Evidence From Svalbard for Cool Episodes in Early Tertiary Arctic Climate

NASA Astrophysics Data System (ADS)

Spielhagen, R. F.; Tripati, A.; Mac Niocaill, C.

2008-12-01

The Arctic is a climatically sensitive and important region. However, very little is known about the climatic and oceanographic evolution of the area, particularly prior to the Neogene. Until recently, the Arctic was assumed to be characterized by relatively warm conditions during the early Cenozoic. The Early Tertiary sedimentary sequence on Svalbard contains several layers with coal seams and broad-leaved plants which were commonly accepted as indicators of a generally temperate-warm climate. Here we report on the intermittent occurrence of certain temperature indicators in the succession, which may represent the first northern high- latitude record of near-freezing temperatures for the early Cenozoic. Besides the findings of probably ice- rafted erratic clasts in the Paleocene and Eocene sandstones and shales, we note especially the occurrence of glendonites which are pseudomorphs of calcite after ikaite (calcium carbonate hexahydrate). Stratigraphic control for the most important glendonite layers was improved by paleomagnetic investigations on the host sediment. We measured the chemical composition of Svalbard glendonites which is almost identical to that of similar pseudomorphs from the Lower Cretaceaous of Northern Canada. Mass spectrometric analyses of the glendonite calcite gave very low carbon isotope values. These values suggest a provenance of the calcium carbonate from marine organic carbon and connect our glendonites to the precursor mineral ikaite which has similar low values. Since a variety of studies has demonstrated that ikaite is stable only at temperatures close to freezing point, we have to infer low temperatures also for the deepositional environment of which the sediments were deposited that now hold glendonites. These results imply the occurrence of cooling phases episodically during the warm background climate of the Paleocene and Eocene, suggesting that temperature variability was much greater than previously recognized.

New geochronological evidence for the timing of early Tertiary ridge subduction in southern Alaska: A section in Geologic studies in Alaska by the U.S. Geological Survey, 1998

USGS Publications Warehouse

Bradley, Dwight C.; Parrish, Randall; Clendenen, William; Lux, Daniel R.; Layer, Paul W.; Heizler, Matthew; Donley, D. Thomas

2000-01-01

We present new U/Pb (monazite, zircon) and 40Ar/39Ar (biotite, amphibole) ages for 10 Tertiary plutons and dikes that intrude the Chugach–Prince William accretionary complex of southern Alaska. The Sanak pluton of Sanak Island yielded ages of 61.1±0.5 Ma (zircon) and 62.7±0.35 (biotite). The Shumagin pluton of Big Koniuji Island yielded a U/Pb zircon age of 61.1±0.3 Ma. Two biotite ages from the Kodiak batholith of Kodiak Island are nearly identical at 58.3±0.2 and 57.3±2.5 Ma. Amphibole from a dike at Malina Bay, Afognak Island, is 59.3±2.2 Ma; amphibole from a dike in Seldovia Bay, Kenai Peninsula, is 57.0±0.2 Ma. The Nuka pluton, Kenai Peninsula, yielded ages of 56.0±0.5 Ma (monazite) and 54.2±0.1 (biotite). Biotite plateau ages are reported for the Aialik (52.2±0.9 Ma), Tustumena (53.2±1.1 Ma), Chernof (54.2±1.1 Ma), and Hive Island (53.4±0.4 Ma) plutons of the Kenai Peninsula. Together, these new results confirm, but refine, the previously documented along-strike diachronous age trend of near-trench magmatism during the early Tertiary. We suggest that this event began at 61 Ma at Sanak Island, 2-4 m.y. later than previously supposed. An intermediate dike near Tutka Bay, Kenai Peninsula, yielded a hornblende age of 115±2 Ma. This represents a near-trench magmatic event that had heretofore gone unrecognized on the Kenai Peninsula; correlative Early Cretaceous near-trench plutons are known from the western Chugach Mountains near Palmer.

Timing Discrepancies of Early Intervention Hearing Services in Urban and Rural Cochlear Implant Recipients

PubMed Central

Bush, Matthew L.; Burton, Mary; Loan, Ashley; Shinn, Jennifer B.

