper-middle classes of the society, it is clear that they do not give the same importance to a pediatric dentist, who is the pediatrician of dentistry.

Chronic pain associated with upper-limb loss.

PubMed

Hanley, Marisol A; Ehde, Dawn M; Jensen, Mark; Czerniecki, Joseph; Smith, Douglas G; Robinson, Lawrence R

2009-09-01

To describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb, back, neck, and nonamputated-limb pain. Cross-sectional survey; 104 respondents with upper-limb loss at least 6 months postamputation completed measures of pain intensity, interference, disability, and health-related quality-of-life. Nearly all (90%) of the respondents reported pain, with 76% reporting more than one pain type. Phantom-limb pain and residual-limb pain were the most prevalent (79% and 71%, respectively), followed by back (52%), neck (43%), and nonamputated-limb pain (33%). Although nonamputated-limb pain was least prevalent, it was reported to cause the highest levels of interference and pain-related disability days. Self-reported quality-of-life was significantly lower for individuals with each type of pain compared with those without any pain. Age, time since amputation, and cause of amputation were not associated with pain. In addition to pain in the phantom and residual limb, back, neck, and nonamputated-limb pain are also common after upper-limb loss. All of these pain types are associated with significant disability and activity interference for some individuals, suggesting that assessment of multiple pain types in persons with upper-limb amputation may be important.

Geographic trend in mercury measured in common loon feathers and blood

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

Evers, D.C.; Kaplan, J.D.; Reaman, P.S.

1998-02-01

The common loon (Gavia immer) is a high-trophic-level, long-lived, obligate piscivore at risk from elevated levels of Hg through biomagnification and bioaccumulation. From 1991 to 1996 feather and blood samples from adult loons were collected between June and September in five regions of North America: Alaska, northwestern US, Upper Great Lakes, New England, and the Canadian Maritimes. Concentrations of Hg in adults ranged from 2.8 to 36.7 {micro}g/g in feathers and from 0.12 to 7.80 {micro}g/g in whole blood. Blood Hg concentrations in 3 to 6-week-old juveniles ranged from 0.03 to 0.78 {micro}g/g. To better interpret exposure data, relationships betweenmore » blood and feather Hg concentrations were examined among age and sex classes. Blood and feather Hg correlated strongest in areas with the highest blood Hg levels, indicating a possible carryover of breeding season Hg that is depurated during winter remigial molt. Mean blood and feather Hg concentrations in males were significantly higher than concentrations in females for each region. The mean blood Hg concentration in adults was 10 times higher than that in juveniles, and feather Hg concentrations significantly increased over 1 to 4-year periods in recaptured individuals. Geographic stratification indicates a significant increasing regional trend in adult and juvenile blood Hg concentrations from west to east. This gradient resembles US Environmental Protection Agency-modeled predictions of total anthropogenic Hg deposition across the US. This gradient is clearest across regions. Within-region blood Hg concentrations in adults and juveniles across nine sites of one region, the Upper Great Lakes, were less influenced by variations in geographic Hg deposition than by hydrology and lake chemistry. Loons breeding on low-pH lakes in the Upper Great Lakes and in all lake types of northeastern North America are most at risk from Hg.« less

Kinetic energy budgets in areas of convection

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.

1979-01-01

Synoptic scale budgets of kinetic energy are computed using 3 and 6 h data from three of NASA's Atmospheric Variability Experiments (AVE's). Numerous areas of intense convection occurred during the three experiments. Large kinetic energy variability, with periods as short as 6 h, is observed in budgets computed over each entire experiment area and over limited volumes that barely enclose the convection and move with it. Kinetic energy generation and transport processes in the smaller volumes are often a maximum when the enclosed storms are near peak intensity, but the nature of the various energy processes differs between storm cases and seems closely related to the synoptic conditions. A commonly observed energy budget for peak storm intensity indicates that generation of kinetic energy by cross-contour flow is the major energy source while dissipation to subgrid scales is the major sink. Synoptic scale vertical motion transports kinetic energy from lower to upper levels of the atmosphere while low-level horizontal flux convergence and upper-level horizontal divergence also occur. Spatial fields of the energy budget terms show that the storm environment is a major center of energy activity for the entire area.

Deep level defects in Ge-doped (010) β-Ga2O3 layers grown by plasma-assisted molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Farzana, Esmat; Ahmadi, Elaheh; Speck, James S.; Arehart, Aaron R.; Ringel, Steven A.

2018-04-01

Deep level defects were characterized in Ge-doped (010) β-Ga2O3 layers grown by plasma-assisted molecular beam epitaxy (PAMBE) using deep level optical spectroscopy (DLOS) and deep level transient (thermal) spectroscopy (DLTS) applied to Ni/β-Ga2O3:Ge (010) Schottky diodes that displayed Schottky barrier heights of 1.50 eV. DLOS revealed states at EC - 2.00 eV, EC - 3.25 eV, and EC - 4.37 eV with concentrations on the order of 1016 cm-3, and a lower concentration level at EC - 1.27 eV. In contrast to these states within the middle and lower parts of the bandgap probed by DLOS, DLTS measurements revealed much lower concentrations of states within the upper bandgap region at EC - 0.1 - 0.2 eV and EC - 0.98 eV. There was no evidence of the commonly observed trap state at ˜EC - 0.82 eV that has been reported to dominate the DLTS spectrum in substrate materials synthesized by melt-based growth methods such as edge defined film fed growth (EFG) and Czochralski methods [Zhang et al., Appl. Phys. Lett. 108, 052105 (2016) and Irmscher et al., J. Appl. Phys. 110, 063720 (2011)]. This strong sensitivity of defect incorporation on crystal growth method and conditions is unsurprising, which for PAMBE-grown β-Ga2O3:Ge manifests as a relatively "clean" upper part of the bandgap. However, the states at ˜EC - 0.98 eV, EC - 2.00 eV, and EC - 4.37 eV are reminiscent of similar findings from these earlier results on EFG-grown materials, suggesting that possible common sources might also be present irrespective of growth method.

Description and interpretation of geologic materials from shotholes drilled for the Trans-Alaska Crustal Transect project, Copper River basin, Alaska, May 1985

USGS Publications Warehouse

Odum, J.K.; Yehle, L.A.; Schmoll, H.R.; Gilbert, Chuck

1986-01-01

This map shows the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity, Florida, for May 1986. The Upper Floridan aquifer is the principal source of potable water in the area. Water level measurements were made on approximately 1,000 wells and on several springs. The potentiometric surface is shown mostly by 5-foot contour intervals. In the Fernandina Beach area of Nassau County, a 30-ft. interval is used to show a deep cone of depression. The potentiometric surface ranged from 125 feet above sea level in Polk County to 75 feet below sea level in Nassau County. Water levels in most key wells ranged from 1 to 9 feet below the May average in response to the lack of recharge from rainfall and an attendant increase in pumpage. Many levels in the district were equal to or lower than the below average levels of May 1985. Declines of about a foot from May 1985 levels were common in the eastern half of the district. However, the largest declines from May 1985 levels, as much as 7 to 9 feet, were mostly in well fields along the coastline. Levels in many wells approached, and in a few wells exceeded, record lows. (USGS)

TOMOGRAPHY OF PLASMA FLOWS IN THE UPPER SOLAR CONVECTION ZONE USING TIME-DISTANCE INVERSION COMBINING RIDGE AND PHASE-SPEED FILTERING

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

Svanda, Michal, E-mail: michal@astronomie.cz; Astronomical Institute, Charles University in Prague, Faculty of Mathematics and Physics, V Holesovickach 2, CZ-18000 Prague 8

2013-09-20

The consistency of time-distance inversions for horizontal components of the plasma flow on supergranular scales in the upper solar convection zone is checked by comparing the results derived using two k-{omega} filtering procedures-ridge filtering and phase-speed filtering-commonly used in time-distance helioseismology. I show that both approaches result in similar flow estimates when finite-frequency sensitivity kernels are used. I further demonstrate that the performance of the inversion improves (in terms of a simultaneously better averaging kernel and a lower noise level) when the two approaches are combined together in one inversion. Using the combined inversion, I invert for horizontal flows inmore » the upper 10 Mm of the solar convection zone. The flows connected with supergranulation seem to be coherent only for the top {approx}5 Mm; deeper down there is a hint of change of the convection scales toward structures larger than supergranules.« less

Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings.

PubMed

Diaz, Liege; Hernandez-Oquet, Rafael Enrique; Deshpande, Amar R; Moshiree, Baharak

2015-11-01

Studies describing the prevalence of upper gastrointestinal (GI) Crohn disease (CD) and its histopathologic changes have been inconsistent as a result of different definitions used for upper GI involvement, diverse populations, and varying indications for endoscopy. We reviewed the literature describing endoscopic findings and histologic lesions in gastric and duodenal mucosa of patients with established CD. PubMed, EMBASE, and the Cochrane Library were searched for gastroduodenal biopsy findings in patients with CD from 1970 to 2014. We included all retrospective and prospective studies in adults. We calculated the prevalence of the most common endoscopic and histopathological findings among patients with overall CD and upper GI CD. Of the 385 articles identified, 20 eligible studies were included. A total of 2511 patients had CD and 815 had upper GI CD. In the CD group, the most common histopathological finding was nonspecific gastric inflammation in 32% of patients, followed by gastric granuloma in 7.9%. Focal gastritis was prevalent in 30.9% of patients. In the upper GI CD group, gastric inflammation was present in 84% of patients, followed by duodenal inflammation in 28.2% and gastric granuloma in 23.2%. The most common gastric endoscopic finding in patients with CD was erythema in 5.9%, followed by erosions in 3.7%. Duodenal endoscopic findings included ulcers and erythema in 5.3% and 3.0% of patients, respectively. We found a prevalence of 34% for CD involving the upper GI tract across these 20 studies. Routine upper endoscopy with biopsies of the upper GI tract in the diagnostic workup of patients with CD can correctly classify the distribution and extent of the disease.

Arousal from Sleep Does Not Lead to Reduced Dilator Muscle Activity or Elevated Upper Airway Resistance on Return to Sleep in Healthy Individuals

PubMed Central

Jordan, Amy S.; Cori, Jennifer M.; Dawson, Andrew; Nicholas, Christian L.; O'Donoghue, Fergal J.; Catcheside, Peter G.; Eckert, Danny J.; McEvoy, R. Doug; Trinder, John

2015-01-01

Study Objectives: To compare changes in end-tidal CO2, genioglossus muscle activity and upper airway resistance following tone-induced arousal and the return to sleep in healthy individuals with small and large ventilatory responses to arousal. Design: Observational study. Setting: Two sleep physiology laboratories. Patients or Participants: 35 men and 25 women with no medical or sleep disorders. Interventions: Auditory tones to induce 3-s to 15-s cortical arousals from sleep. Measurements and Results: During arousal from sleep, subjects with large ventilatory responses to arousal had higher ventilation (by analytical design) and tidal volume, and more marked reductions in the partial pressure of end-tidal CO2 compared to subjects with small ventilatory responses to arousal. However, following the return to sleep, ventilation, genioglossus muscle activity, and upper airway resistance did not differ between high and low ventilatory response groups (Breath 1 on return to sleep: ventilation 6.7 ± 0.4 and 5.5 ± 0.3 L/min, peak genioglossus activity 3.4% ± 1.0% and 4.8% ± 1.0% maximum, upper airway resistance 4.7 ± 0.7 and 5.5 ± 1.0 cm H2O/L/s, respectively). Furthermore, dilator muscle activity did not fall below the pre-arousal sleeping level and upper airway resistance did not rise above the pre-arousal sleeping level in either group for 10 breaths following the return to sleep. Conclusions: Regardless of the magnitude of the ventilatory response to arousal from sleep and subsequent reduction in PETCO2, healthy individuals did not develop reduced dilator muscle activity nor increased upper airway resistance, indicative of partial airway collapse, on the return to sleep. These findings challenge the commonly stated notion that arousals predispose to upper airway obstruction. Citation: Jordan AS, Cori JM, Dawson A, Nicholas CL, O'Donoghue FJ, Catcheside PG, Eckert DJ, McEvoy RD, Trinder J. Arousal from sleep does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals. SLEEP 2015;38(1):53–59. PMID:25325511

UPPER BOUND RISK ESTIMATES FOR MIXTURES OF CARCINOGENS

EPA Science Inventory

The excess cancer risk that might result from exposure to a mixture of chemical carcinogens usually is estimated with data from experiments conducted on individual chemicals. An upper bound on the total excess risk is estimated commonly by summing individual upper bound risk esti...

Student Perceived and Determined Knowledge of Biology Concepts in an Upper-Level Biology Course.

PubMed

Ziegler, Brittany; Montplaisir, Lisa

2014-01-01

Students who lack metacognitive skills can struggle with the learning process. To be effective learners, students should recognize what they know and what they do not know. This study examines the relationship between students' perception of their knowledge and determined knowledge in an upper-level biology course utilizing a pre/posttest approach. Significant differences in students' perception of their knowledge and their determined knowledge exist at the beginning (pretest) and end (posttest) of the course. Alignment between student perception and determined knowledge was significantly more accurate on the posttest compared with the pretest. Students whose determined knowledge was in the upper quartile had significantly better alignment between their perception and determined knowledge on the pre- and posttest than students in the lower quartile. No difference exists between how students perceived their knowledge between upper- and lower-quartile students. There was a significant difference in alignment of perception and determined knowledge between males and females on the posttest, with females being more accurate in their perception of knowledge. This study provides evidence of discrepancies that exist between what students perceive they know and what they actually know. © 2014 B. Ziegler and L. Montplaisir. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

PubMed

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

Upper respiratory tract infections in athletes.

PubMed

Page, Clifton L; Diehl, Jason J

2007-07-01

Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

Ares I-X Upper Stage Simulator Structural Analyses Supporting the NESC Critical Initial Flaw Size Assessment

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Phillips, Dawn R.; Raju, Ivatury S.

2008-01-01

The structural analyses described in the present report were performed in support of the NASA Engineering and Safety Center (NESC) Critical Initial Flaw Size (CIFS) assessment for the ARES I-X Upper Stage Simulator (USS) common shell segment. The structural analysis effort for the NESC assessment had three thrusts: shell buckling analyses, detailed stress analyses of the single-bolt joint test; and stress analyses of two-segment 10 degree-wedge models for the peak axial tensile running load. Elasto-plastic, large-deformation simulations were performed. Stress analysis results indicated that the stress levels were well below the material yield stress for the bounding axial tensile design load. This report also summarizes the analyses and results from parametric studies on modeling the shell-to-gusset weld, flange-surface mismatch, bolt preload, and washer-bearing-surface modeling. These analyses models were used to generate the stress levels specified for the fatigue crack growth assessment using the design load with a factor of safety.

Incidence and prevalence of complaints of the neck and upper extremity in general practice

PubMed Central

Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Schellevis, F; Bouter, L; Dekker, J

2005-01-01

Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 person-years were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care. PMID:15608309

State-dependent and reflex drives to the upper airway: basic physiology with clinical implications

PubMed Central

Hughes, Stuart W.; Malhotra, Atul

2013-01-01

The root cause of the most common and serious of the sleep disorders is impairment of breathing, and a number of factors predispose a particular individual to hypoventilation during sleep. In turn, obstructive hypopneas and apneas are the most common of the sleep-related respiratory problems and are caused by dysfunction of the upper airway as a conduit for airflow. The overarching principle that underpins the full spectrum of clinical sleep-related breathing disorders is that the sleeping brain modifies respiratory muscle activity and control mechanisms and diminishes the ability to respond to respiratory distress. Depression of upper airway muscle activity and reflex responses, and suppression of arousal (i.e., “waking-up”) responses to respiratory disturbance, can also occur with commonly used sedating agents (e.g., hypnotics and anesthetics). Growing evidence indicates that the sometimes critical problems of sleep and sedation-induced depression of breathing and arousal responses may be working through common brain pathways acting on common cellular mechanisms. To identify these state-dependent pathways and reflex mechanisms, as they affect the upper airway, is the focus of this paper. Major emphasis is on the synthesis of established and recent findings. In particular, we specifically focus on 1) the recently defined mechanism of genioglossus muscle inhibition in rapid-eye-movement sleep; 2) convergence of diverse neurotransmitters and signaling pathways onto one root mechanism that may explain pharyngeal motor suppression in sleep and drug-induced brain sedation; 3) the lateral reticular formation as a key hub of respiratory and reflex drives to the upper airway. PMID:23970535

Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects

PubMed Central

Dominguez, Mariana Chiaradia; Alvares, Beatriz Regina

2018-01-01

Objective To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. Results The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Conclusion Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition. PMID:29559762

Comparative study of trophic organization of juvenile fish assemblages of three tidal creeks in a tropical semi-arid estuary.

PubMed

Figueiredo, G G A A; Pessanha, A L M

2016-07-01

A comparison of three tidal creeks assessed the effects of the hydrological regime on trophic organization in juvenile fish assemblages of 21 species in a tropical estuary in north-eastern Brazil. There were seven trophic guilds represented spatially. Zooplanktivore and zoobenthivore guilds dominated the lower estuary, whereas omnivores and detritivores dominated the upper estuary. In the rainy season, the zooplanktivore and omnivore guilds were more common throughout the estuary, but in the dry season, zoobenthivores and piscivores occurred throughout. The trophic organization results show that (1) there was a higher complexity in tidal creeks in the upper estuary compared with the first tidal creek in the lower region and (2) trophic linkages increased in the upper estuary, principally the number of omnivore and detritivore species. Spatial variation in trophic structure was primarily associated with differences in the location of the tidal creeks along the estuary, and this variability was partly attributed to fish species richness; the number of species increased towards the upper estuary, and additional species occupied different trophic levels or used additional resources. © 2015 The Fisheries Society of the British Isles.

The Relationship between Food Insecurity and Esophageal and Gastric Cancers: A Case-Control Study.

PubMed

Daneshi-Maskooni, Milad; Badri-Fariman, Mahtab; Habibi, Nahal; Dorosty-Motlagh, Ahmadreza; Yavari, Hashem; Kashani, Arvin; Hosseini, Mostafa

2017-06-14

Food insecurity is defined as the limited or uncertain availability of enough food for permanent active and healthy life. Upper gastrointestinal (GI) cancers (esophagus and stomach) are one of five most common cancers in Iran. This study aimed to determine the association of food insecurity and upper GI cancers in newly diagnosed patients. Case-control study. Overall, 120 patients with upper GI cancers as cases and 120 patients with orthopedic, ear-nose-throat (ENT), and neurologic diseases as controls were recruited from Imam Khomeini Hospital, Tehran, Iran in 2013. The patients were newly diagnosed using endoscopy or imaging or biopsy methods. They were individually matched for age, sex, and residential area. The general and United States Department of Agriculture (USDA) household food security questionnaires were completed. The univariate and multivariate conditional logistic regression tests were applied using the Stata 11SE statistical software. The food insecurity prevalence was 69.2% and 43.3% in cases and controls, respectively. Food insecurity, low economic level and family history of cancer were significantly associated with cancer (P<0.05). Food insecurity was one of the important risk factors for upper GI cancers that health care providers should consider it.

Subaru HDS transmission spectroscopy of the transiting extrasolar planet HD209458b

NASA Astrophysics Data System (ADS)

Narita, N.; Suto, Y.; Winn, J. N.; Turner, E. L.; Aoki, W.; Leigh, C. J.; Sato, B.; Tamura, M.; Yamada, T.

2006-02-01

We have searched for absorption in several common atomic species due to the atmosphere or exosphere of the transiting extrasolar planet HD 209458b, using high precision optical spectra obtained with the Subaru High Dispersion Spectrograph (HDS). Previously we reported an upper limit on Hα absorption of 0.1% (3σ) within a 5.1Å band. Using the same procedure, we now report upper limits on absorption due to the optical transitions of Na D, Li, Hα, Hβ, Hγ, Fe, and Ca. The 3σ upper limit for each transition is approximately 1% within a 0.3Å band (the core of the line), and a few tenths of a per cent within a 2Å band (the full line width). The wide-band results are close to the expected limit due to photon-counting (Poisson) statistics, although in the narrow-band case we have encountered unexplained systematic errors at a few times the Poisson level. These results are consistent with all previously reported detections (Charbonneau et al. 2002, ApJ, 568, 377) and upper limits (Bundy & Marcy 2000, PASP, 112, 1421; Moutou et al. 2001, A&A, 371, 260), but are significantly more sensitive yet achieved from ground based observations.

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

PubMed

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

The upper airway in sleep-disordered breathing: UA in SDB.

PubMed

Taranto Montemurro, L; Kasai, T

2014-02-01

Sleep disordered breathing (SDB) is a common condition and could be a risk factor for cardiovascular morbidity and mortality. However, the pathogenesis of SDB remains to be elucidated. In general, SDB is divided into two forms, obstructive and central sleep apnea (OSA and CSA, respectively). OSA results from the sleep-related collapse of the upper airway (UA) in association with multiple factors like race, gender, obesity and UA dimensions. CSA primarily results from a fall in PaCO2 to a level below the apnea threshold during sleep through the reflex inhibition of central respiratory drive. It has been reported that UA alterations (i.e., collapse or dilation) can be observed in CSA. This review highlights the roles of the UA in the pathogenesis and pathophysiology of SDB.

Improving students' understanding of quantum mechanics

NASA Astrophysics Data System (ADS)

Zhu, Guangtian

2011-12-01

Learning physics is challenging at all levels. Students' difficulties in the introductory level physics courses have been widely studied and many instructional strategies have been developed to help students learn introductory physics. However, research shows that there is a large diversity in students' preparation and skills in the upper-level physics courses and it is necessary to provide scaffolding support to help students learn advanced physics. This thesis explores issues related to students' common difficulties in learning upper-level undergraduate quantum mechanics and how these difficulties can be reduced by research-based learning tutorials and peer instruction tools. We investigated students' difficulties in learning quantum mechanics by administering written tests and surveys to many classes and conducting individual interviews with a subset of students. Based on these investigations, we developed Quantum Interactive Learning Tutorials (QuILTs) and peer instruction tools to help students build a hierarchical knowledge structure of quantum mechanics through a guided approach. Preliminary assessments indicate that students' understanding of quantum mechanics is improved after using the research-based learning tools in the junior-senior level quantum mechanics courses. We also designed a standardized conceptual survey that can help instructors better probe students' understanding of quantum mechanics concepts in one spatial dimension. The validity and reliability of this quantum mechanics survey is discussed.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L.; Gilbert, Ronald W.

2007-10-23

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L [Morgan Hill, CA; Gilbert, Ronald W [Morgan Hill, CA

2009-12-29

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

[Choledocholithiasis and pregnancy. Hybrid laparo-endoscopic treatment in one step].

PubMed

Valadez-Caballero, David; González-Santamaría, Roberto; Soto-Mendoza, Héctor; Alberto Blanco-Figueroa, Jorge; Flores-Pantoja, Juan Manuel

2014-01-01

Complications associated with choledocholithiasis are uncommon during pregnancy. However, when it occurs, the morbidity and mortality related for the product and the mother increases, so a proper treatment is imperative in these patients. A 25-year-old pregnant woman on her second trimester. The current condition was started four days prior to the hospital admission with abdominal pain in the right upper quadrant with nausea and vomit.Twenty-four hours later jaundice and dark urine is observed. Physical examination shows scleral jaundice, right upper quadrant abdominal pain without peritoneal irritation. Uterus at umbilicus level without uterine activity. Uterus at umbilicus level without uterine activity. Laboratory tests showed elevated bilirubin and transaminases without leukocytosis; ultrasound reported live intrauterine unique product, with a heart rate of 128 beats per minute, gallbladder with multiple images inside that cast acoustic shadowing, and a 10 mm common bile duct dilated bile duct with dilatation of intrahepatic bile ducts. It was perform laparoscopic cholecystectomy with intraoperative cholangiography and placement of a transcystic jaguar guide for selective cannulation of the common bile duct. Intraoperative endoscopic retrograde cholangiopancreatography was performed with endoscopic stone extraction. The outcome was satisfactory with a hospital discharge at 48 hours. Current evidence has shown that the combined use of laparoscopy and therapeutic endoscopic cholangiography in one step is effective for the treatment of choledocholithiasis, decreasing the risk of complications associated with cannulation of the bile duct.

On the Roles of Upper- versus Lower-level Thermal Forcing in Shifting the Eddy-Driven Jet

NASA Astrophysics Data System (ADS)

Zhang, Y.; Nie, Y.; Chen, G.; Yang, X. Q.

2017-12-01

One most drastic atmospheric change in the global warming scenario is the increase in temperature over tropical upper-troposphere and polar surface. The strong warming over those two area alters the spacial distributions of the baroclinicity in the upper-troposphere of subtropics and in the lower-level of subpolar region, with competing effects on the mid-latitude atmospheric circulation. The final destination of the eddy-driven jet in future climate could be "a tug of war" between the impacts of such upper- versus lower-level thermal forcing. In this study, the roles of upper- versus lower-level thermal forcing in shifting the eddy-driven jet are investigated using a nonlinear multi-level quasi-geostrophic channel model. All of our sensitivity experiments show that the latitudinal position of the eddy-driven jet is more sensitive to the upper-level thermal forcing. Such upper-level dominance over the lower-level forcing can be attributed to the different mechanisms through which eddy-driven jet responses to them. The upper-level thermal forcing induces a jet shift mainly by affecting the baroclinic generation of eddies, which supports the latitudinal shift of the eddy momentum flux convergence. The jet response to the lower-level thermal forcing, however, is strongly "eddy dissipation control". The lower-level forcing, by changing the baroclinicity in the lower troposphere, induces a direct thermal zonal wind response in the upper level thus modifies the nonlinear wave breaking and the resultant irreversible eddy mixing, which amplifies the latitudinal shift of the eddy-driven jet. Whether the eddy response is "generation control" or "dissipation control" may strongly depend on the eddy behavior in its baroclinic processes. Only the anomalous eddy generation that penetrates into the upper troposphere can have a striking impact on the eddy momentum flux, which pushes the jet shift more efficiently and dominates the eddy response.

Upper limb injury in rugby union football: results of a cohort study.

PubMed

Usman, Juliana; McIntosh, Andrew Stuart

2013-04-01

There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

Lateral line pore diameters correlate with the development of gas bubble trauma signs in several Columbia River fishes

USGS Publications Warehouse

Morris, R.G.; Beeman, J.W.; VanderKooi, S.P.; Maule, A.G.

2003-01-01

Gas bubble trauma (GBT) caused by gas supersaturation of river water continues to be a problem in the Columbia River Basin. A common indicator of GBT is the percent of the lateral line occluded with gas bubbles; however, this effect has never been examined in relation to lateral line morphology. The effects of 115, 125 and 130% total dissolved gas levels were evaluated on five fish species common to the upper Columbia River. Trunk lateral line pore diameters differed significantly (P<0.0001) among species (longnose sucker>largescale sucker>northern pikeminnow≥chinook salmon≥redside shiner). At all supersaturation levels evaluated, percent of lateral line occlusion exhibited an inverse correlation to pore size but was not generally related to total dissolved gas level or time of exposure. This study suggests that the differences in lateral line pore diameters between species should be considered when using lateral line occlusion as an indicator of gas bubble trauma.

Development of an innovative sandwich common bulkhead for cryogenic upper stage propellant tank

NASA Astrophysics Data System (ADS)

Szelinski, B.; Lange, H.; Röttger, C.; Sacher, H.; Weiland, S.; Zell, D.

2012-12-01

In the frame of the Future Launcher Preparatory Program (FLPP) investigating advancing technologies for the Next Generation of Launchers (NGL) a number of novel key technologies are presently under development for significantly improving vehicle performance in terms of payload capacity and mission versatility. As a respective ESA guided technology development program, Cryogenic Upper Stage Technologies (CUST) has been launched within FLPP that hosts among others the development of a common bulkhead to separate liquid hydrogen from the liquid oxygen compartment. In this context, MT Aerospace proposed an advanced sandwich design concept which is currently in the development phase reaching for TRL4 under MT Aerospace responsibility. Key components of this sandwich common bulkhead are a specific core material, situated in-between two thin aluminum face sheets, and an innovative thermal decoupling element at the equatorial region. The combination of these elements provides excellent thermal insulation capabilities and mechanical performance at a minimum weight, since mechanical and thermal functions are merged in the same component. This improvement is expressed by substantial performance figures of the proposed concept that include high resistance against reverse pressure, an optimized heat leak and minimized mass, involving the sandwich dome structure and the adjacent interface rings. The development of single sub-technologies, all contributing to maturate the sandwich common bulkhead towards the desired technology readiness level (TRL), is described in the context of the given design constraints as well as technical, functional and programmatic requirements, issued from the stage level. This includes the thermal and mechanical characterization of core materials, manufacturing issues as well as non-destructive testing and the thermal and structural analyses and dimensioning of the complete common bulkhead system. Dedicated TRL assessments in the Ariane 5 Mid-life Evolution (A5-ME) program track the progress of these technology developments and analyze their applicability in time for A5-ME. In order to approximate A5-ME concerned preconditions, activities are initiated aiming at harmonization of the available specifications. Hence, a look-out towards a further technology step approaching TRL6 in a subsequent phase is given, briefly addressing topics of full scale manufacture and appropriate thermo-mechanical testing of an entire sandwich common bulkhead.

Operation and Maintenance. 9-Foot Navigation Channel, Upper Mississippi River, Head of Navigation to Guttenberg, Iowa. Volume 1. Narrative.

DTIC Science & Technology

1974-08-01

forest, along with wood nettle, which is by far the most common shrub layer vegetation, although neither is abundant in the forest proper. Vine form...poison ivy, Virginia creeper, wild grape, p" are common woody vines . The high unshaded edges of running sloughs in the forest areas often have thick...Mississippi River floodplain. 36 7.....a................ S -"’ 2.10 Beginning about 1 million years ago, the Upper Midwest entered what is commonly referred to

A survey of major east coast snowstorms, 1960-1983. Part 2. Summary of surface and upperlevel characteristics

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Surface and upper-level characteristics of selected meteorological fields are summarized. Two major types of sea level development are described and applied to the cases at hand, with a few storm systems showing characteristics of both types. Aspects such as rapid sea level deepening, coastal frontogenesis, cold air damming, low level jet formation, the development of an S-shaped isotherm pattern, diffluence downwind of a negatively tilted upper level trough axis, upper level confluence and an increase of geopotential heights at the base of the upper level trough characterized the pre-cyclogenetic and cyclogenetic periods of many of the storm systems. Large variability was also observed, especially with regard to the spatial dimensions of the surface and upper level systems, as well as variations in trough/ridge amplification and the evolution of upper level jet streak systems. The influence of transverse circulations associated with a confluent jet streak entrance region and the diffluent exit region of a jet streak/trough system on the production of snowfall is also discussed.

Does the advantage of the upper part of words occur at the lexical level?

PubMed

Perea, Manuel; Comesaña, Montserrat; Soares, Ana P

2012-11-01

Several recent studies have shown that the upper part of words is more important than the lower part in visual word recognition. Here, we examine whether or not this advantage arises at the lexical or at the letter (letter feature) level. To examine this issue, we conducted two lexical decision experiments in which words/pseudowords were preceded by a very brief (50-ms) presentation of their upper or lower parts (e.g., ). If the advantage for the upper part of words arises at the letter (letter feature) level, the effect should occur for both words and pseudowords. Results revealed an advantage for the upper part of words, but not for pseudowords. This suggests that the advantage for the upper part of words occurs at the lexical level, rather than at the letter (or letter feature) level.

Temporal arteritis

MedlinePlus

... the blood vessels that supply blood to the head, neck, upper body and arms. It is also called ... the blood vessels that supply blood to the head, neck, upper body, and arms. It most commonly occurs ...

Upper limb musculoskeletal complaints among technicians working in a diagnostic tuberculosis laboratory: two case reports.

PubMed

Wong, Joyce Y P; Chin, David; Fung, Henry; Li, Ann; Wong, Marcus M S; Kwok, Henry K H

2014-01-01

Upper limb musculoskeletal complaints are common among certain health professionals. We report two cases, both involving technicians working in a diagnostic tuberculosis laboratory in Hong Kong. A work process evaluation suggest that the need to repeatedly open and close small bottles, as well as to work for prolonged periods of time in confined areas, could be related to the workers' clinical presentation. The cases are also compatible with the diagnosis of repetitive strain injury (RSI) of the upper limb, but this term is not commonly used nowadays because of various definitional issues. A review of the various diagnostic issues in RSI is presented.

Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents.

PubMed

Kaiser, Radek; Waldauf, Petr; Haninec, Pavel

2012-07-01

Brachial plexus injuries occur in up to 5% of polytrauma cases involving motorcycle accidents and in approximately 4% of severe winter sports injuries. One of the criteria for a successful operative therapy is the type of lesion. Upper plexus palsy has the best prognosis, whereas lower plexus palsy is surgically untreatable. The aim of this study was to evaluate a group of patients with brachial plexus injury caused by traffic accidents, categorize the injuries according to type of accident, and look for correlations between type of palsy (injury) and specific accidents. A total of 441 brachial plexus reconstruction patients from our department were evaluated retrospectively(1993 to 2011). Sex, age, neurological status, and the type and cause of injury were recorded for each case. Patients with BPI caused by a traffic accident were assessed in detail. Traffic accidents were the cause of brachial plexus injury in most cases (80.7%). The most common type of injury was avulsion of upper root(s) (45.7%) followed by rupture (28.2%), complete avulsion (16.9%) and avulsion of lower root(s) (9.2%). Of the patients, 73.9% had an upper,22.7% had a complete and only 3.4% had a lower brachial plexus palsy. The main cause was motorcycle accidents(63.2%) followed by car accidents (23.5%), bicycle accidents(10.7%) and pedestrian collisions (3.1%) (p<0.001).Patients involved in car accidents had a higher percentage of lower avulsion (22.7%) and a lower percentage of upper avulsion (29.3%), whereas cyclists had a higher percentage of upper avulsion (68.6%) based on the data from the entire group of patients (p<0.001). Lower plexus palsy was significantly increased in patients after car accidents (9.3%,p<0.05). In the two main groups (car and motorcycle accidents),significantly more upper and fewer lower palsies were present. In the bicycle accident group, upper palsy was the most common (89%). Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the potential of a brachial plexus injury after serious traffic accidents and to examine both upper extremities in detail even if some motor function is preserved.

Teaching strategies for assessing and managing urinary incontinence in older adults.

PubMed

Bradway, Christine; Cacchione, Pamela

2010-07-01

Urinary incontinence is common and affects many aspects of older adults' lives; therefore, it is essential that nursing faculty include this content in classroom and clinical teaching situations. This article describes innovative strategies for teaching upper-level nursing students (e.g., junior and senior undergraduates) about urinary incontinence in older adults, specifically, the relevant anatomy and physiology of continence and associated pathophysiology of urinary incontinence, risk factors and consequences, definitions and types, and effective nursing assessment and management strategies. Copyright 2010, SLACK Incorporated.

White light Sagnac interferometer—a common (path) tale of light

NASA Astrophysics Data System (ADS)

Schwartz, Eyal

2017-11-01

White or polychromatic light sources are vastly abundant in nature and lie in our most basic understanding of the theory of light, beginning from stars like our Sun and extending to every common household light bulb or street lamp. In this paper, I present concepts of white light interferometery using a common-path Sagnac interferometer, manifested in a straightforward laboratory experiment. I further show the use of this as a Fourier transform spectrometer while presenting a basic overview of the theoretical concepts and spectrum of different light sources obtained experimentally. This work, both experimentally and analytically, is suitable for upper-level undergraduate physics or engineering courses where electromagnetic theory and optics are discussed. The experiment and theory presents important deep concepts and aspects in modern optics and physics that every science student should acquire.

Climate Control on Tree Growth at the Upper and Lower Treelines: A Case Study in the Qilian Mountains, Tibetan Plateau

PubMed Central

Yang, Bao; He, Minhui; Melvin, Thomas M.; Zhao, Yan; Briffa, Keith R.

2013-01-01

It is generally hypothesized that tree growth at the upper treeline is normally controlled by temperature while that at the lower treeline is precipitation limited. However, uniform patterns of inter-annual ring-width variations along altitudinal gradients are also observed in some situations. How changing elevation influences tree growth in the cold and arid Qilian Mountains, on the northeastern Tibetan Plateau, is of considerable interest because of the sensitivity of the region’s local climate to different atmospheric circulation patterns. Here, a network of four Qilian juniper (Sabina przewalskii Kom.) ring-width chronologies was developed from trees distributed on a typical mountain slope at elevations ranging from 3000 to 3520 m above sea level (a.s.l.). The statistical characteristics of the four tree-ring chronologies show no significant correlation with increasing elevation. All the sampled tree growth was controlled by a common climatic signal (local precipitation) across the investigated altitudinal gradient (520 m). During the common reliable period, covering the past 450 years, the four chronologies have exhibited coherent growth patterns in both the high- and low-frequency domains. These results contradict the notion of contrasting climate growth controls at higher and lower elevations, and specifically the assumption that inter-annual tree-growth variability is controlled by temperature at the upper treeline. It should be stressed that these results relate to the relatively arid conditions at the sampling sites in the Qilian Mountains. PMID:23874871

Upper gastrointestinal bleeding - state of the art.

PubMed

Szura, Mirosław; Pasternak, Artur

2014-01-01

Upper gastrointestinal (GI) bleeding is a condition requiring immediate medical intervention, with high associated mortality exceeding 10%. The most common cause of upper GI bleeding is peptic ulcer disease, which largely corresponds to the intake of NSAIDs and Helicobacter pylori infection. Endoscopy is the essential tool for the diagnosis and treatment of active upper GI hemorrhage. Endoscopic therapy together with proton pump inhibitors and eradication of Helicobacter pylori significantly reduces rebleeding rates, mortality and number of emergency surgical interventions. This paper presents contemporary data on the diagnosis and treatment of upper gastrointestinal bleeding.

Educational Discourse and the Making of Educational Legislation in Early Upper Canada

ERIC Educational Resources Information Center

Di Mascio, Anthony

2010-01-01

The educational history of Upper Canada is commonly written as the succession of an elite group of educational reformers who advocated a centralized system of mass schooling. However, the recent shift in research on Upper Canada away from the narrative of prominent individuals who controlled the social, political, and economic development of the…

Atmos/Atlas 3 Infrared Profile Measurements of Trace Gases in The November 1994 Tropical and Subtropical Upper Troposphere

NASA Technical Reports Server (NTRS)

Rinsland, C. P.; Gunson, M. R.; Wang, P.-H.; Arduini, R. F.; Baum, B. A.; Minnis, P.; Minnis, P.; Goldman, A.; Abrams, M. C.; Zander, R.;

Upper-Tropospheric Synoptic-Scale Waves. Part II: Maintenance and Excitation of Quasi Modes.

NASA Astrophysics Data System (ADS)

Rivest, Chantal; Farrell, Brian F.

1992-11-01

In a preceding paper a simple dynamical model for the maintenance of upper-tropospheric waves was proposed: the upper-level Eady normal modes. In this paper it is shown that these modes have counterparts in basic states with positive tropospheric gradients of potential vorticity, and that these counterparts can be maintained and excited on time scales consistent with observations.In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal-mode solutions no longer exist. That the normal-mode solution disappears when gradients are infinitesimal represents an apparent singularity and challenges the interpretation of upper-level synoptic-scale waves as related to the upper-level Eady normal modes. What happens to the upper-level modal solution in the presence of tropospheric gradients of potential vorticity is examined in a series of initial-value experiments. Our results show that they become slowly decaying quasi modes. Mathematically the quasi modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained.Following a previous study by Farrell, a class of near-optimal initial conditions for the excitation of upper-level waves is identified. The initial conditions consist of upper-tropospheric disturbances that lean against the shear. They strongly excite upper-level waves not only in the absence of tropospheric potential vorticity gradients, but also in their presence. This result is important mathematically since it suggests that quasi modes are as likely to emerge from favorably configured initial disturbances as true normal modes, although the excitation is followed by a slow decay.

Overuse injuries of the upper extremity in the competitive athlete: magnetic resonance imaging findings associated with repetitive trauma.

PubMed

Banks, Kevin P; Ly, Justin Q; Beall, Douglas P; Grayson, David E; Bancroft, Laura W; Tall, Michael A

2005-01-01

Overuse injuries are a very common cause of pain in athletes, accounting for a significant loss of training time and missed competitions. Magnetic resonance imaging (MRI) is playing an increasing role in facilitating the expeditious and safe return of these individuals to their preinjury level of physical performance by allowing accurate diagnosis. Sports physicians are increasingly relying on the exquisite anatomic detail afforded by this technique to formulate diagnoses that assist with the optimal management of these athletic injuries. Some upper extremity overuse entities are well recognized; two examples are medial epicondylitis, classically appearing in baseball pitchers, and lateral epicondylitis, in tennis players. Other less well-known injuries of the upper extremity, such as intersection syndrome in rowers and distal clavicular stress fractures in weightlifters, are frequent occurrences in certain circles of athletes. The following article is a pictorial review of the MRI findings of upper extremity overuse injuries encountered in the competitive athlete, with an emphasis on the sports scenarios in which they occur. We will depict mechanisms of injury and applicable anatomy and show characteristic imaging findings. A wide range of entities are addressed, including but not limited to overuse injuries occurring in baseball, swimming, gymnastics, weightlifting, bowling, and cycling.

AccessScope project: Accessible light microscope for users with upper limb mobility or visual impairments.

PubMed

Mansoor, Awais; Ahmed, Wamiq M; Samarapungavan, Ala; Cirillo, John; Schwarte, David; Robinson, J Paul; Duerstock, Bradley S

2010-01-01

A web-based application was developed to remotely view slide specimens and control all functions of a research-level light microscopy workstation, called AccessScope. Students and scientists with upper limb mobility and visual impairments are often unable to use a light microscope by themselves and must depend on others in its operation. Users with upper limb mobility impairments and low vision were recruited to assist in the design process of the AccessScope personal computer (PC) user interface. Participants with these disabilities were evaluated in their ability to use AccessScope to perform microscopical tasks. AccessScope usage was compared with inspecting prescanned slide images by grading participants' identification and understanding of histological features and knowledge of microscope operation. With AccessScope subjects were able to independently perform common light microscopy functions through an Internet browser by employing different PC pointing devices or accessibility software according to individual abilities. Subjects answered more histology and microscope usage questions correctly after first participating in an AccessScope test session. AccessScope allowed users with upper limb or visual impairments to successfully perform light microscopy without assistance. This unprecedented capability is crucial for students and scientists with disabilities to perform laboratory coursework or microscope-based research and pursue science, technology, engineering, and mathematics fields.

New tools for investigating student learning in upper-division electrostatics

NASA Astrophysics Data System (ADS)

Wilcox, Bethany R.

Student learning in upper-division physics courses is a growing area of research in the field of Physics Education. Developing effective new curricular materials and pedagogical techniques to improve student learning in upper-division courses requires knowledge of both what material students struggle with and what curricular approaches help to overcome these struggles. To facilitate the course transformation process for one specific content area --- upper-division electrostatics --- this thesis presents two new methodological tools: (1) an analytical framework designed to investigate students' struggles with the advanced physics content and mathematically sophisticated tools/techniques required at the junior and senior level, and (2) a new multiple-response conceptual assessment designed to measure student learning and assess the effectiveness of different curricular approaches. We first describe the development and theoretical grounding of a new analytical framework designed to characterize how students use mathematical tools and techniques during physics problem solving. We apply this framework to investigate student difficulties with three specific mathematical tools used in upper-division electrostatics: multivariable integration in the context of Coulomb's law, the Dirac delta function in the context of expressing volume charge densities, and separation of variables as a technique to solve Laplace's equation. We find a number of common themes in students' difficulties around these mathematical tools including: recognizing when a particular mathematical tool is appropriate for a given physics problem, mapping between the specific physical context and the formal mathematical structures, and reflecting spontaneously on the solution to a physics problem to gain physical insight or ensure consistency with expected results. We then describe the development of a novel, multiple-response version of an existing conceptual assessment in upper-division electrostatics courses. The goal of this new version is to provide an easily-graded electrostatics assessment that can potentially be implemented to investigate student learning on a large scale. We show that student performance on the new multiple-response version exhibits a significant degree of consistency with performance on the free-response version, and that it continues to provide significant insight into student reasoning and student difficulties. Moreover, we demonstrate that the new assessment is both valid and reliable using data from upper-division physics students at multiple institutions. Overall, the work described in this thesis represents a significant contribution to the methodological tools available to researchers and instructors interested in improving student learning at the upper-division level.

The Synoptic Climatology of Severe Thunderstorms in Manitoba.

NASA Astrophysics Data System (ADS)

Ladochy, Stephen Eugene Gabriel

The thesis presents the climatologies for Manitoba thunderstorms, hailstorms and tornadoes as well as investigates the synoptic weather conditions conducive for their development. The study not only uses standard meteorological information, but also various kinds of proxy data, in the form of damage reports. These damage reports complement the meteorological data by providing a higher resolution of observations, particularly in the sparsely populated regions. The synoptic conditions are relatively similar for all forms of severe thunderstorms, though the upper level jet stream (ULJ) is stronger for tornadoes, in general. Composite charts, drawn for 50 larger, more damaging hail days and 48 tornado days in the 1970's, helped identify important surface and upper air weather parameters and their inter -relationships with each other and the location of the storm. Time sequence composite charts were used to also show the development process in severe weather occurrences. From the composites, a synoptic weather type classification was devised with 10 categories to identify each storm by type. The most common pattern for severe weather has a strong southwesterly ULJ, with the storm occurring ahead of an advancing cold front. The ULJ patterns were drawn for each synoptic type days, showing differences between categories. The average conditions during tornado touchdowns were also seen from composite maps of surface and upper air isobaric charts. While severe thunderstorms are seen to occur under the "ideal" conditions, often described for U.S. severe weather, they can also be produced under other weather patterns and combinations of atmospheric parameters thought less favorable. The ULJ and LLJ (low-level jet stream) models used in U.S. studies do not always fit Manitoba storms, however, less favorable jet positions, at specific levels, can be compensated for by low-level advection of warm, and moist air.

Effect of listening to Vedic chants and Indian classical instrumental music on patients undergoing upper gastrointestinal endoscopy: A randomized control trial.

PubMed

Padam, Anita; Sharma, Neetu; Sastri, O S K S; Mahajan, Shivani; Sharma, Rajesh; Sharma, Deepak

2017-01-01

A high level of preoperative anxiety is common among patients undergoing medical and surgical procedures. Anxiety impacts of gastroenterological procedures on psychological and physiological responses are worth consideration. To analyze the effect of listening to Vedic chants and Indian classical instrumental music on anxiety levels and on blood pressure (BP), heart rate (HR), and oxygen saturation in patients undergoing upper gastrointestinal (GI) endoscopy. A prospective, randomized controlled trial was done on 199 patients undergoing upper GI endoscopy. On arrival, their anxiety levels were assessed using state and trait scores and various physiological parameters such as HR, BP, and SpO 2 . Patients were randomly divided into three groups: Group I of 67 patients who were made to listen prerecorded Vedic chants for 10 min, Group II consisting of 66 patients who listened to Indian classical instrumental music for 10 min, and Group III of 66 controls who remained seated for same period in the same environment. Thereafter, their anxiety state scores and physiological parameters were reassessed. A significant reduction in anxiety state scores was observed in the patients in Group I (from 40.4 ± 8.9 to 38.5 ± 10.7; P < 0.05) and Group II (from 41.8 ± 9.9 to 38.0 ± 8.6; P < 0.001) while Group III controls showed no significant change in the anxiety scores. A significant decrease in systolic BP ( P < 0.001), diastolic BP ( P < 0.05), and SpO 2 ( P < 0.05 was also observed in Group II. Listening to Vedic chants and Indian classical instrumental music has beneficial effects on alleviating anxiety levels induced by apprehension of invasive procedures and can be of therapeutic use.

Quantum interactive learning tutorial on the double-slit experiment to improve student understanding of quantum mechanics

NASA Astrophysics Data System (ADS)

Sayer, Ryan; Maries, Alexandru; Singh, Chandralekha

2017-06-01

Learning quantum mechanics is challenging, even for upper-level undergraduate and graduate students. Research-validated interactive tutorials that build on students' prior knowledge can be useful tools to enhance student learning. We have been investigating student difficulties with quantum mechanics pertaining to the double-slit experiment in various situations that appear to be counterintuitive and contradict classical notions of particles and waves. For example, if we send single electrons through the slits, they may behave as a "wave" in part of the experiment and as a "particle" in another part of the same experiment. Here we discuss the development and evaluation of a research-validated Quantum Interactive Learning Tutorial (QuILT) which makes use of an interactive simulation to improve student understanding of the double-slit experiment and strives to help students develop a good grasp of foundational issues in quantum mechanics. We discuss common student difficulties identified during the development and evaluation of the QuILT and analyze the data from the pretest and post test administered to the upper-level undergraduate and first-year physics graduate students before and after they worked on the QuILT to assess its effectiveness. These data suggest that on average, the QuILT was effective in helping students develop a more robust understanding of foundational concepts in quantum mechanics that defy classical intuition using the context of the double-slit experiment. Moreover, upper-level undergraduates outperformed physics graduate students on the post test. One possible reason for this difference in performance may be the level of student engagement with the QuILT due to the grade incentive. In the undergraduate course, the post test was graded for correctness while in the graduate course, it was only graded for completeness.

Paediatric cervical spine injures. Nineteen years experience of a single centre.

PubMed

Ribeiro da Silva, Manuel; Linhares, Daniela; Cacho Rodrigues, Pedro; Monteiro, Eurico Lisboa; Santos Carvalho, Manuel; Negrão, Pedro; Pinto, Rui Peixoto; Neves, Nuno

2016-06-01

This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. Seventy-five cases of C-spine injuries (nine SCIWORA) were identified. Group A included 23 patients and group B 52. In group A, skeletal injuries at the upper C-spine were more common than injuries at the lower C-spine, whereas in group B, injuries of the lower C-spine were more frequent (p = 0.035). Motor vehicle accidents were the main cause of injury (44 %); 25.3 % of patients were surgically treated. Thirty-nine patients presented neurologic deficits, 16 of which improved. The overall mortality rate was 18.7 % and significantly higher in patients with neurological damages (p < 0.001) CONCLUSIONS: This study revealed a low incidence of cervical spine injuries in the paediatric population. As in previous reports younger children mainly sustained injuries at the upper C-spine, higher incidence of spinal injuries, and higher risk of death than older children.

Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial.

PubMed

Dunning, James R; Cleland, Joshua A; Waldrop, Mark A; Arnot, Cathy F; Young, Ian A; Turner, Michael; Sigurdsson, Gisli

2012-01-01

Randomized clinical trial. To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain. Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain. Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively. The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain. Therapy, level 1b.

Upper Gastrointestinal Stent Insertion in Malignant and Benign Disorders

PubMed Central

Kang, Hyoun Woo

2015-01-01

Upper gastrointestinal (GI) stents are increasingly being used to manage upper GI obstructions. Initially developed for palliative treatment of esophageal cancer, upper GI stents now play an emerging role in benign strictures of the upper GI tract. Because recurrent obstruction and stent-related complications are common, new modifications of stents have been implemented. Self-expandable metal stents (SEMS) have replaced older plastic stents. In addition, newly designed SEMS have been developed to prevent complications. This review provides an overview of the various types, indications, methods, complications, and clinical outcomes of upper GI stents in a number of malignant and benign disorders dividing the esophagus and gastroduodenum. PMID:26064817

Right Upper Quadrant Pain: Ultrasound First!

PubMed

Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

2017-10-01

Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

Seam profiling of three coals from Upper Cretaceous Menefee formation near Durango, CO

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

Pawlewicz, M.J.

1985-05-01

Column samples of three separate coal seams from the Upper Cretaceous Menefee Formation near Durango were examined with reflected light and oil immersion to characterize the vertical variation in the coal petrography. In order to interpret the paleoenvironments of the coal, the macerals (microlithotypes) that make up the coal were identified and their association (whether they are in microbands or dispersed throughout), their physical condition (if they show signs of weathering or transportation), and their modal composition were observed. The observed petrography indicates two main environments of deposition. Most of the microlithotypes are rich in vitrinite. This and the associationmore » and physical condition of the macerals indicate a terrestrial forest containing mainly woody plants and trees with a slightly fluctuating ground-water level. Less commonly, the microlithotypes have less vitrinite and more mineral matter, suggesting deposition in an open moor or deep water usually inhabited mainly be herbaceous plants. Macerals from both environments are weathered, suggesting infrequent dry periods or periods of lower water-table levels where the peat was exposed to subaerial oxidation.« less

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience.

PubMed

Chung, Amy S Y; Luk, W H; Lo, Adrian X N; Lo, C F

2015-04-01

To determine the prevalence and characteristics of sonographically evident upper-extremity deep vein thrombosis in symptomatic Chinese patients and identify its associated risk factors. Regional hospital, Hong Kong. Data on patients undergoing upper-extremity venous sonography examinations during a 13-year period from November 1999 to October 2012 were retrieved. Variables including age, sex, history of smoking, history of lower-extremity deep vein thrombosis, major surgery within 30 days, immobilisation within 30 days, cancer (history of malignancy), associated central venous or indwelling catheter, hypertension, diabetes mellitus, sepsis within 30 days, and stroke within 30 days were tested using binary logistic regression to understand the risk factors for upper-extremity deep vein thrombosis. The presence of upper-extremity deep vein thrombosis identified. Overall, 213 patients with upper-extremity sonography were identified. Of these patients, 29 (13.6%) had upper-extremity deep vein thrombosis. The proportion of upper-extremity deep vein thrombosis using initial ultrasound was 0.26% of all deep vein thrombosis ultrasound requests. Upper limb swelling was the most common presentation seen in a total of 206 (96.7%) patients. Smoking (37.9%), history of cancer (65.5%), and hypertension (27.6%) were the more prevalent conditions among patients in the upper-extremity deep vein thrombosis-positive group. No statistically significant predictor of upper-extremity deep vein thrombosis was noted if all variables were included. After backward stepwise logistic regression, the final model was left with only age (P=0.119), female gender (P=0.114), and history of malignancy (P=0.024) as independent variables. History of malignancy remained predictive of upper-extremity deep vein thrombosis. Upper-extremity deep vein thrombosis is uncommon among symptomatic Chinese population. The most common sign is swelling and the major risk factor for upper-extremity deep vein thrombosis identified in this study is malignancy.

Prospective study on antibiotics misuse among infants with upper respiratory infections.

PubMed

El Sayed, Manal F; Tamim, Hala; Jamal, Diana; Mumtaz, Ghina; Melki, Imad; Yunis, Khalid

2009-06-01

The judicious prescription of antibiotics has become a central focus of professional and public health measures to combat the spread of resistant organisms. A one-year multi-center prospective follow-up study of 1,320 healthy infants was conducted. The study aim was to determine the prevalence and identify the predictors of antibiotics misuse in viral respiratory illnesses among healthy infants in the first year of life. Infants born between August 2001 and February 2002 were recruited through the clinics and dispensaries of 117 pediatricians located in the Greater Beirut area of Lebanon. On each routine visit from birth until one year of life, pediatricians reported any episodes of upper respiratory tract infection (URTI; common cold) and bronchiolitis, as well as the treatment type, duration, and dose. Predictors that were considered included infant, maternal, and pediatrician characteristics. Of the 1,320 recruited infants, 770 (58.3%) had common cold or acute bronchiolitis on at least one occasion during the study period. Pediatricians prescribed antibiotics at least once in 21.4% of cases diagnosed as the common cold and 45.5% of cases of acute bronchiolitis. Logistic regression analysis revealed that antibiotics misuse was more common among infants born to mothers with lower educational levels (odds ratio [OR] = 1.6; 95% confidence interval [CI]: 1.1-2.3). Furthermore, pediatricians tend to prescribe antibiotics in dispensaries more often than in private clinics (OR = 1.4; 95% CI: 1.0-2.3). This study shows a substantial quantity of antibiotics prescriptions for common cold and acute bronchiolitis in our population. Our findings suggest that lower maternal education and pediatricians working in dispensaries (versus private clinics) are associated with increased antibiotics misuse.

Commonly Asked Questions about Children and Heart Disease

MedlinePlus

... heart is a pump with a built-in electrical system. Normally, electricity starts in the upper chamber and spreads to ... function. Heart block occurs when the spread of electricity from the upper chambers (atria) to the lower ...

Hard work never hurt anyone: or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb.

PubMed

Walker-Bone, K; Cooper, C

2005-10-01

Pain in the neck and upper limb is common and contributes considerably to absence from work due to sickness. Evidence suggest that prolonged abnormal posture and repetition contribute to such conditions. Psychosocial risk factors may also play a part in the aetiology of upper limb disorders.

Upper gastrointestinal bleeding.

PubMed

Feinman, Marcie; Haut, Elliott R

2014-02-01

Upper gastrointestinal (GI) bleeding remains a commonly encountered diagnosis for acute care surgeons. Initial stabilization and resuscitation of patients is imperative. Stable patients can have initiation of medical therapy and localization of the bleeding, whereas persistently unstable patients require emergent endoscopic or operative intervention. Minimally invasive techniques have surpassed surgery as the treatment of choice for most upper GI bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

Chlamydia trachomatis-induced Fitz-Hugh-Curtis syndrome: a case report.

PubMed

Ekabe, Cyril Jabea; Kehbila, Jules; Njim, Tsi; Kadia, Benjamin Momo; Tendonge, Celestine Ntemlefack; Monekosso, Gottlieb Lobe

2017-01-03

Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease. Chlamydia trachomatis is one of its most common aetiologies. This syndrome usually presents with right upper quadrant abdominal pain mimicking other hepatobiliary and gastrointestinal pathologies, hence, posing a diagnostic dilemma in settings with limited diagnostic tools. A 32 year old African female presented with acute right upper quadrant abdominal pain and vaginal discharge, for which she had previously received treatment in another health center with no improvement. Clinical and laboratory findings were suggestive of Fitz-Hugh-Curtis syndrome. Five days after treatment with oral doxycycline, the patient showed marked clinical improvement. Fitz-Hugh-Curtis syndrome is a common cause of right upper quadrant pain which is often under diagnosed in poor communities. Hence, it should be included as a differential diagnosis in patients presenting with right upper quadrant pain, especially in females of reproductive age.

Neck pain: manipulating the upper back helps lessen pain and improve neck motion.

PubMed

2011-09-01

Neck pain is very common. In the United States, between 30% and 50% of people suffer from an aching neck each year. Although neck pain can be caused by injury, most of this pain results from more gradual stresses, such as particular sitting, standing, or work postures, lifting patterns, or sleeping positions. Typical neck pain can also cause headaches, pain between your shoulders, or a feeling of knots in your neck and upper back muscles. Although manual therapy, sometimes called "manipulation," is a common treatment for many types of spine pain, some people are uncomfortable having their necks manipulated. Recently, though, researchers have tested the benefits of a thrust manipulation of the upper back to treat neck pain. A study published in the September 2011 issue of JOSPT provides new insight and an evidence-based summary of the benefits of manipulating the upper back to ease and eliminate neck pain.

Predictors of septic shock in obstructive acute pyelonephritis.

PubMed

Tambo, Mitsuhiro; Okegawa, Takatsugu; Shishido, Toshihide; Higashihara, Eiji; Nutahara, Kikuo

2014-06-01

Acute pyelonephritis (APN) with obstructive uropathy is not uncommon and often causes serious conditions including sepsis and septic shock. We assessed the risk factors for septic shock in patients with obstructive APN associated with upper urinary tract calculi. We retrospectively studied 69 patients with obstructive APN associated with upper urinary tract calculi who were admitted to our hospital. Emergency drainage for decompression of the renal collecting system was performed for empirical treatment in cases of failure of initial treatment and for severe cases. We assessed the risk factors for septic shock by multivariate logistic regression analysis. Overall, 45 patients (65.2 %) underwent emergency drainage and 23 (33.3 %) patients showed septic shock. Poor performance status and the presence of diabetes mellitus (DM) in the septic shock group were more common than in the non-septic shock group (p = 0.012 and p = 0.011, respectively). The platelet count and serum albumin level in the septic shock group were significantly lower than in the non-septic shock group (p = 0.002 and p = 0.003, respectively). Positive rates of midstream urine culture and blood culture in the septic shock group were significantly higher than in the non-septic shock group (p = 0.022 and p = 0.001, respectively). Multivariate analysis showed that decreases in the platelet count (OR 5.43, p = 0.014) and serum albumin level (OR 5.88, p = 0.023) were independent risk factors for septic shock. Patients with obstructive APN associated with upper urinary tract calculi who have decreases in platelet count and serum albumin level should be treated with caution against the development of septic shock.

Upper tract urothelial carcinomas: frequency of association with mismatch repair protein loss and lynch syndrome.

PubMed

Harper, Holly L; McKenney, Jesse K; Heald, Brandie; Stephenson, Andrew; Campbell, Steven C; Plesec, Thomas; Magi-Galluzzi, Cristina

2017-01-01

Increased risk for upper tract urothelial carcinoma is described in patients with Lynch syndrome, caused by germline mutations in mismatch repair genes. We aimed to identify the frequency of mismatch repair protein loss in upper tract urothelial carcinoma and its potential for identifying an association with Lynch syndrome. We queried our database to identify upper tract urothelial carcinomas. Patients were cross-referenced for history of colorectal carcinoma or other common Lynch syndrome-associated neoplasms to enrich for potential Lynch syndrome cases. Tumor histopathologic characteristics were reviewed and each case was analyzed for loss of mismatch repair proteins, MLH1, MSH2, MSH6, and PMS2, by immunohistochemistry. Of 444 patients with upper tract urothelial carcinoma, a subset of 215 (encompassing 30 with upper tract urothelial carcinoma and another common Lynch syndrome-associated neoplasm) was analyzed for loss of mismatch repair protein expression. Of 30 patients with Lynch syndrome-associated neoplasms, six had documented Lynch syndrome, including two with Muir-Torre syndrome. Mismatch repair protein loss was identified in 7% of total upper tract urothelial carcinomas and 30% of patients with Lynch syndrome-associated neoplasms (including all patients with Lynch syndrome/Muir-Torre syndrome). Of patients without history of Lynch syndrome-associated neoplasms, 5 of 184 (2.7%) had loss of mismatch repair protein expression. Twelve cases with mismatch repair protein loss demonstrated loss of MSH2 and MSH6, and 2 had isolated loss of MSH6. MLH1 and PMS2 expression were consistently retained. Although increased intratumoral lymphocytes, inverted growth, pushing tumor-stromal interface, and lack of nuclear pleomorphism were more commonly seen in cases with mismatch repair protein loss, only intratumoral lymphocytes and presence of pushing borders were statistically significant. MLH1 and PMS2 testing appear to have little utility in upper tract urothelial carcinoma; however, mismatch repair protein loss of MSH2 and/or MSH6 by immunohistochemistry seems relatively sensitive and specific for identifying patients with potential Lynch syndrome.

Deposition and deformation of fluvial-lacustrine sediments of the Upper Triassic-Lower Jurassic Whitmore Point Member, Moenave Formation, northern Arizona

NASA Astrophysics Data System (ADS)

Tanner, Lawrence H.; Lucas, Spencer G.

2010-01-01

The stratigraphic section of the Upper Triassic-Lower Jurassic Whitmore Point Member of the Moenave Formation at Potter Canyon, Arizona, comprises c. 26 m of gray to black shales and red mudstones interbedded with mainly sheet-like siltstones and sandstones. These strata represent deposition from suspension and sheetflow processes in shallow, perennial meromictic to ephemeral lakes, and on dry mudflats of the terminal floodout of the northward-flowing Moenave stream system. The lakes were small, as indicated by the lack of shoreline features and limited evidence for deltas. Changes in base level, likely forced by climate change, drove the variations between mudflat and perennial lacustrine conditions. Lenticular sandstones that occur across the outcrop face in the same stratigraphic interval in the lower part of the sequence represent the bedload fill of channels incised into a coarsening-upward lacustrine sequence following a fall in base level. These sandstones are distinctive for the common presence of over-steepened bedding, dewatering structures, and less commonly, folding. Deformation of these sandstones is interpreted as aseismic due to the lack of features typically associated with seismicity, such as fault-graded bedding, diapirs, brecciated fabrics and clastic dikes. Rapid deposition of the sands on a fluid-rich substrate produced a reverse density gradient that destabilized, and potentially fluidized the underlying, finer-grained sediments. This destabilization allowed synsedimentary subsidence of most of the channel sands, accompanied by longitudinal rotation and/or ductile deformation of the sand bodies.

Incentivizing advanced mathematics study at upper secondary level: the case of bonus points in Ireland

NASA Astrophysics Data System (ADS)

Treacy, Páraic Thomas

2018-04-01

Secondary level mathematics education in Ireland has recently experienced a period of significant change with the introduction of new curricula and the addition of an incentive to study upper secondary mathematics at the most advanced level (Higher Level). This incentive, typically referred to as 'bonus points', appears to have aided a significant increase in the number of students studying upper secondary mathematics at Higher Level. However, thematic analysis of interviews with experienced upper secondary mathematics examiners and exploration of mathematics diagnostic test data outlined in this paper suggest that the difficulty of the Higher Level upper secondary mathematics final examination in Ireland has reduced since the introduction of the bonus points initiative. The sharp increase in students attempting this examination coupled with a policy of maintaining a consistent proportion of students achieving passing grades was identified as a key reason for this possible reduction in standards.

Variation of p53 mutational spectra between carcinoma of the upper and lower respiratory tract.

PubMed

Law, J C; Whiteside, T L; Gollin, S M; Weissfeld, J; El-Ashmawy, L; Srivastava, S; Landreneau, R J; Johnson, J T; Ferrell, R E

1995-07-01

Mutations of the p53 tumor suppressor gene are the most common genetic alterations associated with human cancer. Tumor-associated p53 mutations often show characteristic tissue-specific profiles which may infer environmentally induced mutational mechanisms. The p53 mutational frequency and spectrum were determined for 95 carcinomas of the upper and lower respiratory tract (32 lung and 63 upper respiratory tract). Mutations were identified at a frequency of 30% in upper respiratory tract (URT) tumors and 31% in lung tumors. All 29 identified mutations were single-base substitutions. Comparison of the frequency of specific base substitutions between lung and URT showed a striking difference. Transitions occurred at a frequency of 68% in URT, but only 30% in lung. Mutations involving G:C-->A:T transitions, which are commonly reported in gastric and esophageal tumors, were the most frequently identified alteration in URT (11/19). Mutations involving G:C-->T:A transversions, which were relatively common in lung tumors (3/10) and are representative of tobacco smoke-induced mutations were rare in URT tumors (1/19). Interestingly, G:C-->A:T mutations at CpG sites, which are characteristic of endogenous processes, were observed frequently in URT tumors (9/19) but only rarely in lung tumors (1/10), suggesting that both endogenous and exogenous factors are responsible for the observed differences in mutational spectra between the upper and lower respiratory systems.

Injuries and medical issues in softball.

PubMed

Briskin, Susannah M

2012-01-01

Softball is enjoyed by millions of female and male athletes of all ages and competitive levels. Windmill pitchers are at risk for developing overuse injuries in the throwing arm. Improper mechanics and lack of pitch counts may increase the risk for developing a pitching-related injury. Softball-related overuse injuries include proximal biceps tendinitis, upper extremity stress fractures, and ulnar neuritis. Acute injuries commonly occur in the lower extremity and include both fractures and ligamentous injuries. Sliding injuries account for a significant number of these lower extremity injuries. The addition of breakaway bases and mandatory use of protective headgear by defensive players may decrease acute injuries commonly seen in softball. Off-season programs should stress proper throwing and sliding mechanics, core conditioning, and a lower extremity neuromuscular education program.

Ares I Crew Launch Vehicle Upper Stage Element Overview

NASA Technical Reports Server (NTRS)

McArthur, J. Craig

2008-01-01

This viewgraph presentation gives an overview of NASA's Ares I Crew Launch Vehicle Upper Stage Element. The topics include: 1) What is NASA s Mission?; 2) NASA s Exploration Roadmap What is our time line?; 3) Building on a Foundation of Proven Technologies Launch Vehicle Comparisons; 4) Ares I Upper Stage; 5) Upper Stage Primary Products; 6) Ares I Upper Stage Development Approach; 7) What progress have we made?; 8) Upper Stage Subsystem Highlights; 9) Structural Testing; 10) Common Bulkhead Processing; 11) Stage Installation at Stennis Space Center; 12) Boeing Producibility Team; 13) Upper Stage Low Cost Strategy; 14) Ares I and V Production at Michoud Assembly Facility (MAF); 15) Merged Manufacturing Flow; and 16) Manufacturing and Assembly Weld Tools.

Integrating Wind Profiling Radars and Radiosonde Observations with Model Point Data to Develop a Decision Support Tool to Assess Upper-level Winds For Space Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2012-01-01

Launch directors need to know upper-level wind forecasts. We developed an Excel-based GUI to display upper-level winds: (1) Rawinsonde at CCAFS, (2) Wind profilers at KSC, (3) Model point data at CCAFS.

Observations of Convectively Coupled Kelvin Waves forced by Extratropical Wave Activity

NASA Astrophysics Data System (ADS)

Kiladis, G. N.; Biello, J. A.; Straub, K. H.

2012-12-01

It is well established by observations that deep tropical convection can in certain situations be forced by extratropical Rossby wave activity. Such interactions are a well-known feature of regions of upper level westerly flow, and in particular where westerlies and equatorward wave guiding by the basic state occur at low enough latitudes to interact with tropical and subtropical moisture sources. In these regions convection is commonly initiated ahead of upper level troughs, characteristic of forcing by quasi-geostrophic dynamics. However, recent observational evidence indicates that extratropical wave activity is also associated with equatorial convection even in regions where there is a "critical line" to Rossby wave propagation at upper levels, that is, where the zonal phase speed of the wave is equal to the zonal flow speed. A common manifestation of this type of interaction involves the initiation of convectively coupled Kelvin waves, as well as mixed Rossby-gravity (MRG) waves. These waves are responsible for a large portion of the convective variability within the ITCZ over the Indian, Pacific, and Atlantic sectors, as well as within the Amazon Basin of South America. For example, Kelvin waves originating within the western Pacific ITCZ are often triggered by Rossby wave activity propagating into the Australasian region from the South Indian Ocean extratropics. At other times, Kelvin waves are seen to originate along the eastern slope of the Andes. In the latter case the initial forcing is sometimes linked to a low-level "pressure surge," initiated by wave activity propagating equatorward from the South Pacific storm track. In yet other cases, such as over Africa, the forcing appears to be related to wave activity in the extratropics which is not necessarily propagating into low latitudes, but appears to "project" onto the Kelvin structure, in line with past theoretical and modeling studies. Observational evidence for extratropical forcing of Kelvin and MRG waves will be presented, and the seasonality of these statistical associations will be discussed. Extratropical forcing of equatorial waves appears to be most efficient during the solstice seasons by waves originating within the winter hemisphere and interacting with convection in the summer hemisphere. A companion presentation by J. Biello will examine the theoretical basis for these interactions.

Prevalence and Spectrum of Gastro Esophageal Reflux Disease in Bronchial Asthma.

PubMed

Rameschandra, Sahoo; Acharya, Vishak; Kunal; Vishwanath, Tantry; Ramkrishna, Anand; Acharya, Preetam

2015-10-01

There exists a complex interplay between asthma and gastroesophageal reflux disease. Both these diseases are known to aggravate each other and amelioration of one is necessary for the control of the other. There is a paucity of studies in Indian population on this subject. To evaluate the clinical features and the endoscopic findings of the upper gastrointestinal tract in patients with bronchial asthma. Study was conducted at KMC group of hospitals, Mangalore in the Department of chest medicine in association with Department of gastroenterology. Subjects included 50 cases of bronchial asthma and controls were 58 non asthmatic patients with allergic rhinitis and chronic urticaria. All patients were queried about presence or absence of symptoms of upper gastro intestinal tract disorders by gastro oesophageal reflux disease (GERD) questionnaire and all the included patients underwent upper gastro intestinal endoscopy. The study showed that symptoms of gastroesophageal reflux were significantly more in asthmatics (52%) as compared to the controls (28%). The common presenting features of gastroesophageal reflux in asthmatics were heartburn (40%) retrosternal pain (24%), nocturnal cough (18%), dyspepsia (16%) and regurgitation (14%) and the above symptoms were significantly more common in asthmatics as compared to controls. Gastroesophageal reflux disease was found to be significantly more common in the asthmatics (58%) as compared to the control group where it was present in 32.75% of the subjects. Clinical or endoscopic evidence of any upper gastrointestinal disorder was found in 68% of the asthmatics as compared to 37.93% of the controls. This difference was found to be statistically significant. The study showed that gastroesophageal reflux disease was significantly more in asthmatics as compared to the controls. Upper gastrointestinal symptoms were more common in asthmatics as against controls. Clinical or endoscopic evidence of upper gastrointestinal disorder and gastroesophageal reflux disease was found in significantly higher proportion of the asthmatics as compared to the controls. Clinically silent gastroesophageal reflux disease was however seen in both control and asthmatic groups equally with a lower prevalence.

Synoptic climatology of the long-distance dispersal of white pine blister rust I. Development of an upper level synoptic classification

Treesearch

K. L. Frank; L. S. Kalkstein; B. W. Geils; H. W. Thistle

2008-01-01

This study developed a methodology to temporally classify large scale, upper level atmospheric conditions over North America, utilizing a newly-developed upper level synoptic classification (ULSC). Four meteorological variables: geopotential height, specific humidity, and u- and v-wind components, at the 500 hPa level over North America were obtained from the NCEP/NCAR...

Open scapulothoracic dissociation.

PubMed

Fischer, P J; Kent, R B

2001-04-01

Scapulothoracic dissociation refers to the traumatic separation of the shoulder from the chest wall. This most commonly occurs as a closed injury. We present a case of open scapulothoracic dissociation and emphasize clinical features unique to this injury. In both closed and open scapulothoracic dissociation, the force necessary to shear the scapula from its thoracic attachments results in vascular disruption and neurologic injury to the upper extremity. As a consequence, patients have a pulseless, flail upper extremity with a significant chest wall hematoma (closed) or active bleeding (open). The first priority is to resuscitate and address life-threatening injuries. If the patient has active bleeding, immediate vascular control to prevent exsanguination is essential. Patients with ischemia and an incomplete injury or unreliable neurologic examination need revascularization. Outcome is based on the extent of brachial plexus or cervical nerve root avulsion. Patients with loss of neurologic function ultimately benefit from amputation at the appropriate level.

Bone pain, growth failure, and skin rash after an upper respiratory illness in a boy with autism: possible association with altered retinoid metabolism.

PubMed

Mawson, Anthony R

2009-01-01

Symptoms of bone pain and skin rashes are not uncommon following a variety of infectious illnesses, but the underlying mechanisms are not well understood. The case of a 9-year-old boy with autism was recently described, who was hospitalized because of pain in the right hip, refusal to walk, fatigue, irritability, skin rash, and subsequent gingival swelling after an unspecified upper respiratory illness. The boy was diagnosed with scurvy. However, the gingival symptoms occurred after treatment with indomethacin, which lowers vitamin C levels; severe bone pain and fatigue are also well-documented symptoms of hypervitaminosis A. This review of a case report of a boy with autism provides an opportunity to present a new hypothesis of the mechanism of these postinfection symptoms in the context of an increasingly common condition of childhood.

Therapeutically equivalent pharmacokinetic profile across three application sites for AG200-15, a novel low-estrogen dose contraceptive patch.

PubMed

Stanczyk, Frank Z; Archer, David F; Rubin, Arkady; Foegh, Marie

2013-06-01

AG200-15 Agile Patch (AP) is a novel 7-day contraceptive patch providing ethinyl estradiol (EE) exposure comparable to low-dose combination oral contraceptives. This study determined whether application of the AP to three different anatomical sites (lower abdomen, buttock and upper torso) influences the pharmacokinetic profile of EE and levonorgestrel (LNG). In this open-label, three-period, crossover study, 24 subjects were randomized to one of six treatment sequences; each included application of patch to abdomen, buttock and upper torso, with the AP worn on one site for 7 days. After a 7-day washout, a new patch was applied to the next anatomical site. Multiple blood samples were collected up to 240 h after patch application. For plasma EE levels, median time to maximum drug concentration (Tmax, 24-48 h) and mean maximum concentration (Cmax, 47.9-61.5 pg/mL) were similar among application sites. Compared with lower abdomen, EE exposure was higher (16%-30%) at buttock and upper torso (15%-22%). For plasma LNG levels, median Tmax (72-120 h) and mean Cmax (1436-1589 pg/mL) were similar across application sites. Compared with lower abdomen, LNG exposure was higher at buttock (1%-7%) and upper torso (16%-17%). No serious adverse events (AEs) or AE-related discontinuations occurred. The most common treatment-emergent AEs were nausea, application site pruritus and headache, with frequencies comparable across anatomical sites. Absorption from the abdomen was slightly lower versus other sites; however, exposure to EE and LNG for all sites was therapeutically equivalent. The AP was well tolerated at all three anatomical sites. Copyright © 2013 Elsevier Inc. All rights reserved.

Outcomes of patients hospitalized with peptic ulcer disease diagnosed in acute upper endoscopy.

PubMed

Malmi, Hanna; Kautiainen, Hannu; Virta, Lauri J; Färkkilä, Martti A

2017-11-01

The incidence and complications of peptic ulcer disease (PUD) have declined, but mortality from bleeding ulcers has remained unchanged. The aims of the current study were to evaluate the significance of PUD among patients admitted for acute upper endoscopy and to evaluate the survival of PUD patients. In this prospective, observational cohort study, data on 1580 acute upper endoscopy cases during 2012-2014 were collected. A total of 649 patients were included with written informed consent. Data on patients' characteristics, living habits, comorbidities, drug use, endoscopy and short-term and long-term survival were collected. Of all patients admitted for endoscopy, 147/649 (23%) had PUD with the main symptom of melena. Of these PUD patients, 35% had major stigmata of bleeding (Forrest Ia-IIb) in endoscopy. Patients with major stigmata had significantly more often renal insufficiency, lower level of blood pressure with tachycardia and lower level of haemoglobin, platelets and ratio of thromboplastin time. No differences in drug use, Charlson comorbidity class, BMI, smoking or alcohol use were found. Of the PUD patients, 31% were Helicobacter pylori positive. The 30-day mortality was 0.7% (95% confidence interval: 0.01-4.7), 1-year mortality was 12.9% (8.4-19.5) and the 2-year mortality was 19.4% (13.8-26.8), with no difference according to major or minor stigmata of bleeding. Comorbidity (Charlson>1) was associated with decreased survival (P=0.029) and obesity (BMI≥30) was associated with better survival (P=0.023). PUD is still the most common cause for acute upper endoscopy with very low short-term mortality. Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival.

Upper extremity impairments in type 1 diabetes with long duration; common problems with great impact on daily life.

PubMed

Gutefeldt, Kerstin; Hedman, Christina A; Thyberg, Ingrid S M; Bachrach-Lindström, Margareta; Arnqvist, Hans J; Spångeus, Anna

2017-11-05

To investigate the prevalence, activity limitations and potential risk factors of upper extremity impairments in type 1 diabetes in comparison to controls. In a cross-sectional population-based study in the southeast of Sweden, patients with type 1 diabetes <35 years at onset, duration ≥20 years, <67 years old and matched controls were invited to answer a questionnaire on upper extremity impairments and activity limitations and to take blood samples. Seven hundred and seventy-three patients (ages 50 ± 10 years, diabetes duration 35 ± 10 years) and 708 controls (ages 54 ± 9 years) were included. Shoulder pain and stiffness, hand paraesthesia and finger impairments were common in patients with a prevalence of 28-48%, which was 2-4-folds higher than in controls. Compared to controls, the patients had more bilateral impairments, often had coexistence of several upper extremity impairments, and in the presence of impairments, reported more pronounced activity limitations. Female gender (1.72 (1.066-2.272), p = 0.014), longer duration (1.046 (1.015-1.077), p = 0.003), higher body mass index (1.08 (1.017-1.147), p = 0.013) and HbA1c (1.029 (1.008-1.05), p = 0.007) were associated with upper extremity impairments. Compared to controls, patients with type 1 diabetes have a high prevalence of upper extremity impairments, often bilateral, which are strongly associated with activity limitations. Recognising these in clinical practise is crucial, and improved preventative, therapeutic and rehabilitative interventions are needed. Implications for rehabilitation Upper extremity impairments affecting the shoulder, hand and fingers are common in patients with type 1 diabetes, the prevalence being 2-4-fold higher compared to non-diabetic persons. Patients with diabetes type 1 with upper extremity impairments have more pronounced limitations in daily activities compared to controls with similar impairments. Recognising upper extremity impairments and activity limitations are important and improved preventive, therapeutic and rehabilitation methods are needed.

Epidemiology of Congenital Upper Limb Anomalies in a Midwest United States Population: An Assessment Using the OMT Classification

PubMed Central

Goldfarb, Charles A.; Wall, Lindley B.; Bohn, Deborah C.; Moen, Patrick; Van Heest, Ann E.

2014-01-01

Purpose To examine the relative presentation frequency of children with upper limb congenital anomalies at 3 Midwestern referral centers using the Oberg, Manske, and Tonkin (OMT) classification and to assess the utility of this new classification system. Methods 641 individuals with 653 congenital upper extremity anomalies were identified at 3 hospitals in 2 large metropolitan areas during a 1-year interval. Patients were identified prospectively and the specific upper extremity anomaly and any associated syndromes were confirmed using medical records and radiographs. We applied the OMT classification that categorizes anomalies using a dysmorphology outline as malformations, dysplasias, deformations, and syndromes, and assessed its utility and ease of use. Results There were 480 extremities (74%) with a limb malformation including 184 involving the entire limb. Arthrogryposis was the most common of these (53 extremities). Anomalies affecting only the hand plate accounted for 62% (296) of the malformations. Of these, radial polydactyly (15%) was the most common specific anomaly, followed by symbrachydactyly (13%) and cleft hand (11%). Dysplasias were noted in 86 extremities; 55 of these were multiple hereditary exostoses. There were 87 extremities with deformations and 58 of these were trigger digits. A total of 98 children had a syndrome or association. Constriction ring sequence was most common. The OMT was straightforward to use and most anomalies could be easily assigned. There were a few conditions, such as Madelung deformity and symbrachydactyly, that would benefit from clarification on how to best classify them. Conclusions Malformations were the most common congenital anomalies in the 653 upper extremities evaluated over a 1-year period at 3 institutions. We were able to classify all individuals using the OMT classification system. PMID:25534840

Epidemiology of congenital upper limb anomalies in a midwest United States population: an assessment using the Oberg, Manske, and Tonkin classification.

PubMed

Goldfarb, Charles A; Wall, Lindley B; Bohn, Deborah C; Moen, Patrick; Van Heest, Ann E

2015-01-01

To examine the relative presentation frequency of children with upper limb congenital anomalies at 3 Midwestern referral centers using the Oberg, Manske, and Tonkin (OMT) classification and to assess the utility of this new classification system. 641 individuals with 653 congenital upper extremity anomalies were identified at 3 hospitals in 2 large metropolitan areas during a 1-year interval. Patients were identified prospectively and the specific upper extremity anomaly and any associated syndromes were confirmed using medical records and radiographs. We applied the OMT classification that categorizes anomalies using a dysmorphology outline as malformations, dysplasias, deformations, and syndromes, and assessed its utility and ease of use. There were 480 extremities (74%) with a limb malformation including 184 involving the entire limb. Arthrogryposis was the most common of these (53 extremities). Anomalies affecting only the hand plate accounted for 62% (296) of the malformations. Of these, radial polydactyly (15%) was the most common specific anomaly, followed by symbrachydactyly (13%) and cleft hand (11%). Dysplasias were noted in 86 extremities; 55 of these were multiple hereditary exostoses. There were 87 extremities with deformations and 58 of these were trigger digits. A total of 109 children had a syndrome or association. Constriction ring sequence was most common. The OMT was straightforward to use and most anomalies could be easily assigned. There were a few conditions, such as Madelung deformity and symbrachydactyly, that would benefit from clarification on how to best classify them. Malformations were the most common congenital anomalies in the 653 upper extremities evaluated over a 1-year period at 3 institutions. We were able to classify all individuals using the OMT classification system. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Theoretical studies of solar-pumped lasers

NASA Technical Reports Server (NTRS)

Harries, W. L.

1983-01-01

Metallic vapor lasers of Na2 and Li2 are examined as solar energy converters. The absorbed photons cause transitions to vibrational-rotational levels in an upper electronic state. With broad band absorption the resultant levels can have quantum numbers considerably higher than the upper lasing level. The excited molecule then relaxes to the upper lasing level which is one of the lower vibrational levels in the upper electronic state. The relaxation occurs from collisions, provided the molecule is not quenched into the ground level electronic state. Lasing occurs with a transition to a vibrational level in the lower electronic state. Rough estimates of solar power efficiencies are 1 percent for Na2 and probably a similar figure for Li2. The nondissociative lasers from a family distinct from materials which dissociate to yield an excited atom.

Physics Identity Development: A Snapshot of the Stages of Development of Upper-Level Physics Students

ERIC Educational Resources Information Center

Irving, Paul W.; Sayre, Eleanor C.

2013-01-01

As part of a longitudinal study into identity development in upper-level physics students a phenomenographic research method is employed to assess the stages of identity development of a group of upper-level students. Three categories of description were discovered which indicate the three different stages of identity development for this group…

Research and Teaching: Integrating Lecture and Laboratory in Health Sciences Courses Improves Student Satisfaction and Performance

ERIC Educational Resources Information Center

Finn, Kevin; FitzPatrick, Kathleen; Yan, Zi

2017-01-01

Students often struggle in introductory health sciences courses; some students have difficulty in upper level classes. To address this, we converted three lecture/lab courses, traditional first-year Anatomy and Physiology (A&P I), upper level Biomechanics, and upper level Microbiology to an integrated studio model. We used the Student…

Intradural Extramedullary Capillary Hemangioma In the Upper Thoracic Spine with Simultaneous Extensive Arachnoiditis

PubMed Central

Lee, Jae Ho; Jeon, Ikchan; Kim, Sang Woo

2017-01-01

Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2–3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma. PMID:28704911

Intradural Extramedullary Capillary Hemangioma In the Upper Thoracic Spine with Simultaneous Extensive Arachnoiditis.

PubMed

Lee, Jae Ho; Jeon, Ikchan; Kim, Sang Woo

2017-06-01

Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2-3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma.

The prevalence of upper respiratory symptoms in a cohort of adults presenting with symptoms of gastro-oesophageal reflux disease.

PubMed

Amarasiri, D L; Pathmeswaran, A; Dassanayake, A S; de Silva, A P; Adikari, M D; Sanjeewa, P A; Jayaratne, A; de Silva, H J

2016-06-01

Gastro-oesophageal reflux disease (GORD) is the pathological reflux of gastric contents into the oesophagus. The oesophagus and the upper respiratory tract have a common origin from the foregut. There is increasing evidence for multiple associations of GORD with the upper respiratory tract. To study the presence of and association of upper respiratory symptoms (URS) with GORD. Seventy adults scoring ≥12.5 on a previously validated GORD symptom score (GORD patients) and 70 healthy controls who had infrequent GORD symptoms or no upper gastro-intestinal complaints completed a pre-tested URS questionnaire on the frequency of 14 URS in 5 categories (laryngeal, nasal, pharyngeal, sinusal and aural). All GORD patients underwent upper gastro-intestinal endoscopy. The calculated URS score was correlated against the GORD symptom score and endoscopy findings. URS scores and individual symptom scores were higher in GORD patients compared to controls (mean ± SE, 4.7 ± 4.0; 1.9 ± 2.3). Individuals with higher GORD symptom scores reported more frequent URS. Pharyngeal symptoms had the highest correlation with the GORD symptom score (r=0.507, p<0.001). The presence of oeso-phagitis did not seem to influence the frequency of reporting URS. Upper respiratory symptoms are common in individuals with GORD symptoms though there appears to be no association with oesophageal mucosal damage.

Understory and small trees contribute importantly to stemflow of a lower montane cloud forest

NASA Astrophysics Data System (ADS)

González Martínez, T. M.; Wiliams-Linera, G.; Holwerda, F.

2016-12-01

Stemflow (Sf) measurements in rainforests and montane forests dominated by large trees rarely include the understory and small trees. In the present study, contributions of woody understory (> 1 m height and < 5 cm DBH), small trees (5 < DBH < 10 cm) and upper canopy trees (> 10 cm DBH) to overall Sf of a lower montane cloud forest in central Veracruz, Mexico, were quantified. Incident precipitation (P), Sf volume and vegetation structure were measured. Subsequently, stemflow funneling ratios (SFR) were calculated, and allometric relationships between tree basal area and Sf volume were used to scale up measurements from individual trees to the stand level. Additionally, two other common methods to calculate areal Sf were used for comparative purposes. Understory woody plants, small trees and upper canopy trees represented 96, 2 and 2 %, respectively, of the total density. Upper canopy trees had the lowest SFRs (1.6 ± 0.5 on average), while the lower understory (> 1 m and < 2 m height) had the highest (36.1 ± 6.4). Small trees and upper understory (> 2 m) presented similar SFRs (22.9 ± 5.4 and 20.2 ± 3.9, respectively). Different scaling methods yielded very similar results for all but the upper understory. Overall areal Sf during the study period was 19 mm (3.8 % of rainfall), to which the understory contributed 66.3 % (12.6 mm), small trees 12.6 % (2.4 mm) and upper canopy trees 21.1 % (4.0 mm). Our results suggest that woody understory vegetation and small trees can have an important role in Sf generation of tall humid tropical forests, provided that the density of plants in these groups is high enough.

Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis, and Gastroesophageal Reflux Disease.

PubMed

Zia, Jasmine K; Heitkemper, Margaret M

2016-06-01

This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility. Copyright © 2016 Elsevier Inc. All rights reserved.

Principal reference section for part of the Eocene Ghazij Formation, Moghal Mine area, Mach coal field, Balochistan, Pakistan

USGS Publications Warehouse

Johnson, Edward A.; Warwick, Peter D.; Khan, Intizar H.; Kazim, Mohsin A.

1994-01-01

The information presented on this sheet was collected as part of a joint U.S. Geological Survey-Geological Survey of Pakistan program sponsored by the U.S. Agency for International Development. As a project within this program, the coal-bearing Ghazij Formation (Eocene) was investigated in the northeastern part of Balochistan cast and south of the provincial capital of Quetta. Strata exposed in this area range in age from Permian to Holocene and crop out as a belt of folded and thrusted rocks that form a southeast-facing orocline. In this region of Pakistan, the Ghazij can usually be divided into three parts. The lower part is the thickest (probably more than 1,000 m) and consists of gray-weathering calcareous mudrock (shale, mudstone, and impure claystone) and a few tabular bodies of fine-to medium-grained calcareous sandstone. The middle part (27-300 m) consists of gray-weathering calcareous mudrock and tabular to lenticular bodies of fine-to medium-grained calcareous sandstone; beds of carbonaceous shale and coal are common. The upper part (as thick as 533 m) contains reddish-weathering calcareous mudrock that contains scattered lenticular bodies of fine- to medium-grained calcareous sandstone. Fossil plant debris is common in mudrock of the lower and middle parts of the Ghazij, and bivalves and gastropods are common in the middle part; the upper part of the Ghazij is usually unfossiliferous. This three-fold division of the Ghazij is less distinct in the Johan area. Here, the upper part of the formation is clearly identifiable, but rocks below it are poorly exposed and assigning a stratigraphic level that separates the middle and lower parts of the formation is problematic. Below the upper part of the formation is a thick sequence of greenish-gray calcareous mudrock that contains locally abundant plant debris and isolated bodies of brown-weathering sandstone. Rare carbonaceous shale and even rarer coal are present in the upper part of this sequence, and this interval of the formation might correspond to the middle part of the Ghazji exposed in areas to the north. We propose that, in the Johan area, those rocks below the upper part of the formation be referred to as the main body of the Ghazij (for example, main-body Ghazij). Underlying the Ghazij are the carbonate rocks of the Paleocene Dungan Formation (or its equivalent), and overlying the Ghazij are the mostly carbonate rocks of the Eocene Kirthar Formation (or its equivalent). Both contacts can be conformable or unconformable. All of the pre-Neogene rocks in Balochistan are greatly deformed by the collision of India and Asia. The Ghazij is especially susceptible to regional compressional tectonics because it contains a large amount of shale and is sandwiched between two thick carbonate units. As a result, bedding-plane faults and isoclinal folds are common.As part of our study of the Ghazij Formation, five stratigraphic sections were measured: one near Pir Ismail Ziarat, one in the Sor Range, two in the vicinity of Mach, and one near Johan. Each area's section is published separately.

Principal reference section for part of the Eocene Ghazij Formation, Sarawan River area, Johan coal field, Balochistan, Pakistan

USGS Publications Warehouse

Johnson, Edward A.; Warwick, Peter D.; Khan, Intizar H.; Rana, Asif N.; Kazim, Mohsin A.

1994-01-01

The information presented on this sheet was collected as part of a joint U.S. Geological Survey-Geological Survey of Pakistan program sponsored by the U.S. Agency for International Development. As a project within this program, the coal-bearing Ghazij Formation (Eocene) was investigated in the northeastern part of Balochistan cast and south of the provincial capital of Quetta. Strata exposed in this area range in age from Permian to Holocene and crop out as a belt of folded and thrusted rocks that form a southeast-facing orocline. In this region of Pakistan, the Ghazij can usually be divided into three parts. The lower part is the thickest (probably more than 1,000 m) and consists of gray-weathering calcareous mudrock (shale, mudstone, and impure claystone) and a few tabular bodies of fine-to medium-grained calcareous sandstone. The middle part (27-300 m) consists of gray-weathering calcareous mudrock and tabular to lenticular bodies of fine-to medium-grained calcareous sandstone; beds of carbonaceous shale and coal are common. The upper part (as thick as 533 m) contains reddish-weathering calcareous mudrock that contains scattered lenticular bodies of fine- to medium-grained calcareous sandstone. Fossil plant debris is common in mudrock of the lower and middle parts of the Ghazij, and bivalves and gastropods are common in the middle part; the upper part of the Ghazij is usually unfossiliferous. This three-fold division of the Ghazij is less distinct in the Johan area. Here, the upper part of the formation is clearly identifiable, but rocks below it are poorly exposed and assigning a stratigraphic level that separates the middle and lower parts of the formation is problematic. Below the upper part of the formation is a thick sequence of greenish-gray calcareous mudrock that contains locally abundant plant debris and isolated bodies of brown-weathering sandstone. Rare carbonaceous shale and even rarer coal are present in the upper part of this sequence, and this interval of the formation might correspond to the middle part of the Ghazji exposed in areas to the north. We propose that, in the Johan area, those rocks below the upper part of the formation be referred to as the main body of the Ghazij (for example, main-body Ghazij). Underlying the Ghazij are the carbonate rocks of the Paleocene Dungan Formation (or its equivalent), and overlying the Ghazij are the mostly carbonate rocks of the Eocene Kirthar Formation (or its equivalent). Both contacts can be conformable or unconformable. All of the pre-Neogene rocks in Balochistan are greatly deformed by the collision of India and Asia. The Ghazij is especially susceptible to regional compressional tectonics because it contains a large amount of shale and is sandwiched between two thick carbonate units. As a result, bedding-plane faults and isoclinal folds are common. As part of our study of the Ghazij Formation, five stratigraphic sections were measured: one near Pir Ismail Ziarat, one in the Sor Range, two in the vicinity of Mach, and one near Johan. Each area's section is published separately.

An Einstein Observatory SAO-based catalog of B-type stars

NASA Technical Reports Server (NTRS)

Grillo, F.; Sciortino, S.; Micela, G.; Vaiana, G. S.; Harnden, F. R., Jr.

1992-01-01

About 4000 X-ray images obtained with the Einstein Observatory are used to measure the 0.16-4.0 keV emission from 1545 B-type SAO stars falling in the about 10 percent of the sky surveyed with the IPC. Seventy-four detected X-ray sources with B-type stars are identified, and it is estimated that no more than 15 can be misidentified. Upper limits to the X-ray emission of the remaining stars are presented. In addition to summarizing the X-ray measurements and giving other relevant optical data, the present extensive catalog discusses the reduction process and analyzes selection effects associated with both SAO catalog completeness and IPC target selection procedures. It is concluded that X-ray emission, at the level of Lx not less than 10 exp 30 ergs/s, is quite common in B stars of early spectral types (B0-B3), regardless of luminosity class, but that emission, at the same level, becomes less common, or nonexistent, in later B-type stars.

Trampoline trauma in children: is it preventable?

PubMed

Sandler, Gideon; Nguyen, Linh; Lam, Lawrence; Manglick, Maria P; Soundappan, Soundappan S V; Holland, Andrew J A

2011-11-01

Trampoline injuries represent a preventable cause of injury in children. This study identified the characteristics of children injured while using trampolines who presented to a pediatric trauma center in Sydney, Australia. The Pediatric Trauma Database at our institution was reviewed to identify children with trampoline-related injuries between January 1999 and June 2008. Data collected included age, sex, Injury Severity Score, anatomical region injured, type of injury, mechanism of injury, site of injury and surface fallen onto, level of supervision, treatment, and hospital length of stay. Over the 9.5-year review period, 383 children presented with trampoline-related injuries: 193 (50.4%) were female. Just over a quarter (n = 106, 27.7%) were treated and discharged the same day. The remaining patients accounted for 725 hospital bed days with a mean length of stay of 2.3 days. The most common area of the body injured was the upper limb (n = 246, 64.2%), with a fall from the trampoline to the ground being the most frequent mechanism of injury (n = 257, 67.1%). The majority (n = 345, 90.1%) of children were injured in their home or at the home of a friend or relative. Surgery was required in 236 (61.6%), with closed reduction of an upper limb fracture being the most common procedure (n = 107, 27.9%). Trampoline-related injuries remain common in children. Implementation of current guidelines and the introduction of innovative trampoline designs should reduce the risk of this injury in children.

Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

PubMed

Koo, Soo Kweon; Kwon, Soon Bok; Kim, Yang Jae; Moon, J I Seung; Kim, Young Jun; Jung, Sung Hoon

2017-03-01

Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0 ), and formant frequencies (F 1 , F 2 , and F 3 ) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p < 0.05). This suggests that the upper airway is more severely obstructed with retrolingual level obstruction and that there is a greater change in tongue position. Acoustic analysis of snoring is a non-invasive diagnostic technique that can be easily applied at a relatively low cost. The analysis of formant frequencies will be a useful screening test for the prediction of occlusion sites. Moreover, smartphone can be effective for recording snoring sounds.

Epidemiology of cough in relation to China

PubMed Central

2013-01-01

Cough is one of the most common complaints for which patients seek medical attention. Misdiagnosis and mistreatment of cough exist commonly in China. The prevalence of acute cough caused by upper airway infection fluctuates between 9% and 64% in the community, for chronic cough, the prevalence >10% in most surveys, ranging from 7.2%-33%. The common causes of chronic cough are upper airway cough syndrome (previously called as post nasal drip syndrome [PNDS]), cough variant asthma (CVA), gastroesophageal reflux related cough (GERD) and eosinophilic bronchitis (EB). There is a regional discrepancy regarding the prevalence of common causes of cough and distribution of gender among China, UK, USA, the most common cause of chronic cough in China are CVA, followed by UACS, EB and atopic cough (AC), the male is almost equal to female in numbers in China. The risk factors for cough includes cold air, smoking, environmental pollutants, noxious substances and allergens, and unreasonable diet habits. PMID:23835047

[New technique for safe removal of impacted foreign bodies in the upper gastrointestinal tract using reusable variceal "cap" (cup, cap or cylinder)].

PubMed

Chávez Rossell, Miguel

2012-01-01

The ingestion of a foreign body is one of the most common endoscopic emergencies. Foreign bodies in the upper gastrointestinal tract should be extracted as soon as possible to avoid serious complications such as perforation o bleeding. However, removals of foreign bodies with sharp edges are very difficult and can develop complications during their removal. Various devices have therefore been developed to prevent mucosal injury from the sharp edges during endoscopic extraction. We report a new technique for the successful foreign body extraction of upper digestive tract using the cap from six shooter variceal banding reused. We present 17 cases (9 males and 8 females). The types of foreign bodies removed were: chicken bones (n:7), fish bones (n:3), denture prosthesis (n:2), food bolus (n:2), long pin (n:1), golden thumb tack (n: 1) and press-through package (n:1). There were no complications. This new technique is safe and effective. Highlights its advantages: enhanced sight pharyngo esophageal junction, foreign bodies disimpact at that level, food bolus suck, avoid sharp object damage mucosal or scope and decrease time removal.

Study of the trapezius muscle region pressure pain threshold and latency time in young people with and without depressed scapula.

PubMed

Lee, Kuan-Ting; Chuang, Chiung-Cheng; Lai, Chien-Hung; Ye, Jing-Jhao; Wu, Chien-Lung

2015-02-01

The scapula is stabilized in or moved to a certain position to coordinate shoulder function and achieve shoulder and arm movement during the athletic and daily activities. An alteration in the scapular position both at rest and during arm movements is commonly associated with shoulder injury or dysfunction. The purpose of this study was to assess the influence of the depressed scapular position using pressure pain threshold (PPT) and delayed muscle activation of the upper and middle trapezius muscles. The study included 20 subjects who were divided into normal shoulder (n = 12) and depressed shoulder (n = 8) group. PPT was measured in a relaxed position. Muscle activity was recorded using surface electromyography and by calculating each shrug's muscle latency time (MLT). The results revealed that the healthy young subjects with depressed scapular position had significantly lower PPT levels than those with normal scapular position both in the upper and middle trapezius muscle (P < 0.05). MLT of the upper trapezius was significantly delayed in both sides during the shoulder shrugs (P < 0.05). Copyright © 2014 Elsevier Ltd. All rights reserved.

Quantitative assessment of upper extremities motor function in multiple sclerosis.

PubMed

Daunoraviciene, Kristina; Ziziene, Jurgita; Griskevicius, Julius; Pauk, Jolanta; Ovcinikova, Agne; Kizlaitiene, Rasa; Kaubrys, Gintaras

2018-05-18

Upper extremity (UE) motor function deficits are commonly noted in multiple sclerosis (MS) patients and assessing it is challenging because of the lack of consensus regarding its definition. Instrumented biomechanical analysis of upper extremity movements can quantify coordination with different spatiotemporal measures and facilitate disability rating in MS patients. To identify objective quantitative parameters for more accurate evaluation of UE disability and relate it to existing clinical scores. Thirty-four MS patients and 24 healthy controls (CG) performed a finger-to-nose test as fast as possible and, in addition, clinical evaluation kinematic parameters of UE were measured by using inertial sensors. Generally, a higher disability score was associated with an increase of several temporal parameters, like slower task performance. The time taken to touch their nose was longer when the task was fulfilled with eyes closed. Time to peak angular velocity significantly changed in MS patients (EDSS > 5.0). The inter-joint coordination significantly decreases in MS patients (EDSS 3.0-5.5). Spatial parameters indicated that maximal ROM changes were in elbow flexion. Our findings have revealed that spatiotemporal parameters are related to the UE motor function and MS disability level. Moreover, they facilitate clinical rating by supporting clinical decisions with quantitative data.

Numerical simulations of a transverse indirect circulation and low-level jet in the exit region of an upper-level jet

NASA Technical Reports Server (NTRS)

Brill, K. F.; Uccellini, L. W.; Burkhart, R. P.; Warner, T. T.; Anthes, R. A.

1985-01-01

A numerical study was performed of a severe weather event (tornado) which occurred on May 10, 1973 in the Ohio region. The situation was modeled with a primitive equation mesoscale dynamic formulation. Account was taken of precipitation, the planetary boundary layer parameters as bulk quantities, the vertical pressure gradient, and lateral boundary conditions based on radiosonde data. Two 12-hr simulations, adiabatic and nondivergent, respectively, were analyzed for relationships between upper and lower level jets. In the adiabatic formulation, a transverse circulation with a low level jet formed at the exit region of the upper level jet. The nondivergent situation led to similar, but weaker, phenomena. Both forms suggest that indirect circulation in the exit zone of an upper level jet is strongly influenced by the initial structure of the jet.

[Evaluation of upper cervical spine injury (C1-C2) with computed tomography].