2013-01-01

Objective The purpose of this study was to examine the timing of early intervention diagnostic and therapeutic services in cochlear implant recipients from rural and urban areas. Study design Retrospective case series review Setting Tertiary referral center Patients Cochlear implant recipients from a single comprehensive hearing institute born with severe congenital sensorineural hearing loss were examined. Timing of diagnostic and therapeutic services was examined. Intervention(s) Diagnosis, amplification, and eventual cochlear implantation for all patients in the study Main outcome measure(s) Time points of definitive diagnosis, amplification, and cochlear implantation for children from urban and rural regions were examined. Correlation analysis of distance to testing center and timing of services was also assessed. Results 40 children born with congenital hearing loss were included in the study and were diagnosed at a median age of 13 weeks after birth. Children from rural regions obtained amplification at a median age of 47.7 weeks after birth, while urban children were amplified at 26 weeks after birth. Cochlear implantation was performed at a median age of 182 weeks after birth in those from rural areas and at 104 weeks after birth in urban-dwelling patients. A linear relationship was identified between distance to the implant center and timing of hearing aid amplification (r=0.5, p=0.033) and cochlear implantation (r=0.5, p=0.016). Conclusions Children residing outside of metro areas may be at higher risk of delayed rehabilitative services and cochlear implantation than those residing in urban areas that may be closer in proximity to tertiary care centers. PMID:24136305

Early Tertiary Exhumation, Erosion, and Sedimentation in the Central Andes, NW Argentina

NASA Astrophysics Data System (ADS)

Carrapa, B.; Decelles, P. G.; Gerhels, G.; Mortimer, E.; Strecker, M. R.

2006-12-01

Timing of deformation and resulting sedimentation patterns in the Altiplano-Puna Plateau-Eastern Cordillera of the southern Central Andes are the subject of ongoing controversial debate. In the Bolivian Altiplano, sedimentation into a foreland basin system commenced during the Paleocene. Farther south in the Puna and Eastern Cordillera of NW Argentina, a lack of data has precluded a similar interpretation. Early Tertiary non-marine sedimentary rocks are preserved within the present day Puna Plateau and Eastern Cordillera of NW Argentina. The Salar de Pastos Grandes basin in the Puna Plateau contains more than 2 km of Eocene alluvial and fluvial strata in the Geste Formation, deposited in close proximity to orogenic source terrains. Sandstone and conglomerate petrographic data document Ordovician quartzites and minor phyllites and schists as the main source rocks. Detrital zircon U-Pb ages from both the Geste Formation and from underlying Ordovician quartzite cluster in the 900-1200 Ma (Grenville) and late Precambrian-Cambrian (Panafrican) ranges. Sparse late Eocene (~37-34 Ma) grains are also present; their large size, euhedral shape, and decreasing mean ages upsection suggest that these grains are volcanogenic (i.e. ash fall contamination), derived from an inferred magmatic arc to the west. The Eocene ages corroborate mammalian paleontological dates, defining the approximate begin of deposition of the Geste Formation. Alternatively, these young zircons could be of plutonic origin; however, no Eocene plutons are present in the surrounding source rocks and this interpretation is not likely. From W to E, fluvial rocks of the Quebrada de los Colorados Formation show similar sedimentological features as those observed for the Geste Formation, suggesting a genetic link between the two. Detrital zircon U-Pb data show mainly Panafrican ages, with sparse ages in the 860-935 Ma range and a few mid-Proterozoic ages. More importantly, a significant number of late Eocene

Geologic signature of early Tertiary ridge subduction in Alaska

USGS Publications Warehouse

Bradley, Dwight C.; Kusky, Timothy M.; Haeussler, Peter J.; Goldfarb, Richard J.; Miller, Marti L.; Dumoulin, Julie A.; Nelson, Steven W.; Karl, Susan M.

2003-01-01

ridge subduction, and changes in the strength of the prism as it was heated and then cooled. In this model, events in the Alaskan interior would have taken place above more distal, deeper parts of the slab window. Extensional (or transtensional) basin subsidence was driven by the two subducting plates that each exerted different tractions on the upper plate. The magmatic lull along the arc presumably marks a time when hydrated lithosphere was not being subducted beneath the arc axis. The absence of a subducting slab also may explain uplift of the Brooks Range and North Slope: Geodynamic models predict that longwavelength uplift of this magnitude will take place far inboard from Andean-type margins when a subducting slab is absent. Precise correlations between events in the accretionary prism and the Alaskan interior are hampered, however, by palinspastic problems. During and since the early Tertiary, margin-parallel strike-slip faulting has offset the near-trench plutonic belt - i.e., the very basis for locating the triple junction and slab window - from its backstop, by an amount that remains controversial.Near-trench magmatism began at 61 Ma at Sanak Island in the west but not until 51 Ma at Baranof Island, 2200 km to the east. A west-to-east age progression suggests migration of a trench-ridge-trench triple junction, which we term the Sanak-Baranof triple junction. Most workers have held that the subducted ridge separated the Kula and Farallon plates. As a possible alternative, we suggest that the ridge may have separated the Kula plate from another oceanic plate to the east, which we have termed the Resurrection plate.

The Professionalization of Educational Leaders through Postgraduate