PubMed

Siemianowicz, Anna; Baron, Jan; Wawrzynek, Wojciech; Koczy, Bogdan; Kasprowska, Sabina

2006-01-01

Cervical spine injuries are common and essential diagnostic problem. Diagnostic imaging is necessary for proper and effective treatment. Helical computed tomography (CT) and plain radiography are the basic diagnostic methods in cervical spine injuries. The purpose of this work was the comparison of CT examination of the upper cervical spine (CI-C2) with patients' clinical state. Twenty four patients (17 men and 7 women) were introduced into the study. The most common cause of cervical spine injuries were car accidents (48.5%). CT examination was performed in all patients. Six patients (25%) had multilevel injury, localized at C1-C2 level and in the lower part of cervical spine. The main pathology diagnosed by CT in the studied group was rotatory subluxation (66.6%). Eight patients (33.3%), with rotatory subluxation did not present any abnormalities in neurological examination performed immediately after the admission to the hospital. C1 and/or C2 fractures were diagnosed in 11 patients (45.8%), in some cases (in 3 patients - 12.5%) they were accompanied by rotatory subluxations. CT examination is the basic technique of diagnostic imaging in a case of cervical spine injuries. It enables quick, accurate and precise evaluation of bone structures and surrounding soft tissues. CT also enables multiplanar imaging and 3-dimentional imaging.

Practices and Processes of Leading High Performance Home Builders in the Upper Midwest

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

Von Thoma, E.; Ojczyk, C.

2012-12-01

The NorthernSTAR Building America Partnership team proposed this study to gain insight into the business, sales, and construction processes of successful high performance builders. The knowledge gained by understanding the high performance strategies used by individual builders, as well as the process each followed to move from traditional builder to high performance builder, will be beneficial in proposing more in-depth research to yield specific action items to assist the industry at large transform to high performance new home construction. This investigation identified the best practices of three successful high performance builders in the upper Midwest. In-depth field analysis of themore » performance levels of their homes, their business models, and their strategies for market acceptance were explored. All three builders commonly seek ENERGY STAR certification on their homes and implement strategies that would allow them to meet the requirements for the Building America Builders Challenge program. Their desire for continuous improvement, willingness to seek outside assistance, and ambition to be leaders in their field are common themes. Problem solving to overcome challenges was accepted as part of doing business. It was concluded that crossing the gap from code-based building to high performance based building was a natural evolution for these leading builders.« less

An outbreak of type E botulism among common loons (Gavia immer) in Michigan's Upper Peninsula

USGS Publications Warehouse

Brand, Christopher J.; Schmitt, Stephen; Duncan, Ruth M.; Cooley, Thomas M.

1988-01-01

An epizootic of type E botulism (Clostridium botulinum) occurred among common loons (Gavia immer) along the Lake Michigan shore of Michigan's Upper Peninsula (USA) during October and November 1983. An estimated 592 dead loons washed ashore along the Garden Peninsula. Type E botulinal toxin was demonstrated in blood samples and stomach contents of dead loons, and in samples of three species of dead fish found on the Lake Michigan shore. We suspect that loons acquired botulism by ingesting sick or dead fish containing type E toxin.

Fruit and vegetables and cancer risk: a review of southern European studies.

PubMed

Turati, Federica; Rossi, Marta; Pelucchi, Claudio; Levi, Fabio; La Vecchia, Carlo

2015-04-01

High intakes of fruit and vegetables may reduce the risk of cancer at several sites. Evidence has been derived mainly from case-control studies. We reviewed the relationship between consumption of vegetables and fruit and the risk of several common cancers in a network of Italian and Swiss case-control studies including over 10,000 cases of fourteen different cancers and about 17,000 controls. Data were suggestive of a protective role of vegetable intake on the risk of several common epithelial cancers. OR for the highest compared with the lowest levels of consumption ranged from 0.2 (larynx, oral cavity and pharynx) to 0.9 (prostate). Inverse associations were found for both raw and cooked vegetables, although for upper digestive tract cancers the former were somewhat stronger. Similar inverse associations were found for cruciferous vegetables. Frequent consumption of allium vegetables was also associated with reduced risk of several cancers. Fruit was a favourable correlate of the risk of several cancers, particularly of the upper digestive tract, with associations generally weaker than those reported for vegetables. A reduced risk of cancers of the digestive tract and larynx was found for high consumption of citrus fruit. Suggestive protections against several forms of cancer, mainly digestive tract cancers, were found for high consumption of apples and tomatoes. High intakes of fibres, flavonoids and proanthocyanidins were inversely related to various forms of cancer. In conclusion, data from our series of case-control studies suggested a favourable role of high intakes of fruit and vegetables in the risk of many common cancers, particularly of the digestive tract. This adds evidence to the indication that aspects of the Mediterranean diet may have a favourable impact not only on CVD, but also on several common (epithelial) cancers, particularly of the digestive tract.

Education Pays Off! On Transition to Work for 25 Year Olds in Norway with Upper Secondary Education or Lower as Their Highest Educational Level

ERIC Educational Resources Information Center

Markussen, Eifred

2017-01-01

In this article we examine the relationship between educational level and position in the labour market at age 25 for those who have completed upper secondary education or lower as their highest educational level. Whilst completion of upper secondary education is widely regarded as being important, we find that early and lasting work experience…

Upper-Level Mediterranean Oscillation index and seasonal variability of rainfall and temperature

NASA Astrophysics Data System (ADS)

Redolat, Dario; Monjo, Robert; Lopez-Bustins, Joan A.; Martin-Vide, Javier

2018-02-01

The need for early seasonal forecasts stimulates continuous research in climate teleconnections. The large variability of the Mediterranean climate presents a greater difficulty in predicting climate anomalies. This article reviews teleconnection indices commonly used for the Mediterranean basin and explores possible extensions of one of them, the Mediterranean Oscillation index (MOi). In particular, the anomalies of the geopotential height field at 500 hPa are analyzed using segmentation of the Mediterranean basin in seven spatial windows: three at eastern and four at western. That is, different versions of an Upper-Level Mediterranean Oscillation index (ULMOi) were calculated, and monthly and annual variability of precipitation and temperature were analyzed for 53 observatories from 1951 to 2015. Best versions were selected according to the Pearson correlation, its related p value, and two measures of standardized error. The combination of the Balearic Sea and Libya/Egypt windows was the best for precipitation and temperature, respectively. The ULMOi showed the highest predictive ability in combination with the Atlantic Multidecadal Oscillation index (AMOi) for the annual temperature throughout the Mediterranean basin. The best model built from the indices presented a final mean error between 15 and 25% in annual precipitation for most of the studied area.

Upper Limit for Regional Sea Level Projections

NASA Astrophysics Data System (ADS)

Jevrejeva, Svetlana; Jackson, Luke; Riva, Riccardo; Grinsted, Aslak; Moore, John

2016-04-01

With more than 150 million people living within 1 m of high tide future sea level rise is one of the most damaging aspects of warming climate. The latest Intergovernmental Panel on Climate Change report (AR5 IPCC) noted that a 0.5 m rise in mean sea level will result in a dramatic increase the frequency of high water extremes - by an order of magnitude, or more in some regions. Thus the flood threat to the rapidly growing urban populations and associated infrastructure in coastal areas are major concerns for society. Hence, impact assessment, risk management, adaptation strategy and long-term decision making in coastal areas depend on projections of mean sea level and crucially its low probability, high impact, upper range. With probabilistic approach we produce regional sea level projections taking into account large uncertainties associated with Greenland and Antarctica ice sheets contribution. We calculate the upper limit (as 95%) for regional sea level projections by 2100 with RCP8.5 scenario, suggesting that for the most coastlines upper limit will exceed the global upper limit of 1.8 m.

Influence of the Tibetan Plateau snow cover on East Asian winter upper-level jet streams at daily time scale

NASA Astrophysics Data System (ADS)

Guo, W.; Li, W.; Qiu, B.; Xue, Y.

2017-12-01

The Tibetan Plateau (TP) acts as an elevated cooling source in the middle troposphere at wintertime. We here present evidence that the intraseasonal variability of the TP snow cover (TPSC) controls part of the East Asian upper-level jet stream. This study found that there is significant positive lag correlation between the East Asian (EA) upper-level westerly jet and the TPSC in winter. When the TPSC increases/decreases, the EA upper-level westerly jet enhances/weakens in the following 8 days. We performed numerical experiments to prove that the lag correlation is causal relationship by using a regional climate model. Due to the high albedo of the snow cover, the increased/decreased snow cover increases/decreases the albedo and affects the surface energy balance over the TP. The energy absorbed by the surface is reduced/increased due to increased/decreased shortwave reflects to the atmosphere. There is anomalous cooling/heating effect over the TP. Such effect leads to anomalous geopotential height (GHT) field that propagates eastward with the zonal wind to the east. The anomalous GHT reaches key region of EA upper-level westerly jet at about 6 days. The adaptive modulation of GHT gradients affects wind fields (through geostrophic balance). As a result, the EA upper-level westerly jet is enhanced (weakened). Through the above process, the TPSC eventually influences the EA upper-level westerly jet. This report reveals that the intraseasonal variability of TPSC can server as an indicator of East Asia Atmospheric circulation on short-to-medium range.

Prevalence and Spectrum of Gastro Esophageal Reflux Disease in Bronchial Asthma

PubMed Central

Rameschandra, Sahoo; Kunal; Vishwanath, Tantry; Ramkrishna, Anand; Acharya, Preetam

2015-01-01

Background There exists a complex interplay between asthma and gastroesophageal reflux disease. Both these diseases are known to aggravate each other and amelioration of one is necessary for the control of the other. There is a paucity of studies in Indian population on this subject. Aim To evaluate the clinical features and the endoscopic findings of the upper gastrointestinal tract in patients with bronchial asthma. Materials and Methods Study was conducted at KMC group of hospitals, Mangalore in the Department of chest medicine in association with Department of gastroenterology. Subjects included 50 cases of bronchial asthma and controls were 58 non asthmatic patients with allergic rhinitis and chronic urticaria. All patients were queried about presence or absence of symptoms of upper gastro intestinal tract disorders by gastro oesophageal reflux disease (GERD) questionnaire and all the included patients underwent upper gastro intestinal endoscopy. Results The study showed that symptoms of gastroesophageal reflux were significantly more in asthmatics (52%) as compared to the controls (28%). The common presenting features of gastroesophageal reflux in asthmatics were heartburn (40%) retrosternal pain (24%), nocturnal cough (18%), dyspepsia (16%) and regurgitation (14%) and the above symptoms were significantly more common in asthmatics as compared to controls. Gastroesophageal reflux disease was found to be significantly more common in the asthmatics (58%) as compared to the control group where it was present in 32.75% of the subjects. Clinical or endoscopic evidence of any upper gastrointestinal disorder was found in 68% of the asthmatics as compared to 37.93% of the controls. This difference was found to be statistically significant. Conclusion The study showed that gastroesophageal reflux disease was significantly more in asthmatics as compared to the controls. Upper gastrointestinal symptoms were more common in asthmatics as against controls. Clinical or endoscopic evidence of upper gastrointestinal disorder and gastroesophageal reflux disease was found in significantly higher proportion of the asthmatics as compared to the controls. Clinically silent gastroesophageal reflux disease was however seen in both control and asthmatic groups equally with a lower prevalence. PMID:26557556

Upper-Level Waves of Synoptic Scale at Midlatitudes

NASA Astrophysics Data System (ADS)

Rivest, Chantal

1990-01-01

Upper-level waves of synoptic scale are important dynamical entities at midlatitudes. They often induce surface cyclogenesis (cf. Peterssen and Smebye, 1971), and their life duration is typically longer than time scales for disruption by the ambient shear (Sanders, 1988). The objectives of the present thesis are to explain the maintenance and genesis of upper-level synoptic-scale waves in the midlatitude flow. We develop an analytical model of waves on generalized Eady basic states that have uniform tropospheric and stratospheric potential vorticity, but allow for the decay of density with height. The Eady basic state represents the limiting case of infinite stratospheric stability and constant density. We find that the Eady normal mode characteristics hold in the presence of realistic tropopause and stratosphere. In particular, the basic states studied support at the synoptic scale upper-level normal modes. These modes provide simple models for the dynamics of upper-level synoptic-scale waves, as waves supported by the large latitudinal gradients of potential vorticity at the tropopause. In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal mode solutions no longer exist, as was demonstrated in Green (1960). Disappearance of the normal mode solution when a parameter changes slightly represents a dilemma that we seek to understand. We examine what happens to the upper-level normal modes in the presence of tropospheric gradients of potential vorticity in a series of initial -value experiments. Our results show that the normal modes become slowly decaying quasi-modes. Mathematically the quasi-modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained. Basic states with positive tropospheric and stratospheric gradients of potential vorticity are found to support upper-level synoptic-scale waves for time scales consistent with observations. Following Farrell (1989), we then identify a class of near optimal initial conditions for the excitation of upper-level waves. The initial conditions consist of upper -tropospheric disturbances that lean against the shear. They strongly excite upper-level waves not only in the absence of tropospheric potential vorticity gradients, but also in their presence. This result demonstrates that quasi -modes are as likely to emerge from favorably configured initial conditions as real normal modes, although their excitation is followed by a slow decay. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.).

Sr-87/Sr-86 isotopic age determination of upper Cretaceous Santonian, Campanian and Maastrichtian chondrichthyan teeth of the Atlantic and Eastern Gulf Coastal Plains: Implications for sea level cyclicity and macrofossil time-averaging in depositional sequence lag deposits

NASA Astrophysics Data System (ADS)

Becker, Martin Andrew

1997-11-01

Unconformities and fossil rich layers are common elements in the stratigraphic architecture of upper Cretaceous sediments exposed on both the Atlantic and Eastern Gulf Coastal Plains. Contacts between the Eutaw Formation and Tombigbee Sands Member in Alabama, the Blufftown Formation and Cusseta Sands in Georgia and the Wenonah- Mt. Laurel and Navesink Formations in New Jersey are marked by erosional surfaces with overlying blankets and lenses of macrofossil residuum. These contacts correspond to bounding unconformities and transgressive lags separating Santonian-Campanian, lower Campanian-upper Campanian and Campanian-Maastrichtian depositional sequences. Regression and subsequent transgression of sea level at the top of these depositional sequences resulted in hydrodynamic sorting of sediments and fossils that had previously accumulated in shelf and lower shoreface paleoenvironments. Remobilization of sediments by shoreface retreat reworked fossil hard-parts which became concentrated above erosional surfaces as sea level rose. Because of the abundance of chondrichthyan, pelecypod and ammonite fossils, these lags have great biostratigraphic significance and provide a basis for examining time averaging in macrofossil zonation. Chondrichthyan teeth are composed of extremely durable and highly insoluble, biogenic apatite. This tooth apatite accurately records the Sr87/Sr86 isotopic signature of seawater, from which the numerical age of the teeth can be calculated using published age/concentration data. Teeth (e.g. Squalicorax kaupi, Scapanorhynchus texanus) from Santonian-Campanian lag deposits at the contact of the Eutaw Formation and Tombigbee Sands Member in Alabama yield approximate ages of 85-81 Ma. Teeth from lower-upper Campanian lag deposits at the contact of the Blufftown Formation and Cusseta Sands in Georgia yield approximate ages of 83-75 Ma. Teeth from Campanian-Maastrichtian lag deposits at the contact of the Wenonah-Mt. Laurel and Navesink Formations in New Jersey yield approximate ages of 80-76 Ma. Isotopic age determination from these chondrichthyan teeth indicate average hiatus of approximately 3-7 million years occur during the development of lag accumulations and transgressive unconformities. Santonian, Campanian and Maastrichtian macrofossils analyzed in this study are hydrodynamically stable components representing time-averaged fossil assemblages sorted together by physical processes and are not life cohorts. Abrupt appearance and disappearance of organisms found in upper Cretaceous lag deposits of the Atlantic and Eastern Gulf Coastal Plains are artifacts of a physical sorting processes associated with sea-level cyclicity.

Mineralogic, Petrographic, Mechanical And Physical Properties Of Incesu Ignimbrite (Central Anatolia - Turkey) Used Building Stone In Historical Buildings

NASA Astrophysics Data System (ADS)

Tasdelen, S.; Korolay, T.; Kadioglu, Y. K.; Kumral, M.

2009-05-01

The Central Anatolian Volcanic Province (CAVP) is located in the Central Turkey and one of the four major volcanic provinces in Turkey. It extends 300 km along a NE-SW direction, over a large area (32500 km2). The CAVP includes various volcanic, pyroclastic rocks, which are related to collision volcanism between the Arabian and Eurasian plates, occurred in Neogene, and Quaternary times There are numerous natural stone pits in the CAVP. They have been commonly used in historical building which had been built in the Anatolian Seljuk and Ottoman empires times. The subject of this study is to figure out petrographic, geochemical, some mechanical and physical properties which include Schmidt hardness, density, porosity, water absorption by weight, point load index and failure load.Incesu ignimbrite is subdivided into three levels as lower, middle and upper according to color, welding degree, crystal contents and lithic components. All of the natural stone pits is the upper part which is characterized by grey pinkish in color, poorly welded, high porosity ratios, high amount of lithic fragments and almost 2 m thickness. In terms of the mineralogical composition, it is composed of plagioclase (oligoclase, andesine) + pyroxene (augite, clinoenstatite) + opaque minerals and low amount of amphibole, biotite and quartz. Vitrofiric texture is dominant in upper level. Al2O3 content of the upper level from 12.75-13.96wt%, SiO2 66.70-68.10wt%, MgO 0.73-1.40wt%, Fe2O3 3.77-4.04wt%, TiO2 0.46-0.51wt%, CaO 1.97-2.91wt%, Na2O 3.41-4.29wt%, K2O 3.21-4.20wt%, P2O5 0.13-0.18wt% and LOI 3.65-4.52wt%. Geochemical analyze results reveal that Incesu ignimbrite has rhyolite, rhyodacite-dacite composition, medium to high-K calc-alkaline and peraluminous nature.Building stones can be classified according to their mineralogy, mechanical and physical properties and processing types. Mechanical and physical properties are more significant depending on the stones practice aim. The mean schmidt hardness value of the upper level of Incesu ignimbrite is 35, bulk density ranges between 2.42 - 2.66 g/cm3, mean water absorption by weight is 90%, mean point load strength is 38.2 MPa and failure load is 1890 kgf/cm based on the mechanical and physical test results.

Using the Pathophysiology of Obstructive Sleep Apnea to Teach Cardiopulmonary Integration

ERIC Educational Resources Information Center

Levitzky, Michael G.

2008-01-01

Obstructive sleep apnea (OSA) is a common disorder of upper airway obstruction during sleep. The effects of intermittent upper airway obstruction include alveolar hypoventilation, altered arterial blood gases and acid-base status, and stimulation of the arterial chemoreceptors, which leads to frequent arousals. These arousals disturb sleep…

A forest health inventory assessment of red fir (Abies magnifica) in upper montane California

Treesearch

Leif Mortenson; Andrew N. Gray; David C. Shaw

2015-01-01

We investigated the forest health of red fir (Abies magnifica) and how it compared with commonly-associated species Jeffrey pine (Pinus jeffreyi), lodgepole pine (Pinus contorta) and white fir (Abies concolor) in the upper montane forests of California. We evaluated tree mortality rates...

Upper Elementary Teachers' Self-Efficacy and Spelling Instruction: A Qualitative Study

ERIC Educational Resources Information Center

Fernandes, Brian E.

2017-01-01

A great deal of research has been conducted regarding spelling instruction at the early childhood and lower elementary levels, but not at the upper elementary level. This qualitative study explored the perceptions and experiences of upper elementary teachers to gain a better understanding of how they instruct spelling and their related…

Prevalence of acne vulgaris and its impact of the quality of life among secondary school-aged adolescents in Sohag Province, Upper Egypt.

PubMed

El-Hamd, Mohammed Abu; Nada, Essam El-Din Abdel-Aziz; Moustafa, Mohammed Abdel-Kareem; Mahboob-Allah, Rehab Ahmed

2017-09-01

Acne vulgaris is the most common dermatological condition encountered in adolescents. It was to determine the prevalence of acne vulgaris and its impact of the quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt. This was a cross-sectional study conducted in randomly selected governmental and technical secondary schools in Sohag Province, Upper Egypt. Approval was taken from the scientific research committee of Sohag Faculty of Medicine and also from Ministry of Education. Every student with acne was subjected to full medical history and local examination of head and neck to assess the severity of acne vulgaris. Assessment of the impact of acne vulgaris on their quality of life was carried out using self-reported validated specific questionnaire, the Cardiff Acne Disability Index (CADI). This study included 994 teenage secondary school students. The overall prevalence of acne vulgaris was 333 (33.5%). The mean age of the students with acne was 16.84±0.87. Acne vulgaris was more common among females than among males (200, 60% vs 133, 40%). The most common form of acne vulgaris was mild 178, 53%, followed by moderate form 135, 41%, and severe form 20, 6%. CADI score was significantly related to the disease grade and it was maximum among those with severe grade, followed by moderate and lastly mild disease grade. Acne vulgaris is a common skin disease and has a valuable impact on quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt. © 2017 Wiley Periodicals, Inc.

Common Manual Therapy Practices in the Netherlands for Infants With Upper Cervical Dysfunction: A Prospective Cohort Study.

PubMed

Saedt, Eric R I C; Driehuis, Femke; Hoogeboom, Thomas J; van der Woude, Bé H; de Bie, Rob A; Nijhuis-van der Sanden, Maria W G

2018-01-01

The purpose of this study was to describe common clinical practices of manual therapists (MTs) in the Netherlands for infants with indications of upper cervical dysfunction (UCD). A prospective observational cohort study was conducted to gain insight into characteristics, reasons for seeking care, and common clinical practice for infants (<27 weeks) with indications of UCD, referred to MTs. Pre- and posttreatment self-reported questionnaires were used to collect data from parents and MTs. Parents reported on infant characteristics and perceived effect of treatment. Manual therapists reported on diagnostics, therapeutic procedures, and outcomes. Between 2006 and 2007, data regarding 307 referred infants (mean age: 11.2 weeks) were collected by parents and 42 MTs. The most frequent reasons for seeking care were positional preference, restlessness, and/or abnormal head position. Manual therapists observed active, spontaneous, and provoked mobility and passive upper cervical mobility. Of the 307 infants, 295 were diagnosed with UCD based on positive outcomes on the flexion-rotation test and/or lateral flexion test. After treatment with mobilization techniques, positive outcomes on the flexion-rotation test decreased from 78.8% to 6.8%. For the lateral flexion test, the positive outcomes decreased from 91.5% to 6.2%. All parents perceived positive treatment effects. No serious adverse events were reported during this study. This is the first study to describe common clinical practice for infants referred for manual therapy. Infants with UCD were treated mainly with upper cervical mobilization techniques, and the greatest perceived effect was observed after approximately 2 treatment sessions. Copyright © 2018. Published by Elsevier Inc.

Recognizing an Irregular Heart Rhythm

MedlinePlus

... a workout, consider checking your rhythm as well. Atrial fibrillation, also referred to as AF, is a common ... upper chambers, or atria, of the heart. “While atrial fibrillation is not common among young people, it can ...

Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

PubMed

Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

2015-01-01

The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local anesthetic with or without steroids, based on at least one high-quality relevant randomized control trial in each category for disc herniation, discogenic pain without facet joint pain, central spinal stenosis, and post surgery syndrome.

Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

PubMed Central

Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

2016-01-01

Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

Targets and timelines for reducing salt in processed food in the Americas.

PubMed

Campbell, Norm; Legowski, Barbara; Legetic, Branka; Ferrante, Daniel; Nilson, Eduardo; Campbell, Christine; L'Abbé, Mary

2014-09-01

Reducing dietary salt is one of the most effective interventions to lessen the burden of premature death and disability. In high-income countries and those in nutrition transition, processed foods are a significant if not the main source of dietary salt. Reformulating these products to reduce their salt content is recommended as a best buy to prevent chronic diseases across populations. In the Americas, there are targets and timelines for reduced salt content of processed foods in 8 countries--Argentina, Brazil, Canada, Chile, Ecuador, Mexico, and the National Salt Reduction Initiative in the United States and Paraguay. While there are common elements across the countries, there are notable differences in their approaches: 4 countries have exclusively voluntary targets, 2 countries have combined voluntary and regulated components, and 1 country has only regulations. The countries have set different types of targets and in some cases combined them: averages, sales-weighted averages, upper limits, and percentage reductions. The foods to which the targets apply vary from single categories to comprehensive categories accounting for all processed products. The most accessible and transparent targets are upper limits per food category. Most likely to have a substantive and sustained impact on salt intake across whole populations is the combination of sales-weighted averages and upper limits. To assist all countries with policies to improve the overall nutritional value of processed foods, the authors call for food companies to supply food composition data and product sales volume data to transparent and open-access platforms and for global companies to supply the products that meet the strictest targets to all markets. Countries participating in common markets at the subregional level can consider harmonizing targets, nutrition labels, and warning labels. ©2014 Wiley Periodicals, Inc.

Water-Table and Potentiometric-Surface Altitudes in the Upper Glacial, Magothy, and Lloyd Aquifers beneath Long Island, New York, March-April 2006

USGS Publications Warehouse

Monti, Jack; Busciolano, Ronald J.

2009-01-01

The U.S. Geological Survey (USGS), in cooperation with State and local agencies, systematically collects ground-water data at varying measurement frequencies to monitor the hydrologic situation on Long Island, New York. Each year during March and April, the USGS conducts a synoptic survey of hydrologic conditions to define the spatial distribution of the water table and potentiometric surfaces within the three main water-bearing units underlying Long Island - the upper glacial, Magothy, and Lloyd aquifers. These data and the maps constructed from them are commonly used in studies of Long Island's hydrology, and by water managers and suppliers for aquifer management and planning purposes. Water-level measurements made in 502 wells across Long Island during March-April 2006, were used to prepare the maps in this report. Measurements were made by the wetted-tape method to the nearest hundredth of a foot. Water-table and potentiometric-surface altitudes in these aquifers were contoured using these measurements. The water-table contours were interpreted using water-level data collected from 341 wells screened in the upper glacial aquifer and (or) shallow Magothy aquifer; the Magothy aquifer's potentiometric-surface contours were interpreted from measurements at 102 wells screened in the middle to deep Magothy aquifer and (or) contiguous and hydraulically connected Jameco aquifer; and the Lloyd aquifer's potentiometric-surface contours were interpreted from measurements at 59 wells screened in the Lloyd aquifer or contiguous and hydraulically connected North Shore aquifer. Many of the supply wells are in continuous operation and, therefore, were turned off for a minimum of 24 hours before measurements were made so that the water levels in the wells could recover to the level of the potentiometric head in the surrounding aquifer. Full recovery time at some of these supply wells can exceed 24 hours; therefore, water levels measured at these wells are assumed to be less accurate than those measured at observation wells, which are not pumped. In this report, all water-level altitudes are referenced to the National Geodetic Vertical Datum of 1929 (NGVD 29).

Radiative Heating of the ISCCP Upper Level Cloud Regimes and its Impact on the Large-scale Tropical Circulation

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

Li, Wei; Schumacher, Courtney; McFarlane, Sally A.

2013-01-31

Radiative heating profiles of the International Satellite Cloud Climatology Project (ISCCP) cloud regimes (or weather states) were estimated by matching ISCCP observations with radiative properties derived from cloud radar and lidar measurements from the Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) sites at Manus, Papua New Guinea, and Darwin, Australia. Focus was placed on the ISCCP cloud regimes containing the majority of upper level clouds in the tropics, i.e., mesoscale convective systems (MCSs), deep cumulonimbus with cirrus, mixed shallow and deep convection, and thin cirrus. At upper levels, these regimes have average maximum cloud occurrences ranging from 30% tomore » 55% near 12 km with variations depending on the location and cloud regime. The resulting radiative heating profiles have maxima of approximately 1 K/day near 12 km, with equal heating contributions from the longwave and shortwave components. Upper level minima occur near 15 km, with the MCS regime showing the strongest cooling of 0.2 K/day and the thin cirrus showing no cooling. The gradient of upper level heating ranges from 0.2 to 0.4 K/(day∙km), with the most convectively active regimes (i.e., MCSs and deep cumulonimbus with cirrus) having the largest gradient. When the above heating profiles were applied to the 25-year ISCCP data set, the tropics-wide average profile has a radiative heating maximum of 0.45Kday-1 near 250 hPa. Column-integrated radiative heating of upper level cloud accounts for about 20% of the latent heating estimated by the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR). The ISCCP radiative heating of tropical upper level cloud only slightly modifies the response of an idealized primitive equation model forced with the tropics-wide TRMM PR latent heating, which suggests that the impact of upper level cloud is more important to large-scale tropical circulation variations because of convective feedbacks rather than direct forcing by the cloud radiative heating profiles. However, the height of the radiative heating maxima and gradient of the heating profiles are important to determine the sign and patterns of the horizontal circulation anomaly driven by radiative heating at upper levels.« less

Epidemiology of functional dyspepsia.

PubMed

Kumar, Arvind; Pate, Jignesh; Sawant, Prabha

2012-03-01

Functional dyspepsia (FD) is the most common cause of dyspeptic symptoms. It refers to a heterogeneous group of symptoms located in the upper abdomen. The prevalence of dyspepsia is variable in different populations and is related to the different definitions of dyspepsia as inclusion criterias, variation in survey population and environmental factors. Epidemiologically some risk factors have been identified and underlying psychological disturbances have been shown to be important factors in FD. Age and ethnicity do not appear to be predictive of dyspepsia. A majority of patients suffering from significant levels of abdominal pain that interrupt daily activities and treatment remains unsatisfactory in this chronic condition.

Assessing Upper-Level Winds on Day-of-Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Wheeler, Mark M.

2012-01-01

On the day-or-launch. the 45th Weather Squadron Launch Weather Officers (LWOS) monitor the upper-level winds for their launch customers to include NASA's Launch Services Program (LSP). During launch operations, the payload launch team sometimes asks the LWO if they expect the upper level winds to change during the countdown but the LWOs did not have the capability to quickly retrieve or display the upper-level observations and compare them to the numerical weather prediction model point forecasts. The LWOs requested the Applied Meteorology Unit (AMU) develop a capability in the form of a graphical user interface (GUI) that would allow them to plot upper-level wind speed and direction observations from the Kennedy Space Center Doppler Radar Wind Profilers and Cape Canaveral Air Force Station rawinsondes and then overlay model point forecast profiles on the observation profiles to assess the performance of these models and graphically display them to the launch team. The AMU developed an Excel-based capability for the LWOs to assess the model forecast upper-level winds and compare them to observations. They did so by creating a GUI in Excel that allows the LWOs to first initialize the models by comparing the O-hour model forecasts to the observations and then to display model forecasts in 3-hour intervals from the current time through 12 hours.

Upper aerodigestive tract cancer and the lung: a tale of two aspirations.

PubMed

Vaideeswar, P; Ghodke, R

2012-01-01

Patients with upper aerodigestive epithelial cancers frequently develop second primary cancers due to common risk factors or develop distant metastases depending on the locoregional status of the primary tumor. In most instances, the organ affected is the lung. Pulmonary spread usually occurs due to hematogenous or lymphatic dissemination. The following is a report of two patients with upper aerodigestive tract squamous cell carcinomas who developed lung metastases due to aspiration, a route not well documented in recent literature.

Assessment of fractionated exhaled nitric oxide as a biomarker for the treatment of eosinophilic esophagitis

PubMed Central

Nguyen-Traxler, Ann; Lee, Erika M.; Yip, Jason S.; Weinstock, Joel V.; Chan, Walter W.; Ngo, Peter; Weinstein, Barbara J.; Bonis, Peter A.

2012-01-01

Diagnosis of eosinophilic esophagitis (EoE) and determination of response to therapy is based on histological assessment of the esophagus, which requires upper endoscopy. In children, in whom a dietary approach is commonly used, multiple endoscopies are needed, because foods are eliminated and then gradually reintroduced. Ideally, noninvasive methods could supplement or replace upper endoscopy to facilitate management. Fractionated exhaled nitric oxide (FeNO) has been proposed as a useful measure for monitoring disease activity in studies of patients with eosinophil-predominant asthma and in other atopic disorders. Thus, we evaluated whether FeNO levels could be a useful biomarker to assess the response to therapy in EoE patients. This study was designed to determine whether there is a change in FeNO levels during treatment with topical corticosteroids and whether changes correlated with clinical response. This was a prospective, multicenter study that enrolled nonasthmatic patients with established EoE. FeNO levels and symptom scores were measured at baseline, biweekly during 6-week swallowed fluticasone treatment, and 4 weeks posttreatment. Twelve patients completed the trial. We found a statistically significant difference between median pre- and posttreatment FeNO levels [20.3 ppb (16.0–29.0 ppb) vs 17.6 ppb (11.7–27.3 ppb), p=0.009]. However, neither the pretreatment FeNO level, a change of FeNO level after 2 weeks of treatment, nor the FeNO level at the end of treatment confidently predicted a clinical or histological response. Although our findings suggest nitric oxide possibly has a physiological role in EoE, our observations do not support a role of FeNo determination for management of EoE. PMID:23394511

75 FR 15357 - Airworthiness Directives; The Boeing Company Model 767 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... airplanes. This proposed AD would require repetitive inspections to detect fatigue cracking in the upper... this AD to detect and correct fatigue cracking in the upper wing skin at the fastener holes common to... October 28, 1999. Further Boeing analysis has determined the cracks to be a result of fatigue due to...

Facies analysis of Lofer cycles (Upper Triassic), in the Argolis Peninsula (Greece)

NASA Astrophysics Data System (ADS)

Pomoni-Papaioannou, F.

The Upper Triassic carbonate sediments of Argolis Peninsula are part of the Upper Triassic-Lower Jurassic extensive and thick neritic carbonate formations (Pantokrator facies) that formed at the passive Pelagonian margin and are considered as Dachstein-type platform carbonates. Facies analysis of the Upper Triassic "Lofer-type" lagoonal-peritidal cycles in the Dhidimi area, proved that cycles, although mostly incomplete, were regressive shallowing-upward. The ideal elementary cyclothems are meter-scale in thickness and begin with a subtidal bed (Member C), represented by a peloidal dolostone with megalodonts (wackestone or packstone), being followed by a stromatolitic intertidal dolomitic mudstone and/or fenestral intertidal dolomitic mudstone (Member B) that is overlain by dolocrete (terrestrial stromatolites or pisoidic dolomite) or a supratidal "soil conglomerate" in red micritic matrix (Member A). Lofer-cycle boundaries are defined at the erosional surfaces and accordingly the Lofer cyclothems are unconformity-bounded units. Due to common post-depositional truncation of the subtidal and intertidal facies, the supratidal members prevail, being developed, in places, directly upon subaerial exposure surfaces (erosionally reduced cyclothems). Peritidal layers are characterized by a well-expressed lamination, sheet cracks, tepee structures, fenestral pores and karst dissolution cavities. The studied lagoonal-peritidal cycles are considered to have been deposited in a tidal-flat setting (inner platform), repeatedly exposed under subaerial conditions, in the context of a broader tropical rimmed platform. Although the studied area was tectonically active due to rift-activity and the autocyclic processes should also be taken in consideration, the great lateral correlatability of cycles, the facies shifting and the widespread erosion that resulted in superposition of supratidal-pedogenic facies directly upon subtidal members (subaerial erosional unconformity), indicating a sea-level drop, reflect allocyclic control via high-frequency eustatic sea-level oscillation (orbital forcing). Sediment deposition occurred during low-stand system tract (LST), that probably continued also in the transgressive system tract (TST) and reflects an overall sea-level fall. Under these conditions dissolution and cement precipitation episodes, as well development of paleosols and karsts, were triggered, during a relatively less arid interval.

Scale-free distribution of Dead Sea sinkholes: Observations and modeling

NASA Astrophysics Data System (ADS)

Yizhaq, H.; Ish-Shalom, C.; Raz, E.; Ashkenazy, Y.

2017-05-01

There are currently more than 5500 sinkholes along the Dead Sea in Israel. These were formed due to the dissolution of subsurface salt layers as a result of the replacement of hypersaline groundwater by fresh brackish groundwater. This process has been associated with a sharp decline in the Dead Sea water level, currently more than 1 m/yr, resulting in a lower water table that has allowed the intrusion of fresher brackish water. We studied the distribution of the sinkhole sizes and found that it is scale free with a power law exponent close to 2. We constructed a stochastic cellular automata model to understand the observed scale-free behavior and the growth of the sinkhole area in time. The model consists of a lower salt layer and an upper soil layer in which cavities that develop in the lower layer lead to collapses in the upper layer. The model reproduces the observed power law distribution without involving the threshold behavior commonly associated with criticality.

Surveillance and management of urologic complications after spinal cord injury.

PubMed

Kreydin, Evgeniy; Welk, Blayne; Chung, Doreen; Clemens, Quentin; Yang, Claire; Danforth, Teresa; Gousse, Angelo; Kielb, Stephanie; Kraus, Stephen; Mangera, Altaf; Reid, Sheilagh; Szell, Nicole; Cruz, Francisco; Chartier-Kastler, Emmanuel; Ginsberg, David A

2018-05-29

Neurogenic bladder due to spinal cord injury has significant consequences for patients' health and quality of life. Regular surveillance is required to assess the status of the upper and lower urinary lower urinary tracts and prevent their deterioration. In this review, we examine surveillance techniques in neurogenic bladder, describe common complications of this disease, and address strategies for their management. This work represents the efforts of SIU-ICUD joint consultation on Urologic Management of the Spinal Cord injury. For this specific topic, a workgroup was formed and comprehensive literature search of English language manuscripts regarding neurogenic bladder management was performed using key words of neurogenic bladder. Articles were compiled, and recommendations in the chapter are based on group discussion and follow the Oxford Centre for Evidence-based Medicine system for Levels of Evidence (LOEs) and Grades of Recommendation (GORs). At a minimum, patients should undergo an annual history and physical examination, renal functional testing (e.g., serum creatinine), and upper tract imaging (e.g., renal ultrasonography). The existing evidence does not support the use of other modalities, such as cystoscopy or urodynamics, for routine surveillance. Urologic complications in neurogenic bladder patients are common and often more complex than in the general population. There is a shortage of high-quality evidence to support any particular neurogenic bladder surveillance protocol. However, there is consensus regarding certain aspects of regular genitourinary system evaluation in these patients. Proper surveillance allows the clinician to avoid or address common urological complications, and to guide, alter, or maintain appropriate therapeutic regimens for individual patients.

Respiratory inflammation and infections in high-performance athletes.

PubMed

Gleeson, Maree; Pyne, David B

2016-02-01

Upper respiratory illness is the most common reason for non-injury-related presentation to a sports medicine clinic, accounting for 35-65% of illness presentations. Recurrent or persistent respiratory illness can have a negative impact on health and performance of athletes undertaking high levels of strenuous exercise. The cause of upper respiratory symptoms (URS) in athletes can be uncertain but the majority of cases are related to common respiratory viruses, viral reactivation, allergic responses to aeroallergens and exercise-related trauma to the integrity of respiratory epithelial membranes. Bacterial respiratory infections are uncommon in athletes. Undiagnosed or inappropriately treated asthma and/or allergy are common findings in clinical assessments of elite athletes experiencing recurrent URS. High-performance athletes with recurrent episodes of URS should undergo a thorough clinical assessment to exclude underlying treatable conditions of respiratory inflammation. Identifying athletes at risk of recurrent URS is important in order to prescribe preventative clinical, training and lifestyle strategies. Monitoring secretion rates and falling concentrations of salivary IgA can identify athletes at risk of URS. Therapeutic interventions are limited by the uncertainty of the underlying cause of inflammation. Topical anti-inflammatory sprays can be beneficial for some athletes. Dietary supplementation with bovine colostrum, probiotics and selected antioxidants can reduce the incidence or severity of URS in some athletes. Preliminary studies on athletes prone to URS indicate a genetic predisposition to a pro-inflammatory response and a dysregulated anti-inflammatory cytokine response to intense exercise as a possible mechanism of respiratory inflammation. This review focuses on respiratory infections and inflammation in elite/professional athletes.

Safe removal of upper esophageal coins by using Magill forceps: two centers' experience.

PubMed

Cetinkursun, Salih; Sayan, Ali; Demirbag, Suzi; Surer, Ilhami; Ozdemir, Tunc; Arikan, Ahmet

2006-01-01

Coin ingestion with subsequent esophageal coin impaction is common in children. Considerable debate surrounds the choice of technique for the removal of esophageal coins. This study demonstrates a minimally invasive technique for upper esophageal coin extraction. A retrospective review was conducted of 165 children who had upper esophageal coins extracted by using a Magill forceps. One hundred fifty-six coins (96.4%) were successfully removed without any complications. The average time taken to remove the coin was 33 seconds. Use of the Magill forceps technique minimizes instrumentation of the esophagus and is an easy, safe technique for removing coins from the upper end of the esophagus.

Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

ERIC Educational Resources Information Center

Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

2011-01-01

The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

Higher species richness of octocorals in the upper mesophotic zone in Eilat (Gulf of Aqaba) compared to shallower reef zones

NASA Astrophysics Data System (ADS)

Shoham, Erez; Benayahu, Yehuda

2017-03-01

Mesophotic coral-reef ecosystems (MCEs), which comprise the light-dependent communities of corals and other organisms found at depths between 30 and 150 m, have received very little study to date. However, current technological advances, such as remotely operated vehicles and closed-circuit rebreather diving, now enable their thorough investigation. Following the reef-building stony corals, octocorals are the second most common benthic component on many shallow reefs and a major component on deep reefs, the Red Sea included. This study is the first to examine octocoral community features on upper MCEs based on species-level identification and to compare them with the shallower reef zones. The study was carried out at Eilat (Gulf of Aqaba, northern Red Sea), comparing octocoral communities at two mesophotic reefs (30-45 m) and two shallow reef zones (reef flat and upper fore-reef) by belt transects. A total of 30 octocoral species were identified, with higher species richness on the upper MCEs compared to the shallower reefs. Although the MCEs were found to host a higher number of species than the shallower reefs, both featured a similar diversity. Each reef zone revealed a unique octocoral species composition and distinct community structure, with only 16% of the species shared by both the MCEs and the shallower reefs. This study has revealed an almost exclusive dominance of zooxanthellate species at the studied upper MCE reefs, thus indicating an adequate light regime for photosynthesis there. The findings should encourage similar studies on other reefs, aimed at understanding the spatiotemporal features and ecological role of octocorals in reef ecosystems down to the deepest limit of the MCEs.

Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy.

PubMed

Zielinski, Ingar Marie; Steenbergen, Bert; Baas, C Marjolein; Aarts, Pauline; Jongsma, Marijtje L A

2016-01-11

Unilateral Cerebral Palsy (CP) is a neurodevelopmental disorder that is a very common cause of disability in childhood. It is characterized by unilateral motor impairments that are frequently dominated in the upper limb. In addition to a reduced movement capacity of the affected upper limb, several children with unilateral CP show a reduced awareness of the remaining movement capacity of that limb. This phenomenon of disregarding the preserved capacity of the affected upper limb is regularly referred to as Developmental Disregard (DD). Different theories have been postulated to explain DD, each suggesting slightly different guidelines for therapy. Still, cognitive processes that might additionally contribute to DD in children with unilateral CP have never been directly studied. The current protocol was developed to study cognitive aspects involved in upper limb control in children with unilateral CP with and without DD. This was done by recording event-related potentials (ERPs) extracted from the ongoing EEG during target-response tasks asking for a hand-movement response. ERPs consist of several components, each of them associated with a well-defined cognitive process (e.g., the N1 with early attention processes, the N2 with cognitive control and the P3 with cognitive load and mental effort). Due to its excellent temporal resolution, the ERP technique enables to study several covert cognitive processes preceding overt motor responses and thus allows insight into the cognitive processes that might contribute to the phenomenon of DD. Using this protocol adds a new level of explanation to existing behavioral studies and opens new avenues to the broader implementation of research on cognitive aspects of developmental movement restrictions in children.

Using Hashimoto thyroiditis as gold standard to determine the upper limit value of thyroid stimulating hormone in a Chinese cohort.

PubMed

Li, Yu; Chen, Dong-Ning; Cui, Jing; Xin, Zhong; Yang, Guang-Ran; Niu, Ming-Jia; Yang, Jin-Kui

2016-11-06

Subclinical hypothyroidism, commonly caused by Hashimoto thyroiditis (HT), is a risk factor for cardiovascular diseases. This disorder is defined as merely having elevated serum thyroid stimulating hormone (TSH) levels. However, the upper limit of reference range for TSH is debated recently. This study was to determine the cutoff value for the upper normal limit of TSH in a cohort using the prevalence of Hashimoto thyroiditis as "gold" calibration standard. The research population was medical staff of 2856 individuals who took part in health examination annually. Serum free triiodothyronine (FT3), free thyroxine (FT4), TSH, thyroid peroxidase antibody (TPAb), thyroglobulin antibody (TGAb) and other biochemistry parameters were tested. Meanwhile, thyroid ultrasound examination was performed. The diagnosis of HT was based on presence of thyroid antibodies (TPAb and TGAb) and abnormalities of thyroid ultrasound examination. We used two different methods to estimate the cutoff point of TSH based on the prevalence of HT. Joinpoint regression showed the prevalence of HT increased significantly at the ninth decile of TSH value corresponding to 2.9 mU/L. ROC curve showed a TSH cutoff value of 2.6 mU/L with the maximized sensitivity and specificity in identifying HT. Using the newly defined cutoff value of TSH can detect patients with hyperlipidemia more efficiently, which may indicate our approach to define the upper limit of TSH can make more sense from the clinical point of view. A significant increase in the prevalence of HT occurred among individuals with a TSH of 2.6-2.9 mU/L made it possible to determine the cutoff value of normal upper limit of TSH.

Awareness and Knowledge of Glaucoma in Central India: A Hospital-Based Study.

PubMed

Maharana, Prafulla K; Rai, Vaishali G; Pattebahadur, Rajesh; Singhi, Shipra; Chauhan, Ashish K

2017-01-01

To assess the awareness and knowledge of glaucoma among people attending the ophthalmology outpatient department at a tertiary care hospital in central India. A prospective observational study. A questionnaire-based study was conducted, involving persons aged 18 and above attending the ophthalmology outpatient department from October 2014 to September 2015. Data on awareness and knowledge of glaucoma was collected through a face-to-face interview. Fourteen hundred people participated in the study. The mean age of participants was 43 ± 15 years (range, 18-85). The study participants included 53% men and 47% women. Only 27% (n = 380/1400) of the participants were aware of glaucoma. Age, sex, and presence or type of refractive error had no impact on glaucoma awareness. Awareness level was greater in individuals with higher education levels and those belonging to an upper socioeconomic class (SEC). Multiple logistic regression analysis revealed significantly higher levels of glaucoma awareness among participants belonging to the upper 2 SECs (P = 0.05) and those educated above the high school level (P = 0.001). The most common source of awareness was close acquaintance with relatives, famly members, and friends of glaucoma patients. Awareness of glaucoma in India is low. Lack of education and lower socioeconomic status are the major risk factors for late preentation of glaucoma. Continuous presence of a low level of awareness and the same factors accounting for it warrants the need for an aggressive and refined approach to increase awareness of glaucoma to prevent glaucoma-related blindness. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

A distributed fluid level sensor suitable for monitoring fuel load on board a moving fuel tank

NASA Astrophysics Data System (ADS)

Arkwright, John W.; Parkinson, Luke A.; Papageorgiou, Anthony W.

2018-02-01

A temperature insensitive fiber Bragg grating sensing array has been developed for monitoring fluid levels in a moving tank. The sensors are formed from two optical fibers twisted together to form a double helix with pairs of fiber Bragg gratings located above one another at the points where the fibers are vertically disposed. The sensing mechanism is based on a downwards deflection of the section of the double helix containing the FBGs which causes the tension in the upper FBG to decrease and the tension in the lower FBG to increase with concomitant changes in Bragg wavelength in each FBG. Changes in ambient temperature cause a common mode increase in Bragg wavelength, thus monitoring the differential change in wavelength provides a temperature independent measure of the applied pressure. Ambient temperature can be monitored simultaneously by taking the average wavelength of the upper and lower FBGs. The sensors are able to detect variations in pressure with resolutions better than 1 mmH2O and when placed on the bottom of a tank can be used to monitor fluid level based on the recorded pressure. Using an array of these sensors located along the bottom of a moving tank it was possible to monitor the fluid level at multiple points and hence dynamically track the total fluid volume in the tank. The outer surface of the sensing array is formed from a thin continuous Teflon sleeve, making it suitable for monitoring the level of volatile fluids such as aviation fuel and gasoline.

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

PubMed Central

Rosen, Tony; Bloemen, Elizabeth M.; LoFaso, Veronica M.; Clark, Sunday; Flomenbaum, Neal; Lachs, Mark S.

2015-01-01

Background Elder abuse is under-recognized by Emergency Department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. Objective To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. Methods ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. 66 ED visits were judged to have high probability of being related to elder abuse and 244 of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Results Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. 42% of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring >1 day prior to presentation and the most common suspicious injury pattern being maxillofacial injuries. Conclusion Victims of physical elder abuse commonly have injuries on upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. PMID:26810019

Metals in fish from the Upper Benue River and lakes Geriyo and Njuwa in northeastern Nigeria

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

Eromosele, C.O.; Eromosele, I.C.; Muktar, S.L.M.

Lakes Geriyo and Njuwa occupy natural depressions near the upper Benue River in northeastern Nigeria. The lakes are flooded by the river during the rainy season spanning the months of May to September. Fishing activities on the lakes and river provide fish for consumption by the local communities. Industrial activity around the upper Benue River and the lakes is low and there is no information on other activities with the potential for polluting the Benue River as it flows from neighboring Cameroon. However, an unconfirmed report indicated high levels of lead in the upper Benue River, generally speculated as arisingmore » from biogeometrical factors. Trace elements, some of which are toxic, may accumulate in edible marine organisms to levels which may be deleterious to human health. For the upper Benue River and its associate lakes, Geriyo and Njuwa, there is yet no report of a systematic study to assess the levels of metals in fish found in these waters. This paper presents the results of a study on metal levels in fish collected from Lakes Geriyo and Njuwa and upper Benue River in northeastern Nigeria. 7 refs., 1 fig., 2 tabs.« less

Initializing a Mesoscale Boundary-Layer Model with Radiosonde Observations

NASA Astrophysics Data System (ADS)

Berri, Guillermo J.; Bertossa, Germán

2018-01-01

A mesoscale boundary-layer model is used to simulate low-level regional wind fields over the La Plata River of South America, a region characterized by a strong daily cycle of land-river surface-temperature contrast and low-level circulations of sea-land breeze type. The initial and boundary conditions are defined from a limited number of local observations and the upper boundary condition is taken from the only radiosonde observations available in the region. The study considers 14 different upper boundary conditions defined from the radiosonde data at standard levels, significant levels, level of the inversion base and interpolated levels at fixed heights, all of them within the first 1500 m. The period of analysis is 1994-2008 during which eight daily observations from 13 weather stations of the region are used to validate the 24-h surface-wind forecast. The model errors are defined as the root-mean-square of relative error in wind-direction frequency distribution and mean wind speed per wind sector. Wind-direction errors are greater than wind-speed errors and show significant dispersion among the different upper boundary conditions, not present in wind speed, revealing a sensitivity to the initialization method. The wind-direction errors show a well-defined daily cycle, not evident in wind speed, with the minimum at noon and the maximum at dusk, but no systematic deterioration with time. The errors grow with the height of the upper boundary condition level, in particular wind direction, and double the errors obtained when the upper boundary condition is defined from the lower levels. The conclusion is that defining the model upper boundary condition from radiosonde data closer to the ground minimizes the low-level wind-field errors throughout the region.

Upper-Level Undergraduate Chemistry Students' Goals for Their Laboratory Coursework

ERIC Educational Resources Information Center

DeKorver, Brittland K.; Towns, Marcy H.

2016-01-01

Efforts to reform undergraduate chemistry laboratory coursework typically focus on the curricula of introductory-level courses, while upper-level courses are bypassed. This study used video-stimulated recall to interview 17 junior- and senior- level chemistry majors after they carried out an experiment as part of a laboratory course. It is assumed…

Upper functional gastrointestinal disorders in young adults.

PubMed

Adibi, Peyman; Behzad, Ebrahim; Shafieeyan, Mohammad; Toghiani, Ali

2012-01-01

Functional Gastrointestinal disorders (FGID) are common disorders in gastroenterology which are common in young adults. The aim of this study is evaluating the prevalence of upper FGID in iranian young adults. This was a cross-sectional study which was on 995 persons who were going to marry. A ROME III based questionnaire was used to determine the frequency of upper GI Syndromes among the sample population. Our results determined 74 subjects had functional dyspepsia (36 subjects diagnosed as postprandial distress syndrome patient and Epigastric pain syndrome was seen in 38 subjects). Functional heartburn was diagnosed in 52 participants. Globus was seen in 35 subjects and 41 had unspecified excessive belching. Many epidemiologic studies were done all around the world but there are different reports about prevalence and incidence of FGIDs. Our results were agreed with reported prevalence of FGIDs in Iran in adults. And our findings were agreed with some other Asian studies.

Fishes and tetrapods in the upper pennsylvanian (kasimovian) cohn coal member of the mattoon formation of illinois, United States: Systematics, paleoecology, and paleoenvironments

USGS Publications Warehouse

Carpenter, D.; Falcon-Lang, H. J.; Benton, M.J.; Nelson, W.J.

2011-01-01

A newly discovered vertebrate assemblage is reported from the Upper Pennsylvanian (mid-to upper Kasimovian) Cohn Coal Member of the Mattoon Formation of southeast Illinois, United States. Teeth, scales, and spines of xenacanth (Dicentrodus, Orthacanthus, Triodus, Xenacanthus) and euselachian (Sphenacanthus) sharks dominate the assemblage. Less common are the teeth, scales, and centra of holocephalan (Helodus) and actinopterygian fishes, together with rare tetrapod (mainly pelycosaur) phalanges and centra. The assemblage occurs within a broad, shallow channel incised into a prominent Vertisol. The channel is interpreted as having been cut during a seasonally dry glacial phase when sea level was low, but filled during a subsequent transgression triggered by deglaciation. We interpret this as a brackish water (estuarine) assemblage, based on the co-occurrence of the vertebrate material with spirorbids (putative microconchids) and paleoecological inferences gleaned from a critical analysis of the literature dealing with Pennsylvanian fish ecology. This interpretation is broadly consistent with taphonomic data and the results of 87Sr/86Sr isotope analysis of shark material. The pelycosaur material may have been reworked from the lowstand Vertisol, however, and these animals occupied dryland niches that developed during glacial phases. ?? 2011 SEPM (Society for Sedimentary Geology).

Association of personal hygiene with common morbidities among upper primary school children in rural Odisha.

PubMed

Paul, Kalyan Kumar; Panigrahi, Sandeep Kumar; Soodi Reddy, Arun Kiran; Sahu, Trilochan

2017-01-01

In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. A cross-sectional study conducted in a rural upper primary school of Odisha. A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. Of 90 participants, 58 (64.4%) were girls. The mean age was 11.8 (±1.01) years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001). More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%), history of worms in stool and lethargy (20%). A mean score of 6.14 ± 0.11 (out of 8) was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ 2 = 8.7; P < 0.005) and foul-smelling breath (χ 2 = 4.93; P < 0.05). Fungal infections were significantly less in children who bathed daily (χ 2 = 28.7; <0.005) and wore clean clothes (χ 2 = 5.06; P < 0.05). Dental caries, foul-smelling breath, and fungal infections were significantly associated with poor personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

22. VIEW ACROSS UPPER LEVEL OF EAST BUILDING TOWARDS THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. VIEW ACROSS UPPER LEVEL OF EAST BUILDING TOWARDS THE SOUTH (RIVER) SHOWING ROOF TRUSSES, PLANK AND PATTERN STORAGE, HINGED ACCESS HATCH TO STREET LEVEL SHOP CAN BE SEEN OPENED IN FOREGROUND. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

The association of residential mold exposure and adenotonsillar hypertrophy in children living in damp environments.

PubMed

Atan Sahin, Ozlem; Kececioglu, Nuray; Serdar, Muhittin; Ozpinar, Aysel

2016-09-01

There are many consequences of mold exposure related to respiratory system health of children This retrospective cohort study aims to find the association between adenoid hypertrophy and mold exposure in children living in damp environments. Children with history of recurrent respiratory tract infections were enrolled in the study between June 2012 and June 2013 and were followed up for adenoid hypertrophy from June 2013 to June 2016. One hundred and forty two children were residents of moldy houses and 242 were living in normal houses. Skin prick test results for 60 common allergens, vitamin D levels, IgE levels, age, presence of comorbidities such as urticaria, atopic dermatitis, allergic conjunctivitis, allergic rhinitis, asthma, frequency of upper respiratory tract infections and lower respiratory tract infections, were evaluated in both groups. A total of 384 children (mean age ± standard deviation = 53.37 ± 36 months; 198 males and 186 females) were included. The children were classified into 2 groups (1)Children living normal houses (n = 242) (2); Children living in damp houses (n = 142) according to mold exposure. Children with adenoid hypertrophy (p < 0,001) and higher IgE levels (p < 0,001) were more common in mold exposed group. Lower respiratory tract infections were more common in children with mold exposure (p < 0,05). Bivariate correlation analysis showed no significant association between IgE levels and adenoid hypertrophy. Multiple linear regression analysis was performed to evaluate IgE levels, vitamin D levels, and presence of adenoid as independent variables; age as dependent variable among two groups and was found statistically significant (p < 0,001). Dermatophagoid sensitive group living in damp houses had a significant increase in adenoid hypertrophy (p = 0,01). Housedustmite sensitive children with recurrent lower respiratory tract infection and upper respiratory tract infection were mainly residents of damp houses (p < 0,001). Allergic comorbidities were significantly more in damp environment group (p < 0,001), but there was no significant increase in any of the subgroups. Children with mold exposure had significantly increased adenoid hypertrophy regardless of their atopic nature, however, they may have become more sensitized due to other environmental triggers and genetic factors. In damp environments, sensitization to dermatophagoids, was significantly increased in children with adenoid hypertrophy. During the period of infancy, when children were mostly vitamin D supplemented, they were not sensitized and had normal adenoids. As children with recurrent respiratory tract infections grow, they tend to have lower vitamin D levels, become more atopic and tend to have adenoid hypertrophy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

CRANE WINCH MECHANISM, UPPER LEVEL OF HYDROELECTRIC POWER HOUSE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

CRANE WINCH MECHANISM, UPPER LEVEL OF HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

ELECTRICAL SWITCHBOARD IN UPPER LEVEL OF HYDROELECTRIC POWER HOUSE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ELECTRICAL SWITCHBOARD IN UPPER LEVEL OF HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

Lithofacies of Spencer Formation, western Tualatin Valley, Oregon

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

Van Atta, R.O.

The Spencer Formation crops out in a narrow band that trends north-northwest on the western edge of the Willamette and Tualatin Valleys, Oregon. It apparently conformably overlies mud rocks of either the Yamhill or the Nestucca Formation and is conformably overlain by the Pittsburgh Bluff Formation. The Spencer Formation consists of two members (informal): a lower highly micaceous sandstone (800-1000 ft) and an upper member that is micaceous siltstone and mudstone (1000-1300 ft). The lower member includes an upper part that is light-gray to creamy-gray, silty to muddy, pebbly lithic arkose to feldspathic litharenite, with minor arkose. Sorting is poormore » and beds may be laminated to ripple cross-laminated or massive and bioturbated with abundant mollusk shells, carbonized wood, and burrows. The lower part of the lower member is medium-gray to greenish-gray, silty, pumiceous lithic arkose to feldspathic litharenite. The texture tends to be more uniform and better sorted than that of the upper part of the member. Bedding is commonly massive due to bioturbation. The upper member is medium to dark-gray mudstone with thin pebble-conglomerate lenses. It intertongues with the lower member. Bioturbation, burrows, and carbonized wood are common. The trend in depositional environments appears to be from outer to mid-neritic (lower part, lower member) to shallow neritic, nearshore, and lagoonal (upper part, lower member, and upper member). The provenance of the Spencer Formation includes both proximal volcanics and distant plutonic and high-grade metamorphics.« less

Community-based epidemiological study of epilepsy in the Qena governorate in Upper Egypt, a door-to-door survey.

PubMed

Fawi, Gharib; Khedr, Eman M; El-Fetoh, Noha Abo; Thabit, Mohamed N; Abbass, Mohamed A; Zaki, Ahmad F

2015-07-01

The aim of this study is to estimate the epidemiological features of epilepsy in a representative governorate of Upper Egypt. A door-to-door community-based survey study was performed using a sample of 10 areas among various districts of the Qena governorate in Upper Egypt. Six were classified as rural areas, and the remaining four were classified as urban areas, with a total population of 8027 inhabitants. The population was screened using an epilepsy-screening questionnaire. Positive cases with suspected epilepsy were referred to Qena University Hospital to be further evaluated by a qualified neurologist and for further investigations, such as neuroimaging and electroencephalography. One hundred patients had a confirmed diagnosis of epilepsy, with a lifetime prevalence of 12.46/1000. The active prevalence rate of epilepsy was 2.12/1000, while the incidence rate was 123/100000. Seventy-six percent of the patients had idiopathic epilepsies, while 24% had symptomatic epilepsy. Generalized epilepsies were more common (70.1%) than partial epilepsy (26.3%), meanwhile epilepsies with mixed seizure types were 2.6%. The most common seizure type was generalized tonic clonic seizures (51.8%). The age-specific prevalence rate of epilepsy was much higher in infancy and early childhood (62.5 and 37.04/1000, respectively), which regressed steadily with age. Idiopathic epilepsies were significantly more common in urban areas than in rural areas (P=0.01), while symptomatic epilepsies were more common in rural areas than in urban areas (P<0.005). Upper Egypt is characterized by a relatively high incidence and prevalence of epilepsy and epilepsy-related medical service, and more cultural education should be directed to those areas in Egypt. Copyright © 2015 Elsevier B.V. All rights reserved.

Foreign body ingestion in children

PubMed Central

Dereci, Selim; Koca, Tuğba; Serdaroğlu, Filiz; Akçam, Mustafa

2015-01-01

Aim: Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. Material and Methods: The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively. The complaints at admission, the types of foreign bodies ingested, the localization of the foreign body in the gastrointestinal tract and the approaches and treatment methods used were examined. Results: Thirty-six (56%) of 64 patients included in the study were male and 28 (44%) were female and the mean age was 5.7±4.6 years (10 months–17 years). Thirty eight (59%) of 64 children who were included in the assessment were below the age of five years. The most common complaint at presentation was parental recognition of the ingested object and dysphagia. The most commonly ingested foreign bodies included coins, sewing pins, safety pins and hairclips. Nail clipper detected in the stomach, sewing pin which penetrated through the duodenal wall and stuck to hepatic parenchyma were the first pediatric cases in the literature. Upper esophagus was the most common location for foreign bodies. Endoscopic examinations were performed in 55 of 64 children. Conclusions: Early detection and treatment of ingested foreign bodies in the upper gastrointestinal system is important in terms of preventing possible complications. In our study, the most frequent foreign bodies detected in the upper digestive tract were coins and they were most frequently detected in the upper esophagus. Most of our patients were below the age of five years. Flexible endoscopic method was used commonly for treatment. PMID:26884693

41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS MAGNETIC PULLEY AT CENTER. ALSO SHOWS 100-TON CRUSHED UNOXIDIZED ORE BIN (RIGHT), PULLEY FORM 18 INCH BELT CONVEYOR CRUSHED OXIDIZED ORE BIN FEED AND STEPHENSADAMSON 25 TON/HR BUCKET ELEVATOR (UPPER CENTER). THE UPPER PORTION OF THE SAMPLING ELEVATOR IS ABOVE THE MAGNETIC PULLEY (CENTER LEFT) WITH THE ROUTE OF THE 16 INCH BELT CONVEYOR FINES FEED TO CRUSHED OXIDIZED ORE BIN TO ITS LEFT. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

The incidence of depression among residents of assisted living: prevalence and related risk factors.

PubMed

Almomani, Fidaa M; Bani-Issa, Wegdan

2017-01-01

This study aims to recognize and estimate the prevalence of depression and its risk factors among residents of assisted living facilities (ALs) in Jordan. Depression is commonly experienced by residents of ALs. The condition is, however, often misunderstood as a part of normal aging and may be overlooked by health care professionals. Little is known about the extent of depression and its risk factors among AL residents in Jordan. A national representative sample of 221 residents selected from all AL units across Jordan was recruited to the study. Data on expected risk factors for depression were collected, including sociodemographics; smoking status; number of roommates; number of family members; assessments for cognitive functioning, for lower limb functioning, for hand, shoulder, and arm impairments; and oral health status. Levels of depression among the sample respondents were also assessed. The study found that around 60% of the participants reported depressive manifestations, with 48.0% of AL residents exhibiting impaired cognitive functions, one-third (33.2%) having >50% upper limb disability, two-thirds (63.2%) being at moderate risk of falls, and 69.7% having fair to poor oral health status. Being female, and having a higher level of education, disability of the upper limbs, and impairment of cognitive functions were found to be independent risk factors for depression in participants. Depression is relatively common among residents of AL units in Jordan. Health care professionals, nurses, physiotherapists, and dentists working in these facilities need to work cooperatively to identify the manifestations of depression in residents and collaboratively implement the best practice in the treatment of depression and circumvent its long-term impacts on the health of residents.

Postoperative Intensity-Modulated Radiotherapy in Low-Risk Endometrial Cancers: Final Results of a Phase I Study

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

Macchia, Gabriella, E-mail: gmacchia@rm.unicatt.i; Cilla, Savino M.P.; Ferrandina, Gabriella

2010-04-15

Purpose: To determine the maximum tolerated dose of short-course radiotherapy (intensity-modulated radiotherapy technique) to the upper two thirds of the vagina in endometrial cancers with low risk of local recurrence. Patients and Methods: A Phase I clinical trial was performed. Eligible patients had low-risk resected primary endometrial adenocarcinomas. Radiotherapy was delivered in 5 fractions over 1 week. The planning target volume was the clinical target volume plus 5 mm. The clinical target volume was defined as the upper two thirds of the vagina as evidenced at CT simulation by a vaginal radio-opaque device. The planning target volume was irradiated bymore » a seven-field intensity-modulated radiotherapy technique, planned by the Plato Sunrise inverse planning system. A first cohort of 6 patients received 25 Gy (5-Gy fractions), and a subsequent cohort received 30 Gy (6-Gy fractions). The Common Toxicity Criteria scale, version 3.0, was used to score toxicity. Results: Twelve patients with endometrial cancer were enrolled. Median age was 58 years (range, 49-74 years). Pathologic stage was IB (83.3%) and IC (16.7%). Median tumor size was 30 mm (range, 15-50 mm). All patients completed the prescribed radiotherapy. No patient experienced a dose-limiting toxicity at the first level, and the radiotherapy dose was escalated from 25 to 30 Gy. No patients at the second dose level experienced dose-limiting toxicity. The most common Grade 2 toxicity was gastrointestinal, which was tolerable and manageable. Conclusions: The maximum tolerated dose of short-course radiotherapy was 30 Gy at 6 Gy per fraction. On the basis of this result, we are conducting a Phase II study with radiotherapy delivered at 30 Gy.« less

[Relationship between the frequency of work-related stress and prevalence of functional dyspepsia in Lima Geriatric Army Hospital].

PubMed

Valenzuela Narváez, Daniel Raúl; Gayoso Cervantes, Milagros

2017-01-01

To determine the relationship between the frequency of work-related stress and prevalence of functional dyspepsia in a sample of 218 military older 50 years in 2010 in Lima Military Hospital Geriatric. Descriptive and explanatory study and for the data collection on stress, were used the Vital Events Scale Holmes-Rahe and clinical records for clinical and upper endoscopy registration that comply the criteria of Rome III for functional dyspepsia. For processing and data analysis the statistical software package SPSS (Statistical Package for Social Sciences) was used. 100% of military showed some level of work stress during the study year; thus, 36.7% had a high level, 31.2% medium or moderate level, and 32.1% had low stress level; these percentages medium and high stress levels accounted for 67.9%. These results establish that job stress is a common discomfort in the study population (tabulated Chi2 = 3.841, chi2 observed = 27,908). Regarding functional dyspepsia prevalence of 37.2%, which indicates that it is a common condition in those military (tabular Z = 1.96, Z c = 9.163) it was determined. There is a significant relationship between the frequency of work-related stress and prevalence of functional dyspepsia in military activity in older than 50 years (tabulated Chi2 = 5.991, chi2 observed = 28,878, contingency coefficient = 0.342).

Influence of annealing atmosphere on formation of electrically-active defects in rutile TiO2

NASA Astrophysics Data System (ADS)

Zimmermann, C.; Bonkerud, J.; Herklotz, F.; Sky, T. N.; Hupfer, A.; Monakhov, E.; Svensson, B. G.; Vines, L.

2018-04-01

Electronic states in the upper part of the bandgap of reduced and/or hydrogenated n-type rutile TiO2 single crystals have been studied by means of thermal admittance and deep-level transient spectroscopy measurements. The studies were performed at sample temperatures between 28 and 300 K. The results reveal limited charge carrier freeze-out even at 28 K and evidence the existence of dominant shallow donors with ionization energies below 25 meV. Interstitial atomic hydrogen is considered to be a major contributor to these shallow donors, substantiated by infrared absorption measurements. Three defect energy levels with positions of about 70 meV, 95 meV, and 120 meV below the conduction band edge occur in all the studied samples, irrespective of the sample production batch and the post-growth heat treatment used. The origin of these levels is discussed in terms of electron polarons, intrinsic point defects, and/or common residual impurities, where especially interstitial titanium atoms, oxygen vacancies, and complexes involving Al atoms appear as likely candidates. In contrast, no common deep-level defect, exhibiting a charge state transition in the 200-700 meV range below the conduction band edge, is found in different samples. This may possibly indicate a strong influence on deep-level defects by the post-growth heat treatments employed.

6. Vacuum purification room and upper level offices Bureau ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Vacuum purification room and upper level offices - Bureau of Mines Boulder City Experimental Station, Titanium Research Building, Date Street north of U.S. Highway 93, Boulder City, Clark County, NV

12. DETAIL OF PAINTED SIGNS AND UPPER LEVEL WINDOWS ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. DETAIL OF PAINTED SIGNS AND UPPER LEVEL WINDOWS ON SOUTH SIDE. VIEW TO NORTHWEST. - Commercial & Industrial Buildings, Dubuque Seed Company Warehouse, 169-171 Iowa Street, Dubuque, Dubuque County, IA

VIEW NORTHEAST, Interior of Power Station, upper level showing windows ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW NORTHEAST, Interior of Power Station, upper level showing windows on east and north elevations - Bay City Traction & Electric Company, Power Station, 301 Washington Street, Bay City, Bay County, MI

VIEW SOUTHEAST, Interior of Power Station, upper level showing windows ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW SOUTHEAST, Interior of Power Station, upper level showing windows on east and south elevations - Bay City Traction & Electric Company, Power Station, 301 Washington Street, Bay City, Bay County, MI

Integrating Wind Profiling Radars and Radiosonde Observations with Model Point Data to Develop a Decision Support Tool to Assess Upper-Level Winds for Space Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2013-01-01

On the day of launch, the 45th Weather Squadron (45 WS) Launch Weather Officers (LWOs) monitor the upper-level winds for their launch customers. During launch operations, the payload/launch team sometimes asks the LWOs if they expect the upper-level winds to change during the countdown. The LWOs used numerical weather prediction model point forecasts to provide the information, but did not have the capability to quickly retrieve or adequately display the upper-level observations and compare them directly in the same display to the model point forecasts to help them determine which model performed the best. The LWOs requested the Applied Meteorology Unit (AMU) develop a graphical user interface (GUI) that will plot upper-level wind speed and direction observations from the Cape Canaveral Air Force Station (CCAFS) Automated Meteorological Profiling System (AMPS) rawinsondes with point forecast wind profiles from the National Centers for Environmental Prediction (NCEP) North American Mesoscale (NAM), Rapid Refresh (RAP) and Global Forecast System (GFS) models to assess the performance of these models. The AMU suggested adding observations from the NASA 50 MHz wind profiler and one of the US Air Force 915 MHz wind profilers, both located near the Kennedy Space Center (KSC) Shuttle Landing Facility, to supplement the AMPS observations with more frequent upper-level profiles. Figure 1 shows a map of KSC/CCAFS with the locations of the observation sites and the model point forecasts.

Maturation of enabling technologies for the next generation reignitable cryogenic upper stage

NASA Astrophysics Data System (ADS)

Mueller, Mark

Following the ESA decision in November 2008, a pre-development phase (Phase 1) of a future evolution of the Ariane 5 launcher (named Ariane 5 Midlife Evolution, A5ME) was started under Astrium Prime leadership. This upgraded version of the Ariane 5 launcher is based on an enhanced performance Upper Stage including the cryogenic re-ignitable VINCI engine. Thanks to this reignition capability, this new Upper Stage shall be "versatile" in the sense that it shall fulfil customer needs on a broader spectrum of orbits than the "standard" orbits (i.e. Geosynchronous Transfer Orbits, GTO) typically used for commercial telecommunications satellites. In order to meet the challenges of versatility, new technologies are currently being investigated. These technologies are mainly related -but not limited-to propellant management during the extended coasting phases with the related heat transfer into the tanks and the required multiple engine re-ignitions. Within the frame of the ESA Future Launchers Preparatory Programme (Period 2 Slice 1), the Cryogenic Upper Stage Technology project (CUST) aims to mature critical technologies to such a Technology Readiness Level (TRL) that they can be integrated into the baseline A5ME Upper Stage development schedule. In addition to A5ME application, these technologies can also be used on the future next generation European launcher. This paper shows the down-selection process implemented to identify the most crucial enabling technologies for a future versatile Upper Stage and gives a description of each technology finally selected for maturation in the frame of CUST. These include -amongst others-a Sandwich Common Bulkhead for the propellant tank, an external thermal insulation kit and various propellant management devices for the coasting phase. The paper also gives an overview on the related development and maturation plan including the tests to be conducted, as well as first results of the maturation activities themselves.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Cross-National Achievement Comparisons of Upper-Secondary Students: A Swiss Perspective.

ERIC Educational Resources Information Center

Ramseier, Erich

This paper shows how the Third International Mathematics and Science Study (TIMSS) can be carried out in a country with a very complicated upper-secondary educational system. The difficulties are not linked to the measurement of achievement, since the international project provides a common achievement scale. The challenge lies in the design of…

Sparkle lamp ingestion: a rare cause of death.

PubMed

Grundlingh, Johann; Dargan, Paul; Gokmen, Refik; Nair, Rajesh

2010-10-01

A 51-year-old man was brought to the emergency department after he had drunk 200 mL of fluid from a decorative sparkle lamp. His calcium level was 4.99 mmol/L with a blood gas pH of 7.21. His calcium levels were corrected and his acidosis improved, but his stay in the intensive care department was complicated on day 10 by upper gastrointestinal hemorrhage because of caustic erosions in his stomach. Ten days after admission, he had an emergency right hemicolectomy during which residual luminescent particles were found to have eroded through his cecal mucosa. He eventually died 15 days after admission because of disseminated intravascular coagulopathy and refractory septic shock. This case demonstrates the potential for fatal toxicity associated with ingestion of a common household item.

Combining uncertainty factors in deriving human exposure levels of noncarcinogenic toxicants.

PubMed

Kodell, R L; Gaylor, D W

1999-01-01

Acceptable levels of human exposure to noncarcinogenic toxicants in environmental and occupational settings generally are derived by reducing experimental no-observed-adverse-effect levels (NOAELs) or benchmark doses (BDs) by a product of uncertainty factors (Barnes and Dourson, Ref. 1). These factors are presumed to ensure safety by accounting for uncertainty in dose extrapolation, uncertainty in duration extrapolation, differential sensitivity between humans and animals, and differential sensitivity among humans. The common default value for each uncertainty factor is 10. This paper shows how estimates of means and standard deviations of the approximately log-normal distributions of individual uncertainty factors can be used to estimate percentiles of the distribution of the product of uncertainty factors. An appropriately selected upper percentile, for example, 95th or 99th, of the distribution of the product can be used as a combined uncertainty factor to replace the conventional product of default factors.

Development of an Ergonomics Checklist for Investigation of Work-Related Whole-Body Disorders in Farming - AWBA: Agricultural Whole-Body Assessment.

PubMed

Kong, Y K; Lee, S J; Lee, K S; Kim, G R; Kim, D M

2015-10-01

Researchers have been using various ergonomic tools to study occupational musculoskeletal diseases in industrial contexts. However, in agricultural work, where the work environment is poorer and the socio-psychological stress is high due to the high labor intensities of the industry, current research efforts have been scarce, and the number of available tools is small. In our preliminary studies, which focused on a limited number of body parts and other working elements, we developed separate evaluation tools for the upper and lower extremities. The current study was conducted to develop a whole-body ergonomic assessment tool for agricultural work that integrates the existing assessment tools for lower and upper extremities developed in the preliminary studies and to verify the relevance of the integrated assessment tool. To verify the relevance of the Agricultural Whole-Body Assessment (AWBA) tool, we selected 50 different postures that occur frequently in agricultural work. Our results showed that the AWBA-determined risk levels were similar to the subjective risk levels determined by experts. In addition, as the risk level increased, the average risk level increased to a similar extent. Moreover, the differences in risk levels between the AWBA and expert assessments were mostly smaller than the differences in risk levels between other assessment tools and the expert assessments in this study. In conclusion, the AWBA tool developed in this study was demonstrated to be appropriate for use as a tool for assessing various postures commonly assumed in agricultural work. Moreover, we believe that our verification of the assessment tools will contribute to the enhancement of the quality of activities designed to prevent and control work-related musculoskeletal diseases in other industries.

A Tunneled Subcricoid Approach for Anterior Cervical Spine Reoperation: Technical and Safety Results.

PubMed

Winkler, Ethan A; Rowland, Nathan C; Yue, John K; Birk, Harjus; Ozpinar, Alp; Tay, Bobby; Ames, Christopher P; Mummaneni, Praveen V; El-Sayed, Ivan H

2016-02-01

Anterior cervical spine decompression and fusion are common neurosurgical operations. Reoperation of the anterior cervical spine is associated with increased morbidity. The authors describe a novel subcricoid approach to protect the recurrent laryngeal nerve in a cuff of tissue while facilitating surgical access to the anterior cervical spine. Single institution, consecutive case review of 48 patients undergoing reoperation in the anterior cervical region including the level of C5 and below. Univariable and multivariable regression analysis was used to determine predictors of postoperative morbidity. No intraoperative complications were reported. Estimated blood loss for the approach was 13.6 ± 3.1 mL. Nine of 48 patients developed immediate postoperative complications, including vocal cord paresis (10.4%), moderate-to-severe dysphagia (10.4%), and neck edema requiring intubation (2.1%). No postoperative hematomas or death occurred. All complications occurred with 4 or more levels of exposure (1-3 disc levels, 0%, vs. ≥ 4 disc levels, 31%). Extension of the exposure to the upper thoracic spine was associated with odds for postoperative complications (adjusted odds ratio, 6.50; 95% confidence interval, 1.14-37.03) and prolonged hospital stay (adjusted increase 4.23 days, P < 0.01). The tunneled subcricoid approach is a relatively safe corridor to reapproach the anterior cervical spine at the level of C5 and below. However, caution must be exercised when using this approach to expose 4 or more disc levels and with extension of the exposure to the upper thoracic spine. Future comparative studies are needed to establish patient selection criteria in determining the use of this technique compared with classic approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

[Localization of upper airway stricture by CT scan in patients with obstructive sleep apnea syndrome during drug-induced sleeping].

PubMed

Hu, Ji-bo; Hu, Hong-jie; Hou, Tie-ning; Gao, Hang-xiang; He, Jian

2010-03-01

To evaluate the feasibility of multi-slice spiral CT scan to localize upper airway stricture in patients with obstructive sleep apnea syndrome (OSAS) during drug-induced sleeping. One hundred and fourteen patients diagnosed as OSAS by polysomnography were included in the study. Multi-slice spiral CT scan covering upper airway was performed at the end of inspiration and clear upper airway images were obtained in waking. After injecting 5 mg of midazolam intravenously slowly in 109 patients, CT scan was performed at apnea and clear upper airway images were obtained in sleeping. Cross-section area and minimal diameter of airway were measured and the parameters were compared under those two states. Upper airway was displayed intuitionisticly by using post-processing techniques. One hundred and nine patients with OSAS finished the examination with a success rate of 100 %. Airway obstruction at retropalatal level was observed in 62 patients, among whom 26 were associated with airway obstruction at retroglossal level, 27 with narrower airway at retroglossal level in sleeping compared with that in waking, and 9 with no significant change of the airway at retroglossal level after sleeping. Narrower airway at retropalatal level in sleeping compared with that in waking was observed in 40 patients, among whom 20 were associated with narrower airway at retroglossal level in sleeping compared with that in waking, 10 with complete airway obstruction at retroglossal level in sleeping, and 7 with no significant change of the airway at both retropalatal and retroglossal levels before and after sleeping. Minimal mean cross-section area of airway at retropalatal level was (72.60 +/-45.15)mm(2) in waking and (8.26 +/-18.16)mm(2) in sleeping; and minimal mean cross-section area of airway at retroglossal level was (133.21 +/-120.36)mm(2)in waking and (16.73 +/-30.21)mm(2) in sleeping (P <0.01). Minimal mean diameter of airway at retropalatal level was (6.91 +/-2.23) mm in waking and (1.18 +/-2.14) mm in sleeping; and minimal mean diameter of airway at retroglossal level was (8.68 +/-4.32) mm in waking and (1.68 +/-2.22) mm in sleeping (P <0.01). Multi-slice spiral CT with post-processing techniques can display the shape of the upper airway in patients with OSAS in sleeping, and can localize the upper airway stricture and assess its range accurately.

The effect of arm weight support on upper limb muscle synergies during reaching movements

PubMed Central

2014-01-01

Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke survivors and other patients who could benefit from upper limb rehabilitation with arm WS. PMID:24594139

Incentivizing Advanced Mathematics Study at Upper Secondary Level: The Case of Bonus Points in Ireland

ERIC Educational Resources Information Center

Treacy, Páraic Thomas

2018-01-01

Secondary level mathematics education in Ireland has recently experienced a period of significant change with the introduction of new curricula and the addition of an incentive to study upper secondary mathematics at the most advanced level (Higher Level). This incentive, typically referred to as 'bonus points', appears to have aided a significant…

Mercury vapor in residential building common areas in communities where mercury is used for cultural purposes versus a reference community

PubMed Central

Garetano, Gary; Stern, Alan H.; Robson, Mark; Gochfeld, Michael

2015-01-01

Background Exposure to elemental mercury (Hg0) in residential buildings can occur from accidental spills, broken objects (thermometers, fluorescent fixtures, thermostats), and deliberate introduction, one mode of which involves cultural practices by individuals who believe dispersal of mercury in a residence will bring luck, enhance health or ward off harm. Objectives To determine whether mercury vapor levels in common areas of residential buildings is higher in a community where cultural uses are likely (study areas S1, S2) than in a reference community (C1) where cultural use is unlikely, and whether levels can serve as a signal of significant cultural mercury use. Methods We monitored Hg0 vapor with a portable spectrophotometer in the three communities. We randomly selected sites in S1 and C1 community, and also include sites in S2 specified by local health officials who suspected cultural mercury use. We evaluated 122 multifamily buildings and 116 outdoor locations. Findings We found >25 ng/m3 Hg0 in 14% of buildings in study areas compared to only one reference building. In the latter we identified an accidental mercury spill from a bottle that had been brought into the building. Both the mean and maximum indoor mercury vapor levels were greater in the study communities than in the reference community. In all communities, we observed mean indoor Hg0 vapor concentration greater than outdoors, although in two-thirds of buildings, indoor levels did not exceed the area-specific outdoor upper-limit concentration. Conclusion After controlling for factors that might influence Hg0 vapor levels, the most plausible explanation for greater Hg0 levels in the study area is a relationship to cultural use of mercury. None of the measured levels exceeded the ATSDR minimum risk level for residences of 200 ng/m3 Hg0 although levels in living quarters might be greater than those in the common areas. PMID:18406445

2. EXTERIOR, SOUTH FRONT, UPPER LEVELS SHOWING ROOF CORNICE AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. EXTERIOR, SOUTH FRONT, UPPER LEVELS SHOWING ROOF CORNICE AND BAY WINDOW UNIT WITH PRESSED TIN SPANDREL - West Lexington Street, Number 314 (Commercial Building), 314 West Lexington Street, Baltimore, Independent City, MD

22. DETAILCATWALKS OF THE UPPER LEVEL OF BUILDING 36 AT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. DETAIL--CATWALKS OF THE UPPER LEVEL OF BUILDING 36 AT THE INTERSECTION OF THE EAST AND NORTH WINGS. - Navy Yard, Ordnance Building, Intersection of Paulding & Kennon Streets, Washington, District of Columbia, DC

Physical Activity and the Common Cold in Undergraduate University Students: Implications for Health Professionals

ERIC Educational Resources Information Center

Vossen, Deborah P.; McArel, Heather; Vossen, Jeffery F.; Thompson, Angela M.

2004-01-01

Objective: The common cold, known as upper respiratory tract infection (URTI), is the world's most prevalent illness. The purpose of this study was to determine if physical activity is linked to the incidence and/or duration of the common cold. Method: Undergraduate university students (n=200) were asked to complete two questionnaires. The…

Upper gastrointestinal bleeding caused by severe esophagitis: a unique clinical syndrome.

PubMed

Guntipalli, Prathima; Chason, Rebecca; Elliott, Alan; Rockey, Don C

2014-12-01

We have recognized a unique clinical syndrome in patients with upper gastrointestinal bleeding who are found to have severe esophagitis. We aimed to more clearly describe the clinical entity of upper gastrointestinal bleeding in patients with severe esophagitis. We conducted a retrospective matched case-control study designed to investigate clinical features in patients with carefully defined upper gastrointestinal bleeding and severe esophagitis. Patient data were captured prospectively via a Gastrointestinal Bleeding Healthcare Registry, which collects data on all patients admitted with gastrointestinal bleeding. Patients with endoscopically documented esophagitis (cases) were matched with randomly selected controls that had upper gastrointestinal bleeding caused by other lesions. Epidemiologic features in patients with esophagitis were similar to those with other causes of upper gastrointestinal bleeding. However, hematemesis was more common in patients with esophagitis 86% (102/119) than in controls 55% (196/357) (p < 0.0001), while melena was less common in patients with esophagitis 38% (45/119) than in controls 68% (244/357) (p < 0.0001). Additionally, the more severe the esophagitis, the more frequent was melena. Patients with esophagitis had less abnormal vital signs, lesser decreases in hematocrit, and lesser increases in BUN. Both pre- and postRockall scores were lower in patients with esophagitis compared with controls (p = 0.01, and p < 0.0001, respectively). Length of hospital stay (p = 0.002), rebleeding rate at 42 days (p = 0.0007), and mortality were less in patients with esophagitis than controls. Finally, analysis of patients with esophagitis and cirrhosis suggested that this group of patients had more severe bleeding than those without cirrhosis. We have described a unique clinical syndrome in patients with upper gastrointestinal bleeding who have erosive esophagitis. This syndrome is manifest by typical clinical features and is associated with favorable outcomes.

Upper Eyelid Fractional CO2 Laser Resurfacing With Incisional Blepharoplasty.

PubMed

Kotlus, Brett S; Schwarcz, Robert M; Nakra, Tanuj

2016-01-01

Laser resurfacing, performed at the same time as blepharoplasty, has most commonly been applied to the lower eyelid skin but can effectively be used on the upper eyelid to reduce rhytidosis and improve skin quality. The authors evaluate the safety and efficacy of this procedure. Fractional CO2 laser resurfacing was performed in conjunction with incisional upper blepharoplasty. The ultrapulsed laser energy was applied to the sub-brow skin, the upper medial canthal skin, and the pretarsal skin in 30 patients. Photos were obtained preoperatively and at 3 months. All patients demonstrated reduction in upper eyelid rhytidosis without any serious complications. Independent rhytidosis grading (0-4) showed a mean improvement of 42%. One patient experienced wound dehiscence that satisfactorily resolved without intervention. Upper eyelid laser resurfacing is effective and can be safely performed at the same time as upper blepharoplasty. This approach reduces or eliminates the need for medial incisions to address medial canthal skin redundancy and rhytidosis and it directly treats upper eyelid wrinkles on residual eyelid and infra-brow skin during blepharoplasty.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

NASA Astrophysics Data System (ADS)

Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress.

PubMed

Anhalt-Depies, Christine M; Knoot, Tricia Gorby; Rissman, Adena R; Sharp, Anthony K; Martin, Karl J

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

11.361 sports injuries in a 15-year survey of a Level I emergency trauma department reveal different severe injury types in the 6 most common team sports.

PubMed

Krutsch, Werner; Krutsch, Volker; Hilber, Franz; Pfeifer, Christian; Baumann, Florian; Weber, Johannes; Schmitz, Paul; Kerschbaum, Maximilian; Nerlich, Michael; Angele, Peter

2018-06-01

 Severe sports-related injuries are a common affliction treated in Level I trauma departments. Detailed knowledge on injury characteristics from different medical settings is essential to improve the development of injury prevention strategies in different team sports.  Team sport injuries were retrospectively analysed in a Level I trauma department registry over 15 years. Injury and treatment data were compared with regard to competition and training exposure. Injury data such as "time of visitation", "type of injury", "multiple injured body regions" and "immediate hospitalisation" helped to define the severity level of each team sports injury.  At the Level I trauma department, 11.361 sports-related injuries were seen over 15 years, of which 34.0 % were sustained during team sports. Soccer injuries were the most common injuries of all team sports (71.4 %). The lower extremity was the most affected body region overall, followed by the upper extremity. Head injuries were mainly seen in Ice hockey and American football and concussion additionally frequently in team handball. Slight injuries like sprains or contusions occurred most frequently in all team sports. In soccer and team handball, injuries sustained in competition were significantly more severe (p < 0.001) than those sustained in practice.Volleyball and basketball had a trend to higher rate of severe injuries sustained during practice sessions.  Depending on the specific injury profile of each team sports, injury prevention strategies should address competitive as well as training situations, whichmay need different strategies. © Georg Thieme Verlag KG Stuttgart · New York.

Annual Tropical Cyclone Report, 1983.

DTIC Science & Technology

1983-01-01

impact on Ellen. In addition to were based primarily on the presence of interferring with Ellen’s outflow at upper- upper-level banding features...upper-level flow impacting Thelma is reflected in the rapidity with which the The first warning on Thelma, as a system sheared while moving...8217 %,d 4 "." ,"." .".-*. .*’,.--" * . . ." .’% .. .J *. " . . . . . . .. . . . . .• . ’ .".• -* ". FOREWORD The Annual Tropical Cyclone Report

DETAIL INTERIOR VIEW OF ELECTRIC GENERATOR ON UPPER LEVEL ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL INTERIOR VIEW OF ELECTRIC GENERATOR ON UPPER LEVEL ON HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

20. VIEW SOUTHEAST OF UPPER LEVEL (LUMBER STORAGE) IN EAST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. VIEW SOUTHEAST OF UPPER LEVEL (LUMBER STORAGE) IN EAST BUILDING SHOWING BUILDING FRAMEWORK, IRON HANGING RODS, AND CEDAR PLANKS BEING SEASONED FOR BOAT CONSTRUCTION. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

Temporal Variability of Upper-level Winds at the Eastern Range, Western Range and Wallops Flight Facility

NASA Technical Reports Server (NTRS)

Decker, Ryan K.; Barbre, Robert E., Jr.

2014-01-01

Space launch vehicles incorporate upper-level wind profiles to determine wind effects on the vehicle and for a commit to launch decision. These assessments incorporate wind profiles measured hours prior to launch and may not represent the actual wind the vehicle will fly through. Uncertainty in the upper-level winds over the time period between the assessment and launch can be mitigated by a statistical analysis of wind change over time periods of interest using historical data from the launch range. Five sets of temporal wind pairs at various times (.75, 1.5, 2, 3 and 4-hrs) at the Eastern Range, Western Range and Wallops Flight Facility were developed for use in upper-level wind assessments. Database development procedures as well as statistical analysis of temporal wind variability at each launch range will be presented.

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse.

PubMed

Rosen, Tony; Bloemen, Elizabeth M; LoFaso, Veronica M; Clark, Sunday; Flomenbaum, Neal E; Lachs, Mark S

2016-03-01

Elder abuse is under-recognized by emergency department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. Sixty-six ED visits were judged to have high probability of being related to elder abuse and 244 were of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. Forty-two percent of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring more than 1 day prior to presentation, and the most common suspicious injury pattern being maxillofacial injuries. Victims of physical elder abuse commonly have injuries on the upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

Upper gastrointestinal bleeding in severely burned patients: a case-control study to assess risk factors, causes, and outcome.

PubMed

Kim, Young Jin; Koh, Dong Hee; Park, Se Woo; Park, Sun Man; Choi, Min Ho; Jang, Hyun Joo; Kae, Sea Hyub; Lee, Jin; Byun, Hyun Woo

2014-01-01

To determine the risk factors, causes, and outcome of clinically important upper gastrointestinal bleeding that occurs in severely burned patients. The charts of all patients admitted to the burn intensive care unit were analyzed retrospectively over a 4-year period (from January 2006 to December 2009). Cases consisted of burned patients who developed upper gastrointestinal bleeding more than 24 hours after admission to the burn intensive care unit. Controls were a set of patients, in the burn intensive care unit, without upper gastrointestinal bleeding matched with cases for age and gender. Cases and controls were compared with respect to the risk factors of upper gastrointestinal bleeding and outcomes. During the study period, clinically important upper gastrointestinal bleeding occurred in 20 patients out of all 964 patients. The most common cause of upper gastrointestinal bleeding was duodenal ulcer (11 of 20 cases, 55%). In the multivariate analysis, mechanical ventilation (p = 0.044) and coagulopathy (p = 0.035) were found to be the independent predictors of upper gastrointestinal bleeding in severely burned patients. Upper gastrointestinal hemorrhage tends to occur more frequently after having prolonged mechanical ventilation and coagulopathy.

17. Interior of upper level (Turf Club level) of south ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Interior of upper level (Turf Club level) of south and west additions to the Clubhouse. Camera pointed W. Stairs in foreground lead to the 'Gallery' room. Stairs in background lead to the 'Callahan' room. 'Broderick' room (not shown) is entered from south side of 'Gallery' room. (July 1993) - Longacres, Clubhouse & Additions, 1621 Southwest Sixteenth Street, Renton, King County, WA

Using Lab Notebooks to Examine Students' Engagement in Modeling in an Upper-Division Electronics Lab Course

ERIC Educational Resources Information Center

Stanley, Jacob T.; Su, Weifeng; Lewandowski, H. J.

2017-01-01

We demonstrate how students' use of modeling can be examined and assessed using student notebooks collected from an upper-division electronics lab course. The use of models is a ubiquitous practice in undergraduate physics education, but the process of constructing, testing, and refining these models is much less common. We focus our attention on…

Upper Secondary Students' Understanding of the Basic Physical Interactions in Analogous Atomic and Solar Systems

ERIC Educational Resources Information Center

Taber, Keith S.

2013-01-01

Comparing the atom to a "tiny solar system" is a common teaching analogy, and the extent to which learners saw the systems as analogous was investigated. English upper secondary students were asked parallel questions about the physical interactions between the components of a simple atomic system and a simple solar system to investigate…

Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia

PubMed Central

Knutson, Jayme S.; Fu, Michael J.; Sheffler, Lynne R.; Chae, John

2015-01-01

Synopsis This article reviews the most common therapeutic and neuroprosthetic applications of neuromuscular electrical stimulation (NMES) for upper and lower extremity stroke rehabilitation. Fundamental NMES principles and purposes in stroke rehabilitation are explained. NMES modalities used for upper and lower limb rehabilitation are described and efficacy studies are summarized. The evidence for peripheral and central mechanisms of action is also summarized. PMID:26522909

Pseudomonas folliculitis in Arabian baths.

PubMed

Molina-Leyva, Alejandro; Ruiz-Ruigomez, Maria

2013-07-14

A 35-year-old man presented with a painful cutaneous skin eruption that was localized on the upper trunk. He stated that the previous weekend he had attended an Arabian bath. The physical examination revealed multiple hair follicle-centered papulopustules surrounded by an erythematous halo. A clinical diagnosis of pseudomonas folliculitis was made and treatment was prescribed. Afterwards Pseudomonas aeruginosa was isolated from a pustule culture. Pseudomonas folliculitis is a bacterial infection of the hair follicles. The most common reservoirs include facilities with hot water and complex piping systems that are difficult to clean, such as hot tubs and bathtubs. Despite adequate or high chlorine levels, Pseudomonas aeruginosa can grow within a biofilm.

Simulated Effects of Ground-Water Augmentation on the Hydrology of Round and Halfmoon Lakes in Northwestern Hillsborough County, Florida

USGS Publications Warehouse

Yager, Richard M.; Metz, P.A.

2004-01-01

Pumpage from the Upper Floridan aquifer in northwest Hillsborough County near Tampa, Florida, has induced downward leakage from the overlying surficial aquifer and lowered the water table in many areas. Leakage is highest where the confining layer separating the aquifers is breached, which is common beneath many of the lakes in the study area. Leakage of water to the Upper Floridan aquifer has lowered the water level in many lakes and drained many wetlands. Ground water from the Upper Floridan aquifer has been added (augmented) to some lakes in an effort to maintain lake levels, but the resulting lake-water chemistry and lake leakage patterns are substantially different from those of natural lakes. Changes in lake-water chemistry can cause changes in lake flora, fauna, and lake sediment composition, and large volumes of lake leakage are suspected to enhance the formation of sinkholes near the shoreline of augmented lakes. The leakage rate of lake water through the surficial aquifer to the Upper Floridan aquifer was estimated in this study using ground-water-flow models developed for an augmented lake (Round Lake) and non-augmented lake (Halfmoon Lake). Flow models developed with MODFLOW were calibrated through nonlinear regression with UCODE to measured water levels and monthly net ground-water-flow rates from the lakes estimated from lake-water budgets. Monthly estimates of ground-water recharge were computed using an unsaturated flow model (LEACHM) that simulated daily changes in storage of water in the soil profile, thus estimating recharge as drainage to the water table. Aquifer properties in the Round Lake model were estimated through transient-state simulations using two sets of monthly recharge rates computed during July 1996 to February 1999, which spanned both average conditions (July 1996 through October 1997), and an El Ni?o event (November 1997 through September 1998) when the recharge rate doubled. Aquifer properties in the Halfmoon Lake model were estimated through steady-state simulations of average conditions in July 1996. Simulated hydrographs computed by the Round and Halfmoon Lake models closely matched measured water-level fluctuations, except during El Ni?o, when the Halfmoon Lake model was unable to accurately reproduce water levels. Possibly, potential recharge during El Ni?o was diverted through ground-water-flow outlets that were not represented in the Halfmoon Lake model, or a large part of the rainfall was diverted into runoff before it could become recharge. Solute transport simulations with MT3D indicate that leakage of lake water extended 250 to 400 feet into the surficial aquifer around Round Lake, and from 75 to 150 feet around Halfmoon Lake before flowing to the underlying Upper Floridan aquifer. These results are in agreement with concentrations of stable isotopes of oxygen-18 (d18O) and deuterium (dD) in the surficial aquifer. Schedules of monthly augmentation rates to maintain constant stages in Round and Halfmoon Lakes were computed using an equation that accounted for changes in the Upper Floridan aquifer head and the deviation from the mean recharge rate. Resulting lake stages were nearly constant during the first half of the study, but increased above target lake stages during El Ni?o; modifying the computation of augmentation rates to account for the higher recharge rate during El Ni?o resulted in lake stages that were closer to the target lake stage. Substantially more lake leakage flows to the Upper Floridan aquifer from Round Lake than from Halfmoon Lake, because the estimated vertical hydraulic conductivities of lake and confining layer sediments and breaches in the confining layer beneath Round Lake are much greater. Augmentation rates required to maintain the low guidance stages in Round Lake (53 feet) and Halfmoon Lake (42 feet) under average Upper Floridan aquifer heads are estimated as 33,850 cubic feet per day and 1,330 to 10,000 cubic feet per day, respectively. T

Endoscopic findings and associated risk factors in primary health care settings in Havana, Cuba.

PubMed

Galbán, Enrique; Arús, Enrique; Periles, Ulises

2012-01-01

INTRODUCTION Upper gastrointestinal endoscopy, traditionally performed in Cuba in specialized hospitals, was decentralized to the primary health care level in 2004 to make it more patient-accessible. OBJECTIVES Describe frequency and distribution of the principal symptomatic diseases of the upper gastrointestinal tract and their relation to the main risk factors associated with each in a sample of urban adults who underwent upper gastrointestinal endoscopy in primary care facilities in Havana in selected months of 2007. METHODS A multicenter cross-sectional study was conducted, including 3556 patients seen in the primary health care network of Havana from May through November 2007. The endoscopies were performed at the 22 polyclinics (community health centers) providing this service. Diagnostic quality and accuracy were assessed by experienced gastroenterologists using a validated tool. Patients responded to a questionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regression) were used to identify associated risk factors. The significance level was set at p < 0.05 (or confidence interval excluding 1.0). RESULTS The diagnoses were: gastritis (91.6%), duodenitis (57.8%), hiatal hernia (46.5%), esophagitis (25.2%), duodenal ulcer (15.8%), gastric ulcer (6.2%) and malignant-appearing lesions (0.4%). Overall prevalence of Helicobacter pylori infection was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.17-3.36) and smoking (OR 2.08, CI 1.68-2.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.17-2.15) and age ≥60 years (OR 1.78, CI 1.28-2.47). H. pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.79-2.95) and duodenitis (OR 1.58, CI 1.38-1.82); and age ≥40 years for hiatal hernia (OR 1.57, CI 1.33-1.84). External evaluation was "very good" or "good" for 99.3% of endoscopic procedures and 97.9% of reports issued. CONCLUSIONS Gastrointestinal endoscopy performed in primary care yielded high quality results and important information about prevalence of the most common diseases of the upper GI tract and associated risk factors. This study provides a reference for new research and can inform objective recommendations for community-based interventions to prevent and control these diseases. The existence of a network of universally accessible diagnostic endoscopy services at the primary care level, will contribute to conducting further research. KEYWORDS Endoscopy, gastrointestinal diseases, upper GI tract, prevalence, risk factors, primary care, Cuba.

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial agents accessed and used without a prescription in Kampala city, Uganda.

4. Upper level of marine museum looking southwest at enclosed ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Upper level of marine museum looking southwest at enclosed exterior wall of area office building - Duluth Ship Canal, Marine Museum-Area Office, North end of Minnesota Point at Canal Park, Duluth, St. Louis County, MN

FAST CHOPPER BUILDING, TRA665, INTERIOR. UPPER LEVEL. CONCRETE WALLS. INL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

FAST CHOPPER BUILDING, TRA-665, INTERIOR. UPPER LEVEL. CONCRETE WALLS. INL NEGATIVE NO. HD42-2. Mike Crane, Photographer, 3/2004 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

Lactobacillus gasseri in the Upper Small Intestine Impacts an ACSL3-Dependent Fatty Acid-Sensing Pathway Regulating Whole-Body Glucose Homeostasis.

PubMed

Bauer, Paige V; Duca, Frank A; Waise, T M Zaved; Dranse, Helen J; Rasmussen, Brittany A; Puri, Akshita; Rasti, Mozhgan; O'Brien, Catherine A; Lam, Tony K T

2018-03-06

Long-chain acyl-CoA synthetase (ACSL)-dependent upper small intestinal lipid metabolism activates pre-absorptive pathways to regulate metabolic homeostasis, but whether changes in the upper small intestinal microbiota alter specific fatty acid-dependent pathways to impact glucose homeostasis remains unknown. We here first find that upper small intestinal infusion of Intralipid, oleic acid, or linoleic acid pre-absorptively increases glucose tolerance and lowers glucose production in rodents. High-fat feeding impairs pre-absorptive fatty acid sensing and reduces upper small intestinal Lactobacillus gasseri levels and ACSL3 expression. Transplantation of healthy upper small intestinal microbiota to high-fat-fed rodents restores L. gasseri levels and fatty acid sensing via increased ACSL3 expression, while L. gasseri probiotic administration to non-transplanted high-fat-fed rodents is sufficient to restore upper small intestinal ACSL3 expression and fatty acid sensing. In summary, we unveil a glucoregulatory role of upper small intestinal L. gasseri that impacts an ACSL3-dependent glucoregulatory fatty acid-sensing pathway. Copyright © 2018 Elsevier Inc. All rights reserved.

Anxiety levels in mothers of children with specific learning disability.

PubMed

Karande, S; Kumbhare, N; Kulkarni, M; Shah, N

2009-01-01

Parents of children with specific learning disability (SpLD) undergo stress in coping with their child's condition. To measure the levels of anxiety and find out the cause of anxiety in mothers of children with SpLD at time of diagnosis. Prospective rating-scale and interview-based study conducted in our clinic. One hundred mothers of children (70 boys, 30 girls) with SpLD were interviewed using the Hamilton anxiety rating scale (HAM-A) and a semi-structured questionnaire. Detailed clinical and demographic data of mothers were noted. Chi-square test or unpaired student's t-test was applied wherever applicable. The mean age of mothers was 40.14 years (+/-SD 4.94, range 25.07-54.0), 73% belonged to upper or upper middle socioeconomic strata of society, 67% were graduates or postgraduates, 58% were full-time home-makers, and 33% lived in joint families. Levels of anxiety were absent in 24%, mild in 75%, and moderate in 1% of mothers. Their mean total anxiety score was 5.65 (+/-SD 4.75, range 0-21), mean psychic anxiety score was 3.92 (+/-SD 3.11, range 0-13), and mean somatic anxiety score was 1.76 (+/-SD 2.05, range 0-10). Their common worries were related to child's poor school performance (95%), child's future (90%), child's behavior (51%), and visits to our clinic (31%). Most mothers of children with SpLD have already developed mild anxiety levels by the time this hidden disability is diagnosed. These anxieties should be addressed by counseling to ensure optimum rehabilitation of these children.

Accuracy of retrieving temperature and humidity profiles by ground-based microwave radiometry in truly complex terrain

NASA Astrophysics Data System (ADS)

Massaro, G.; Stiperski, I.; Pospichal, B.; Rotach, M. W.

2015-03-01

Within the Innsbruck Box project, a ground-based microwave radiometer (RPG-HATPRO) was operated in the Inn Valley (Austria), in very complex terrain, between September 2012 and May 2013 to obtain temperature and humidity vertical profiles of the full troposphere with a specific focus on the valley boundary layer. The profiles obtained by the radiometer with different retrieval algorithms based on different climatologies, are compared to local radiosonde data. A retrieval that is improved with respect to the one provided by the manufacturer, based on better resolved data, shows a significantly smaller root mean square error (RMSE), both for the temperature and humidity profiles. The improvement is particularly substantial at the heights close to the mountaintop level and in the upper troposphere. Lower level inversions, common in an alpine valley, are resolved to a satisfactory degree. On the other hand, upper level inversions (above 1200 m) still pose a significant challenge for retrieval. For this purpose, specialized retrieval algorithms were developed by classifying the radiosonde climatologies into specialized categories according to different criteria (seasons, daytime, nighttime) and using additional regressors (e.g., measurements from mountain stations). The training and testing on the radiosonde data for these specialized categories suggests that a classification of profiles that reproduces meaningful physical characteristics can yield improved targeted specialized retrievals. A really new and very promising method of improving the profile retrieval in a mountain region is adding further information in the retrieval, such as the surface temperature at fixed levels along a topographic slope or from nearby mountain tops.

Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque.

PubMed

Rudolfsson, Thomas; Björklund, Martin; Svedmark, Åsa; Srinivasan, Divya; Djupsjöbacka, Mats

2017-01-01

Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.

Nondestructive Evaluation Methods for the Ares I Common Bulkhead

NASA Technical Reports Server (NTRS)

Walker, James

2010-01-01

A large scale bonding demonstration test article was fabricated to prove out manufacturing techniques for the current design of the NASA Ares I Upper Stage common bulkhead. The common bulkhead serves as the single interface between the liquid hydrogen and liquid oxygen portions of the Upper Stage propellant tank. The bulkhead consists of spin-formed aluminum domes friction stir welded to Y-rings and bonded to a perforated phenolic honeycomb core. Nondestructive evaluation methods are being developed for assessing core integrity and the core-to-dome bond line of the common bulkhead. Detection of manufacturing defects such as delaminations between the core and face sheets as well as service life defects such as crushed or sheared core resulting from impact loading are all of interest. The focus of this work will be on the application of thermographic, shearographic, and phased array ultrasonic methods to the bonding demonstration article as well as various smaller test panels featuring design specific defect types and geometric features.

A case report: a young waiter with Paget-Schroetter syndrome.

PubMed

Drakos, Nicholas; Gausche-Hill, Marianne

2013-03-01

Paget-Schroetter syndrome (PSS) is a rare presentation of primary axillary subclavian vein thrombosis that classically occurs in young men with a degree of underlying thoracic outlet syndrome after a period of upper extremity exertion. The primary complication of PSS is post-thrombotic syndrome, a result of chronic venous hypertension. To educate Emergency Physicians on this condition to potentiate timely diagnosis and appropriate disposition. A 29-year-old right-handed restaurant waiter presented with 3 days of non-painful, gradual-onset right upper extremity swelling with normal vital signs. The patient's history was otherwise notable for subjective fevers and a right forearm abrasion. Upon examination, the right upper extremity was neurovascularly intact and remarkable for uniform edema and erythema extending distally from the level of the mid-humerus. The primary differential diagnoses were deep venous thrombosis (DVT) vs. soft tissue infection. Venous phase contrast computed tomography did not reveal evidence of underlying soft tissue infection and was inconclusive regarding a DVT. Ultrasound demonstrated a right subclavian vein DVT. The patient was admitted and underwent thrombolysis, venolysis, and first rib resection and initiation of warfarin. PSS is a rare presentation of upper-extremity DVT occurring classically in patients without commonly recognized pro-thrombotic risk factors. PSS carries the potential of significant morbidity in the form of post-thrombotic syndrome and pulmonary embolism. Current literature suggests that optimal outcomes are achieved when treatment is initiated within 6 weeks of onset. The treatment paradigm calls for thrombolysis and, frequently, a first rib resection. Copyright © 2013 Elsevier Inc. All rights reserved.

Delayed pneumothorax after stab wound to thorax and upper abdomen: Truth or myth?

PubMed

Zehtabchi, Shahriar; Morley, Eric J; Sajed, Dana; Greenberg, Oded; Sinert, Richard

2009-01-01

Stab wounds to the thorax and upper abdomen have the potential to cause pneumothorax (PTX). When a CXR (CXR) obtained during initial resuscitation is negative, a second CXR (CXR-2) is commonly performed with the goal of identifying delayed PTX. To assess the diagnostic yield of the CXR-2 in identifying delayed PTX. Prospective observational study of patients (age >or=13 years) with stab wounds to the thorax (chest/back) and upper abdomen with suspected PTX, in a level 1 trauma centre. Patients were included if they had a negative initial CXR followed by a repeat CXR 3-6h after the initial one. patients who died, were transferred out of the ED, or received chest tubes before the second CXR. The outcome of interest was delayed PTX. All CXR were read by an attending radiologist. To test the inter-observer agreement, another blinded radiologist reviewed 20% of CXR. Continuous data is presented as mean+/-standard deviation and categorical data as percentages with 95% confidence interval (CI). Kappa statistics were used to measure the inter-observer agreement between radiologists. Between January 2003 and December 2006 a total of 185 patients qualified for the enrollment (mean age: 28+/-10 years, age range: 13-65, 94% male). Only 2 patients (1.1%, 95% CI, 0.4- 4.1%) had PTX on the CXR-2. Both patients received chest tubes. The inter-observer agreement for radiology reports was high (kappa: 0.79). Occurrence of delayed PTX in patients with stab wounds to the thorax and upper abdomen and negative triage CXR is rare.

UPPER BODY PUSH AND PULL STRENGTH RATIO IN RECREATIONALLY ACTIVE ADULTS

PubMed Central

Hanney, William J.; Pabian, Patrick; Kolber, Morey J.

2013-01-01

Introduction: Agonist to antagonist strength data is commonly analyzed due to its association with injury and performance. The purpose of this study was to examine the agonist to antagonist ratio of upper body strength using two simple field tests (timed push up/timed modified pull up) in recreationally active adults and to establish the basis for reference standards. Methods: One hundred eighty (180) healthy recreationally active adults (111 females and 69 males, aged 18‐45 years) performed two tests of upper body strength in random order: 1. Push‐ups completed during 3 sets of 15 seconds with a 45 second rest period between each set and 2. Modified pull‐ups completed during 3 sets of 15 seconds with a 45 second rest period between each set. Results: The push‐up to modified pull‐up ratio for the males was 1.57:1, whereas females demonstrated a ratio of 2.72:1. The results suggest that for our group of healthy recreationally active subjects, the upper body “pushing” musculature is approximately 1.5–2.7 times stronger than the musculature involved for pulling. Conclusions: In this study, these recreationally active adults displayed greater strength during the timed push‐ups than the modified pull‐ups. The relationship of these imbalances to one's performance and or injury risk requires further investigation. The reference values, however, may serve the basis for future comparison and prospective investigations. The field tests in this study can be easily implemented by clinicians and an agonist/antagonist ratio can be determined and compared to our findings. Level of Evidence: 2b PMID:23593552

High salivary secretory IgA antibody levels are associated with less late-onset wheezing in IgE-sensitized infants.

PubMed

Sandin, Anna; Björkstén, Bengt; Böttcher, Malin F; Englund, Erling; Jenmalm, Maria C; Bråbäck, Lennart

2011-08-01

Low levels of secretory IgA (SIgA) and transient IgA deficiency have been associated with an increased risk for allergy, but data are conflicting. The aim was to assess the relationship between salivary SIgA antibody levels at 1 yr and wheezing at age four in a birth cohort, in particular the possible protective role of salivary SIgA in sensitized children. Saliva samples were obtained from all children (n=67) with a positive skin prick test (SPT) at 1 yr and 212 children with a negative SPT. In all, 200 of these children responded to questionnaires at 4 yrs and 183 were skin prick tested at that age. The levels of salivary SIgA and salivary IgA antibodies to the most common food allergen egg and inhalant allergen cat were analyzed by ELISA. Serum was analyzed for IgE antibodies to egg and cat. Development of late-onset wheezing was associated with low SIgA levels in children with positive SPT to at least one allergen both at 1 and 4 yrs of age (p=0.04), as well as in children with circulating IgE antibodies to egg or cat at 1 yr (p=0.02). None of nine persistently sensitized children with SIgA levels in the upper quartile developed wheezing, when compared to 10/20 children with lower levels (p=0.01). Older siblings, more than three infections during infancy, at least one smoking parent, and male gender, were all associated with SIgA in the upper quartile. In conclusion, high levels of SIgA antibodies in sensitized infants were associated with significantly less late-onset wheezing, supporting a protective role against development of asthmatic symptoms. Recurrent infections and other factors supporting an increased microbial pressure during infancy were associated with high levels of salivary SIgA. © 2011 John Wiley & Sons A/S.

8. EAST ELEVATION OF SKIDOO MILL AND UPPER ORE BIN, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. EAST ELEVATION OF SKIDOO MILL AND UPPER ORE BIN, LOOKING WEST FROM ACCESS ROAD. THE ROADWAY ON THIS LEVEL (CENTER) WAS USED FOR UNLOADING ORE BROUGHT ON BURROWS INTO THE ORE BIN AT THE TOP LEVEL OF THE MILL. THE ORE BIN IN THE UPPER LEFT WAS ADDED LATER WHEN ORE WAS BROUGHT TO THE MILL BY TRUCKS. - Skidoo Mine, Park Route 38 (Skidoo Road), Death Valley Junction, Inyo County, CA

51. View of upper radar scanner switch in radar scanner ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

51. View of upper radar scanner switch in radar scanner building 105 from upper catwalk level showing emanating waveguides from upper switch (upper one-fourth of photograph) and emanating waveguides from lower radar scanner switch in vertical runs. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

Definitive airway management of patients presenting with a pre-hospital inserted King LT(S)-D laryngeal tube airway: a historical cohort study.

PubMed

Subramanian, Arun; Garcia-Marcinkiewicz, Annery G; Brown, Daniel R; Brown, Michael J; Diedrich, Daniel A

2016-03-01

The King LT(S)-D laryngeal tube (King LT) has gained popularity as a bridge airway for pre-hospital airway management. In this study, we retrospectively reviewed the use of the King LT and its associated airway outcomes at a single Level 1 trauma centre. The data on all adult patients presenting to the Mayo Clinic in Rochester, Minnesota with a King LT in situ from July 1, 2007 to October 10, 2012 were retrospectively evaluated. Data collected and descriptively analyzed included patient demographics, comorbidities, etiology of respiratory failure, airway complications, subsequent definitive airway management technique, duration of mechanical ventilation, and status at discharge. Forty-eight adult patients met inclusion criteria. The most common etiology for respiratory failure requiring an artificial airway was cardiac arrest [28 (58%) patients] or trauma [9 (19%) patients]. Four of the nine trauma patients had facial trauma. Surgical tracheostomy was the definitive airway management technique in 14 (29%) patients. An airway exchange catheter, direct laryngoscopy, and video laryngoscopy were used in 11 (23%), ten (21%), and ten (21%) cases, respectively. Seven (78%) of the trauma patients underwent surgical tracheostomy compared with seven (18%) of the medical patients. Adverse events associated with King LT use occurred in 13 (27%) patients, with upper airway edema (i.e., tongue engorgement and glottic edema) being most common (19%). In this study of patients presenting to a hospital with a King LT, the majority of airway exchanges required an advanced airway management technique beyond direct laryngoscopy. Upper airway edema was the most common adverse observation associated with King LT use.

Best practice in the assessment of bladder function in infants

PubMed Central

Leonard, Michael; Castagnetti, Marco

2014-01-01

The purpose of this article is to review normal developmental bladder physiology in infants and bladder dysfunction in conditions such as neurogenic bladder, posterior urethral valves and high grade vesicoureteric reflux. We contrast the classical concept that bladder function in nontoilet-trained children is thought to be ‘reflexive’ or ‘uninhibited’, with the results of more recent research showing that infants most commonly have a stable detrusor. The infant bladder is physiologically distinct from the state seen in older children or adults. The voiding pattern of the infant is characterized by an interrupted voiding stream due to lack of proper urinary sphincter relaxation during voiding. This is called physiologic detrusor sphincter dyscoordination and is different from the pathologic ‘detrusor sphincter dyssynergy’ seen in patients with neurogenic bladder. Urodynamic abnormalities in neonates born with spina bifida are common and depend on the level and severity of the spinal cord malformation. Upper neuron lesions most commonly lead to an overactive bladder with or without detrusor sphincter dyssynergy while a lower neuron lesion is associated with an acontractile detrusor with possible denervation of the external urinary sphincter. In infants with neurogenic bladder, the role of ‘early prophylactic treatment (clean intermittent catheterization and anticholinergics)’ versus initial ‘watchful waiting and treatment as needed’ is still controversial and needs more research. Many urodynamic-based interventions have been suggested in patients with posterior urethral valves and are currently under scrutiny, but their impact on the long-term outcome of the upper and lower urinary tract is still unknown. Cumulative data suggest that there is no benefit to early intervention regarding bladder function in infants with high-grade vesicoureteric reflux. PMID:25083164

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

HIV/AIDS prevention funds are often allocated at multiple levels of decision-making. Optimal allocation of HIV prevention funds maximizes the number of HIV infections averted. However, decision makers often allocate using simple heuristics such as proportional allocation. We evaluate the impact of using incentives to encourage optimal allocation in a two-level decision-making process. We model an incentive based decision-making process consisting of an upper-level decision maker allocating funds to a single lower-level decision maker who then distributes funds to local programs. We assume that the lower-level utility function is linear in the amount of the budget received from the upper-level, the fraction of funds reserved for proportional allocation, and the number of infections averted. We assume that the upper level objective is to maximize the number of infections averted. We illustrate with an example using data from California, U.S. PMID:23766551

Glacial-eustatic/climatic model for Upper Pennsylvanian marine and nonmarine cyclothems in the Appalachian basin

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

Heckel, P.H.

1992-01-01

Only glacial-eustatic sea-level fluctuations can account for all the characteristics of Upper Pennsylvanian marine cyclothems in the Midcontinent. Because this control is global, it must have affected deposition during this time everywhere. In the Appalachian basin widespread well developed paleosols represent long-term sea-level lowstand. During Conemaugh marine incursions, rising sea level ponded fresh-water influx to form peat swamps that migrated landward ahead of transgression and produced early transgressive coals. Marine highstand deposits commonly are conodont-rich limestones, typically skeletal packstone with glaucony and phosphorite. Regression resulted in progradation of detrital shorelines with local delta cycles, followed eventually by more paleosol formationmore » and local erosional incision that removed older sediments including the marine units in places. Fluvial sands filled many of these channels. During Monongahela deposition when marine incursions no longer entered the Appalachian basin, the climatic fluctuations recognized by Cecil can reasonably be related to sea-level fluctuations nearby, but with shifts in climatic significance of gross lithotopes. Coal swamps would more likely have formed at maximum marine highstand when the nearby sea would have provided both high base level and an abundant source of rainfall. Nonmarine limestones would more likely have formed at maximum lowstand when the sea was most distant and the climate driest. The intervening detrital deposits between the coals and limestones formed under intermediate seasonal rainfall regimes during both marine transgression and regression farther west in the Midcontinent. Conemaugh and Allegheny coals without overlying marine units probably also represent mainly marine highstand elsewhere, and nonmarine limestones of these ages typically are associated with lowstand paleosols.« less

Are occupational repetitive movements of the upper arm associated with rotator cuff calcific tendinopathies?

PubMed

Sansone, Valerio C; Meroni, Roberto; Boria, Paola; Pisani, Salvatore; Maiorano, Emanuele

2015-02-01

Calcifying tendinopathy (CT) of the shoulder is a common painful disorder, although the etiology and pathogenesis remain largely unknown. Recent theories about the role of excessive mechanical load in the genesis of CT have been proposed. Driven by the interest for these new theories, we investigated the hypothesis of a relationship between work-related repetitive movements of the upper arm, considered a potential cause of shoulder overload, and the presence of shoulder CT. A secondary aim was to obtain data on CT prevalence in a female sample from the working-age general population, as little data currently exist. 199 supermarket cashiers and 304 female volunteers recruited from the general population underwent a high-resolution ultrasonography of the rotator cuffs of both shoulders, and the presence of tendinopathies, with or without calcification, was recorded. The prevalence of calcific tendinopathy was 22.6 % in the cashiers group and 24.4 % in the control group. There were no statistically significant differences in the prevalence of calcifications between the two groups (p = 0.585), either for the dominant shoulder [OR = 0.841 (95 % CI 0.534-1.326)] or for the non-dominant shoulder [OR = 0.988 (95 % CI 0.582-1.326)]. We observed bilateral calcifications in 8.5 % of cashiers, and 9.6 % of controls, and an increase in prevalence of CT with age in both groups. Work-related repetitive movements of the upper arm did not induce a higher prevalence of shoulder CT compared with the female sample from the general population. If CT etiopathogenesis is related to mechanical load, CT onset may be influenced not only by loading history, but also by individual factors. Level of evidence Prognosis study, Level II.

Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea.

PubMed

Cui, Dan-Mo; Han, De-Min; Nicolas, Busaba; Hu, Chang-Long; Wu, Jun; Su, Min-Min

2016-03-20

Obstructive sleep apnea (OSA) is a common sleep disorder and is characterized by airway collapse at multiple levels of upper airway. The effectiveness of nasal surgery has been discussed in several studies and shows a promising growing interest. In this study, we intended to evaluate the effects of nasal surgery on the upper airway dimensions in patients with OSA using three-dimensional (3D) reconstruction of cone-beam computed tomography (CT). Twelve patients with moderate to severe OSA who underwent nasal surgery were included in this study. All patients were diagnosed with OSA using polysomnography (PSG) in multi sleep health centers associated with Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary and the Partners Health Care from May 31, 2011 to December 14, 2013. The effect of nasal surgery was evaluated by the examination of PSG, subjective complains, and 3D reconstructed CT scan. Cross-sectional area was measured in eleven coronal levels, and nasal cavity volume was evaluated from anterior nasal spine to posterior nasal spine. The thickness of soft tissue in oral pharynx region was also measured. Five out of the 12 patients were successfully treated by nasal surgery, with more than 50% drop of apnea-hypopnea index. All the 12 patients showed significant increase of cross-sectional area and volume postoperatively. The thickness of soft tissue in oral pharynx region revealed significant decrease postoperatively, which decreased from 19.14 ± 2.40 cm 2 and 6.11 ± 1.76 cm 2 to 17.13 ± 1.91 cm 2 and 5.22 ± 1.20 cm 2 . Nasal surgery improved OSA severity as measured by PSG, subjective complaints, and 3D reconstructed CT scan. 3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

Petrology and geochemistry of primitive lower oceanic crust from Pito Deep: Implications for the accretion of the lower crust at the Southern East Pacific Rise

USGS Publications Warehouse

Perk, N.W.; Coogan, L.A.; Karson, J.A.; Klein, E.M.; Hanna, H.D.

2007-01-01

A suite of samples collected from the uppermost part of the plutonic section of the oceanic crust formed at the southern East Pacific Rise and exposed at the Pito Deep has been examined. These rocks were sampled in situ by ROV and lie beneath a complete upper crustal section providing geological context. This is only the second area (after the Hess Deep) in which a substantial depth into the plutonic complex formed at the East Pacific Rise has been sampled in situ and reveals significant spatial heterogeneity in the plutonic complex. In contrast to the uppermost plutonic rocks at Hess Deep, the rocks studied here are generally primitive with olivine forsterite contents mainly between 85 and 88 and including many troctolites. The melt that the majority of the samples crystallized from was aggregated normal mid-ocean ridge basalt (MORB). Despite this high Mg# clinopyroxene is common despite model predictions that clinopyroxene should not reach the liquidus early during low-pressure crystallization of MORB. Stochastic modeling of melt crystallisation at various levels in the crust suggests that it is unlikely that a significant melt mass crystallized in the deeper crust (for example in sills) because this would lead to more evolved shallow level plutonic rocks. Similar to the upper plutonic section at Hess Deep, and in the Oman ophiolite, many samples show a steeply dipping, axis-parallel, magmatic fabric. This suggests that vertical magmatic flow is an important process in the upper part of the seismic low velocity zone beneath fast-spreading ridges. We suggest that both temporal and spatial (along-axis) variability in the magmatic and hydrothermal systems can explain the differences observed between the Hess Deep and Pito Deep plutonics. ?? Springer-Verlag 2007.

Stratigraphic and structural distribution of reservoirs in Romania

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

Stefanescu, M.O.

1991-08-01

In Romania, there are reservoirs at different levels of the whole Cambrian-Pliocene interval, but only some of these levels have the favorable structural conditions to accumulate hydrocarbons in commercial quantities. These levels are the Devonian, Triassic, Middle Jurassic, Lower Cretaceous (locally including the uppermost Jurassic), Eocene, Oligocene-lower Miocene, middle and upper Miocene, and Pliocene. The productive reservoirs are represented either by carbonate rocks (in Devonian, Middle Triassic and uppermost Jurassic-Lower Cretaceous) or by detrital rocks (in Lower and Upper Triassic, Middle Jurassic, Eocene, Oligocene, Miocene, and Pliocene). From the structural point of view, the Romanian territory is characterized by themore » coexistence both of platforms (East European, Scythian, and Moesian platforms) and of the strongly tectonized orogenes (North Dobrogea and Carpathian orogenes). Each importance crust shortening was followed by the accumulation of post-tectonic covers, some of them being folded during subsequently tectonic movements. The youngest post-tectonic cover is common both for the platforms (foreland) and Carpathian orogene, representing the Carpathian foredeep. Producing reservoirs are present in the East European and Moesian platforms, in the outer Carpathian units (Tarcau and Marginal folds nappes) and in certain post-tectonic covers which fill the Carpathian foredeep and the Transylvanian and Pannonian basins. In the platforms, hydrocarbons accumulated both in calcareous and detrital reservoirs, whereas in the Carpathian units and in their reservoirs, whereas in the Carpathian units and in their post-tectonic covers, hydrocarbons accumulated only in detrital reservoirs.« less

Shoulder model validation and joint contact forces during wheelchair activities.

PubMed

Morrow, Melissa M B; Kaufman, Kenton R; An, Kai-Nan

2010-09-17

Chronic shoulder impingement is a common problem for manual wheelchair users. The loading associated with performing manual wheelchair activities of daily living is substantial and often at a high frequency. Musculoskeletal modeling and optimization techniques can be used to estimate the joint contact forces occurring at the shoulder to assess the soft tissue loading during an activity and to possibly identify activities and strategies that place manual wheelchair users at risk for shoulder injuries. The purpose of this study was to validate an upper extremity musculoskeletal model and apply the model to wheelchair activities for analysis of the estimated joint contact forces. Upper extremity kinematics and handrim wheelchair kinetics were measured over three conditions: level propulsion, ramp propulsion, and a weight relief lift. The experimental data were used as input to a subject-specific musculoskeletal model utilizing optimization to predict joint contact forces of the shoulder during all conditions. The model was validated using a mean absolute error calculation. Model results confirmed that ramp propulsion and weight relief lifts place the shoulder under significantly higher joint contact loading than level propulsion. In addition, they exhibit large superior contact forces that could contribute to impingement. This study highlights the potential impingement risk associated with both the ramp and weight relief lift activities. Level propulsion was shown to have a low relative risk of causing injury, but with consideration of the frequency with which propulsion is performed, this observation is not conclusive.

The medial temporal lobe-conduit of parallel connectivity: a model for attention, memory, and perception.

PubMed

Mozaffari, Brian

2014-01-01

Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)-located deep in the hierarchy-serves as a bridge connecting supra- to infra-MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL "bridge" allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these "bridge" predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

38. DETAIL OF CYLINDER LEVELING SYSTEM SHOWING TYPICAL UPPER AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

38. DETAIL OF CYLINDER LEVELING SYSTEM SHOWING TYPICAL UPPER AND LOWER PULLEY BRACKET. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-701-S-8. INEL INDEX CODE - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL HOUSE LOCATED ON THE SOUTH END OF BIG TUJUNGA DAM SHOWING THE CONTROL PANEL. - Big Tujunga Dam, Control House, 809 West Big Tujunga Road, Sunland, Los Angeles County, CA

Radionuclide Concentrations in Honey Bees from Area G at TA-54 during 1999

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

T. K. Haarmann; P. R. Fresquez

Honey bees were collected from two colonies located at Los Alamos National Laboratory's Area G, Technical Area 54, and from one control (background) colony located near Jemez Springs, NM. Samples were analyzed for various radionuclides. Area G sample results from both colonies were higher than the upper (95%) level background concentration for {sup 3}H. Sample results from one colony were higher than the upper (95%) level background concentration for total uranium, while sample results from the other colony were higher than the upper (95%) level background concentration for {sup 90}Sr.

CT measurement of glenoid erosion in arthritis.

PubMed

Mullaji, A B; Beddow, F H; Lamb, G H

1994-05-01

We studied serial CT scans of 45 arthritic shoulders (34 rheumatoid, 11 osteoarthritic) and 19 normal shoulders, making measurements at three levels on axial images. The maximum anteroposterior diameter of the glenoid was increased in rheumatoid glenoids at the upper and middle levels by 6 mm and in osteoarthritic glenoids at all levels by 5 to 8 mm as compared with normal. In rheumatoid cases, nearly half the available surface of the glenoid was of unsupported bone, mainly posteriorly at the upper and middle levels. In osteoarthritic glenoids, the best supported bone was anterior at the upper level and central at the middle and lower levels. The depth of the rheumatoid glenoid was reduced by a mean of 6 mm at the upper and middle levels and by 3 mm at the lower level. This inclined the surface of the glenoid superiorly. The depth at the middle level in osteoarthritis was reduced by a mean of 5 mm, suggesting central protrusion. Osteoarthritic glenoids were retroverted by a mean of 12.5 degrees, but of rheumatoid glenoids two-thirds were retroverted (mean 15.1 degrees) and one-third anteverted (mean 8.2 degrees). Our findings have important implications for the planning and placement of the glenoid component of total shoulder replacements; CT can provide useful information.

Urothelial carcinoma of the bladder and the upper tract: disparate twins.

PubMed

Green, David A; Rink, Michael; Xylinas, Evanguelos; Matin, Surena F; Stenzl, Arnulf; Roupret, Morgan; Karakiewicz, Pierre I; Scherr, Douglas S; Shariat, Shahrokh F

2013-04-01

Urothelial carcinoma of the bladder is the 4th most common malignancy in men and the 8th most common cause of male cancer death in the United States. Conversely, upper tract urothelial carcinoma accounts for only 5% to 10% of all urothelial carcinoma. Due to the relative preponderance of urothelial carcinoma of the bladder, much of the clinical decision making regarding upper tract urothelial carcinoma is extrapolated from evidence that is based on urothelial carcinoma of the bladder cohorts. In fact, only 1 major urological organization has treatment guidelines specific for upper tract urothelial carcinoma. While significant similarities exist between these 2 diseases, ignoring the important differences may be preventing us from optimizing therapy in patients with upper tract urothelial carcinoma. Therefore, we explored these dissimilarities, including the differential importance of gender, anatomy, staging, intracavitary therapy, surgical lymphadenectomy and perioperative systemic chemotherapy on the behavior of urothelial carcinoma of the bladder and upper tract urothelial carcinoma. A nonsystematic literature search using the MEDLINE/PubMed® database was conducted to identify original articles, review articles and editorials. Searches were limited to the English language and studies in humans and in adults, and used the key words urothelial carcinoma, upper tract urothelial carcinoma or transitional cell carcinoma combined with several different sets of key words to identify appropriate publications for each section of the manuscript. The key words, broken down by section, were 1) epidemiology, sex, gender; 2) location, tumor location; 3) staging, stage; 4) intracavitary, intravesical, topical therapy; 5) lymphadenectomy, lymph node, lymph node dissection and 6) adjuvant, neoadjuvant, chemotherapy. Women who present with urothelial carcinoma of the bladder do so with less favorable tumor characteristics and have worse survival than men. However, gender does not appear to be associated with survival outcomes in upper tract urothelial carcinoma. The prognostic effect that urothelial carcinoma tumor location has on outcomes prediction is a matter of debate, and the influence of tumor location may reflect our technical ability to accurately stage and treat the disease more than the actual tumor biology. Moreover, technical limitations of upper tract urothelial carcinoma sampling compared to transurethral resection for urothelial carcinoma of the bladder are the most important source of staging differences between the 2 diseases. Intravesical chemotherapy and immunotherapy are essential components of standard of care for most nonmuscle invasive bladder cancer, while adjuvant intracavitary therapy for patients with upper tract urothelial carcinoma treated endoscopically or percutaneously has been sparsely used and without any clear guidelines. The widespread adoption of the use of intracavitary therapy in the upper tract will likely not only require additional data to support its efficacy, but will also require a less cumbersome means of administration. Lymphadenectomy at the time of radical cystectomy is widely accepted while lymphadenectomy at the time of radical nephroureterectomy is performed largely at the discretion of the surgeon. Among other reasons, this may be due in part to the variable lymphatic drainage along the course of the ureter compared to the relatively confined lymphatic landing sites for the bladder. Level I evidence has demonstrated a clear survival benefit for systemic chemotherapy before radical surgery or radiation in patients with clinical T2-4N0M0 urothelial carcinoma of the bladder. Such data are not available in the population with upper tract urothelial carcinoma. However, the use of neoadjuvant chemotherapy may be even more important in upper tract urothelial carcinoma than in urothelial carcinoma of the bladder because of the obligatory kidney function loss that occurs at radical nephroureterectomy. While urothelial carcinoma of the bladder and upper tract urothelial carcinoma share many characteristics, they represent 2 distinct diseases. There are practical, anatomical, biological and molecular differences that warrant consideration when risk stratifying and treating patients with these disparate twin diseases. To overcome the challenges that impede progress toward evidence-based medicine in upper tract urothelial carcinoma, we believe that focused collaborative efforts will best augment our understanding of this rare disease and ultimately improve the care we deliver to our patients. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A proposed procedure for derivation of regulatory values for carcinogenic airborne polycyclic aromatic hydrocarbons (PAHs) based on coal tar pitch (CTP) volatiles.

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

Foureman, G.L.; Smith, R.L.

A procedure for estimating upper bound lifetime human cancer risk from air levels of six common carcinogenic polycyclic aromatic hydrocarbons (PAHs), termed APAHs of concern, is proposed. These PAHs are benzo(a)pyrene, benz(a)anthracene, benzo(b)fluoranthene, benzo(k)fluoranthene, indeno(1,2,3-c,d)pyrene, and chrysene. In application, this proposed procedure would regard any given air level obtained for a APAH of concern to originate from a standard mixture of coal tar pitch (CTP). The given air level for the APAHs of concern is then related to a corresponding air level of CTP and thence, to an inhalation unit cancer risk calculated for CTP. Reference values for the proceduremore » are the relative and absolute PAH composition of a CTP standard (SRM-1597) and the inhalation unit cancer risk. Qualitative characterization of the results are a vital part of the procedure especially when more than one APAH of concern{at} is being considered. Toxic equivalency factors (TEFs) may be used as an evaluative tool in characterization of the procedure and outcome. Limitations of this proposed procedure include the uneven database for the reference values and the inability to consider air samples inclusive of another common carcinogenic PAH, dibenz(a,h)anthracene, due to its lack of documentation in CTP and high TEF« less

Worldwide Regulations of Standard Values of Pesticides for Human Health Risk Control: A Review.

PubMed

Li, Zijian; Jennings, Aaron

2017-07-22

Abstract : The impact of pesticide residues on human health is a worldwide problem, as human exposure to pesticides can occur through ingestion, inhalation, and dermal contact. Regulatory jurisdictions have promulgated the standard values for pesticides in residential soil, air, drinking water, and agricultural commodity for years. Until now, more than 19,400 pesticide soil regulatory guidance values (RGVs) and 5400 pesticide drinking water maximum concentration levels (MCLs) have been regulated by 54 and 102 nations, respectively. Over 90 nations have provided pesticide agricultural commodity maximum residue limits (MRLs) for at least one of the 12 most commonly consumed agricultural foods. A total of 22 pesticides have been regulated with more than 100 soil RGVs, and 25 pesticides have more than 100 drinking water MCLs. This research indicates that those RGVs and MCLs for an individual pesticide could vary over seven (DDT drinking water MCLs), eight (Lindane soil RGVs), or even nine (Dieldrin soil RGVs) orders of magnitude. Human health risk uncertainty bounds and the implied total exposure mass burden model were applied to analyze the most commonly regulated and used pesticides for human health risk control. For the top 27 commonly regulated pesticides in soil, there are at least 300 RGVs (8% of the total) that are above all of the computed upper bounds for human health risk uncertainty. For the top 29 most-commonly regulated pesticides in drinking water, at least 172 drinking water MCLs (5% of the total) exceed the computed upper bounds for human health risk uncertainty; while for the 14 most widely used pesticides, there are at least 310 computed implied dose limits (28.0% of the total) that are above the acceptable daily intake values. The results show that some worldwide standard values were not derived conservatively enough to avoid human health risk by the pesticides, and that some values were not computed comprehensively by considering all major human exposure pathways.

Worldwide Regulations of Standard Values of Pesticides for Human Health Risk Control: A Review

PubMed Central

Jennings, Aaron

2017-01-01

The impact of pesticide residues on human health is a worldwide problem, as human exposure to pesticides can occur through ingestion, inhalation, and dermal contact. Regulatory jurisdictions have promulgated the standard values for pesticides in residential soil, air, drinking water, and agricultural commodity for years. Until now, more than 19,400 pesticide soil regulatory guidance values (RGVs) and 5400 pesticide drinking water maximum concentration levels (MCLs) have been regulated by 54 and 102 nations, respectively. Over 90 nations have provided pesticide agricultural commodity maximum residue limits (MRLs) for at least one of the 12 most commonly consumed agricultural foods. A total of 22 pesticides have been regulated with more than 100 soil RGVs, and 25 pesticides have more than 100 drinking water MCLs. This research indicates that those RGVs and MCLs for an individual pesticide could vary over seven (DDT drinking water MCLs), eight (Lindane soil RGVs), or even nine (Dieldrin soil RGVs) orders of magnitude. Human health risk uncertainty bounds and the implied total exposure mass burden model were applied to analyze the most commonly regulated and used pesticides for human health risk control. For the top 27 commonly regulated pesticides in soil, there are at least 300 RGVs (8% of the total) that are above all of the computed upper bounds for human health risk uncertainty. For the top 29 most-commonly regulated pesticides in drinking water, at least 172 drinking water MCLs (5% of the total) exceed the computed upper bounds for human health risk uncertainty; while for the 14 most widely used pesticides, there are at least 310 computed implied dose limits (28.0% of the total) that are above the acceptable daily intake values. The results show that some worldwide standard values were not derived conservatively enough to avoid human health risk by the pesticides, and that some values were not computed comprehensively by considering all major human exposure pathways. PMID:28737697

Imaging of upper extremity stress fractures in the athlete.

PubMed

Anderson, Mark W

2006-07-01

Although it is much less common than injuries in the lower extremities, an upper extremity stress injury can have a significant impact on an athlete. If an accurate and timely diagnosis is to be made, the clinician must have a high index of suspicion of a stress fracture in any athlete who is involved in a throwing, weightlifting, or upper extremity weight-bearing sport and presents with chronic pain in the upper extremity. Imaging should play an integral role in the work-up of these patients; if initial radiographs are unrevealing, further cross-sectional imaging should be strongly considered. Although a three-phase bone scan is highly sensitive in this regard, MRI has become the study of choice at most centers.

Low levels of 25-hydroxyvitamin D are associated with the occurrence of concomitant upper limb fractures in older women who sustain a fall-related fracture of the hip.

PubMed

Di Monaco, Marco; Vallero, Fulvia; Castiglioni, Carlotta; Di Monaco, Roberto; Tappero, Rosa

2011-01-01

To investigate the association between serum levels of 25-hydroxyvitamin D and the occurrence of simultaneous fractures of the upper limb in older women who sustain a fall-related fracture of the hip. Cross-sectional study. We investigated 472 of 480 white women consecutively admitted to a rehabilitation hospital because of a fall-related hip fracture. Twenty-seven (5.7%) of the 472 women sustained a concomitant upper-limb fracture of either distal radius (20 women) or proximal humerus (seven women). We assessed serum levels of 25-hydroxyvitamin D 14.2 ± 4.1 (mean ± SD) days after surgical repair of the hip fracture in the 472 women by an immunoenzymatic assay. Twenty-five-hydroxyvitamin D levels were significantly lower in the 27 women with concomitant fractures of both hip and upper limb than in the remaining 445 hip-fracture women: mean ± SD values were 6.5 ± 5.0 ng/ml and 11.7 ± 10.4 ng/ml respectively in the two groups (mean difference between groups 5.2 ng/ml: 95% CI 1.2-9.2; p=0.011). Low levels of 25-hydroxyvitamin D were significantly associated with concomitant fractures of the upper limb (p=0.017), after adjustment for eight potential confounders including age, height, weight, hip-fracture type, cognitive impairment, neurologic impairment, previous hip fracture, and previous upper-limb fracture. Low levels of 25-hydroxyvitamin D were significantly associated with concomitant upper-limb fractures in our sample of older women with a fall-related fracture of the hip. Preventing vitamin D deficiency may lower the incidence of simultaneous fractures due to a singe fall in elderly women. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A Rasch-validated version of the upper extremity functional index for interval-level measurement of upper extremity function.

PubMed

Hamilton, Clayon B; Chesworth, Bert M

2013-11-01

The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0-100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity.

A Rasch-Validated Version of the Upper Extremity Functional Index for Interval-Level Measurement of Upper Extremity Function

PubMed Central

Chesworth, Bert M.

2013-01-01

Background The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. Objective The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. Design This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Methods Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. Results A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0–100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Limitations Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Conclusion Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity. PMID:23813086

Non-variceal upper gastrointestinal bleeding in cirrhotic patients in Nile Delta.

PubMed

Gabr, Mamdouh Ahmed; Tawfik, Mohamed Abd El-Raouf; El-Sawy, Abd Allah Ahmed

2016-01-01

Acute upper gastrointestinal bleeding (AUGIB) in cirrhotic patients occurs mainly from esophageal and gastric varices; however, quite a large number of cirrhotic patients bleed from other sources as well. The aim of the present work is to determine the prevalence of non-variceal UGIB as well as its different causes among the cirrhotic portal hypertensive patients in Nile Delta. Emergency upper gastrointestinal (UGI) endoscopy for AUGIB was done in 650 patients. Out of these patients, 550 (84.6%) patients who were proved to have cirrhosis were the subject of the present study. From all cirrhotic portal hypertensive patients, 415 (75.5%) bled from variceal sources (esophageal and gastric) while 135 (24.5%) of them bled from non-variceal sources. Among variceal sources of bleeding, esophageal varices were much more common than gastric varices. Peptic ulcer was the most common non-variceal source of bleeding. Non-variceal bleeding in cirrhosis was not frequent, and sources included peptic ulcer, portal hypertensive gastropathy, and erosive disease of the stomach and duodenum.

A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

PubMed Central

2016-01-01

The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth. PMID:27528796

Photos for estimating fuel loadings before and after prescribed burning in the upper coastal plain of the southeast

Treesearch

Eric R. Scholl; Thomas A. Waldrop

1999-01-01

Although prescribed burning is common in the Southeastern United States, most fuel models apply to only western forests. This paper documents a fuel classification system that was developed for plantations of loblolly and longleaf pines for the Upper Coastal Plain region. Multivariate analysis of variance and discriminant function analysis were used to confirm eight...

Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management

PubMed Central

Chung, Kevin C.; Lark, Meghan E.

2016-01-01

Synopsis Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. PMID:27886833

The second case of a young man with L-arginine-induced acute pancreatitis.

PubMed

Binet, Quentin; Dufour, Inès; Agneessens, Emmanuel; Debongnie, Jean-Claude; Aouattah, Tarik; Covas, Angélique; Coche, Jean-Charles; De Koninck, Xavier

2018-04-21

Dietary supplementation of arginine has been used by numerous world-class athletes and professional bodybuilders over the past 30 years. L-Arginine indeed enhances muscular power and general performance via maintaining ATP level. However, L-arginine is also known to induce acute pancreatitis in murine models. We report the case of young man presenting with upper abdominal pain and increased serum lipase levels. Contrast-enhanced computed tomography confirms a mild acute pancreatitis. Common etiologies have been ruled out and toxicological anamnestic screening reveals the intake of protein powder. This is, to the best of our knowledge, the second case in human of arginine-induced acute pancreatitis. This case report suggests that every patient presenting with acute pancreatitis without obvious etiology should be evaluated for the intake of toxics other than alcohol, including L-arginine.

Resolution of obstructive atelectasis with non-invasive mechanical ventilation.

PubMed

Mirambeaux Villalona, Rosa; Mayoralas Alises, Sagrario; Díaz Lobato, Salvador

2014-10-01

Bronchoscopy is a commonly used technique in patients with atelectasis due to mucus plugs. We present here the case of an 82-year-old patient with a history of Meige's syndrome who developed acute respiratory failure due to atelectasis of the right upper lobe associated with hospital-acquired pneumonia. The patient had a severely reduced level of consciousness, significant work-of-breathing and severe hypercapnic acidosis, all of which contraindicated bronchoscopy. Bi-level noninvasive mechanical ventilation (NIMV) was initiated by way of a face mask. Progress was favourable, with clear clinical and gasometric improvement. The chest X-ray performed 12hours later showed complete resolution of the atelectasis. These data suggest that NIMV may be useful in the treatment of atelectasis is some critical patients. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Upper limb dysfunction following selective neck dissection: a retrospective questionnaire study.

PubMed

Carr, Simon D; Bowyer, Duncan; Cox, Graham

2009-06-01

To determine total upper limb function following selective neck dissection over a mean follow-up of 1.6 years. A retrospective questionnaire study in a tertiary head and neck surgical unit. One hundred forty-eight patients who underwent selective neck dissection for head and neck cancer from January 2000 to December 2005 were invited to participate. The main outcome measure was ipsilateral upper limb dysfunction as measured by the Disability of Arm, Shoulder and Hand (DASH) questionnaire. Sixty-five patients responded to the invitation to join the study from 148 invited. Despite accessory nerve conserving surgery for all the selective neck dissections studied, 23% reported no upper limb dysfunction, 54% reported mild upper limb dysfunction, 15% reported moderate, and 8% reported a severe dysfunction. Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections. (c) 2009 Wiley Periodicals, Inc.

Craniocervical chiropractic procedures – a précis of upper cervical chiropractic

PubMed Central

Woodfield, H. Charles; York, Craig; Rochester, Roderic P.; Bales, Scott; Beebe, Mychal; Salminen, Bryan; Scholten, Jeffrey N.

2015-01-01

Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources. PMID:26136610

Successful treatment of limy bile syndrome extending to the common bile duct by laparoscopic cholecystectomy and common bile duct exploration: A case report and literature review.

PubMed

Masuda, Yuka; Mizuguchi, Yoshiaki; Kanda, Tomohiro; Furuki, Hiroyasu; Mamada, Yasuhiro; Taniai, Nobuhiko; Nakamura, Yoshiharu; Yoshioka, Masato; Matsushita, Akira; Kawano, Yoichi; Shimizu, Tetsuya; Uchida, Eiji

2017-02-01

Limy bile syndrome extending to the common bile duct (CBD) is a rare condition that lacks a standardized treatment. Laparoscopic cholecystectomy with laparoscopic choledocholithotomy by CBD exploration is preferred because it preserves the function of the sphincter of the Vater's papilla and allows treatment of both lesions. A 37-year-old man who was receiving entecavir for chronic hepatitis B developed right upper quadrant pain. Abdominal ultrasonography revealed a calcified shadow in the gallbladder and CBD. Abdominal imaging revealed a liquid-like material identified by a calcified shadow in two phases separated by a fluid-fluid level. Abdominal and 3-D drip infusion cholangiography CT showed stones in the gallbladder and CBD with limy bile. The patient underwent laparoscopic cholecystectomy and choledocholithotomy. Intraoperatively, white-yellow-colored bile and stones were drained from the CBD. A C-tube was placed. Postoperatively, remnant stones and radiopaque materials were absent. The stones comprised of >95% calcium carbonate. © 2016 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

20. Readiness Crew Building interior, upper level corridor. This corridor ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. Readiness Crew Building interior, upper level corridor. This corridor runs from northwest to southeast. Photograph taken at the northwest end looking southeast. Lyon - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

Gastrointestinal symptoms are still common in a general Western population.

PubMed

van Kerkhoven, L A S; Eikendal, T; Laheij, R J F; van Oijen, M G H; Jansen, J B M J

2008-01-01

Results from studies conducted in the late 1980s and early 1990 s showed that gastrointestinal symptoms were common among the general population. Meanwhile, lifestyle habits have changed and important treatment options have been introduced. This might have influenced symptom prevalence. This study aimed to describe the current prevalence of upper and lower gastrointestinal symptoms within the general population. For this purpose, a demographically representative sample of the Dutch population within the city of Nijmegen and surrounding areas was selected after careful comparison with demographic figures from a government demographic database. Participants were invited to fill in a valid self-report questionnaire about gastrointestinal symptoms and prevalence figures were calculated. A total of 5000 questionnaires was sent and 1616 (32%) were returned. Of these, 839 (52%) subjects reported having had upper (43%) or lower (38%) gastrointestinal symptoms in the past four weeks. The most prevalent individual symptoms reported were flatulence (47%), abdominal rumbling (40%), bloating (37%), alternating solid and loose stools (31%), belching (25%) and postprandial fullness (25%). People who smoked or used a proton pump inhibitor had an increased risk for reporting upper as well as lower gastrointestinal symptoms (OR 1.99; 95% CI 1.56 to 2.55, and OR 1.37; 95% CI 1.01 to 1.75, respectively for smoking; and OR 3.17; 95% CI 2.17 to 4.72, and OR 2.14; 95% CI 1.49 to 3.08, respectively for PPIs). Both upper and lower gastrointestinal symptoms are very common in a representative sample of a general Western population.

Inflammatory Mediator Profiling of n-butanol Exposed Upper Airways in Individuals with Multiple Chemical Sensitivity.

PubMed

Dantoft, Thomas Meinertz; Skovbjerg, Sine; Andersson, Linus; Claeson, Anna-Sara; Lind, Nina; Nordin, Steven; Brix, Susanne

2015-01-01

Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by reports of recurrent symptoms in response to low level exposure to various chemical substances. Recent findings suggests that dysregulation of the immune system may play a role in MCS pathophysiology. The aim of this study was to examine baseline and low dose n-butanol-induced upper airway inflammatory response profiles in MCS subjects versus healthy controls. Eighteen participants with MCS and 18 age- and sex-matched healthy controls were enrolled in the study. Epithelial lining fluid was collected from the nasal cavity at three time points: baseline, within 15 minutes after being exposed to 3.7 ppm n-butanol in an exposure chamber and four hours after exposure termination. A total of 19 cytokines and chemokines were quantified. Furthermore, at baseline and during the exposure session, participants rated the perceived intensity, valence and levels of symptoms and autonomic recordings were obtained. The physiological and psychophysical measurements during the n-butanol exposure session verified a specific response in MCS individuals only. However, MCS subjects and healthy controls displayed similar upper airway inflammatory mediator profiles (P>0.05) at baseline. Likewise, direct comparison of mediator levels in the MCS group and controls after n-butanol exposure revealed no significant group differences. We demonstrate no abnormal upper airway inflammatory mediator levels in MCS subjects before or after a symptom-eliciting exposure to low dose n-butanol, implying that upper airways of MCS subjects are functionally intact at the level of cytokine and chemokine production and secretory capacity. This suggests that previous findings of increased cytokine plasma levels in MCS are unlikely to be caused by systemic priming via excessive upper airway inflammatory processes.

Developing and validating a conceptual survey to assess introductory physics students’ understanding of magnetism

NASA Astrophysics Data System (ADS)

Li, Jing; Singh, Chandralekha

2017-03-01

Development of validated physics surveys on various topics is important for investigating the extent to which students master those concepts after traditional instruction and for assessing innovative curricula and pedagogies that can improve student understanding significantly. Here, we discuss the development and validation of a conceptual multiple-choice survey related to magnetism suitable for introductory physics courses. The survey was developed taking into account common students’ difficulties with magnetism concepts covered in introductory physics courses found in our investigation and the incorrect choices to the multiple-choice questions were designed based upon those common student difficulties. After the development and validation of the survey, it was administered to introductory physics students in various classes in paper-pencil format before and after traditional lecture-based instruction in relevant concepts. We compared the performance of students on the survey in the algebra-based and calculus-based introductory physics courses before and after traditional lecture-based instruction in relevant magnetism concepts. We discuss the common difficulties of introductory physics students with magnetism concepts we found via the survey. We also administered the survey to upper-level undergraduates majoring in physics and PhD students to benchmark the survey and compared their performance with those of traditionally taught introductory physics students for whom the survey is intended. A comparison with the base line data on the validated magnetism survey from traditionally taught introductory physics courses and upper-level undergraduate and PhD students discussed in this paper can help instructors assess the effectiveness of curricula and pedagogies which is especially designed to help students integrate conceptual and quantitative understanding and develop a good grasp of the concepts. In particular, if introductory physics students’ average performance in a class is significantly better than those of students in traditionally taught courses described here (and particularly when it is comparable to that of physics PhD students’ average performance discussed here), the curriculum or pedagogy used in that introductory class can be deemed effective. Moreover, we discuss the use of the survey to investigate gender differences in student performance.

Ageostrophic winds and vertical motion fields accompanying upper level jet streak propagation during the Red River Valley tornado outbreak

NASA Technical Reports Server (NTRS)

Moore, J. T.; Squires, M. F.

1982-01-01

Preliminary results are shown relating the ageostrophic wind field, through the terms of a semigeostrophic wind equation (assuming adiabatic conditions and the geostrophic momentum approximation) to both air parcel trajectories and their vertical motion fields computed from the parcels' displacement on isentropic surfaces, with respect to pressure. The analysis of results considers both upper-level (324 K) ageostrophic fields and low-level (304 K) fields. Preliminary results tend to support Uccellini and Johnson's (1979) hypothesis concerning upper-level-jet/low-level-jet (ULJ/LLJ) coupling in the exit region of the ULJ. Future plans are described briefly for research intended to clarify the mechanism behind ULJ streak propagation, LLJ development and their relationship to the initiation of severe convection.

The Anterior Interosseus Artery Perforator Flap: Anatomical Dissections and Clinical Study.

PubMed

Panse, Nikhil S; Joshi, Sheetal B; Sahasrabudhe, Parag B; Bahetee, B; Gurude, Pradnya; Chandanwale, Ajay

2017-05-01

Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap. This study was divided into anatomical study and clinical application in a IV level of evidence. In the anatomical study, five upper extremities were studied. Clinically, 12 patients underwent reconstruction using the anterior interosseus artery perforator flap. Flaps were performed by a single surgeon. A retrospective review of these cases from November 2008 to May 2014 is presented. The anterior interosseus artery perforator was identified in four out of five cadaver limbs. The septocutaneous perforator was in the fifth extensor compartment around 4 cm proximal to the wrist joint. Of the twelve flaps, there was complete necrosis in one flap, and partial necrosis in one flap. The patient with complete necrosis underwent skin grafting at a later date. The wound healed secondarily in case of partial flap necrosis. Anterior interosseus artery perforator flap must be considered as an important reconstructive option in the armamentarium of the plastic surgeon, while managing hand and wrist defects.

An in vitro assessment of type, position and incidence of isthmus in human permanent molars

PubMed Central

de LIMA, Fernando José Camello; MONTAGNER, Francisco; JACINTO, Rogério Castilho; AMBROSANO, Glaucia Maria Bovi; GOMES, Brenda Paula Figueiredo de Almeida

2014-01-01

Root canal anatomical complexities, such as isthmus, may limit the action of the endodontic instruments, irrigant solutions and intracanal medications, leading to endodontic treatment failure. Objectives This in vitro study assessed the type, position and incidence of isthmus in human permanent molars. Material and Methods One hundred and twenty eight upper and lower first and second permanent molars were analyzed. The roots were embedded in transparent resin, and then split at different distances from the apex (1.0-2.5-4.0-5.5-7.0 mm). Following the sample examination in stereomicroscope, the data were submitted to chi-square statistical test at a 5% significance level. Results The highest isthmus incidence was at 7.0 mm from the root apex in all samples, except the distal root of lower molars (at 5.5 mm). In upper and lower molars, type V (complete isthmus with a continuous opening between the two main root canals) was the most common classification of isthmus (28.8%). In the mesial root of first and second mandibular molars, type IV had the highest incidence (36% and 23.9%, respectively). Conclusion It was concluded that isthmus was widely found in flat roots, with a low percentage in areas close to the apex. In upper and lower molars, these structures were most frequently found at 7 mm from the apex. PMID:25141198

Perceptions of Emergency Medicine Residency and Hand Surgery Fellowship Program Directors in the Appropriate Disposition of Upper Extremity Emergencies.

PubMed

Drolet, Brian C; Lifchez, Scott D; Jacoby, Sidney M; Varone, Andrew; Regan, Linda A; Baren, Jill M; Akelman, Edward; Osterman, A Lee; Levin, L Scott

2015-12-01

To survey emergency medicine (EM) residency and hand surgery fellowship program directors (PDs) to identify consensus in their perceptions of appropriate emergency care of upper extremity emergencies. We created a framework to group common upper extremity emergency diagnoses and surveyed PDs to evaluate the training background--EM, general orthopedic or plastic surgery, or hand fellowship--most appropriate to provide acute, point-of-care management for each of these diagnostic groupings. Responses were pooled and consensus was established with greater than 75% agreement between groups. We received 79 responses from hand fellowship PDs (90% response rate) and 151 responses from EM PDs (49% response rate). We identified consensus for the training background that PDs in both specialties felt was appropriate to care for 17 of 21 diagnostic groupings in the framework. There was a high level of consensus between EM and hand surgery PDs regarding diagnoses that acutely require training in hand surgery versus those that can be managed by an EM physician. Our diagnostic framework may help reduce unnecessary hand surgery consultation and may help to identify patients who do not require more specialized acute care and thus decrease unnecessary transfers. Economic and Decision Analyses IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Effect of the El Nino/southern oscillation on Gulf of Mexico, winter, frontal-wave cyclones: 1960-1989. (Volumes I and II)

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

Manty, R.E.

Seasonal counts of frontal-wave cyclones forming over the Gulf of Mexico and its coastal plain show more storms in the five El Nino winters and fewer storms in the eight La Nina winters, from 1960 to 1989, significant at the .01 level by a rank sum test. This is corroborated by two results. First, during the same period, the frequency of frontal-overrunning weather conditions in the region, indicative of storms, was higher in El Nino winters and lower in La Nina winters. Second, 100 years of precipitation and temperature records show wetter, cooler El Nino winters and drier, warmer Lamore » Nina winters at gulf-region land stations and climatic divisions. A threefold explanation, based on National Meteorological Center, upper-air data, is offered for the greater frequency of gulf-region cyclogenesis during El Nino winters between 1960 and 1989. (1) The winter, mean, 250-mb jet over the southern US is intensified by 5 to 10 ms[sup [minus]1] and displaced southward between 110[degrees] and 75[degrees]W by an average of 200 to 285 km during the five El Nino winters. This implies stronger and more frequent episodes of jet-associated, upper-level troughing and divergence over the region, reinforcing surface, frontal-wave cyclones. (2) In the five El Nino winters between 1963 and 1989, seasonal average heights and temperatures of the 850-, 700-, 500-, and 200-mb surfaces are lower over the region than they are in non-El Nino winters. This implies more-common presence of cold, low-pressure troughs at upper levels, reinforcing surface cyclones. (3) A 10[degrees] eastward shift, at sea level, of the western edge of the Bermuda high during the eight El Nino winters, changes normally due-easterly trades in the northwestern Caribbean Sea to slightly south of east, allowing greater advection of moisture and heat into the gulf from the tropics, preconditioning the area for development of surface cyclones. Only winter season shows all three conditions and an increase in cyclogenesis.« less

Reflections on the present and future of upper limb prostheses.

PubMed

Farina, Dario; Amsüss, Sebastian

2016-01-01

Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.

Groundwater levels for selected wells in Upper Kittitas County, Washington

USGS Publications Warehouse

Fasser, E.T.; Julich, R.J.

2011-01-01

Groundwater levels for selected wells in Upper Kittitas County, Washington, are presented on an interactive, web-based map to document the spatial distribution of groundwater levels in the study area measured during spring 2011. Groundwater-level data and well information were collected by the U.S. Geological Survey using standard techniques and are stored in the U.S. Geological Survey National Water Information System, Groundwater Site-Inventory database.

The common cold: current therapy and natural history.

PubMed

Spector, S L

1995-05-01

Despite its prevalence, the common cold is complicated and can be difficult to treat, even symptomatically. There is still no cure for the myriad of viruses that cause the common cold. Many of the most popular remedies are either ineffective or counterproductive. This paper reviews the causes and course of upper respiratory infections, and discusses treatment options, including a new anticholinergic aqueous formulation for controlling rhinorrhea.

Numbers and distribution of Double-crested Cormorants on the upper Mississippi river

USGS Publications Warehouse

Kirsch, E.M.

1997-01-01

Historic records indicate that Double-crested Cormorants (Phalacrocorax auritus) were common breeders and abundant during migration on the Upper Mississippi River from St. Paul, Minnesota, to St. Louis, Missouri, during the 1940s and 1950s. Their numbers declined in the mid- to late-1950s, remained low through the 1970s, and began to increase somewhat in the late 1980s. Aerial surveys of migrating cormorants and ground surveys at cormorant colonies during 1991-1993, indicate that numbers have not returned to historic levels. Only 500-2,000 cormorants were seen during spring migration 1992-1993; and 5,000-7,000 during fall migration 1991-1992; whereas, tens of thousands were reported in the 1940s and 1950s. Four hundred ninety-six nests were counted at 4 colonies in 1992, and 545 nests were counted in 9 colonies in 1993; whereas, during the 1940s and 1950s, about 2,500 birds were reported nesting in 4 locations. Pools 6 and 13 have always attracted breeding and migrating cormorants, currently attract the largest numbers of cormorants during migration, and still support breeding colonies.

Numbers and distribution of double-crested cormorants on the upper Mississippi River

USGS Publications Warehouse

Kirsch, E.M.

1997-01-01

Historic records indicate that Double-crested Cormorants (Phalacrocorax auritus) were common breeders and abundant during migration on the Upper Mississippi River from St. Paul, Minnesota, to St. Louis, Missouri, during the 1940s and 1950s. Their numbers declined in the mid-to late-1950s, remained low through the 1970s, and began to increase somewhat in the late 1980s. Aerial surveys of migrating cormorants and ground surveys at cormorant colonies during 1991-1993, indicate that numbers have not returned to historic levels. Only 500-2,000 cormorants were seen during spring migration 1992-1993; and 5,000-7,000 during fall migration 1991-1992; whereas, tens of thousands were reported in the 1940s and 1950s. Four hundred ninety-six nests were counted at 4 colonies in 1992, and 545 nests were counted in 9 colonies in 1993; whereas, during the 1940s and 1950s, about 2,500 birds were reported nesting in 4 locations. Pools 6 and 13 have always attracted breeding and migrating cormorants, currently attract the largest numbers of cormorants during migration, and still support breeding colonies.

A Rare Case of Cavitary Lesion of the Lung Caused by Mycoplasma pneumoniae in an Immunocompetent Patient

PubMed Central

Dudekula, Rizwan Ahmed

2017-01-01

Mycoplasma pneumoniae is an atypical bacterium that most commonly causes upper respiratory tract infections, but it can also cause pneumonia, referred to as “walking pneumonia.” Although cavitary lesions are present in a wide variety of infectious and noninfectious processes, those attributable to M. pneumoniae are extremely uncommon; thus, to date, epidemiological studies are lacking. Here, we present a rare case of a 20-year-old male, referred to us from a psychiatric facility for evaluation of a cough, who was found to have a cavitary lesion in the right upper lobe. An extensive workup for cavitary lesion was negative, but his mycoplasma IgM level was high. A computed tomography (CT) of the chest confirmed the presence of a cavitary lesion. After treatment with levofloxacin antibiotics, a follow-up CT showed complete resolution of the lesion. Our case is a rare presentation of mycoplasma pneumonia as a cavitary lesion in a patient without any known risk factors predisposing to mycoplasma infection. Early recognition and treatment with an appropriate antibiotic may lead to complete resolution of the cavitary lesion. PMID:28912822

Osteology of the Late Triassic aetosaur Scutarx deltatylus (Archosauria: Pseudosuchia)

PubMed Central

2016-01-01

Aetosaurians are some of the most common fossils collected from the Upper Triassic Chinle Formation of Arizona, especially at the Petrified Forest National Park (PEFO). Aetosaurians collected from lower levels of the park include Desmatosuchus spurensis, Paratypothorax, Adamanasuchus eisenhardtae, Calyptosuchus wellesi, and Scutarx deltatylus. Four partial skeletons collected from the park between 2002 and 2009 represent the holotype and referred specimens of Scutarx deltatylus. These specimens include much of the carapace, as well as the vertebral column, and shoulder and pelvic girdles, and a new naming convention proposed for osteoderms descriptions better differentiates portions of the carapace and ventral armor. A partial skull from the holotype specimen represents the first aetosaur skull recovered and described from Arizona since the 1930s. The key morphological feature distinguishing Scutarx deltatylus is the presence of a prominent, triangular boss located in the posteromedial corner of the dorsal surface of the dorsal paramedian osteoderms. Scutarx deltatylus can be distinguished from closely related forms Calyptosuchus wellesi and Adamanasuchus eisenhardtae not only morphologically, but also stratigraphically. Thus, Scutarx deltatylus is potentially an index taxon for the upper part of the Adamanian biozone. PMID:27635359

Sports-specific injuries.

PubMed

Plancher, K D; Minnich, J M

1996-04-01

Injuries to the upper extremities can happen in any sport. Injury patterns are common to specific sports. Understanding which injuries occur with these sports allows the examiner to diagnose and treat the athlete easily. This article reviews some of the injuries common in sports such as bicycling, golf, gymnastics, martial arts, racquet sports, and weightlifting.

Bioactive xanthones from the roots of Hypericum perforatum (common St John's Wort)

USDA-ARS?s Scientific Manuscript database

In contemporary western alternative medicine, extracts of the inflorescences and upper stem leaves of Hypericum perforatum L. (common St. John’s Wort; Clusiaceae) are taken orally for the treatment of mild to moderate depression and applied topically to promote wound-healing. Numerous researchers h...

DIGITAL Q METER

DOEpatents

Briscoe, W.L.

1962-02-13

A digital Q meter is described for measuring the Q of mechanical or electrical devices. The meter comprises in combination a transducer coupled to an input amplifier, and an upper and lower level discriminator coupled to the amplifier and having their outputs coupled to an anticoincidence gate. The output of the gate is connected to a scaler. The lower level discriminator is adjusted to a threshold level of 36.8 percent of the operating threshold level of the upper level discriminator. (AEC)

Modifying upper-limb inter-joint coordination in healthy subjects by training with a robotic exoskeleton.

PubMed

Proietti, Tommaso; Guigon, Emmanuel; Roby-Brami, Agnès; Jarrassé, Nathanaël

2017-06-12

The possibility to modify the usually pathological patterns of coordination of the upper-limb in stroke survivors remains a central issue and an open question for neurorehabilitation. Despite robot-led physical training could potentially improve the motor recovery of hemiparetic patients, most of the state-of-the-art studies addressing motor control learning, with artificial virtual force fields, only focused on the end-effector kinematic adaptation, by using planar devices. Clearly, an interesting aspect of studying 3D movements with a robotic exoskeleton, is the possibility to investigate the way the human central nervous system deals with the natural upper-limb redundancy for common activities like pointing or tracking tasks. We asked twenty healthy participants to perform 3D pointing or tracking tasks under the effect of inter-joint velocity dependant perturbing force fields, applied directly at the joint level by a 4-DOF robotic arm exoskeleton. These fields perturbed the human natural inter-joint coordination but did not constrain directly the end-effector movements and thus subjects capability to perform the tasks. As a consequence, while the participants focused on the achievement of the task, we unexplicitly modified their natural upper-limb coordination strategy. We studied the force fields direct effect on pointing movements towards 8 targets placed in the 3D peripersonal space, and we also considered potential generalizations on 4 distinct other targets. Post-effects were studied after the removal of the force fields (wash-out and follow up). These effects were quantified by a kinematic analysis of the pointing movements at both end-point and joint levels, and by a measure of the final postures. At the same time, we analysed the natural inter-joint coordination through PCA. During the exposition to the perturbative fields, we observed modifications of the subjects movement kinematics at every level (joints, end-effector, and inter-joint coordination). Adaptation was evidenced by a partial decrease of the movement deviations due to the fields, during the repetitions, but it occurred only on 21% of the motions. Nonetheless post-effects were observed in 86% of cases during the wash-out and follow up periods (right after the removal of the perturbation by the fields and after 30 minutes of being detached from the exoskeleton). Important inter-individual differences were observed but with small variability within subjects. In particular, a group of subjects showed an over-shoot with respect to the original unexposed trajectories (in 30% of cases), but the most frequent consequence (in 55% of cases) was the partial persistence of the modified upper-limb coordination, adopted at the time of the perturbation. Temporal and spatial generalizations were also evidenced by the deviation of the movement trajectories, both at the end-effector and at the intermediate joints and the modification of the final pointing postures towards targets which were never exposed to any field. Such results are the first quantified characterization of the effects of modification of the upper-limb coordination in healthy subjects, by imposing modification through viscous force fields distributed at the joint level, and could pave the way towards opportunities to rehabilitate pathological arm synergies with robots.

Interior, north end, upper level, looking south towards door to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior, north end, upper level, looking south towards door to one of the building's refrigeration rooms. Photograph taken just south of CO-172-AQ-4. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Interior, north end, upper level, looking west. This photograph taken ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior, north end, upper level, looking west. This photograph taken inside the refrigeration room whose door is in the background of CO-172-AQ-5. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Skylab

NASA Image and Video Library

1972-01-01

This photograph, with callouts, depicts the experiment area of the forward compartment at the upper level of the Orbital Workshop. The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

Service Learning in Domestic and International Settings

ERIC Educational Resources Information Center

Miller, Kari Knutson; Gonzalez, Amber M.

2009-01-01

This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. One group of upper-division undergraduate level pre service teachers participated in supervised experiences in domestic settings. A second group of upper-division undergraduate level pre-service teachers participated in…

The analysis and kinetic energy balance of an upper-level wind maximum during intense convection

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.; Jedlovec, G. J.

1982-01-01

The purpose of this paper is to analyze the formation and maintenance of the upper-level wind maximum which formed between 1800 and 2100 GMT, April 10, 1979, during the AVE-SESAME I period, when intense storms and tornadoes were experienced (the Red River Valley tornado outbreak). Radiosonde stations participating in AVE-SESAME I are plotted (centered on Oklahoma). National Meteorological Center radar summaries near the times of maximum convective activity are mapped, and height and isotach plots are given, where the formation of an upper-level wind maximum over Oklahoma is the most significant feature at 300 mb. The energy balance of the storm region is seen to change dramatically as the wind maximum forms. During much of its lifetime, the upper-level wind maximum is maintained by ageostrophic flow that produces cross-contour generation of kinetic energy and by the upward transport of midtropospheric energy. Two possible mechanisms for the ageostrophic flow are considered.

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

Chronic gastritis in China: a national multi-center survey

PubMed Central

2014-01-01

Background Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. Methods A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Results Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. Conclusions The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy. PMID:24502423

Chronic gastritis in China: a national multi-center survey.

PubMed

Du, Yiqi; Bai, Yu; Xie, Pei; Fang, Jingyuan; Wang, Xiaozhong; Hou, Xiaohua; Tian, Dean; Wang, Chengdang; Liu, Yandi; Sha, Weihong; Wang, Bangmao; Li, Yanqing; Zhang, Guoliang; Li, Yan; Shi, Ruihua; Xu, Jianming; Li, Youming; Huang, Minghe; Han, Shengxi; Liu, Jie; Ren, Xu; Xie, Pengyan; Wang, Zhangliu; Cui, Lihong; Sheng, Jianqiu; Luo, Hesheng; Wang, Zhaohui; Zhao, Xiaoyan; Dai, Ning; Nie, Yuqiang; Zou, Yiyou; Xia, Bing; Fan, Zhining; Chen, Zhitan; Lin, Sanren; Li, Zhao-Shen

2014-02-07

Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.

On the assessment of coordination between upper extremities: towards a common language between rehabilitation engineers, clinicians and neuroscientists.

PubMed

Shirota, Camila; Jansa, Jelka; Diaz, Javier; Balasubramanian, Sivakumar; Mazzoleni, Stefano; Borghese, N Alberto; Melendez-Calderon, Alejandro

2016-09-08

Well-developed coordination of the upper extremities is critical for function in everyday life. Interlimb coordination is an intuitive, yet subjective concept that refers to spatio-temporal relationships between kinematic, kinetic and physiological variables of two or more limbs executing a motor task with a common goal. While both the clinical and neuroscience communities agree on the relevance of assessing and quantifying interlimb coordination, rehabilitation engineers struggle to translate the knowledge and needs of clinicians and neuroscientists into technological devices for the impaired. The use of ambiguous definitions in the scientific literature, and lack of common agreement on what should be measured, present large barriers to advancements in this area. Here, we present the different definitions and approaches to assess and quantify interlimb coordination in the clinic, in motor control studies, and by state-of-the-art robotic devices. We then propose a taxonomy of interlimb activities and give recommendations for future neuroscience-based robotic- and sensor-based assessments of upper limb function that are applicable to the everyday clinical practice. We believe this is the first step towards our long-term goal of unifying different fields and help the generation of more consistent and effective tools for neurorehabilitation.

A generalized public goods game with coupling of individual ability and project benefit

NASA Astrophysics Data System (ADS)

Zhong, Li-Xin; Xu, Wen-Juan; He, Yun-Xin; Zhong, Chen-Yang; Chen, Rong-Da; Qiu, Tian; Shi, Yong-Dong; Ren, Fei

2017-08-01

Facing a heavy task, any single person can only make a limited contribution and team cooperation is needed. As one enjoys the benefit of the public goods, the potential benefits of the project are not always maximized and may be partly wasted. By incorporating individual ability and project benefit into the original public goods game, we study the coupling effect of the four parameters, the upper limit of individual contribution, the upper limit of individual benefit, the needed project cost and the upper limit of project benefit on the evolution of cooperation. Coevolving with the individual-level group size preferences, an increase in the upper limit of individual benefit promotes cooperation while an increase in the upper limit of individual contribution inhibits cooperation. The coupling of the upper limit of individual contribution and the needed project cost determines the critical point of the upper limit of project benefit, where the equilibrium frequency of cooperators reaches its highest level. Above the critical point, an increase in the upper limit of project benefit inhibits cooperation. The evolution of cooperation is closely related to the preferred group-size distribution. A functional relation between the frequency of cooperators and the dominant group size is found.

Effect of outflow on spring and summertime distribution and abundance of larval and juvenile fishes in the upper San Francisco Estuary

USGS Publications Warehouse

Dege, M.; Brown, L.R.

2004-01-01

We analyzed data on spring and summertime larval and juvenile fish distribution and abundance in the upper San Francisco Estuary (SFE), California between 1995 and 2001. The upper SFE includes the tidal freshwater areas of the Sacramento-San Joaquin Delta downstream to the euryhaline environment of San Pablo Bay. The sampling period included years with a variety of outflow conditions. Fifty taxa were collected using a larval tow net. Two common native species, delta smelt Hypomesus transpacifucus and longfin smelt Spirinchus thaleichthys, and four common alien taxa, striped bass Morone saxatilis, threadfin shad Dorosoma petenense, gobies of the genus Tridentiger, and yellowfin goby Acanthogobins flavimanus, were selected for detailed analysis. Outflow conditions had a strong influence on the geographic distribution of most of the species, but distribution with respect to the 2 psu isohaline (X2) was not affected. The distribution patterns of delta smelt, longfin smelt, and striped bass were consistent with larvae moving from upstream freshwater spawning areas to down-stream estuarine rearing areas. There were no obvious relationships of outflow with annual abundance indices. Our results support the idea of using X2 as an organizing principle in understanding the ecology of larval fishes in the upper SFE. Additional years of sampling will likely lead to additional insights into the early life history of upper SFE fishes. ?? Copyright by the American Fisheries Society 2004.

The Oncology of Discrimination and the Disparate Impact Therapy: Title VII and Upper Level Professional and Managerial Jobs.

ERIC Educational Resources Information Center

Sanders, Wayne

An examination was made of the evidentiary problems that exist in using a disparate impact theory to challenge the subjective criteria many organizations use to hire, promote, or dismiss upper-level professional and managerial employees. Although subjective criteria occur at all levels of employment, they are especially prevalent when dealing with…

Risk factors associated with upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy.

PubMed

Wu, Feng L; Sun, Yu; Pan, Sheng F; Zhang, Li; Liu, Zhong J

2014-06-01

Postoperative paresis, so-called C5 palsy, of the upper extremities is a common complication of cervical surgery. There have been several reports about upper extremity palsy after cervical laminoplasty for patients with cervical myelopathy. However, the possible risk factors remain unclear. To investigate the factors associated with the development of upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy. A retrospective review of medical records. A total of 102 patients (76 men and 26 women) were eligible for analysis in this study. The mean age of the patients was 58.7 years (range 35-81 years). Sixteen patients (13 men and 3 women, average age 62.8 years) with palsy were categorized as Group P, and eighty-six patients (63 men and 23 women, average age 57.8 years) without palsy as Group C. The demographic data collected from both groups were age, sex, duration of symptoms, disease, and type of surgical procedure. Cervical curvature index, width of the intervertebral foramen (WIF) at C5, anterior protrusion of the superior articular process (APSAP), number of compressed segments, high-signal intensity zone at the level corresponding to C3-C5 (HIZ:C3-C5), and posterior shift of the spinal cord (PSSC) were also evaluated. Upper extremity palsy was defined as weakness of Grade 4 or less of the key muscles in the upper extremity by manual muscle test without any deterioration of myelopathic symptoms after surgery. Comparisons were made with screen for the parameters with significant differences, and then we further analyzed these parameters by logistic regression analysis (the forward method) to verify the risk factors of the upper extremity palsy. Significant differences in diagnosis, the type of procedure, WIF, APSAP, and HIZ:C3-C5 were observed between the two groups. No statistical difference in PSSC between the groups was noted (2.06 vs. 2.53 mm, p=.247). In logistic regression analysis, ossification of the posterior longitudinal ligament (OPLL), cervical open-door laminoplasty together with posterior instrumented fusion (CLP+PIF), and WIF were found to be significant risk factors for postoperative upper extremity palsy. Patients with preoperative foraminal stenosis, OPLL, and additional iatrogenic foraminal stenosis because of CLP+PIF were more likely to develop postoperative upper extremity palsy. Attention should be given to the WIF determined on preoperative computed tomography of the C5 root. To prevent iatrogenic foraminal stenosis, appropriate distraction between spine segments should be provided during placement of the rod. Copyright © 2014 Elsevier Inc. All rights reserved.

The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis

PubMed Central

Elghuel, Abdulbaset

2011-01-01

Background Acute upper gastrointestinal bleeding (UGIB) is a common reason for hospital admissions worldwide. Aetiological causes of UGIB vary according to geographic region and socioeconomic status. However, despite the implementation of early endoscopy as the standard method for the diagnosis and treatment of UGIB, data on the characteristics of patients with UGIB in Libya are still minimal. In this study, we describe patient demographics, aetiological causes for UGIB, and possible risk factors for upper gastrointestinal bleeding in patients admitted to the Gastroenterology Department at Tripoli Medical Center from January 2001 through June 2006. Method This is a retrospective case-series analysis of all adult patients with upper gastrointestinal bleeding admitted to the Gastroenterology Department at TMC. Patients' medical records were individually reviewed and relevant data abstracted. Results A total of 928 cases with diagnoses of UGIB were admitted to Tripoli Medical Center during the study period. Of these cases, 60.3% were males and 39.7% females (3:2) and males were significantly younger than females (49.6 years vs. 53.9 years, p=0.001). The most common cause of UGIB was peptic ulcer (37.1%) of which duodenal ulcer was the most common (30.7% of all UGIB), especially amongst male patients (36.4%). The second most common cause was bleeding due to varices (29.8%), especially amongst females (35.1%). Additionally, smoking and NSAIDs use were reported by 18.6% and 9.7% of cases and both were significantly associated with bleeding due to peptic ulcers. Conclusion This study has investigated the characteristics of adults with UGIB at a tertiary referral center in Libya. The high frequency of bleeding due to varices amongst females mandates further investigations into the possible underlying hepatic causes and their management, and the potential impact on patient outcome and prognosis. PMID:21526040

Biomechanical analyses of whiplash injuries using an experimental model.

PubMed

Yoganandan, Narayan; Pintar, Frank A; Cusick, Joseph F

2002-09-01

Neck pain and headaches are the two most common symptoms of whiplash. The working hypothesis is that pain originates from excessive motions in the upper and lower cervical segments. The research design used an intact human cadaver head-neck complex as an experimental model. The intact head-neck preparation was fixed at the thoracic end with the head unconstrained. Retroreflective targets were placed on the mastoid process, anterior regions of the vertebral bodies, and lateral masses at every spinal level. Whiplash loading was delivered using a mini-sled pendulum device. A six-axis load cell and an accelerometer were attached to the inferior fixation of the specimen. High-speed video cameras were used to obtain the kinematics. During the initial stages of loading, a transient decoupling of the head occurs with respect to the neck exhibiting a lag of the cranium. The upper cervical spine-head undergoes local flexion concomitant with a lag of the head while the lower column is in local extension. This establishes a reverse curvature to the head-neck complex. With continuing application of whiplash loading, the inertia of the head catches up with the neck. Later, the entire head-neck complex is under an extension mode with a single extension curvature. The lower cervical facet joint kinematics demonstrates varying local compression and sliding. While the anterior- and posterior-most regions of the facet joint slide, the posterior-most region of the joint compresses more than the anterior-most region. These varying kinematics at the two ends of the facet joint result in a pinching mechanism. Excessive flexion of the posterior upper cervical regions can be correlated to headaches. The pinching mechanism of the facet joints can be correlated to neck pain. The kinematics of the soft tissue-related structures explain the mechanism of these common whiplash associated disorders.

US-guided percutaneous cholecystostomy: features predicting culture-positive bile and clinical outcome.

PubMed

Sosna, Jacob; Kruskal, Jonathan B; Copel, Laurian; Goldberg, S Nahum; Kane, Robert A

2004-03-01

To assess sonographic and clinical features that might be used to predict infected bile and/or patient outcome from ultrasonography (US)-guided percutaneous cholecystostomy. Between February 1997 and August 2002 at one institution, 112 patients underwent US-guided percutaneous cholecystostomy (59 men, 53 women; average age, 69.3 years). All US images were scored on a defined semiquantitative scale according to preset parameters: (a) gallbladder distention, (b) sludge and/or stones, (c) wall appearance, (d) pericholecystic fluid, and (e) common bile duct size and/or choledocholithiasis. Separate and total scores were generated. Retrospective evaluation of (a) the bacteriologic growth of aspirated bile and its color and (b) clinical indices (fever, white blood cell count, bilirubin level, liver function test results) was conducted by reviewing medical records. For each patient, the clinical manifestation was classified into four groups: (a) localized right upper quadrant symptoms, (b) generalized abdominal symptoms, (c) unexplained sepsis, or (d) sepsis with other known infection. Logistic regression models, exact Wilcoxon-Mann-Whitney test, and the Kruskal-Wallis test were used. Forty-seven (44%) of 107 patients had infected bile. A logistic regression model showed that wall appearance, distention, bile color, and pericholecystic fluid were not individually significant predictors for culture-positive bile, leaving sludge and/or stones (P =.003, odds ratio = 1.647), common bile duct status (P =.02, odds ratio = 2.214), and total score (P =.007, odds ratio = 1.267). No US covariates or clinical indices predicted clinical outcome. Clinical manifestation was predictive of clinical outcome (P =.001) and aspirating culture-positive bile (P =.008); specifically, 30 (86%) of 35 patients with right upper quadrant symptoms had their condition improve, compared with one (7%) of 15 asymptomatic patients with other known causes of infection. US variables can be used to predict culture-positive bile but not patient outcome. Clinical manifestation is important because patients with right upper quadrant symptoms have the best clinical outcome. Copyright RSNA, 2004

Association of body flexibility and carotid atherosclerosis in Japanese middle-aged men: a cross-sectional study

PubMed Central

Imoto, Takayuki; Kida, Akira; Yokochi, Takashi; Iwase, Mitsunori; Kozawa, Kenji

2018-01-01

Objective This study examined the associations of body flexibility with carotid arterial remodelling, including intima–media thickness (IMT) and plaque formation in middle-aged men. Methods The subjects of this cross-sectional study included 1354 Japanese men aged 35–59 years without histories of stroke or cardiac diseases. The arm extensibility test, which can estimate flexibility of the upper extremity (composed of shoulder external rotation and forearm supination), and the sit-and-reach test were performed. Common carotid IMT and plaque formation (≥1.1 mm) were estimated by ultrasound. Results The proportion of subjects who fully completed the arm extensibility test was 55.0%, and who had plaques in the common carotid artery was 37.8%. IMT was associated with poor arm extensibility (β=–0.073, 95% CI –0.02224 to –0.00041, P=0.004), while plaque formation was associated with poor sit-and-reach (OR 0.98579, 95% CI 0.97257 to 0.99919, P=0.038) after adjustment by all covariates. Conclusions This study demonstrated that poor upper extremity and trunk flexibility were associated with characteristics of early onset of atherosclerosis. Furthermore, these associations were independent of covariates such as age, blood pressure, blood lipids glucose levels and abdominal fat accumulation, handgrip strength and lifestyle, including sleeping, drinking, exercise and smoking habits. Poor flexibility may reflect subclinical atherosclerosis in middle-aged men. PMID:29306892

Chronic Pain in People With Chronic Obstructive Pulmonary Disease: Prevalence, Clinical and Psychological Implications.

PubMed

Lee, Annemarie L; Goldstein, Roger S; Brooks, Dina

2017-05-21

Background: Although pain is a common symptom in chronic obstructive pulmonary disease (COPD), pain characteristics such as frequency, duration and type are unclear. The primary study aim was to identify these pain characteristics in individuals with COPD versus healthy control participants. The secondary aim was to explore the clinical and psychological associations with pain in those with COPD. Methods : Participants with COPD and age and gender-matched, healthy controls completed questionnaires to elicit pain characteristics. Those with COPD also had assessments of dyspnea, health-related quality of life, psychological associations (anxiety and depression) and physical activity. Results: Sixty-four participants with COPD (mean [standard deviation (SD)] age 71[10] , forced expiratory volume in 1 second [FEV 1 ] 38% predicted) and 64 control participants (mean [SD] age 67 [13] , FEV 1 91% predicted) were included. Chronic pain was more prevalent in individuals with COPD compared to control participants (41% versus 29%, p =0.03). The pain was more prevalent in the chest and upper back ( p =0.04). COPD participants with chest or upper back pain had a higher total lung capacity (mean difference 2.0L, 95% confidence interval [CI] 0.6 to 3.0L) compared to COPD participants without pain. Greater dyspnea ( p <0.001), more depression ( p =0.02) and lower physical activity levels ( p =0.03) were also present in people with COPD experiencing pain. Conclusions: Chronic pain is common in COPD. It is associated with higher dyspnea and depression and lower physical activity.

Patterns of lumbar disc degeneration are different in degenerative disc disease and disc prolapse magnetic resonance imaging analysis of 224 patients.

PubMed

Kanna, Rishi M; Shetty, Ajoy Prasad; Rajasekaran, S

2014-02-01

Existing research on lumbar disc degeneration has remained inconclusive regarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated. To analyze the patterns of lumbar disc degeneration in patients with chronic back pain and DDD and those with acute DP. Prospective, magnetic resonance imaging-based radiological study. Two groups of patients (aged 20-50 years) were prospectively studied. Group 1 included patients requiring a single level microdiscectomy for acute DP. Group 2 included patients with chronic low back pain and DDD. Discs were assessed by magnetic resonance imaging through Pfirmann grading, Schmorl nodes, Modic changes, and the total end-plate damage score for all the five lumbar discs. Group 1 (DP) had 91 patients and group 2 (DDD) had 133 patients. DP and DDD patients differed significantly in the number, extent, and severity of degeneration. DDD patients had a significantly higher number of degenerated discs than DP patients (p<.000). The incidence of multilevel and pan-lumbar degeneration was also significantly higher in DDD group. The pattern of degeneration also differed in both the groups. DDD patients had predominant upper lumbar involvement, whereas DP patients had mainly lower lumbar degeneration. Modic changes were more common in DP patients, especially at the prolapsed level. Modic changes were present in 37% of prolapsed levels compared with 9.9% of normal discs (p<.00). The total end-plate damage score had a positive correlation with disc degeneration in both the groups. Further the mean total end-plate damage score at prolapsed level was also significantly higher. The results suggest that patients with disc prolapse, and those with back pain with DDD are clinically and radiologically different groups of patients with varying patterns, severity, and extent of disc degeneration. This is the first study in literature to compare and identify significant differences in these two commonly encountered patient groups. In patients with single-level DP, the majority of the other discs are nondegenerate, the lower lumbar spine is predominantly involved and the end-plate damage is higher. Patients with back pain and DDD have larger number of degenerate discs, early multilevel degeneration, and predominant upper lumbar degeneration. The knowledge that these two groups of patients are different clinically and radiologically is critical for our improved understanding of the disease and for future studies on disc degeneration and disc prolapse. Copyright © 2014 Elsevier Inc. All rights reserved.

Foraminiferal, lithic, and isotopic changes across four major unconformities at Deep Sea Drilling Project Site 548, Goban Spur: Chapter 14 in Initial reports of the Deep Sea Drilling Project

USGS Publications Warehouse

Poag, C. Wylie; Reynolds, Leslie A.; Mazzullo, James M.; Keigwin, Loyd D.

1985-01-01

Sediment samples taken at close intervals across four major unconformities (middle Miocene/upper Miocene, lower Oligocene/upper Oligocene, lower Eocene/upper Eocene, lower Paleocene/upper Paleocene) at DSDP-IPOD Site 548, Goban Spur, reveal that coeval biostratigraphic gaps, sediment discontinuities, and seismic unconformities coincide with postulated low stands of sea level. Foraminiferal, lithic, and isotopic analyses demonstrate that environments began to shift prior to periods of marine erosion, and that sedimentation resumed in the form of turbidites derived from nearby upper-slope sources. The unconformities appear to have developed where a water-mass boundary intersected the continental slope, rhythmically crossing the drill site in concert with sea-level rise and fall.

The medial temporal lobe—conduit of parallel connectivity: a model for attention, memory, and perception

PubMed Central

Mozaffari, Brian

2014-01-01

Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)—located deep in the hierarchy—serves as a bridge connecting supra- to infra—MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL “bridge” allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these “bridge” predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation. PMID:25426036

24. Pump Room interiordewatering pump motor on upper level. Note ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Pump Room interior-dewatering pump motor on upper level. Note the removable roof hatch (steel frame) directly above motor. Dewatering pumps motor control center at left - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

41. Upper level, electronic racks, left to rightprogrammer group, status ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. Upper level, electronic racks, left to right--programmer group, status command message processing group, UHF radio, impss rack security - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

43. Upper level, left to rightground missile guidance system liquid ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. Upper level, left to right--ground missile guidance system liquid cooling equipment, guidance and control coupler rack, programmer group - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Skylab

NASA Image and Video Library

1972-01-01

This image, with callouts, depicts the storage area of the forward compartment at the upper level of the Orbital Workshop (OWS). The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

Propellant Management in Booster and Upper Stage Propulsion Systems

NASA Technical Reports Server (NTRS)

Fisher, Mark F.

1997-01-01

A summary review of some of the technical issues which surround the design of the propulsion systems for Booster and Upper Stage systems are presented. The work focuses on Propellant Geyser, Slosh, and Orientation. A brief description of the concern is given with graphics which help the reader to understand the physics of the situation. The most common solutions to these problems are given with there respective advantages and disadvantages.

Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management.

PubMed

Chung, Kevin C; Lark, Meghan E

2017-02-01

Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow, and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. Copyright © 2016 Elsevier Inc. All rights reserved.

Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia.

PubMed

Knutson, Jayme S; Fu, Michael J; Sheffler, Lynne R; Chae, John

2015-11-01

This article reviews the most common therapeutic and neuroprosthetic applications of neuromuscular electrical stimulation (NMES) for upper and lower extremity stroke rehabilitation. Fundamental NMES principles and purposes in stroke rehabilitation are explained. NMES modalities used for upper and lower limb rehabilitation are described, and efficacy studies are summarized. The evidence for peripheral and central mechanisms of action is also summarized. Copyright © 2015 Elsevier Inc. All rights reserved.

Importance of viruses in acute otitis media.

PubMed

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

Potentiometric surface and water-level difference maps of selected confined aquifers in Southern Maryland and Maryland’s Eastern Shore, 1975-2015

USGS Publications Warehouse

Curtin, Stephen E.; Staley, Andrew W.; Andreasen, David C.

2016-01-01

Key Results This report presents potentiometric-surface maps of the Aquia and Magothy aquifers and the Upper Patapsco, Lower Patapsco, and Patuxent aquifer systems using water levels measured during September 2015. Water-level difference maps are also presented for these aquifers. The water-level differences in the Aquia aquifer are shown using groundwater-level data from 1982 and 2015, while the water-level differences are shown for the Magothy aquifer using data from 1975 and 2015. Water-level difference maps for both the Upper Patapsco and Lower Patapsco aquifer systems are shown using data from 1990 and 2015. The water-level differences in the Patuxent aquifer system are shown using groundwater-level data from 2007 and 2015. The potentiometric surface maps show water levels ranging from 53 feet above sea level to 164 feet below sea level in the Aquia aquifer, from 86 feet above sea level to 106 feet below sea level in the Magothy aquifer, from 115 feet above sea level to 115 feet below sea level in the Upper Patapsco aquifer system, from 106 feet above sea level to 194 feet below sea level in the Lower Patapsco aquifer system, and from 165 feet above sea level to 171 feet below sea level in the Patuxent aquifer system. Water levels have declined by as much as 116 feet in the Aquia aquifer since 1982, 99 feet in the Magothy aquifer since 1975, 66 and 83 feet in the Upper Patapsco and Lower Patapsco aquifer systems, respectively, since 1990, and 80 feet in the Patuxent aquifer system since 2007.

Responsive upper limb and cognitive fatigue measures during light precision work: an 8-hour simulated micro-pipetting study.

PubMed

Yung, Marcus; Wells, Richard P

2017-07-01

Many contemporary occupations are characterised by long periods of low loads. These lower force levels, which are relevant to the development of work-related musculoskeletal disorders, are usually not the focus of fatigue studies. In studies that did measure fatigue in light manual or precision work, within and between measurement responses were inconsistent. The aim of this study was to identify fatigue measures that were responsive at lower force levels (<10% MVC) over the course of an 8-h period. A complementary set of fatigue measures, reflecting both neuromuscular and cognitive mechanisms, was measured during a light precision micro-pipetting task performed by 11 participants. Nine measures were found to be significantly responsive over the 8-h period, including: ratings of perceived fatigue, postural tremor, blink frequency and critical flicker fusion frequency threshold. Common field measures, specifically electromyography RMS amplitude and maximum voluntary contractions, did not lead to extraordinary time effects. Practitioner summary: The findings provide insight towards the responsiveness of a complementary set of field usable fatigue measures at low work intensities Although commonly used measures did not reveal significant increases in fatigue, nine alternative measures were significantly responsive over the 8-h period.

Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

PubMed

Mai, Harry T; Burgmeier, Robert J; Mitchell, Sean M; Hecht, Andrew C; Maroon, Joseph C; Nuber, Gordon W; Hsu, Wellington K

2016-12-01

Retrospective cohort study. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper- (C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P = 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P = 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels. 4.

Feasibility of ultrasound-guided sacroiliac joint injection considering sonoanatomic landmarks at two different levels in cadavers and patients.

PubMed

Klauser, Andrea; De Zordo, Tobias; Feuchtner, Gudrun; Sögner, Peter; Schirmer, Michael; Gruber, Johann; Sepp, Norbert; Moriggl, Bernhard

2008-11-15

Sacroiliitis is often caused by rheumatic diseases, and besides other therapeutic options, treatment consists of intraarticular injection of corticosteroids. The purpose of this study was to assess the feasibility of ultrasound (US)-guided sacroiliac joint (SI joint) injection at 2 different puncture levels in cadavers and patients when defined sonoanatomic landmarks were considered. After defining sonoanatomic landmarks, US-guided needle insertion was performed in 10 human cadavers (20 SI joints) at 2 different puncture sites. Upper level was defined at the level of the posterior sacral foramen 1 and lower level at the level of the posterior sacral foramen 2. In 10 patients with unilateral sacroiliitis, injection at the most feasible level was attempted. Computed tomography confirmed correct intraarticular needle placement in cadavers by showing the tip of the needle in the joint and intraarticular diffusion of contrast media in 16 (80%) of 20 SI joints (upper level 7 [70%] of 10; lower level 9 [90%] of 10). In all 4 cases in which needle insertion failed, intraarticular SI joint injection at the other level was successful. In patients, 100% of US-guided injections were successful (8 lower level, 2 upper level), with a mean pain relief of 8.6 after 3 months. US guidance of needle insertion into SI joints was feasible at both levels when defined sonoanatomic landmarks were used. If SI joint alterations do not allow for direct visualization of the dorsal joint space of the lower level, which is easier to access, the upper level might offer an appropriate alternative.

Injury and illness at the Newport-Bermuda race 1998- 2006.

PubMed

Nathanson, Andrew T; Fischer, Edwin G; Mello, Michael J; Baird, Janette

2008-01-01

To describe the relative frequency and types of injury and illness in the Newport-Bermuda off-shore yachting race. At the end of each race held in even numbered years from 1998-2006, the captain of each boat was asked to complete a survey detailing any injury or illness among his/her crew. There was an overall 87% response rate to the survey. During the study period, 38 injuries and 57 illnesses were reported for an estimated 8105 sailors, yielding rate of injury or illness of 12 per 1000 races per sailor. Most common were injuries to the upper extremity (47%), and lacerations were the most common type of injury (45%). Sea sickness was the most common illness, and the rate of illness and injury increased in races that took place in heavy weather. Radio consultations were used 4 times, and 3 sailors required transport to a hospital. The rate of injury and illness was relatively low in the Newport-Bermuda race. Injuries to the upper extremities and lacerations were most common, and sea sickness was the most common illness. The majority of illness and injury can be initially managed onboard.

Carbon dioxide concentration in caves and soils in an alpine setting: implications for speleothem fabrics and their palaeoclimate significance

NASA Astrophysics Data System (ADS)

Borsato, Andrea; Frisia, Silvia; Miorandi, Renza

2015-04-01

Carbon dioxide concentration in soils controls carbonate dissolution, soil CO2 efflux to the atmosphere, and CO2 transfer to the subsurface that lead, ultimately, to speleothem precipitation. Systematic studies on CO2 concentration variability in soil and caves at regional scale are, however, few. Here, the systematic investigation of CO2 concentration in caves and soils in a temperate, Alpine region along a 2,100 m altitudinal range transect, which corresponds to a mean annual temperature (MAT) range of 12°C is presented. Soil pCO2 is controlled by the elevation and MAT and exhibits strong seasonality, which follows surface air temperature with a delay of about a month. The aquifer pCO2, by contrast, is fairly constant throughout the year, and it is primarily influenced by summer soil pCO2. Cave CO2 concentration is a balance between the CO2 influx and CO2 efflux, where the efflux is controlled by the cave ventilation, which is responsible for low pCO2 values recorded in most of the caves with respect to soil levels. Carbon dioxide in the innermost part of the studied caves exhibits a clear seasonal pattern. Thermal convection is the most common mechanism causing higher ventilation and low cave air pCO2 levels during the winter season: this promotes CO2 degassing and higher supersaturation in the drip water and, eventually, higher speleothem growth rates during winter. The combined influence of three parameters - dripwater pCO2, dripwater Ca content, and cave air pCO2 - all related to the infiltration elevation and MAT directly controls calcite supersaturation in dripwater. Four different altitudinal belts are then defined, which reflect temperature-dependent saturation state of dripwaters. These belts broadly correspond to vegetation zones: the lower montane (100 to 800 m asl), the upper montane (800 to 1600 m asl), the subalpine (1600 to 2200 m asl) and the Alpine (above 2200 m asl). Each altitudinal belt is characterised by different calcite fabrics, which can shift upward/downward in elevation as a response to temperature increase/decrease through time. In the lower and upper montane zones the columnar types (compact, open, fascicular optic) are the most common fabrics, with the microcrystalline type most typical of the upper montane zone. The dendritic fabric becomes predominant in the higher upper montane and lower subalpine zones. The higher subalpine to lower alpine zones the only speleothem actually forming is moonmilk. Eventually, the occurrence of "altitudinal" fabrics within the vertical growth axis of a stalagmite is indicative of changes in the MAT through time Therefore, fabric changes in fossil speleothems in temperate climate settings can be potentially used to reconstruct regional MAT changes in the past.

Impacts of golden alga Prymnesium parvum on fish populations in reservoirs of the upper Colorado River and Brazos River basins, Texas

USGS Publications Warehouse

VanLandeghem, Matthew M.; Farooqi, Mukhtar; Farquhar, B.; Patino, Reynaldo

2013-01-01

Several reservoirs in the upper Colorado River and Brazos River basins in Texas have experienced toxic blooms of golden alga Prymnesium parvum and associated fish kills since 2001. There is a paucity of information, however, regarding the population-level effects of such kills in large reservoirs, species-specific resistance to or recovery from kills, or potential differences in the patterns of impacts among basins. We used multiple before-after, control-impact analysis to determine whether repeated golden alga blooms have led to declines in the relative abundance and size structure of fish populations. Sustained declines were noted for 9 of 12 fish species surveyed in the upper Colorado River, whereas only one of eight species was impacted by golden alga in the Brazos River. In the upper Colorado River, White Bass Morone chrysops, White Crappie Pomoxis annularis, Largemouth Bass Micropterus salmoides, Bluegill Lepomis macrochirus, River Carpsucker Carpiodes carpio, Freshwater Drum Aplodinotus grunniens, Channel Catfish Ictalurus punctatus, Flathead Catfish Pylodictis olivaris, and Blue Catfish I. furcatus exhibited sustained declines in relative abundance, size structure, or both; Gizzard Shad Dorosoma cepedianum, Longnose Gar Lepisosteus osseus, and Common Carp Cyprinus carpio did not exhibit those declines. In the Brazos River, only the relative abundance of Blue Catfish was impacted. Overall, toxic golden alga blooms can negatively impact fish populations over the long-term, but the patterns of impact can vary considerably among river basins and species. In the Brazos River, populations of most fish species appear to be healthy, suggesting a positive angling outlook for this basin. In the upper Colorado River, fish populations have been severely impacted, and angling opportunities have been reduced. Basin-specific management plans aimed at improving water quality and quantity will likely reduce bloom intensity and allow recovery of fish populations to the abundances and size structures present before golden alga. Received August 26, 2011; accepted November 25, 2012

Searching for Innovations and Methods of Using the Cultural Heritage on the Example of Upper Silesia

NASA Astrophysics Data System (ADS)

Wagner, Tomasz

2017-10-01

The basic subject of this paper is historical and cultural heritage of some parts of Upper Silesia, bind by common history and similar problems at present days. The paper presents some selected historical phenomena that have influenced contemporary space, mentioned above, and contemporary issues of heritage protection in Upper Silesia. The Silesian architecture interpretation, since 1989, is strongly covered with some ideological and national ideas. The last 25 years are the next level of development which contains rapidly transformation of the space what is caused by another economical transformations. In this period, we can observe landscape transformations, liquidation of objects and historical structures, loos of regional features, spontaneous adaptation processes of objects and many methods of implementation forms of protection, and using of cultural resources. Some upheaval linked to the state borders changes, system, economy and ethnic transformation caused that former Upper Silesia border area focuses phenomena that exists in some other similar European areas which are abutments of cultures and traditions. The latest period in the history of Upper Silesia gives us time to reflect the character of changes in architecture and city planning of the area and appraisal of efficiency these practices which are connected to cultural heritage perseveration. The phenomena of the last decades are: decrement of regional features, elimination of objects, which were a key feature of the regional cultural heritage, deformation of these forms that were shaped in the history and some trials of using these elements of cultural heritage, which are widely recognized as cultural values. In this situation, it is important to seek creative solutions that will neutralize bad processes resulting from bad law and practice. The most important phenomena of temporary space is searching of innovative fields and methods and use of cultural resources. An important part of the article is the role of the ‘network community’ in the protection of cultural heritage.

Stratigraphic and structural reconstruction of an Upper Ordovician super-eruption (Catalan Pyrenees)

NASA Astrophysics Data System (ADS)

Marti, Joan; Casas, Josep Maria; Muñoz, Josep A.

2017-04-01

Pre-Variscan basement of the Pyrenees includes evidence of many magmatic episodes represented by different types of granitoids and volcanic rocks, which indicates the complex geodynamic history of this peri-Gondwana terrane during Palaeozoic. One of the most significative magmatic episodes is that of Upper Ordovician (Caradocian) age, which is represented by several granitic and granodioritic bodies and volcanic rocks mostly of pyroclastic nature. In the Catalan Pyrenees this magmatism is well represented in the Ribes de Freser and Nuria area, where the orthogneisses from the Nuria massif and the Ribes granophyre, both with a similar age of 457 Ma, seem to form a calc-alkaline plutonic suite covering terms from deeper to shallower levels. The presence of numerous pyroclastic deposits and lavas interbedded with Caradocian sediments and intruded by and immediately above the Ribes granophyre, suggests that this intrusive episode also generated significant volcanism. The area also hosts an important volume of rhyolitic ignimbrites and andesitic lavas strongly affected by Alpine tectonics and commonly showing tectonised contacts at the base and top of the sequences. These volcanic rocks were previously attributed to the Upper Carboniferous late-Variscan volcanism, extensively represented in the Pyrenees. However, new laser ablation U-Pb zircon geochronology from these rocks has revealed an Upper Ordovician age ( 455 Ma), similar to that of the plutonic rocks of the same area, thus suggesting a probable genetic relation between all them. The palinspatic reconstruction of the Alpine and Variscan tectonic units that affect this area has permitted to infer the geometry, facies distribution, original position, and thickness of these volcanic rocks previously attributed to the late-Variscan volcanism, and reveals how they are spatially (and stratigraphically) associated with the previously identified Late Ordovician volcanic rocks. In particular, the volcanic rocks cropping out at the Ribes de Fresser area correspond to intra-caldera deposits representing a minimum volume of 600 km3, (DRE), which confirm the existence of super-eruptions of Upper Ordovician age in the Pyrenees.

Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice.

PubMed

Sostres, Carlos; Carrera-Lasfuentes, Patrica; Lanas, Angel

2017-10-01

The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (<30 days) of NSAIDs including high-dose acetylsalicylic acid (ASA). NSAID use was associated with increased risk of upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that current prevention strategies may not reach a wide population of short-term NSAID users.

40. Upper level, electronic racks, left to rightstatus command message ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. Upper level, electronic racks, left to right--status command message processing group, UHF radio, impss rack security, power supply group rack - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

42. Upper level, electronic racks, left to rightguidance and control ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. Upper level, electronic racks, left to right--guidance and control coupler rack, programmer group, status command message processing group, UHF radio - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Fostering Students' Preparation and Achievement in Upper Level Mathematics Courses

ERIC Educational Resources Information Center

Celik, Mehmet; Shaqlaih, Ali

2017-01-01

This study describes an intervention to address both motivation, student engagement and preparation in upper-level mathematics courses. The effect of the intervention regarding students' achievements is investigated via students' opinions and data analysis from students' assessments. The results of this study show the featured intervention…

Sample Size Limits for Estimating Upper Level Mediation Models Using Multilevel SEM

ERIC Educational Resources Information Center

Li, Xin; Beretvas, S. Natasha

2013-01-01

This simulation study investigated use of the multilevel structural equation model (MLSEM) for handling measurement error in both mediator and outcome variables ("M" and "Y") in an upper level multilevel mediation model. Mediation and outcome variable indicators were generated with measurement error. Parameter and standard…

Terminology modeling for an enterprise laboratory orders catalog.

PubMed

Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A

2009-11-14

Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7's "Common Terminology Services 2 - Upper Level Class Model" as a terminology metamodel for guiding the development of fully specified laboratory orders and related services.

About an Extreme Achievable Current in Plasma Focus Installation of Mather Type

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

Nikulin, V. Ya.; Polukhin, S. N.; Vikhrev, V. V.

A computer simulation and analytical analysis of the discharge process in Plasma Focus has shown that there is an upper limit to the current which can be achieved in Plasma Focus installation of Mather type by only increasing the capacity of the condenser bank. The maximum current achieved for various plasma focus installations of 1 MJ level is discussed. For example, for the PF-1000 (IFPiLM) and 1 MJ Frascati PF, the maximum current is near 2 MA. Thus, the commonly used method of increasing the energy of the PF installation by increasing of the capacity has no merit. Alternative optionsmore » in order to increase the current are discussed.« less

Terminology Modeling for an Enterprise Laboratory Orders Catalog

PubMed Central

Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S.; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A.

2009-01-01

Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7’s “Common Terminology Services 2 – Upper Level Class Model” as a terminology metamodel for guiding the development of fully specified laboratory orders and related services. PMID:20351950

More Precise Estimation of Lower-Level Interaction Effects in Multilevel Models.

PubMed

Loeys, Tom; Josephy, Haeike; Dewitte, Marieke

2018-01-01

In hierarchical data, the effect of a lower-level predictor on a lower-level outcome may often be confounded by an (un)measured upper-level factor. When such confounding is left unaddressed, the effect of the lower-level predictor is estimated with bias. Separating this effect into a within- and between-component removes such bias in a linear random intercept model under a specific set of assumptions for the confounder. When the effect of the lower-level predictor is additionally moderated by another lower-level predictor, an interaction between both lower-level predictors is included into the model. To address unmeasured upper-level confounding, this interaction term ought to be decomposed into a within- and between-component as well. This can be achieved by first multiplying both predictors and centering that product term next, or vice versa. We show that while both approaches, on average, yield the same estimates of the interaction effect in linear models, the former decomposition is much more precise and robust against misspecification of the effects of cross-level and upper-level terms, compared to the latter.

Changes in the triterpenoid content of cuticular waxes during fruit ripening of eight grape (Vitis vinifera) cultivars grown in the Upper Rhine Valley.

PubMed

Pensec, Flora; Pączkowski, Cezary; Grabarczyk, Marta; Woźniak, Agnieszka; Bénard-Gellon, Mélanie; Bertsch, Christophe; Chong, Julie; Szakiel, Anna

2014-08-13

Triterpenoids present in grape cuticular waxes are of interest due to their potential role in protection against biotic stresses, their impact on the mechanical toughness of the fruit surface, and the potential industrial application of these biologically active compounds from grape pomace. The determination of the triterpenoid profile of cuticular waxes reported here supplements existing knowledge of the chemical diversity of grape, with some compounds reported in this species for the first time. Common compounds identified in eight examined cultivars grown in the Upper Rhine Valley include oleanolic acid, oleanolic and ursolic acid methyl esters, oleanolic aldehyde, α-amyrin, α-amyrenone, β-amyrin, cycloartanol, 24-methylenecycloartanol, erythrodiol, germanicol, lupeol accompanied by lupeol acetate, campesterol, cholesterol, sitosterol, stigmasterol, and stigmasta-3,5-dien-7-one, whereas 3,12-oleandione was specific for the Muscat d'Alsace cultivar. Changes in the triterpenoid content of cuticular waxes were determined at three different phenological stages: young grapes, grapes at véraison (the onset of ripening), and mature grapes. The results reveal a characteristic evolution of triterpenoid content during fruit development, with a high level of total triterpenoids in young grapes that gradually decreases with a slight increase in the level of neutral triterpenoids. This phenomenon may partially explain changes in the mechanical properties of the cuticle and possible modulations in the susceptibility to pathogens of mature grapes.

Advice for Gaining Upper Administration Support for Research at an Undergraduate Institution

NASA Astrophysics Data System (ADS)

Isenhower, Donald

2015-10-01

This talk has its beginnings in questions asked after my invited talk for the 2015 APS Prize for Outstanding Research at an Undergraduate Institution at the April APS Meeting. A common question was how to gain support from one's university's administration to start an undergraduate research program. As my talk was addressing work done during 28 years at a university that had a long history of undergraduate research, I was not prepared to answer the question. It is easy to point out what one must do to obtain funding, even if actually obtaining the funding is difficult. Many other aspects of choosing appropriate research projects, collaborations, and such can also be relatively easy to do. Answers and advice in how to get upper level university administrators to notice and help you start a research program is not as easy or obvious, but is what this talk will address. It will be based on the premiss that one is at a university that is centered on providing high quality undergraduate education. Thus you have the job of showing your administration that having students working on a research program under you will help provide the highest level of education possible. Experience over many years of interactions at ACU will be drawn on for the advice provided. Research supported in part by Grants from the U.S. DOE Office of Science.

An Analysis of Labwork Tasks Used in Science Teaching at Upper Secondary School and University Levels in Several European Countries.

ERIC Educational Resources Information Center

Tiberghien, Andree; Veillard, Laurent; Le Marechal, Jean-Francois; Buty, Christian; Millar, Robin

2001-01-01

Describes the results of a study on the similarities and differences in laboratory tasks used in science education at upper secondary school and university level in the three main science subjects in seven European countries. Some differences are noted between the science subjects and educational levels, but the dominant impression of the analysis…

The assessment of midface distraction osteogenesis in treatment of upper airway obstruction.

PubMed

Xu, Haisong; Yu, Zheyan; Mu, Xiongzheng

2009-09-01

Le Fort III osteotomy with midface distraction osteogenesis (Le Fort III DO) can improve the midface form and change the upper airway space. Some surgeons believe that midface advancement can improve respiratory outcome dramatically, but others think it does not predictably result in the cure of obstructive sleep apnea (OSA). In this study, we evaluated the structural and functional changes of the upper airway before and after Le Fort III DO; we hope these studies can improve future protocols for midface advancement. A retrospective study of 11 patients with severe midface retrusion who underwent Le Fort III osteotomy with midface external distractor system was undertaken. These patients had an average of 5.4 months of follow-up. Three-dimensional volumetric assessment of the upper airway was used before and after surgery. We also evaluated the two-dimensional cross-sectional area of the upper airway to show the changes in different airway levels. Two patients with preoperative evidence of OSA were evaluated both preoperatively and postoperatively by overnight polysomnography. The midface was distracted for an average of 20.27 +/- 8.04 mm. Comparison between preoperative and postoperative three-dimensional computed tomographic data showed an average 64.30% increase in upper airway volume, an improvement of 9.13 +/- 6.94 mL (P < 0.05). The two-dimensional measurement also showed that the cross-sectional area at the posterior nasal spine and uvula airway level increased (P < 0.05), but the cross-sectional area at the epiglottis level and the separation of airway and esophagus level did not increase (P > 0.05). Two patients with preoperative evidence of OSA had both preoperative and postoperative sleeping studies that showed improvement. Le Fort III DO can significantly improve the upper airway space in the cases of syndromic craniosynostosis. The upper airway space above the uvula level was significantly enlarged after Le Fort III DO according to two-dimensional and three-dimensional image measurements, and according to the polysomnography, the OSA was alleviated. Le Fort III DO is a promising procedure in the treatment of severe midface retrusion with OSA in young patients.

Total arsenic concentrations in Chinese children's urine by different geographic locations, ages, and genders.

PubMed

Zhang, Xuan; Wang, Beibei; Cui, Xiaoyong; Lin, Chunye; Liu, Xitao; Ma, Jin

2018-06-01

Little is known about the variation of Chinese children's exposure to arsenic by geography, age, gender, and other potential factors. The main objective of this study was to investigate the total arsenic concentration in Chinese children's urine by geographic locations, ages, and genders. In total, 259 24-h urine samples were collected from 210 2- to 12-year-old children in China and analyzed for total arsenic and creatinine concentrations. The results showed that the upper limit (upper limit of the 90% confidence interval for the 97.5 fractile) was 27.51 µg/L or 55.88 µg/g creatinine for Chinese children. The total urinary arsenic levels were significantly different for children in Guangdong, Hubei, and Gansu provinces (P < 0.05), where the upper limits were 24.29, 58.70, and 44.29 µg/g creatinine, respectively. In addition, the total urinary arsenic levels were higher for 2- to 7-year-old children than for 7- to 12-year-old children (P < 0.05; the upper limits were 59.06 and 44.29 µg/g creatinine, respectively) and higher for rural children than for urban children (P < 0.05; the upper limits were 59.06 and 50.44 µg/g creatinine, respectively). The total urinary arsenic levels for boys were not significantly different from those for girls (P > 0.05), although the level for boys (the upper limit was 59.30 µg/g) was slightly higher than that for girls (the upper limit was 58.64 µg/g creatinine). Because the total urinary arsenic concentrations are significantly different for general populations of children in different locations and age groups, the reference level of total urinary arsenic might be dependent on the geographic site and the child's age.

Petrology and Geochemistry of an Upper Crustal Mafic Complex- Hidden Lakes, Sierra Nevada Batholith, California

NASA Astrophysics Data System (ADS)

Lewis, M.; Bucholz, C. E.; Jagoutz, O. E.; Eddy, M. P.

2017-12-01

Magmatic differentiation in arc settings is likely a polybaric process, with crystallization of primitive basalts occurring primarily in the lower crust and more evolved melts in the upper crust. The general lack of mafic-ultramafic cumulates in the silicic paleo-arc upper crust supports this model. However, the Sierra Nevada Batholith preserves numerous mafic intrusions up to 25 km2, suggesting that significant volumes of mafic magma may differentiate at shallow crustal levels. Previous studies on several such intrusions report ages contemporaneous with Cretaceous batholith emplacement (Coleman et al., 1995), but only a few have investigated their chemistry and relationship to arc magmatism (Frost, 1987; Frost & Mahood, 1987; Sisson et al., 1996). We present field observations, petrography, mineral chemistry, and bulk rock compositional data for the Hidden Lakes Mafic Complex (HLMC), located in the Central Sierra Nevada Batholith. Preliminary CA-ID-TIMS U-Pb zircon ages constrain crystallization between 90 and 95 Ma, slightly older than the surrounding Cretaceous felsic plutons (89-90 Ma) and younger than adjacent Jurassic granodiorites (172 Ma). This 2.2 km2 complex consists of biotite+amphibole gabbros through qtz-monzonites, in gradational contact, and contains local pods of biotite- and amphibole-bearing olivine-orthopyroxenites and gabbronorites. Mineral compositions and field relations suggest that these lithologies were derived from a common crystallization sequence. The most primitive olivine-pyroxenite contains olivine and orthopyroxene in equilibrium with a melt with Mg# 54. Subsequent crystallization over a temperature range of 1025 to 700°C produced more evolved lithologies up to qtz-monzonites. Al-in-hornblende calculations for HLMC qtz-monzonites indicate a crystallization depth of 9-10 km, well into the upper crust. The early crystallization of amphibole requires a parental basalt with >6 wt% H2O, which may have enabled it to ascend into the upper crust due to decreased density and viscosity. However, the estimated parental melt is not primitive (rather than Mg# 70), suggesting that differentiation of a more mafic precursor parental melt in the lower crust modified the chemistry and rheological properties of the melt prior to its ascent into the upper crust.

A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery.

PubMed

Sebbag, Ilana; Massey, Simon R; Albert, Arianne Y K; Dube, Alison; Gunka, Vit; Douglas, M Joanne

2015-09-01

Shivering is common during cesarean delivery (CD) under neuraxial anesthesia and may disrupt the measurement of noninvasive blood pressure (BP). BP measured at the wrist may be less affected by shivering. There have been no studies comparing trends in BP measured on the upper arm and wrist. We hypothesized that wrist systolic blood pressure (sBP) would accurately trend with upper arm sBP measurements (agree within a limit of ±10%) in parturients undergoing elective CD under spinal anesthesia or combined spinal-epidural anesthesia. After initiation of spinal anesthesia, BP measurements were obtained simultaneously from the upper arm and wrist on opposite arms. The interval between measurements was 1 to 2 minutes, and data were collected for 20 minutes or until delivery. The primary outcome was agreement in dynamic changes in sBP measurements between the upper arm and the wrist. Bland-Altman plots indicating the levels of agreement between the methods were drawn for baseline measurements, over multiple measurements, and over multiple measurements on percentage change from baseline. Forty-nine patients were recruited and completed the study. The wrist sBP tended to overestimate the upper sBP for both baseline data (sBP bias = 13.4 mm Hg; 95% confidence interval = +10.4 to +16.4 mm Hg) and data obtained over multiple measurements (sBP bias = 12.8 mm Hg; 95% confidence interval = +9.3 to +16.3 mm Hg). For change in sBP from baseline over multiple measurements, the mean difference between the wrist and the arm sBP was -0.2 percentage points (99% limits of agreement -25 to +25 percentage points). The wrist measurement overestimated the reading relative to the upper arm measurement for multiple measurements over time. However, when the time series for each subject was examined for percentage change from baseline, the 2 methods mirrored each other in most cases. Nevertheless, our hypothesis was rejected as the limits of agreement were higher than ±10%. This finding suggests that wrist BP may not be an accurate method of detecting hypotension or hypertension during spinal or combined spinal-epidural anesthesia for CD.

Inserting pedicle screws in the upper thoracic spine without the use of fluoroscopy or image guidance. Is it safe?

PubMed

Schizas, Constantin; Theumann, Nicolas; Kosmopoulos, Victor

2007-05-01

Several studies have looked at accuracy of thoracic pedicle screw placement using fluoroscopy, image guidance, and anatomical landmarks. To our knowledge the upper thoracic spine (T1-T6) has not been specifically studied in the context of screw insertion and placement accuracy without the use of either image guidance or fluoroscopy. Our objective was to study the accuracy of upper thoracic screw placement without the use of fluoroscopy or image guidance, and report on implant related complications. A single surgeon inserted 60 screws in 13 consecutive non-scoliotic spine patients. These were the first 60 screws placed in the high thoracic spine in our institution. The most common diagnosis in our patient population was trauma. All screws were inserted using a modified Roy-Camille technique. Post-operative axial computed tomography (CT) images were obtained for each patient and analyzed by an independent senior radiologist for placement accuracy. Implant related complications were prospectively noted. No pedicle screw misplacement was found in 61.5% of the patients. In the remaining 38.5% of patients some misplacements were noted. Fifty-three screws out of the total 60 implanted were placed correctly within all the pedicle margins. The overall pedicle screw placement accuracy was 88.3% using our modified Roy-Camille technique. Five medial and two lateral violations were noted in the seven misplaced screws. One of the seven misplaced screws was considered to be questionable in terms of pedicle perforation. No implant related complications were noted. We found that inserting pedicle screws in the upper thoracic spine based solely on anatomical landmarks was safe with an accuracy comparable to that of published studies using image-guided navigation at the thoracic level.

Anisotropy in the Australasian upper mantle from Love and Rayleigh waveform inversion

NASA Astrophysics Data System (ADS)

Debayle, Eric; Kennett, B. L. N.

2000-12-01

Records of both Rayleigh and Love waves have been analyzed to determine the pattern of anisotropy in the Australasian region. The approach is based on a two-stage inversion. Starting from a smooth PREM model with transverse isotropy about a vertical symmetry axis, the first step is an inversion of the waveforms of surface waves to produce path specific one-dimensional (1-D) upper mantle models. Under the assumption that the 1-D models represent averages along the paths, the results from 1584 Love and Rayleigh wave seismograms are combined in a tomographic inversion to provide a representation of three-dimensional structure for wavespeed heterogeneities and anisotropy. Polarization anisotropy with SH faster than SV is retrieved in the upper 200-250 km of the mantle for most of Precambrian Australia. In this depth interval, significant lateral variations in the level of polarization anisotropy are present. Locally, the anisotropy can be large, reaching an extreme value of 9% that is difficult to reconcile with current mineralogical models. However, the discrepancy may be explained in part by the presence of strong lateral heterogeneities along the path, or by effects introduced by the simplifying assumption of transverse isotropy for each path. The consistency between the location of polarization and azimuthal anisotropy in depth suggests that both observations share a common origin. The observation of polarization anisotropy down to at least 200 km supports a two-layered anisotropic model as constrained by the azimuthal anisotropy of SV waves. In the upper layer, 150 km thick, anisotropy would be related to past deformation frozen in the lithosphere while in the lower layer, anisotropy would reflect present day deformation due to plate motion.

Time course of upper limb function and return-to-work post-radiotherapy in young adults with breast cancer: a pilot randomized control trial on effects of targeted exercise program.

PubMed

Ibrahim, Marize; Muanza, Thierry; Smirnow, Nadia; Sateren, Warren; Fournier, Beatrice; Kavan, Petr; Palumbo, Michael; Dalfen, Richard; Dalzell, Mary-Ann

2017-12-01

Breast cancer (BC) diagnosis in young adults (YA) is rising, and both disease and treatments are aggressive in this population. Evidence supports the use of physical activity in reducing shoulder dysfunction, which is common among BC survivors. A pilot randomized clinical trial was performed to determine the effectiveness of a 12-week post-radiation exercise program in minimizing upper extremity dysfunction in YA with BC. Participants were randomized to either an exercise arm or a control arm receiving standard care. Data was collected over six time points using: the Disability of Arm, Shoulder, and Hand (DASH); the Metabolic Equivalent of Task-hours per week (MET-hours/week), and a post hoc questionnaire on return to work. In total, 59 young women participated in the study (n = 29 exercise; n = 30 control). No statistically significant differences were found in overall DASH results between groups; however, those who underwent total mastectomy had residual upper limb dysfunction (p < 0.05). Both groups returned to pre-diagnosis activity levels by 18 months. Final evaluation showed that 86% of the women returned to work, and 89% resumed prior work activities with a decrease of 8.5 h/week. Although the short-term targeted exercise program had no effect on long-term upper limb function post-radiation, timing and program specificity may require consideration of tissue healing post-radiation and surgery type. The majority of participants returned to work, however not returning to pre-diagnosis work hours. Exercise interventions alone may not reverse the long-term sequelae of breast cancer treatment and allow young adult patients to return to work.

Feasibility and nutritional impact of laparoscopy-assisted subtotal gastrectomy for early gastric cancer in the upper stomach.

PubMed

Kosuga, Toshiyuki; Hiki, Naoki; Nunobe, Souya; Noma, Hisashi; Honda, Michitaka; Tanimura, Shinya; Sano, Takeshi; Yamaguchi, Toshiharu

2014-06-01

Laparoscopy-assisted total gastrectomy (LATG) is commonly performed for early gastric cancer (EGC) in the upper stomach; however, the incidence of anastomotic complications remains high, and postoperative nutritional status is not satisfactory. This study aimed to evaluate the feasibility and nutritional impact of a novel surgical procedure, laparoscopy-assisted subtotal gastrectomy (LAsTG). This was a retrospective study of 167 patients with EGC in the upper stomach. Of these, 57 patients underwent LAsTG, while 110 patients underwent LATG. Postoperative change in body weight, and serum concentration of albumin (Alb) and total protein (TP) were compared between the LAsTG and LATG groups. Analysis of covariance (ANCOVA) was used to assess the influence of potential confounding factors. Frequency of anastomotic complications was significantly higher in the LATG group (16.3 %) than in the LAsTG group (5.3 %, P = 0.040). Postoperative recovery of body weight at 12 months after surgery was significantly better in the LAsTG group (89.8 ± 1.4 %) than in the LATG group (82.1 ± 1.0 %, P < 0.001). By ANCOVA, adjusted mean differences of Alb and TP at 12 months after surgery between the LAsTG and LATG groups were 0.226 g/dl (95 % CI 0.141-0.312; P < 0.001) and 0.380 g/dl (95 % CI 0.265-0.495; P < 0.001); thus, the surgical procedure was significantly associated with the postoperative Alb and TP levels. LAsTG could be a better choice than LATG for EGC in the upper stomach as a result of improvements in the incidence of anastomotic complications and postoperative nutritional status.

[Comparison between Glascow-Blatchford, Rockall and AIMS65 scores in patients with upper gastrointestinal bleeding in a hospital in Lima, Peru].

PubMed

Espinoza-Ríos, Jorge; Aguilar Sánchez, Victor; Bravo Paredes, Eduar Alban; Pinto Valdivia, José; Huerta-Mercado Tenorio, Jorge

2016-01-01

Identify the best score that predicts each variable outcome (mortality, rebleeding and need for transfusion for more than 2 red blood cells pack) in patients with upper gastrointestinal bleeding until 30 days of the event. Material y methods: Patients included were those over 18 years, who had upper gastrointestinal bleeding between January 2014 to June 2015 in a general hospital of third level. The data was analyzed by the area under the curve ROC (Receiver Operating Characteristic). In total, there were 231 cases of upper gastrointestinal bleeding, 154 (66.7%) cases were male, the average age was 57.8 ± 20.02 years, the most common cause of bleeding was peptic ulcer: 111 (48.1%) cases, the mortality rate and rebleeding was 7.8% and 3.9% respectively. 5 patients were excluded from the analysis because they do not count with endoscopy study, the analysis was performed in 226 rest. In the evaluation of mortality, it was found an area under the curve ROC for Glasgow-Blatchford: 0.73, Rockall score: 0.86 and AIMS65 score: 0.90 (p<0.05) to predict rebleeding the Glasgow-Blatchford score: 0.73 Rockall score: 0.66 and AIMS65 score: 0.64 (p=0.41) and transfusion requirements of more than 2 globular packages the Glasgow-Blatchford score: 0.72, Rockall score: 0.67 and AIMS65 score: 0.77 (p=0.09). AIMS65 score is a good predictor of mortality and is useful in predicting the need for more than 2 transfusions of red blood cells pack compared to score Glasgow-Blatchford and Rockall score.

Airway inflammation and upper respiratory tract infection in athletes: is there a link?

PubMed

Bermon, Stéphane

2007-01-01

Upper Respiratory Tract Infection (URTI) is regarded as the most common medical condition affecting both highly trained and elite athletes, in particular those participating in endurance events. The causes of these disturbances, also occurring during training, remain unclear. Viruses such as rhinovirus, adenovirus and para-influenza virus are frequently reported as the source of URTI. However, in a few comprehensive laboratory and epidemiological studies which reported at least a 30% incidence of URTI, no identifiable pathogens were either reported or studied. A recent, longitudinal study investigated symptomatology and pathogenic etiology in sedentary controls, recreational and elite athletes. The highest incidence of URTI occurred in elite athletes. However; only 11 out of 37 illness episodes overall had pathogenic origins, and most of the unidentified upper respiratory illnesses were shorter in duration and less severe than infectious ones. This concept of inflammation without infection in athletes is quite new and leads us to consider other explanatory pathophysiological conditions. Increases in airway neutrophils, eosinophils and lymphocytes have been described under resting conditions in endurance sports, swimmers and cross-country skiers. These inflammatory patterns may be due to pollutants or chlorine-related compounds in swimmers. After intense exercise similar airways cellular profiles have been reported, with a high amount of bronchial epithelial cells. This increase in airway inflammatory cells in athletes can result from a hyperventilation-induced increase in airway osmolarity stimulating bronchial epithelial cells to release chemotactic factors. Fortunately, in most cases, these inflammatory cells express rather low level of adhesion molecules, explaining why airway inflammation may appear blunted in athletes despite numerous inflammatory cellular elements. However it can be hypothesized that a transient loss of control of this local inflammation, due to various external physico-chemical strains, might occur. This might account for some of the unidentified upper respiratory illnesses.

ILLUSTRATED HANDBOOK OF SOME COMMON MOLDS.

ERIC Educational Resources Information Center

CHANDLER, MARION N.

THIS DOCUMENT IS A PICTURE GUIDE FOR THE IDENTIFICATION OF TEN COMMON MOLDS. IT IS DESIGNED FOR USE WITH THE ELEMENTARY SCIENCE STUDY UNIT "MICROGARDENING" AND IS SUGGESTED FOR UPPER ELEMENTARY GRADES. INCLUDED FOR EACH MOLD ARE COLOR PHOTOGRAPHS AND PHOTOMICROGRAPHS OF THE INTACT MOLD MASS AND OF THE MOLD'S SPORE PRODUCING STRUCTURES.…

Common bile duct stricture as a late complication of upper abdominal radiotherapy.

PubMed

Cherqui, D; Palazzo, L; Piedbois, P; Charlotte, F; Duvoux, C; Duron, J J; Fagniez, P L; Valla, D

1994-06-01

We report the cases of two patients who developed symptomatic common bile duct stricture 10 years after upper abdominal radiotherapy for malignant lymphoma. Both patients were in complete remission and presented with marked obstructive jaundice. Endosonography was useful in both cases and showed segmental thickening of the bile duct wall narrowing in the lumen. Both patients underwent surgical exploration, confirming biliary obstruction due to intrinsic wall thickening, and had successful biliary drainage by Roux-en-Y hepatico-jejunostomy. Histological examination of the resected bile duct, in one case, and of a bile duct biopsy, in the other, was consistent with late irradiation injury. We conclude that stricture may be a delayed consequence of radiotherapy applied to normal bile ducts.

Histopathological diagnosis of eyelid tumors in Chiang Mai University Hospital.

PubMed

Nithithanaphat, Chanut; Ausayakhun, Sakarin; Wiwatwongwana, Damrong; Mahanupab, Pongsak

2014-10-01

To report the histopathological diagnosis ofeyelid tumors and to study the prevalence of eyelid tumors in Chiang Mai University Hospital Chiang Mai, Thailand. A retrospective review of medical and pathological records ofpatients diagnosed as eyelid tumor that underwent histopathological biopsy between January 2007 and December 2013 in Chiang Mai University Hospital was done. Three hundred sixteen cases of eyelid tumors were reviewed. The mean age at diagnosis was 54.2 +/- 19.6 years (range 1 month-99 years), women were 59.5% (n = 188) and men 40.5% (n = 128). The tumor sites were left lower eyelid (27.5%), right upper eyelid (24.4%), right lower eyelid (21.2%), and left upper eyelid (18.7%). There were 204 (64.6%) benign tumors and 112 (35.4%) malignant tumors. Nevi were the most common in benign group (16.4%) and basal cell carcinoma was the most common eyelid malignancy (18.0%). The most common histopathological diagnosis for benign eyelid tumor was nevus, while the most common malignant eyelid tumor was basal cell carcinoma at Chiang Mai University Hospital.

Holocene sea-level variations and geomorphological response: An example from northern Brittany (France)

NASA Astrophysics Data System (ADS)

Regnauld, H.; Jennings, S.; Delaney, C.; Lemasson, L.

In northern Brittany an important geomorphological response to Holocene sea-level rise has been the development of coastal dunes with associated lagoons and marshes. At Anse du Verger, a marsh has formed behind a dune system which has been developing in situ for the last 4000 years. The lithostratigraphy of the marsh comprises extensive peat formation, with sands, silts and occasional sand lenses, the latter probably associated with storm surges. The sequence dates from 10,320±120 BP. After 3000 BP, flood episodes on the marsh are more common, while the upper marsh deposits can be correlated with the recent period of dune building. Prehistoric artifacts (remains of cooking implements) have been found on a cliff to the east of the marsh and are buried by washover deposits, which indicates a sudden abandonment of a settlement possibly due to a storm surge soon after 2460±80 BP. Surge levels are proposed as a controlling factor on dune crest elevation.

Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.

PubMed

Watson, Sheri; Aguas, Marita; Colegrove, Pat; Foisy, Nancy; Jondahl, Bonnie; Anastas, Zoe

2017-02-01

The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Alternative configurations of Quantile Regression for estimating predictive uncertainty in water level forecasts for the Upper Severn River: a comparison

NASA Astrophysics Data System (ADS)

Lopez, Patricia; Verkade, Jan; Weerts, Albrecht; Solomatine, Dimitri

2014-05-01

Hydrological forecasting is subject to many sources of uncertainty, including those originating in initial state, boundary conditions, model structure and model parameters. Although uncertainty can be reduced, it can never be fully eliminated. Statistical post-processing techniques constitute an often used approach to estimate the hydrological predictive uncertainty, where a model of forecast error is built using a historical record of past forecasts and observations. The present study focuses on the use of the Quantile Regression (QR) technique as a hydrological post-processor. It estimates the predictive distribution of water levels using deterministic water level forecasts as predictors. This work aims to thoroughly verify uncertainty estimates using the implementation of QR that was applied in an operational setting in the UK National Flood Forecasting System, and to inter-compare forecast quality and skill in various, differing configurations of QR. These configurations are (i) 'classical' QR, (ii) QR constrained by a requirement that quantiles do not cross, (iii) QR derived on time series that have been transformed into the Normal domain (Normal Quantile Transformation - NQT), and (iv) a piecewise linear derivation of QR models. The QR configurations are applied to fourteen hydrological stations on the Upper Severn River with different catchments characteristics. Results of each QR configuration are conditionally verified for progressively higher flood levels, in terms of commonly used verification metrics and skill scores. These include Brier's probability score (BS), the continuous ranked probability score (CRPS) and corresponding skill scores as well as the Relative Operating Characteristic score (ROCS). Reliability diagrams are also presented and analysed. The results indicate that none of the four Quantile Regression configurations clearly outperforms the others.

Accuracy of retrieving temperature and humidity profiles by ground-based microwave radiometry in truly complex terrain

NASA Astrophysics Data System (ADS)

Massaro, G.; Stiperski, I.; Pospichal, B.; Rotach, M. W.

2015-08-01

Within the Innsbruck Box project, a ground-based microwave radiometer (RPG-HATPRO) was operated in the Inn Valley (Austria), in very complex terrain, between September 2012 and May 2013 to obtain temperature and humidity vertical profiles of the full troposphere with a specific focus on the valley boundary layer. In order to assess its performance in a deep alpine valley, the profiles obtained by the radiometer with different retrieval algorithms based on different climatologies are compared to local radiosonde data. A retrieval that is improved with respect to the one provided by the manufacturer, based on better resolved data, shows a significantly smaller root mean square error (RMSE), both for the temperature and humidity profiles. The improvement is particularly substantial at the heights close to the mountaintop level and in the upper troposphere. Lower-level inversions, common in an alpine valley, are resolved to a satisfactory degree. On the other hand, upper-level inversions (above 1200 m) still pose a significant challenge for retrieval. For this purpose, specialized retrieval algorithms were developed by classifying the radiosonde climatologies into specialized categories according to different criteria (seasons, daytime, nighttime) and using additional regressors (e.g., measurements from mountain stations). The training and testing on the radiosonde data for these specialized categories suggests that a classification of profiles that reproduces meaningful physical characteristics can yield improved targeted specialized retrievals. A novel and very promising method of improving the profile retrieval in a mountainous region is adding further information in the retrieval, such as the surface temperature at fixed levels along a topographic slope or from nearby mountaintops.

Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque

PubMed Central

Björklund, Martin; Svedmark, Åsa; Srinivasan, Divya; Djupsjöbacka, Mats

2017-01-01

Background Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. Methods Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. Findings Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. Interpretation The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments. PMID:28099504

The Late Triassic bivalve Monotis in accreted terranes of Alaska

USGS Publications Warehouse

Silberling, Norman J.; Grant-Mackie, J. A.; Nichols, K.M.

1997-01-01

Late Triassic bivalves of the genus Monotis occur in at least 16 of the lithotectonic terranes and subterranes that together comprise nearly all of Alaska, and they also occur in the Upper Yukon region of Alaska where Triassic strata are regarded as representing non-accretionary North America. On the basis of collections made thus far, 14 kinds of Monotis that differ at the species or subspecies level can be recognized from alaska. These are grouped into the subgenera Monotis (Monotis), M. (Pacimonotis), M. (Entomonotis), and M. (Eomonotis). In places, Monotis shells of one kind or another occur in rock-forming abundance. On the basis of superpositional data from Alaska, as well as from elsewhere in North America and Far Eastern Russia, at least four distince biostratigraphic levels can be discriminated utilizing Monotis species. Different species of M. (Eomonotis) characterize two middle Norian levels, both probably within the supper middle Norian Columbianus Ammonite Zone. Two additional levels are recognized in the lower upper Norian Cordilleranus Ammonite Zone utilizing species of M. (Monotis) or M. (Entomonotis), both of which subgenera are restricted to the late Norian. An attached-floating mode of life is commonly attributed to Monotis; thus, these bivalves would have been pseudoplanktonic surface dwellers that were sensitive to surface-water temperature and paleolatitude. Distinctly different kinds of Monotis occur at different paleolatitudes along the Pacific and Arctic margins of the North American craton inboard of the accreted terranes. Comparison between thse craton-bound Monotis faunas and those of the Alaskan terranes in southern Alaska south of the Denali fault were paleoequatorial in latitude during Late Triassic time. Among these terranes, the Alexander terrane was possibly in the southern hemisphere at that time. Terranes of northern Alaska, on the other hand, represent middle, possibly high-middle, northern paleolatitudes.

Lynch Syndrome: A Primer for Urologists and Panel Recommendations.

PubMed

Mork, Maureen; Hubosky, Scott G; Rouprêt, Morgan; Margulis, Vitaly; Raman, Jay; Lotan, Yair; O'Brien, Timothy; You, Nancy; Shariat, Shahrokh F; Matin, Surena F

2015-07-01

Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, is a common genetic disease. The predisposition of patients with Lynch syndrome to urological cancer, particularly upper tract urothelial carcinoma, is underappreciated. Urologists may be involved in several aspects of care involving Lynch syndrome, including identifying undiagnosed patients, surveillance of those with established Lynch syndrome or screening family members, in addition to treating patients with Lynch syndrome in whom upper tract urothelial carcinoma develops. We sought to increase awareness in the urological community about Lynch syndrome and provide some guidance where little currently exists. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement we reviewed the available published literature and guidelines from 1998 to 2014 on Lynch syndrome and its association with upper tract urothelial carcinoma. Recommendations based on the literature and the consensus of expert opinion are provided. No randomized or prospective study has been done to evaluate Lynch syndrome in the setting of urological cancer. All data were based on retrospective studies. Lynch syndrome is an autosomal dominant genetic disease caused by germline mutations in 4 mismatch repair genes, leading to the accumulation of DNA errors in microsatellite regions. Upper tract urothelial carcinoma develops in up to 28% of patients with known Lynch syndrome. The diagnosis of Lynch syndrome is established by clinical criteria, tumor tissue testing and genetic evaluation. Urologists should suspect Lynch syndrome when a patient with upper tract urothelial carcinoma presents before age 60 years or meets the 3-2-1 rule. Screening patients with Lynch syndrome for upper tract urothelial carcinoma presents a particular challenge. While no ideal screening test exists, at a minimum routine urinalysis is recommended using the American Urological Association guideline of 3 or more red blood cells per high power field as a trigger for further assessment. Upper tract urothelial carcinoma associated with Lynch syndrome presents at a younger age than sporadic upper tract urothelial carcinoma. It shows a higher proportion of ureteral cancer with a female preponderance and a possible predisposition to bilaterality. Lynch syndrome is a common genetic disease that is an underappreciated cause of upper tract urothelial carcinoma and possibly other urological cancers. Optimal screening for upper tract urothelial carcinoma in this population is unclear. Further study is needed to identify the best screening test and interval of testing. Urologists should consider routine tissue testing of de novo upper tract urothelial carcinoma tissue in individuals at risk. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Measuring the space between vagina and rectum as it relates to rectocele

PubMed Central

Liu, Jin; Zhai, Li-Dong; Li, Yun-Sheng; Liu, Wan-Xiang; Wang, Rui-Hua

2009-01-01

AIM: To measure the normal space between the posterior wall of the vagina and the anterior wall of the respectively rectum using computed tomography (CT) and reveal its were relationship to rectocele. METHODS: A total of twenty female volunteers without rectocele were examined by CT scan. We performed a middle level continuous horizontal pelvic scan from the upper part to the lower part and collected the measurement data to analyze the results using t-test. RESULTS: Twenty volunteers were enrolled in the study. The space between the posterior wall of the vagina and the anterior wall of the rectum was measured at three levels (upper 1/3, middle, lower 1/3 level of vagina). The results showed that the space from the posterior wall of the vagina to the anterior wall of the rectum at the upper 1/3 level and the middle level was 3.896 ± 0.3617 mm and 4.6575 ± 0.3052 mm, respectively. When the two groups of data were compared, we found the space at the upper 1/3 level was shorter than at the middle level (P < 0.01). Moreover, at the lower 1/3 level the space measured was 10.058 ± 0.4534 mm. The results revealed that the space at the lower 1/3 level was longer than that at the middle level (P < 0.01). CONCLUSION: These measurement data may be helpful in assessing rectocele clinical diagnosis and functional outcomes of rectocele repair. PMID:19554660

Linking Measures of Adult Nicotine Dependence to a Common Latent Continuum and a Comparison with Adolescent Patterns

PubMed Central

Strong, David R.; Schonbrun, Yael Chatav; Schaffran, Christine; Griesler, Pamela C.; Kandel, Denise

2012-01-01

Background An ongoing debate regarding the nature of Nicotine Dependence (ND) is whether the same instrument can be applied to measure ND among adults and adolescents. Using a hierarchical item response model (IRM), we examined evidence for a common continuum underlying ND symptoms among adults and adolescents. Method The analyses are based on two waves of interviews with subsamples of parents and adolescents from a multi-ethnic longitudinal cohort of 1,039 6th–10th graders from the Chicago Public Schools (CPS). Adults and adolescents who reported smoking cigarettes the last 30 days prior to waves 3 and 5 completed three common instruments measuring ND symptoms and one item measuring loss of autonomy. Results A stable continuum of ND, first identified among adolescents, was replicated among adults. However, some symptoms, such as tolerance and withdrawal, differed markedly across adults and adolescents. The majority of mFTQ items were observed within the highest levels of ND, the NDSS items within the lowest levels, and the DSM-IV items were arrayed in the middle and upper third of the continuum of dependence severity. Loss of Autonomy was positioned at the lower end of the continuum. We propose a ten-symptom measure of ND for adolescents and adults. Conclusions Despite marked differences in the relative severity of specific ND symptoms in each group, common instrumentation of ND can apply to adults and adolescents. The results increase confidence in the ability to describe phenotypic heterogeneity in ND across important developmental periods. PMID:21855236

Double-crested cormorants along the upper Mississippi River

USGS Publications Warehouse

Kirsch, E.M.

1995-01-01

The Upper Mississippi River is an important habitat corridor for migratory birds and other wildlife, and it supports an important commercial and sport fishery. A study was initiated by the U.S. Fish and Wildlife Service in 1991 to describe Double-crested cormorant (Phalacrocorax auritus) distribution and abundance on the Upper Mississippi River throughout the year to better understand the possible impacts of cormorants on fish resources and populations of other piscivorous birds. Double-crested Cormorants were common breeders and abundant during migration on the Upper Mississippi River during the 1940s. Numbers of cormorants declined in the 1960s and 1970s along the Upper Mississippi River as they did in other parts of the United States. In 1992, 418 cormorant pairs were estimated to have nested in four colonies on the Upper Mississippi River, and less than 7,000 cormorants were estimated to have migrated along the river during the fall and spring of 1991 and 1992. Recent public concern for fish resources has grown with a perceived growth of the local cormorant population. Migrating cormorants collected on the Upper Mississippi River took Gizzard Shad (Dorosoma cepedianum) primarily, but chicks were fed a wide variety of fish species.

Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes.

PubMed

Spence, Luke; Brown, Wendy J; Pyne, David B; Nissen, Michael D; Sloots, Theo P; McCormack, Joseph G; Locke, A Simon; Fricker, Peter A

2007-04-01

Upper respiratory illness (URI) is the most common medical condition affecting elite athletes. The aims of this study were to identify and evaluate the incidence, pathogenic etiology, and symptomatology of acute URI during a 5-month training and competition period. Thirty-two elite and 31 recreationally competitive triathletes and cyclists, and 20 sedentary controls (age range 18.0-34.1 yr) participated in a prospective surveillance study. Nasopharyngeal and throat swabs were collected from subjects presenting with two or more defined upper respiratory symptoms. Swabs were analyzed using microscopy, culture, and PCR testing for typical and atypical respiratory pathogens. The Wisconsin Upper Respiratory Symptom Survey (WURSS-44) was used to assess symptomatology and functional impairment. Thirty-seven URI episodes were reported in 28 subjects. Incidence rate ratios for illness were higher in both the control subjects (1.93, 95% CI: 0.72-5.18) and elite athletes (4.50, 1.91-10.59) than in the recreationally competitive athletes. Infectious agents were identified in only 11 (two control, three recreationally competitive, and six elite) out of 37 illness episodes. Rhinovirus was the most common respiratory pathogen isolated. Symptom and functional impairment severity scores were higher in subjects with an infectious pathogen episode, particularly on illness days 3-4. The results confirm a higher rate of URI among elite athletes than recreationally competitive athletes during this training and competition season. However, because pathogens were isolated in fewer than 30% of URI cases, further study is required to uncover the causes of unidentified but symptomatic URI in athletes. Despite the common perception that all URI are infections, physicians should consider both infectious and noninfectious causes when athletes present with symptoms.

Theoretical investigation of output features of a diode-pumped rubidium vapor laser

NASA Astrophysics Data System (ADS)

Wang, You; Cai, He; Zhang, Wei; Xue, Liangping; Wang, Hongyuan; Han, Juhong

2014-02-01

In the recent years, diode-pumped alkali lasers (DPALs) have been paid many attentions because of their excellent performances. In fact, the characteristics of a DPAL strongly depend on the physical features of buffer gases. In this report, we selected a diode-pumped rubidium vapor laser (DPRVL), which is an important type among three common DPALs, to investigate how the characteristics of a DPRVL are affected by different conditions. The results signify that the population ratio of two excitation energy-levels are close to that corresponding to thermal equilibrium as the pressure of buffer gases and the temperature of a vapor cell become higher. It has been found that quenching of the upper levels cannot be simply ignored especially for the case of weak pump. The conclusions are thought to be helpful for the configuration design of an end-pumped DPAL.

Student understanding of time dependence in quantum mechanics

NASA Astrophysics Data System (ADS)

Emigh, Paul J.; Passante, Gina; Shaffer, Peter S.

2015-12-01

[This paper is part of the Focused Collection on Upper Division Physics Courses.] The time evolution of quantum states is arguably one of the more difficult ideas in quantum mechanics. In this article, we report on results from an investigation of student understanding of this topic after lecture instruction. We demonstrate specific problems that students have in applying time dependence to quantum systems and in recognizing the key role of the energy eigenbasis in determining the time dependence of wave functions. Through analysis of student responses to a set of four interrelated tasks, we categorize some of the difficulties that underlie common errors. The conceptual and reasoning difficulties that have been identified are illustrated through student responses to four sets of questions administered at different points in a junior-level course on quantum mechanics. Evidence is also given that the problems persist throughout undergraduate instruction and into the graduate level.

Controlling the fluoride dosage in a patient with compromised salivary function.

PubMed

Eichmiller, Frederick C; Eidelman, Naomi; Carey, Clifton M

2005-01-01

High-concentration topical fluorides are used commonly to with compromised salivary function due to irradiation and chemotherapy. The authors describe a 50-year-old man with previously treated cancer who was using tray-applied topical fluoride gel. He complained of gastric symptoms, difficulty in swallowing, leg muscle soreness and knee joint soreness. A computed tomographic scan revealed thickening of the esophageal walls. An upper endoscopy revealed abnormal motility. The motility test indicated high-amplitude peristalsis and hypertensive lower esophageal sphincter, and urine testing indicated high levels of systemic fluoride. The patient's fluoride regimen was altered, and within a short period his urinary fluoride levels returned to normal and his symptoms resolved. Clinicians prescribing home-applied high-concentration fluorides need to be cognizant of the symptoms of fluoride toxicity, carefully monitor the patient's compliance with the treatment regimen, and adjust the dosage or mode of application to control the total ingested dose of fluoride.

Stress hyperglycaemia as a result of a catecholamine producing tumour in an infant.

PubMed

de Grauw, Anne Mariëtte; Mul, Dick; van Noesel, Max M; Buddingh, Emilie P

2015-09-04

Hyperglycaemia commonly occurs in children presenting at the emergency department. In the absence of diabetic symptoms, this stress-related hyperglycaemia is considered a benign condition. We present a malignant cause of hyperglycaemia in an 11-month-old girl with concomitant symptoms of a neuroendocrine malignancy. One month earlier, she had undergone an episode of stress-related hyperglycaemia concurrent with fever during an upper respiratory tract infection. Current glucose level was 234 mg/dL (13 mmol/L) and the glycosylated haemoglobin level was 44 mmol/mol (6.2%) without metabolic acidosis. We observed periods of hyperglycaemia, sweating, flushing, hypertension and tachypnoea. Urinalysis showed high amounts of catecholamine intermediates. Abdominal ultrasound revealed a mass originating in the right adrenal gland. Histology confirmed the diagnosis of neuroblastoma. Hyperglycaemia in this patient was the first presenting symptom of a metabolically active neuroblastoma. 2015 BMJ Publishing Group Ltd.

Hyperthyroidism: an unusual case presentation.

PubMed

Scripture, D L

1998-02-01

Hyperthyroidism is the most common disorder of the thyroid. Patients typically present with complaints consistent with a hypermetabolic state, including nervousness, weight loss, heat intolerance, palpitations, irritability, and tremor. This case report reviews a 34-year-old woman who presented with unilateral upper extremity weakness, weight gain, and an episode of atrial fibrillation, the latter coinciding with a 36-hour lack of sleep and excess alcohol and caffeine intake. Although an extensive neurologic evaluation failed to identify any abnormality, the patient's laboratory analysis revealed elevations in thyroxine (T4) and triiodothyronine (T3) levels with unsuppressed thyroid-stimulating hormone levels. Subsequent treatment with the antithyroid drug methimazole (Tapazole) provided complete relief of symptoms. This case report illustrates how health care providers can be diverted to pursue a neurologic etiology when muscle weakness presents as a unilateral symptom. Plausible alternative causes for muscle weakness and other symptoms are presented.

Multilevel animal societies can emerge from cultural transmission

PubMed Central

Cantor, Maurício; Shoemaker, Lauren G.; Cabral, Reniel B.; Flores, César O.; Varga, Melinda; Whitehead, Hal

2015-01-01

Multilevel societies, containing hierarchically nested social levels, are remarkable social structures whose origins are unclear. The social relationships of sperm whales are organized in a multilevel society with an upper level composed of clans of individuals communicating using similar patterns of clicks (codas). Using agent-based models informed by an 18-year empirical study, we show that clans are unlikely products of stochastic processes (genetic or cultural drift) but likely originate from cultural transmission via biased social learning of codas. Distinct clusters of individuals with similar acoustic repertoires, mirroring the empirical clans, emerge when whales learn preferentially the most common codas (conformism) from behaviourally similar individuals (homophily). Cultural transmission seems key in the partitioning of sperm whales into sympatric clans. These findings suggest that processes similar to those that generate complex human cultures could not only be at play in non-human societies but also create multilevel social structures in the wild. PMID:26348688

Rossby waves, extreme fronts, and wildfires in southeastern Australia

NASA Astrophysics Data System (ADS)

Reeder, Michael J.; Spengler, Thomas; Musgrave, Ruth

2015-03-01

The most catastrophic fires in recent history in southern Australia have been associated with extreme cold fronts. Here an extreme cold front is defined as one for which the maximum temperature at 2 m is at least 17°C lower on the day following the front. An anticyclone, which precedes the cold front, directs very dry northerlies or northwesterlies from the interior of the continent across the region. The passage of the cold front is followed by strong southerlies or southwesterlies. European Centre for Medium-Range Weather Forecasts ERA-Interim Reanalyses show that this regional synoptic pattern common to all strong cold fronts, and hence severe fire conditions, is a consequence of propagating Rossby waves, which grow to large amplitude and eventually irreversibly overturn. The process of overturning produces the low-level anticyclone and dry conditions over southern Australia, while simultaneously producing an upper level trough and often precipitation in northeastern Australia.

Vagus nerve stimulation during rehabilitative training improves forelimb strength following ischemic stroke.

PubMed

Khodaparast, N; Hays, S A; Sloan, A M; Hulsey, D R; Ruiz, A; Pantoja, M; Rennaker, R L; Kilgard, M P

2013-12-01

Upper limb impairment is a common debilitating consequence of ischemic stroke. Physical rehabilitation after stroke enhances neuroplasticity and improves limb function, but does not typically restore normal movement. We have recently developed a novel method that uses vagus nerve stimulation (VNS) paired with forelimb movements to drive specific, long-lasting map plasticity in rat primary motor cortex. Here we report that VNS paired with rehabilitative training can enhance recovery of forelimb force generation following infarction of primary motor cortex in rats. Quantitative measures of forelimb function returned to pre-lesion levels when VNS was delivered during rehab training. Intensive rehab training without VNS failed to restore function back to pre-lesion levels. Animals that received VNS during rehab improved twice as much as rats that received the same rehabilitation without VNS. VNS delivered during physical rehabilitation represents a novel method that may provide long-lasting benefits towards stroke recovery. © 2013.

Hard work never hurt anyone--or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb.

PubMed

Walker-Bone, K; Cooper, C

2005-08-01

Pain in the neck and upper limb is common and contributes greatly to absence due to sickness. Evidence is accumulating that factors such as prolonged abnormal posture and repetition contribute to these conditions. Psychosocial factors may also play a part and the relative importance of these is not yet known. Primary and secondary prevention trials are needed.

Translations on North Korea. Number 615. Foreign Delegations Attend DARK 30th Anniversary Celebrations.

DTIC Science & Technology

1978-09-19

Guinea-Bissau Alexandre Nunes Correia, secretary general of the State Commissariat for Foreign Affairs [name and title as received], member of the...of Upper Volta Ouedraogo Mousha Ernest, director of the secretariat of the Foreign Ministry of the Republic of Upper Volta ; head of the delegation...the common cause for independence, sovereignty and the building of a new society against imperialism and dominationist forces. Alexandre Nunes

Synthesis and revision of the lithostratigraphic groups and formations in the Upper Permian?–Lower Jurassic Newark Supergroup of eastern North America

USGS Publications Warehouse

Weems, Robert E.; Tanner, Lawrence H.; Lucas, Spencer G.

2016-01-01

The Upper Permian? - Lower Jurassic Newark Supergroup of eastern North America has a strikingly uniform succession of lithologic units. This uniformity is seen regardless of whether these units are characterized on the basis of their lithostratigraphy, allostratigraphy, biostratigraphy, or chemostratigraphy. After deposition, these units were broken up tectonically and attacked erosionally; parts of them survive today only within localized, down-faulted areas. Many lines of evidence compellingly demonstrate that most or all of these remnant units once were physically continuous between remaining outcrops. It is needlessly confusing to give every remnant of each unit a different name in each area where it persists simply because it is now physically isolated by erosion from other portions of the same unit. Instead, these units should be defined within a regional lithostratigraphic framework that emphasizes their common origins and original stratigraphic continuity. To this end, the formation-level stratigraphy of the Newark Supergroup is reduced from 58 locally applied and locally defined formations to a succession of only 16 uniformly defined and regionally recognizable formations. In all cases the oldest name validly applied to each formation is given priority over more recently erected synonymous names, which are either abandoned or, in a few cases, changed in rank to a member of one of the formations recognized here. The Newark Supergroup is here organized into four regionally recognizable groups, each subdivided into regionally recognizable formations. In ascending order, the Upper Permian?-Middle Triassic Acadia Group (new name) includes the Honeycomb Point Formation, Chedabucto Formation, Economy Formation, and Evangeline Formation. This group is preserved only in the Canadian Fundy and Chedabucto basins. The Upper Triassic (Carnian-Norian) Chatham Group includes the Doswell Formation, Stockton Formation, Lockatong Formation, and Passaic Formation. The Upper Triassic-Lower Jurassic (upper Rhaetian-lower Hettangian) Meriden Group includes the Talcott Formation, Shuttle Meadow Formation, Holyoke Formation, East Berlin Formation, and Hampden Formation. The term "Agawam Group," previously proposed to encompass all Newark Supergroup strata above the highest basalt of the Meriden Group, is here abandoned and replaced with the name "Portland Group" for the same suite of strata. The Lower Jurassic (upper Hettangian-lower Sinemurian) Portland Group includes a lower Boonton Formation, an overlying Longmeadow Sandstone (here reinstated), and the Mount Toby Conglomerate, which laterally intertongues with both the Boonton Formation and the Longmeadow Sandstone. 

Effect of parallel refraction on magnetospheric upper hybrid waves

NASA Technical Reports Server (NTRS)

Engel, J.; Kennel, C. F.

1984-01-01

Large amplitude (not less than 10 mV/m) electrostatic plasma waves near the upper hybrid (UH) frequency have been observed from 0 to 50 deg magnetic latitude (MLAT) during satellite plasma-pause crossings. A three-dimensional numerical ray-tracing calculation, based on an electron distribution measured during a GEOS 1 dayside intense upper-hybrid wave event, suggests how UH waves might achieve such large amplitudes away from the geomagnetic equator. Refractive effects largely control the wave amplification and, in particular, the unavoidable refraction due to parallel geomagnetic field gradients restricts growth to levels below those observed. However, a cold electron density gradient parallel to the field can lead to upper hybrid wave growth that can account for the observed emission levels.

Thermal insulation and SIDS-an investigation of selected 'Eastern' and 'Western' infant bedding combinations.

PubMed

Wilson, C A; Chu, M S

2005-08-01

Differences in the incidence of SIDS between 'Western' and 'Eastern' countries has been attributed to cultural practices, which may affect the infants care and thermal environment. The purpose of this work was to estimate for selected 'commonly' used bedding, sleep positions and practices in Japan, Korea and New Zealand, the intrinsic 'dry' thermal resistance of bedding. Insulation levels are also discussed in the context of published information about the thermal environment in which the bedding is likely to be used. Selected Japanese, Korean and New Zealand bedding was loosely tucked over an infant manikin in the lateral, prone and supine sleep positions. Thickness in use was measured, and intrinsic 'dry' thermal resistance estimated using the Wilson Laing model which accommodates the effect on insulation of the three-dimensional arrangement of bedding combinations during use. Thickness of under- and upper-bedding varied among countries with thickness and estimated 'dry' thermal resistance of the upper-bedding affected by the type/combination of bedding and the infants sleep position. Insulation levels are discussed in relation to environmental conditions within and among countries and between seasons. Further information on thermal environments, bedding combinations used and care practices within both Asian and Western countries is needed. 'Eastern' infants appear likely to be generally covered in bedding combinations of greater insulation than those used to cover 'Western' infants in comparable seasons. Differences existed between insulation of the Japanese and Korean bedding combinations investigated. Lower rates of SIDS apparent in 'Asian' populations do not appear attributable to use of lower levels of bedding insulation only.

A comparison of muscular activity during single and double mouse clicks.

PubMed

Thorn, Stefan; Forsman, Mikael; Hallbeck, Susan

2005-05-01

Work-related musculoskeletal disorders (WMSDs) in the neck/shoulder region and the upper extremities are a common problem among computer workers. Occurrences of motor unit (MU) double discharges with very short inter-firing intervals (doublets) have been hypothesised as a potential additional risk for overuse of already exhausted fibres during long-term stereotyped activity. Doublets are reported to be present during double-click mouse work tasks. A few comparative studies have been carried out on overall muscle activities for short-term tasks with single types of actions, but none on occurrences of doublets during double versus single clicks. The main purpose of this study was to compare muscle activity levels of single and double mouse clicks during a long-term combined mouse/keyboard work task. Four muscles were studied: left and right upper trapezius, right extensor digitorum communis (EDC) and right flexor carpi ulnaris. Additionally, MU activity was analysed through intramuscular electromyography in the EDC muscle for a selection of subjects. The results indicate that double clicking produces neither higher median or 90th percentile levels in the trapezius and EDC muscles, nor a higher disposition for MU doublets, than does single clicking. Especially for the 90th percentile levels, the indications are rather the opposite (in the EDC significantly higher during single clicks in 8 of 11 subjects, P < 0.05). Although it cannot be concluded from the present study that double clicks are harmless, there were no signs that double clicks during computer work generally constitute a larger risk factor for WMSDs than do single clicks.

Stratigraphy of lower to middle Paleozoic rocks of northern Nevada and the Antler orogeny

USGS Publications Warehouse

Ketner, Keith B.

2013-01-01

Commonly accepted concepts concerning the lower Paleozoic stratigraphy of northern Nevada are based on the assumption that the deep-water aspects of Ordovician to Devonian siliceous strata are due to their origin in a distant oceanic environment, and their presence where we find them is due to tectonic emplacement by the Roberts Mountains thrust. The concept adopted here is based on the assumption that their deep-water aspects are the result of sea-level rise in the Cambrian, and all of the Paleozoic strata in northern Nevada are indigenous to that area. The lower part of the Cambrian consists mainly of shallow-water cross-bedded sands derived from the craton. The upper part of the Cambrian, and part of the Ordovician, consists mainly of deep-water carbonate clastics carried by turbidity currents from the carbonate shelf in eastern Nevada, newly constructed as a result of sea-level rise. Ordovician to mid-Devonian strata are relatively deep-water siliceous deposits, which are the western facies assemblage. The basal contact of this assemblage on autochthonous Cambrian rocks is exposed in three mountain ranges and is clearly depositional in all three. The western facies assemblage can be divided into distinct stratigraphic units of regional extent. Many stratigraphic details can be explained simply by known changes in sea level. Upper Devonian to Mississippian strata are locally and westerly derived orogenic clastic beds deposited disconformably on the western facies assemblage. This disconformity, clearly exposed in 10 mountain ranges, indicates regional uplift and erosion of the western facies assemblage and absence of local deformation. The disconformity represents the Antler orogeny.

Ares V: Progress Toward Unprecedented Heavy Lift

NASA Technical Reports Server (NTRS)

Sumrall, Phil

2010-01-01

Ares V represents the vehicle that will again make possible human exploration beyond low Earth orbit. The Ares V is part of NASA s Constellation Program architecture developed to support the International Space Station (ISS), establish a permanent human presence on the Moon, and explore it to an extent far greater than was possible with the Apollo Program. Ares V will carry the lunar lander to orbit where it will join the Orion crew spacecraft, launched by the smaller Ares I launch vehicle. Then the Ares V upper stage will send the Orion and lander to the Moon. Ares V is also intended to launch automated cargo landers to the Moon. The Ares vehicles are designed to employ the proven technologies and experience from the Space Shuttle, Delta IV, and earlier U.S. programs, as well as sharing common components where feasible. The Ares V is in an early stage of concept development. However, commonality allows it to benefit from development work already under way on the Ares I, including the first stage booster, and upper stage, J-2X upper stage engine. This paper will discuss progress to date on the Ares V and its potential for freeing payload designers from current mass and volume constraints. Progress includes development progress on Ares I elements that will be shared by the two launch vehicles. The Ares I first stage recently completed a successful test firing of Development Motor 1 (DM-1). The J-2X engine is proceeding with manufacturing of components for the first development engines that will be used for testing. Several component-level tests have been completed or are under way that will help verify designs and confirm solutions to design challenges. The Ares V Earth departure stage will benefit from the Ares I upper stage development, including design, manufacturing, and materials testing. NASA is also working with government and industry to collect data on flights and testing of the operational RS-68 engine and potential upgrades. The Ares V team continues to evaluate technical options, vehicle configurations, and operations concepts for the Ares V. The team recently completed a Fall Face-to-Face meeting that served as a stepping-stone to the Systems Requirements Review (SRR). This four-day meeting served as an information exchange for the various teams at several NASA field centers and supporting contractors.

LPT. Shield test facility assembly and test building (TAN646). East ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

LPT. Shield test facility assembly and test building (TAN-646). East facade of ebor helium wing addition. Camera facing west. Note asbestos-cement siding on stair enclosure and upper-level. Concrete siding at lower level. Metal stack. Monorail protrudes from upper level of south wall at left of view. INEEL negative no. HD-40-7-4 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Multiweek Cell Culture Project for Use in Upper-Level Biology Laboratories

ERIC Educational Resources Information Center

Marion, Rebecca E.; Gardner, Grant E.; Parks, Lisa D.

2012-01-01

This article describes a laboratory protocol for a multiweek project piloted in a new upper-level biology laboratory (BIO 426) using cell culture techniques. Human embryonic kidney-293 cells were used, and several culture media and supplements were identified for students to design their own experiments. Treatments included amino acids, EGF,…

Women in Leadership in Higher Education: Leadership Styles and the "Glass Ceiling"

ERIC Educational Resources Information Center

Michael, Rebecka

2013-01-01

Women in upper-level leadership positions in higher education are underrepresented. This study examined the predominant leadership styles of women who have achieved upper-level leadership positions in higher education explored intentional changes in their leadership styles. Primarily, the study sought to determine if these leaders had similar…

Undergraduate Chemistry Students' Perceptions of and Misconceptions about Buffers and Buffer Problems

ERIC Educational Resources Information Center

Orgill, MaryKay; Sutherland, Aynsley

2008-01-01

Both upper- and lower-level chemistry students struggle with understanding the concept of buffers and with solving corresponding buffer problems. While it might be reasonable to expect general chemistry students to struggle with this abstract concept, it is surprising that upper-level students in analytical chemistry and biochemistry continue to…

Pedagogical Issues in Teaching Upper-Level Science Courses at a "Community University"

ERIC Educational Resources Information Center

Deutch, Charles E.; Jurutka, Peter W.; Marshall, Pamela A.

2008-01-01

The authors teach upper-level science courses in cell biology, genetics, and biochemistry at a public, four-year "community university" that serves a demographically diverse population of traditional and nontraditional students. In this article, they describe some of the issues they have found to be particularly significant at their "community…

Upper Secondary and Vocational Level Teachers at Social Software

ERIC Educational Resources Information Center

Valtonen, Teemu; Kontkanen, Sini; Dillon, Patrick; Kukkonen, Jari; Väisänen, Pertti

2014-01-01

This study focuses on upper secondary and vocational level teachers as users of social software i.e. what software they use during their leisure and work and for what purposes they use software in teaching. The study is theorised within a technological pedagogical content knowledge framework, the emphasis is especially on technological knowledge…

BUFR TABLE A

Science.gov Websites

Surface data - sea 2 Vertical soundings (other than satellite) 3 Vertical soundings (satellite) 4 Single level upper-air data (other than satellite) 5 Single level upper-air data (satellite) 6 Radar data 7 tables, complete replacement or update 12 Surface data (satellite) 13 Forecasts 14 Warnings 15-19

An Experiential Approach to an Upper Division Course in Intercultural Communication.

ERIC Educational Resources Information Center

Ostermeier, Terry H.

Rapidly changing demographics are forcing more and more Americans to interact with people who are different from themselves. Americans must become more sensitive to cultural diversity. One way to address this challenge at the university level is to offer courses in intercultural communication. At one university, an upper level course in…

Online Learning: Outcomes and Satisfaction among Underprepared Students in an Upper-Level Psychology Course

ERIC Educational Resources Information Center

McDonough, Colleen; Roberts, Ramona Palmerio; Hummel, Jessamy

2014-01-01

Online learning is on the rise, but research on outcomes and student satisfaction has produced conflicting results, and systematic, targeted research on underprepared college students is generally lacking. This study compared three sections (traditional, online, and 50% hybrid) of the same upper-level psychology course, taught with identical…

CROCKETT BARN’S UPPER LEVEL, LOOKING NORTHEAST. This image shows the ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

CROCKETT BARN’S UPPER LEVEL, LOOKING NORTHEAST. This image shows the construction of the three interior bents, the south end of the loft and stairs, the ladder leading to the cupola, and the dance floor added in 2006. - Crockett Farm, Barn, 1056 Fort Casey Road, Coupeville, Island County, WA

Student Perceptions of an Upper-Level, Undergraduate Human Anatomy Laboratory Course without Cadavers

ERIC Educational Resources Information Center

Wright, Shirley J.

2012-01-01

Several programs in health professional education require or are considering requiring upper-level human anatomy as prerequisite for their applicants. Undergraduate students are confronted with few institutions offering such a course, in part because of the expense and logistical issues associated with a cadaver-based human anatomy course. This…

Personality Type and Student Performance in Upper-Level Economics Courses: The Importance of Race and Gender.

ERIC Educational Resources Information Center

Borg, Mary O.; Stranahan, Harriet A.

2002-01-01

Demonstrates that personality type is an important explanatory variable in student performance in upper level economics courses. Finds that certain personality types, combined with race and gender effects, produce students who outperform other students. Introverts and those with the Keirsey-Bates temperament combination of sensing/judging…

An Instrument to Determine the Technological Literacy Levels of Upper Secondary School Students

ERIC Educational Resources Information Center

Luckay, Melanie B.; Collier-Reed, Brandon I.

2014-01-01

In this article, an instrument for assessing upper secondary school students' levels of technological literacy is presented. The items making up the instrument emerged from a previous study that employed a phenomenographic research approach to explore students' conceptions of technology in terms of their understanding of the "nature…

Student perceptions of an upper-level, undergraduate human anatomy laboratory course without cadavers.

PubMed

Wright, Shirley J

2012-01-01

Several programs in health professional education require or are considering requiring upper-level human anatomy as prerequisite for their applicants. Undergraduate students are confronted with few institutions offering such a course, in part because of the expense and logistical issues associated with a cadaver-based human anatomy course. This study describes the development of and student reactions to an upper-level human anatomy laboratory course for undergraduate students that used a regional approach and contemporary, alternative teaching methods to a cadaver-based course. The alternative pedagogy to deliver the curriculum included use of commercially available, three-dimensional anatomical virtual dissection software, anatomical models coupled with a learning management system to offer Web-based learning, and a new laboratory manual with collaborative exercises designed to develop the student's anatomical skills and collaborative team skills. A Likert-scale survey with open-ended questions was used to ascertain student perceptions of the course and its various aspects. Students perceived that the noncadaver-based, upper-level human anatomy course with an engaging, regional approach is highly valuable in their learning of anatomy. anatomy. Copyright © 2012 American Association of Anatomists.

Stark parameter dependence of the rest core charge of the emitters for multiply charged ions spectral lines

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

Šćepanović, M., E-mail: mara.scepanovic@gmail.com; Purić, J.

2016-03-25

Stark width and shift simultaneous dependence on the upper level ionization potential and rest core charge of the emitter has been evaluated and discussed. It has been verified that the found relations, connecting Stark broadening parameters with upper level ionization potential and rest core charge of the emitters for particular electron temperature and density, can be used for prediction of Stark line width and shift data in case of ions for which observed data, or more detailed calculations, are not yet available. Stark widths and shifts published data are used to demonstrate the existence of other kinds of regularities withinmore » similar spectra of different elements and their ionization stages. The emphasis is on the Stark parameter dependence on the upper level ionization potential and on the rest core charge for the lines from similar spectra of multiply charged ions. The found relations connecting Stark widths and shift parameters with upper level ionization potential, rest core charge and electron temperature were used for a prediction of new Stark broadening data, thus avoiding much more complicated procedures.« less

Sonographic demonstration of stomach pathology: Reviewing the cases

PubMed Central

2015-01-01

Abstract Introduction: The stomach can be the source of complaints for many patients attending for upper abdominal ultrasound. It is not routinely imaged as part of most upper abdominal ultrasound protocols, with sonographers and sonologists alike commonly muttering the line; “I can't see the stomach on ultrasound”. However, this is incorrect, as the gastric antrum can almost always be visualised sonographically. Discussion: It is possible to detect a range of pathologies affecting the stomach sonographically, from common, largely tolerable conditions such as hiatus hernias through to life‐threatening neoplasms. Conclusion: The stomach can easily be assessed during routine abdominal ultrasound providing the sonographer has knowledge of stomach anatomy, normal ultrasound appearances and limitations to its visualisation. While endoscopy is the gold standard for investigation of the stomach and upper gastrointestinal tract, many patients will initially present for abdominal ultrasound due to its easy, non‐invasive nature, ready availability and low cost. For patients with mild abdominal symptoms, a normal abdominal ultrasound may be the extent of their imaging investigations meaning stomach pathologies may go undiagnosed. PMID:28191199

Ground-based remote sensing of HDO/H2O ratio profiles: introduction and validation of an innovative retrieval approach

NASA Astrophysics Data System (ADS)

Schneider, M.; Hase, F.; Blumenstock, T.

2006-10-01

We propose an innovative approach for analysing ground-based FTIR spectra which allows us to detect variabilities of lower and middle/upper tropospheric HDO/H2O ratios. We show that the proposed method is superior to common approaches. We estimate that lower tropospheric HDO/H2O ratios can be detected with a noise to signal ratio of 15% and middle/upper tropospheric ratios with a noise to signal ratio of 50%. The method requires the inversion to be performed on a logarithmic scale and to introduce an inter-species constraint. While common methods calculate the isotope ratio posterior to an independent, optimal estimation of the HDO and H2O profile, the proposed approach is an optimal estimator for the ratio itself. We apply the innovative approach to spectra measured continuously during 15 months and present, for the first time, an annual cycle of tropospheric HDO/H2O ratio profiles as detected by ground-based measurements. Outliers in the detected middle/upper tropospheric ratios are interpreted by backward trajectories.

Ground-based remote sensing of HDO/H2O ratio profiles: introduction and validation of an innovative retrieval approach

NASA Astrophysics Data System (ADS)

Schneider, M.; Hase, F.; Blumenstock, T.

2006-06-01

We propose an innovative approach for analysing ground-based FTIR spectra which allows us to detect variabilities of lower and middle/upper tropospheric HDO/H2O ratios. We show that the proposed method is superior to common approaches. We estimate that lower tropospheric HDO/H2O ratios can be detected with a noise to signal ratio of 15% and middle/upper tropospheric ratios with a noise to signal ratio of 50%. The method requires the inversion to be performed on a logarithmic scale and to introduce an inter-species constraint. While common methods calculate the isotope ratio posterior to an independent, optimal estimation of the HDO and H2O profile, the proposed approach is an optimal estimator for the ratio itself. We apply the innovative approach to spectra measured continuously during 15 months and present, for the first time, an annual cycle of tropospheric HDO/H2O ratio profiles as detected by ground-based measurements. Outliers in the detected middle/upper tropospheric ratios are interpreted by backward trajectories.

STUDIES IN THE COMMON COLD

PubMed Central

Mills, Katherine C.; Shibley, G. S.; Dochez, A. R.

1928-01-01

1. A study of the Gram-negative, filter-passing, anaerobic organisms, described by Olitsky and Gates, and Gates and McCartney, has been undertaken with a view to determining their general character and their possible rôle in the causation of the common cold. 2. These organisms seem to constitute part of the normal flora of the upper respiratory tract and would seem to bear no etiological relationship to the common cold. PMID:19869406

Analysis of injuries' prevalence in surfers from Paraná seacoast

PubMed Central

de Moraes, Gabriela Chueiri; Guimarães, Ana Tereza Bittencourt; Gomes, Anna Raquel Silveira

2013-01-01

OBJECTIVE: to analyze the prevalence of musculoskeletal injuries of surfers from the Paraná's seacoast. METHODS: Sixty men (27 ± 6 years) completed a surf semi structured questionnaire (category, time of daily practice, frequency and exercises performed before and/or after surfing) and characteristics of injuries induced by this sport. A descriptive analysis of the data on distribution of the relative frequency was performed. RESULTS: It was found that 70% of the respondents practiced surfing as a relaxing activity, 28% were amateurs and 2% were professionals, who were surfing for 10 years or more. Most of them surfed between 2 to 4 times a week during 2 to 4 hours a day. The most common exercise performed before surfing was upper and lower limbs stretching and no exercises at all was done after practice. The most common injury was contusion (29%), lower limb was the most affected segment (46%) and the most common cause of injury was due to contact with the board (52%). The interruption period mostly reported was 1-3 months and the most frequent treatment was taking medicines. CONCLUSIONS: Recreational was the predominant category of surfers with lower limb's contusion as the most common musculoskeletal injury, resulting from contact with the board, being treated with medication and rest. Level of Evidence II, Retrospective Study. PMID:24453671

Genetic divergence analysis of the Common Barn Owl Tyto alba (Scopoli, 1769) and the Short-eared Owl Asio flammeus (Pontoppidan, 1763) from southern Chile using COI sequence

PubMed Central

Colihueque, Nelson; Gantz, Alberto; Rau, Jaime Ricardo; Parraguez, Margarita

2015-01-01

Abstract In this paper new mitochondrial COI sequences of Common Barn Owl Tyto alba (Scopoli, 1769) and Short-eared Owl Asio flammeus (Pontoppidan, 1763) from southern Chile are reported and compared with sequences from other parts of the World. The intraspecific genetic divergence (mean p-distance) was 4.6 to 5.5% for the Common Barn Owl in comparison with specimens from northern Europe and Australasia and 3.1% for the Short-eared Owl with respect to samples from north America, northern Europe and northern Asia. Phylogenetic analyses revealed three distinctive groups for the Common Barn Owl: (i) South America (Chile and Argentina) plus Central and North America, (ii) northern Europe and (iii) Australasia, and two distinctive groups for the Short-eared Owl: (i) South America (Chile and Argentina) and (ii) north America plus northern Europe and northern Asia. The level of genetic divergence observed in both species exceeds the upper limit of intraspecific comparisons reported previously for Strigiformes. Therefore, this suggests that further research is needed to assess the taxonomic status, particularly for the Chilean populations that, to date, have been identified as belonging to these species through traditional taxonomy. PMID:26668551

C-reactive protein as a prognostic indicator for rebleeding in patients with nonvariceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Lee, Soon-Wook; Kang, Seung Hun; Lim, Chul-Hyun; Cho, Yu Kyung; Lee, Bo-In; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu

2015-05-01

In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Surveying the interest of individuals with upper limb loss in novel prosthetic control techniques.

PubMed

Engdahl, Susannah M; Christie, Breanne P; Kelly, Brian; Davis, Alicia; Chestek, Cynthia A; Gates, Deanna H

2015-06-13

Novel techniques for the control of upper limb prostheses may allow users to operate more complex prostheses than those that are currently available. Because many of these techniques are surgically invasive, it is important to understand whether individuals with upper limb loss would accept the associated risks in order to use a prosthesis. An online survey of individuals with upper limb loss was conducted. Participants read descriptions of four prosthetic control techniques. One technique was noninvasive (myoelectric) and three were invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces). Participants rated how likely they were to try each technique if it offered each of six different functional features. They also rated their general interest in each of the six features. A two-way repeated measures analysis of variance with Greenhouse-Geisser corrections was used to examine the effect of the technique type and feature on participants' interest in each technique. Responses from 104 individuals were analyzed. Many participants were interested in trying the techniques - 83 % responded positively toward myoelectric control, 63 % toward targeted muscle reinnervation, 68 % toward peripheral nerve interfaces, and 39 % toward cortical interfaces. Common concerns about myoelectric control were weight, cost, durability, and difficulty of use, while the most common concern about the invasive techniques was surgical risk. Participants expressed greatest interest in basic prosthesis features (e.g., opening and closing the hand slowly), as opposed to advanced features like fine motor control and touch sensation. The results of these investigations may be used to inform the development of future prosthetic technologies that are appealing to individuals with upper limb loss.

Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

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

Jiang, Sen, E-mail: jasfly77@vip.163.com; Sun, Xi-Wen, E-mail: xwsun@citiz.net; Yu, Dong, E-mail: yudong_mail@126.com

2013-05-15

PurposeOur experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described.MethodsAltogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed.ResultsThe ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotidmore » artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred.ConclusionsApplication of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA.« less

Two-Level Scheduling for Video Transmission over Downlink OFDMA Networks

PubMed Central

Tham, Mau-Luen

2016-01-01

This paper presents a two-level scheduling scheme for video transmission over downlink orthogonal frequency-division multiple access (OFDMA) networks. It aims to maximize the aggregate quality of the video users subject to the playback delay and resource constraints, by exploiting the multiuser diversity and the video characteristics. The upper level schedules the transmission of video packets among multiple users based on an overall target bit-error-rate (BER), the importance level of packet and resource consumption efficiency factor. Instead, the lower level renders unequal error protection (UEP) in terms of target BER among the scheduled packets by solving a weighted sum distortion minimization problem, where each user weight reflects the total importance level of the packets that has been scheduled for that user. Frequency-selective power is then water-filled over all the assigned subcarriers in order to leverage the potential channel coding gain. Realistic simulation results demonstrate that the proposed scheme significantly outperforms the state-of-the-art scheduling scheme by up to 6.8 dB in terms of peak-signal-to-noise-ratio (PSNR). Further test evaluates the suitability of equal power allocation which is the common assumption in the literature. PMID:26906398

Trends in Upper-Level Cloud Cover and Surface Divergence Over the Tropical Indo-Pacific Ocean Between 1952 And 1997

NASA Technical Reports Server (NTRS)

Norris, Joel R.

2005-01-01

This study investigated the spatial pattern of linear trends in surface-observed upper-level (combined mid-level and High-level) cloud cover, precipitation, and surface divergence over the tropical Indo-Pacific Ocean during 1952-1957. Cloud values were obtained from the Extended Edited Cloud Report Archive (EECRA), precipitation values were obtained from the Hulme/Climate Research Unit Data Set, and surface divergence was alternatively calculated from wind reported Comprehensive Ocean-Atmosphere Data Set and from Smith and Reynolds Extended Reconstructed sea level pressure data.

NASA Ares 1 Crew Launch Vehicle Upper Stage Configuration Selection Process

NASA Technical Reports Server (NTRS)

Cook, Jerry R.

2006-01-01

The Upper Stage Element of NASA s Ares I Crew Launch Vehicle (CLV) is a "clean-sheet" approach that is being designed and developed in-house, with Element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115 long and 216" in diameter. While the Reusable Solid Rocket Booster (RSRB) design has changed since the CLV inception, the Upper Stage Element design has remained essentially a clean-sheet approach. Although a clean-sheet upper stage design inherently carries more risk than a modified design, it does offer many advantages: a design for increased reliability; built-in extensibility to allow for commonality/growth without major redesign; and incorporation of state-of-the-art materials, hardware, and design, fabrication, and test techniques and processes to facilitate a potentially better, more reliable system.

Placement of Upper Extremity Arteriovenous Access in Patients with Central Venous Occlusions: A Novel Technique.

PubMed

Murga, Allen G; Chiriano, Jason T; Bianchi, Christian; Sheng, Neha; Patel, Sheela; Abou-Zamzam, Ahmed M; Teruya, Theodore H

2017-07-01

Central venous occlusion is a common occurrence in patients with end-stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascularly. A Hemodialysis Reliable Outflow catheter was then placed in the right atrium and completed with an arterial anastomosis. We describe a novel technique for placing upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins. This technique was utilized in 3 patients. The technical success was 100%. The placement of upper extremity arteriovenous access in patients with central venous occlusions is technically feasible. Published by Elsevier Inc.

Understanding Wave-mean Flow Feedbacks and Tropospheric Annular Variability

NASA Astrophysics Data System (ADS)

Lorenz, D. J.

2016-12-01

The structure of internal tropospheric variability is important for determining the impact of the stratosphere on the troposphere. This study aims to better understand the fundamental dynamical mechanisms that control the feedbacks between the eddies and the mean flow, which in turn select the tropospheric annular mode. Recent work using Rossby Wave Chromatography suggests that "barotropic processes", which directly impact the meridional propagation of wave activity (specifically the reflectivity of the poleward flank of the mid-latitude jet), are more important for the positive feedback between the annular mode and the eddies than "baroclinic processes", which involve changes in the generation of wave activity by baroclinic instability. In this study, experiments with a fully nonlinear quasi-geostrophic model are discussed which provide independent confirmation of the importance of barotropic versus baroclinic processes. The experiments take advantage of the steady-state balance at upper-levels between the meridional gradient in diabatic heating and the second derivative of the upper-level EP flux divergence. Simulations with standard Newtonian heating are compared to simulations with constant-in-time heating taken from the climatology of the standard run and it is found that the forced annular mode response to changes in surface friction is very similar. Moreover, as expected from the annular mode response, the eddy momentum fluxes are also very similar. This is despite the fact that the upper-level EP flux divergence is very different between the two simulations (upper-level EP flux divergence must remain constant in the constant heating simulation while in the standard simulation there is no such constraint). The upper-level balances are maintained by a large change in the baroclinic wave source (i.e. vertical EP flux), which is accompanied by little momentum flux change. Therefore the eddy momentum fluxes appear to be relatively insensitive to the wave activity source. A more detailed comparison suggests a helpful rule-of-thumb relating the amplitude of the baroclinic wave source to the upper-level vorticity flux forced by this wave source.

Evaluation of document location during computer use in terms of neck muscle activity and neck movement.

PubMed

Goostrey, Sonya; Treleaven, Julia; Johnston, Venerina

2014-05-01

This study evaluated the impact on neck movement and muscle activity of placing documents in three commonly used locations: in-line, flat desktop left of the keyboard and laterally placed level with the computer screen. Neck excursion during three standard head movements between the computer monitor and each document location and neck extensor and upper trapezius muscle activity during a 5 min typing task for each of the document locations was measured in 20 healthy participants. Results indicated that muscle activity and neck flexion were least when documents were placed laterally suggesting it may be the optimal location. The desktop option produced both the greatest neck movement and muscle activity in all muscle groups. The in-line document location required significantly more neck flexion but less lateral flexion and rotation than the laterally placed document. Evaluation of other holders is needed to guide decision making for this commonly used office equipment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

[Thought and method of classic formulae in treatment of chronic cough].

PubMed

Su, Ke-Lei; Zhang, Ye-Qing

2018-06-01

Chronic cough is a common clinical disease with complex etiology, which is easily misdiagnosed and mistreated. Chronic cough guideline has been developed based on the modern anatomical etiology classification, and it may improve the level of diagnosis and treatment. Common causes of chronic cough are as follows: cough variant asthma, upper airway cough syndrome, eosinophilic bronchitis, gastroesophageal reflux-related cough, post-infectious cough, etc. There is a long history and rich experience in treatment of cough in traditional Chinese medicine which is characterized by syndrome differentiation. The four elements of pathogenesis for chronic cough include wind, phlegm, fire, and deficiency. Classic formula is widely used in the treatment of chronic cough, and the focus is on prescriptions corresponding to syndromes. This article attempts to explore the thought and method of classic formulae in treatment of chronic cough based on three perspectives: differentiation of etiology, pathogenesis and formula-syndrome. Three medical cases are selected at last in order to prove its correction. Copyright© by the Chinese Pharmaceutical Association.

The diffusion of ecstasy through urban youth networks.

PubMed

Schensul, Jean J; Diamond, Sarah; Disch, William; Bermudez, Rey; Eiserman, Julie

2005-01-01

Ecstasy is a drug commonly associated with all-night, or all-weekend electronic dance events known as raves. Upper- and middle-class clubs, gay bars and clubs, and party venues are other common public settings where ecstasy use occurs. During the mid to late 1990s its use was reported in locations as distant as Australia and New Zealand, England and Scotland, and North America. In the United States, use increased dramatically at the end of the millennium, and drug monitoring systems began to report its presence among urban youth. Using social influence, social marketing and diffusion theory, this paper outlines the micro-level processes through which ecstasy traveled from downtown clubs catering to suburban young adults through urban youth networks through distributors and users. The paper is based on participant observation, and in-depth interviews with dealers and users collected during the period of peak diffusion 1999-2001, and survey data collected from 401 poly-drug users between the ages of 16 and 24 and collected at two time points from 1999-2002.

Upper bounds on superpartner masses from upper bounds on the Higgs boson mass.

PubMed

Cabrera, M E; Casas, J A; Delgado, A

2012-01-13

The LHC is putting bounds on the Higgs boson mass. In this Letter we use those bounds to constrain the minimal supersymmetric standard model (MSSM) parameter space using the fact that, in supersymmetry, the Higgs mass is a function of the masses of sparticles, and therefore an upper bound on the Higgs mass translates into an upper bound for the masses for superpartners. We show that, although current bounds do not constrain the MSSM parameter space from above, once the Higgs mass bound improves big regions of this parameter space will be excluded, putting upper bounds on supersymmetry (SUSY) masses. On the other hand, for the case of split-SUSY we show that, for moderate or large tanβ, the present bounds on the Higgs mass imply that the common mass for scalars cannot be greater than 10(11)  GeV. We show how these bounds will evolve as LHC continues to improve the limits on the Higgs mass.

Comparison of upper arm and forearm blood pressure.

PubMed

Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

2008-11-01

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.

PubMed

Kessel, Boris; Olsha, Oded; Younis, Aurwa; Daskal, Yaakov; Granovsky, Emil; Alfici, Ricardo

2016-02-01

Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. A total of 386 patients were included in the study. Of these, 279 (72.2%) patients had negative nasogastric aspirate. The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.

Laser action by optically depumping lower states

DOEpatents

Krupke, William F.

1977-01-01

A method and apparatus for obtaining laser action between an upper energy level and a lower energy level of a gaseous medium, which comprises populating the upper energy level to some degree (short of achieving a conventional inverted population) by any suitable pumping means, and thereafter establishing an inverted population by transiently and selectively depumping the lower energy level such as by exposing the medium to an intense source of radiation which selectively causes the transformation of the lower energy level species to some other energy level. Thus, a thermally pumped/optically depumped gas laser system is produced.

Laser action by optically depumping lower states

DOEpatents

Krupke, W.F.

1975-11-26

A method and apparatus are described for obtaining laser action between an upper energy level and a lower energy level of a gaseous medium. The upper energy level is populated to some degree (short of achieving a conventional inverted population) by any suitable pumping means, and an inverted population is established by transiently and selectively depumping the lower energy level. The depumping may be done by exposing the medium to an intense source of radiation which selectively causes the transformation of the lower energy level species to some other energy level. Thus, a thermally pumped/optically depumped gas laser system is produced.

Teaching Comparative Local History: Upper Mississippi River Towns.

ERIC Educational Resources Information Center

Crozier, William L.

Intended to engage students in a comparative look at local history in two upper Mississippi river towns (Winona, Minnesota and Dubuque, Iowa), this paper describes the computer-assisted component of an upper-level American Studies course. With emphasis on the 19th century, students examine the transition made by the United States from a…

SOCIOECONOMIC STATUS AND LEARNING PROFICIENCY IN YOUNG CHILDREN.

ERIC Educational Resources Information Center

ROHWER, WILLIAM D., JR.; AND OTHERS

THIS STUDY WAS INITIATED TO DETERMINE WHY CHILDREN OF LOWER SOCIOECONOMIC STATUS, WHO DO INFERIOR WORK ON SCHOOL-RELATED LEARNING TASKS WHEN COMPARED TO UPPER SOCIOECONOMIC STATUS CHILDREN, LEARN AS EFFICIENTLY AS UPPER LEVEL CHILDREN ON PAIRED-ASSOCIATE TASKS. THE SAMPLE CONSISTED OF 120 LOWER STATUS CHILDREN AND 120 UPPER STATUS CHILDREN,…

Attention deficit hyperactivity disorder may be a highly inflammation and immune-associated disease (Review).

PubMed

Zhou, Rong-Yi; Wang, Jiao-Jiao; Sun, Ji-Chao; You, Yue; Ying, Jing-Nang; Han, Xin-Min

2017-10-01

Attention deficit hyperactivity disorder (ADHD) is a common behavioral disorder. Previous research has indicated that genetic factors, family education, environment and dietary habits are associated with ADHD. It has been determined that in China many children with ADHD also have allergic rhinitis or asthma. These children are more susceptible to the common cold or upper respiratory infections compared with normal healthy children. Additionally, the common cold or an upper respiratory infection may lead to disease recurrence or worsen the symptoms in these children. Previous studies have determined that ADHD may have a close association with allergic disease. Based on the clinically observed phenomenon and previous studies, it was hypothesized that ADHD is a high inflammation and immune‑associated disease. Therefore, the authors designed clinical and animal experiments to test this hypothesis in the future. Immune system disorders may be a novel part of the etiology of ADHD. The current report may have implications for future clinical practice.

Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels

NASA Astrophysics Data System (ADS)

Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

2010-10-01

A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

The Anterior Interosseus Artery Perforator Flap: Anatomical Dissections and Clinical Study

PubMed Central

Panse, Nikhil S; Joshi, Sheetal B; Sahasrabudhe, Parag B; Bahetee, B; Gurude, Pradnya; Chandanwale, Ajay

2017-01-01

BACKGROUND Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap. METHODS This study was divided into anatomical study and clinical application in a IV level of evidence. In the anatomical study, five upper extremities were studied. Clinically, 12 patients underwent reconstruction using the anterior interosseus artery perforator flap. Flaps were performed by a single surgeon. A retrospective review of these cases from November 2008 to May 2014 is presented. RESULTS The anterior interosseus artery perforator was identified in four out of five cadaver limbs. The septocutaneous perforator was in the fifth extensor compartment around 4 cm proximal to the wrist joint. Of the twelve flaps, there was complete necrosis in one flap, and partial necrosis in one flap. The patient with complete necrosis underwent skin grafting at a later date. The wound healed secondarily in case of partial flap necrosis. CONCLUSION Anterior interosseus artery perforator flap must be considered as an important reconstructive option in the armamentarium of the plastic surgeon, while managing hand and wrist defects. PMID:28713704

[Body proportions of healthy and short stature adolescent girls].

PubMed

Milde, Katarzyna; Tomaszewski, Paweł; Majcher, Anna; Pyrżak, Beata; Stupnicki, Romuald

2011-01-01

Regularly conducted assessment of body proportions is of importance as early detection of possible growth disorders and immediate prevention may allow gathering an optimum of child's genetically conditioned level of development. To assess body proportions of adolescent girls, healthy or with growth deficiency. Three groups were studied: 104 healthy, short-statured girls (body height below the 10th percentile), 84 girls with Turner's syndrome (ZT) and 263 healthy girls of normal stature (between percentiles 25 and 75), all aged 11-15 years. The following measurements were conducted according to common anthropometric standards: body height, sitting body height, shoulder width, upper extremity length and lower extremity length - the last one was computed as the difference between standing and sitting body heights. All measurements were converted to logarithms and allometric linear regressions vs log body height were computed. The Turner girls proved to have allometrically shorter legs (p<0.001) and wider shoulders (p<0.001) compared with both groups of healthy girls, and longer upper extremities (p<0.001) compared with the girls of normal stature. Healthy, short-statured girls had longer lower extremities (p<0.001) as compared to other groups; they also had wider shoulders (p<0.001) and longer upper extremities (p<0.001) compared to healthy girls of normal height. Allometric relations of anthropometric measurements enable a deeper insight into the body proportions, especially in the growth period. The presented discrimination of Turner girls may serve as a screening test, and recommendation for further clinical treatment.

Working Conditions in Carpet Weaving Workshops and Muscu-loskeletal Complaints among Workers in Tabriz - Iran

PubMed Central

Nazari, Jalil; Mahmoudi, Nader; Dianat, Iman; Graveling, Richard

2012-01-01

Background: Carpet weaving operations usualy involve poor working conditions that can lead to the development of musculoskeletal disorders (MSDs). This study investigated MSDs among car¬pet weavers in relation to working conditions from workers' view in Tabriz City, Northwest Iran. Methods: This cross-sectional and descriptive study was conducted in city of Tabriz, Iran. Data were col¬lected using interviews and questionnaires. The study population consisted of 200 randomly selected healthy weavers from twenty five active carpet weaving workshops. Results: The results showed a high prevalence of musculoskeletal problems among the study population. The most commonly affected body areas were neck, lower back, ankles/feet, hands/wrists, upper back, shoulders and knees, respectively. More than half of the weavers were not satisfied with the thermal con¬dition, noise level and cleanliness of the air in the workshops. The result indicated a significant relation¬ship between upper back symptoms and daily working time and between lower back symptoms and the numbers of rows of knots woven in a day. Weavers' satisfaction with hand tools shape and thermal condi¬tion of the workshops were associated with lower back symptoms, whereas satisfaction with weaving looms were associated with upper back complaints. Conclusion: The poor working condition of hand-woven carpet workshops such as environmental con¬ditions and work station design and tools should be the subject of ergonomics interventions. PMID:24688943

Hydrogeology of the Canal Creek area, Aberdeen Proving Ground, Maryland

USGS Publications Warehouse

Oliveros, J.P.; Vroblesky, D.A.

1989-01-01

Geologic and borehole geophysical logs made at 77 sites show that the hydrogeologic framework of the study area consists of a sequence of unconsolidated sediments typical of the Coastal Plain of Maryland. Three aquifers and two confining units were delineated within the study area. From the surface down, they are: (1) the surficial aquifer; (2) the upper confining unit; (3) the Canal Creek aquifer; (4) the lower confining unit; and (5) the lower confined aquifer. The aquifer materials range from fine sand to coarse sand and gravel. Clay lenses were commonly found interfingered with the sand, isolating parts of the aquifers. All the units are continuous throughout the study area except for the upper confining unit, which crops out within the study area but is absent in updip outcrops. The unit also is absent within a Pleistocene paleochannel, where it has been eroded. The surficial and Canal Creek aquifers are hydraulically connected where the upper confining unit is absent, and a substantial amount of groundwater may flow between the two aquifers. Currently, no pumping stresses are known to affect the aquifers within the study area. Under current conditions, downward vertical hydraulic gradients prevail at topographic highs, and upward gradients typically prevail near surface-water bodies. Regionally, the direction of groundwater flow in the confined aquifers is to the east and southeast. Significant water level fluctuations correspond with seasonal variations in rainfall, and minor daily fluctuations reflect tidal cycles. (USGS)

Association between anthropometric measures of obesity and subclinical atherosclerosis in Bangladesh.

PubMed

Ge, Wenzhen; Parvez, Faruque; Wu, Fen; Islam, Tariqul; Ahmed, Alauddin; Shaheen, Ishrat; Sarwar, Golam; Demmer, Ryan T; Desvarieux, Moise; Ahsan, Habibul; Chen, Yu

2014-01-01

Anthropometric measures such as waist-hip-ratio (WHR), waist-height-ratio (WHtR), waist circumference, Mid-upper arm circumference (MUAC), and upper thigh circumference, have been linked to the risk of cardiovascular disease (CVD). However, their relationships with subclinical atherosclerosis are unclear. Studies in normal-weight populations, especially in Asian countries where leanness is prevalent, are lacking. We conducted a cross-sectional study to assess the associations of WHR, WHtR, waist circumference, hip circumference, body mass index (BMI), MUAC and upper thigh circumference with carotid intima-media thickness (cIMT) among 562 middle-aged participants free of CVD in rural Bangladesh. After adjusting for age and sex, WHR and waist circumference but not BMI showed a positive significant association with cIMT. In multivariate analysis, each standard deviation (SD) increase of WHR (0.08) or WHtR (0.07) was associated with an 8.96 μm (95% CI, 1.12-16.81) or 11.45 μm (95%CI, 0.86-22.04) difference in cIMT, respectively, after controlling for age, sex, BMI, smoking status, education level, and systolic blood pressure (SBP). The associations of WHR and WHtR with cIMT were independent of the influence of other anthropometric measures. The associations of other anthropometric measures and cIMT were not apparent. In our relatively lean, healthy Asian population, WHR and WHtR appear to be better predictors of early atherosclerosis than other common surrogates of adiposity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks

DTIC Science & Technology

2016-01-01

Upper ☐Lower Side of amputation: ☐Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee...Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee ☐shoulder/hip Initial Amputation Etiology...extremity: ☐Upper ☐Lower Side of amputation: ☐Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee

Hydrogeologic and water-quality characteristics of the Upper Carbonate aquifer, Southeast Minnesota

USGS Publications Warehouse

Ruhl, J.F.; Wolf, R.J.

1983-01-01

The quality of water in the Upper Carbonate aquifer is suitable for most uses. However, the water is susceptible to contamination in karst areas because sinkholes and disappearing streams provide direct passageways for entry of contaminants into the aquifer. Calcium magnesium bicarbonate type waters are most common. Concentrations of dissolved solids and some major ions, specifically magnesium, sodium, bicarbonate, and sulfate, are generally highest in the southwestern part of the study area.

Upper-limb tremor suppression with a 7DOF exoskeleton power-assist robot.

PubMed

Kiguchi, Kazuo; Hayashi, Yoshiaki

2013-01-01

A tremor which is one of the involuntary motions is somewhat rhythmic motion that may occur in various body parts. Although there are several kinds of the tremor, an essential tremor is the most common tremor disorder of the arm. The essential tremor is a disorder of unknown cause, and it is common in the elderly. The essential tremor interferes with a patient's daily living activity, because it may occur during a voluntary motion. If a patient of an essential tremor uses an EMG-based controlled power-assist robot, the robot might misunderstand the user's motion intention because of the effect of the essential tremor. In that case, upper-limb power-assist robots must carry out tremor suppression as well as power-assist, since a person performs various precise tasks with certain tools by the upper-limb in daily living. Therefore, it is important to suppress the tremor at the hand and grasped tool. However, in the case of the tremor suppression control method which suppressed the vibrations of the hand and the tip of the tool, vibration of other part such as elbow might occur. In this paper, the tremor suppression control method for upper-limb power-assist robot is proposed. In the proposed method, the vibration of the elbow is suppressed in addition to the hand and the tip of the tool. The validity of the proposed method was verified by the experiments.

Brachioplasty outcomes: a review of a multipractice cohort.

PubMed

Zomerlei, Terri A; Neaman, Keith C; Armstrong, Shannon D; Aitken, Marguerite E; Cullen, William T; Ford, Ronald D; Renucci, John D; VanderWoude, Douglas L

2013-04-01

Upper arm deformities secondary to massive weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures such as brachioplasty. The records of all patients who underwent a brachioplasty procedure from a multipractice medical center were reviewed. Outcomes measured included patient demographics, operative interventions, and postoperative course. Ninety-six patients were analyzed. Fifty-three patients (55.2 percent) underwent a concomitant procedure, with 53.1 percent undergoing arm liposuction at the time of brachioplasty. Major and minor complications rates were 17.7 percent and 44.8 percent, respectively. Common complications included hypertrophic scarring (24.0 percent) and infection (14.6 percent). The total revision rate was 22.9 percent, with residual contour deformity (40.9 percent of revisions) and hypertrophic scarring (36.4 percent of revisions) representing the most common causes for revision. Patients who underwent a previous bariatric procedure were at an increased risk of developing a major complication (p = 0.02). Concomitant upper arm liposuction and concomitant procedures were not associated with a significantly increased complication rate. Brachioplasty, despite being an effective treatment for contour irregularities of the upper arm, is associated with significant revision and complication rates. Post-bariatric surgery patients should be informed of the potential for increased complications. Additional procedures performed at the time of brachioplasty do not significantly increase complications. Liposuction of the upper arm can be performed safely in conjunction with brachioplasty.

Practical ranges of loudness levels of various types of environmental noise, including traffic noise, aircraft noise, and industrial noise.

PubMed

Salomons, Erik M; Janssen, Sabine A

2011-06-01

In environmental noise control one commonly employs the A-weighted sound level as an approximate measure of the effect of noise on people. A measure that is more closely related to direct human perception of noise is the loudness level. At constant A-weighted sound level, the loudness level of a noise signal varies considerably with the shape of the frequency spectrum of the noise signal. In particular the bandwidth of the spectrum has a large effect on the loudness level, due to the effect of critical bands in the human hearing system. The low-frequency content of the spectrum also has an effect on the loudness level. In this note the relation between loudness level and A-weighted sound level is analyzed for various environmental noise spectra, including spectra of traffic noise, aircraft noise, and industrial noise. From loudness levels calculated for these environmental noise spectra, diagrams are constructed that show the relation between loudness level, A-weighted sound level, and shape of the spectrum. The diagrams show that the upper limits of the loudness level for broadband environmental noise spectra are about 20 to 40 phon higher than the lower limits for narrowband spectra, which correspond to the loudness levels of pure tones. The diagrams are useful for assessing limitations and potential improvements of environmental noise control methods and policy based on A-weighted sound levels.

Polymyalgia Rheumatica

MedlinePlus

... symptom) Aches or pain in your neck, upper arms, buttocks, hips or thighs Stiffness in affected areas, ... two times more likely to develop the disorder. Race and geographic region. Polymyalgia rheumatica is most common ...

Examining Perceptions of Networking among African American Women in Student Affairs

ERIC Educational Resources Information Center

Burke, Monica G.; Carter, Joelle D.

2015-01-01

Since career networks offer access to upper level positions, being a part of one can offer opportunities and access to information, knowledge and referrals for career mobility. However, the duality of race and gender can create a distinctive challenge to gaining access to career networks, which are crucial components to rise to the upper level of…

The Performance of Methods to Test Upper-Level Mediation in the Presence of Nonnormal Data

ERIC Educational Resources Information Center

Pituch, Keenan A.; Stapleton, Laura M.

2008-01-01

A Monte Carlo study compared the statistical performance of standard and robust multilevel mediation analysis methods to test indirect effects for a cluster randomized experimental design under various departures from normality. The performance of these methods was examined for an upper-level mediation process, where the indirect effect is a fixed…

FAST CHOPPER BUILDING, TRA665. DETAIL SHOWS UPPER AND LOWER LEVEL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

FAST CHOPPER BUILDING, TRA-665. DETAIL SHOWS UPPER AND LOWER LEVEL WALLS OF DIFFERING MATERIALS. NOTE DOORWAY TO MTR TO RIGHT OF CHOPPER BUILDING'S CLIPPED CORNER. CAMERA FACING WEST. INL NEGATIVE NO. HD42-1. Mike Crane, Photographer, 3/2004 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID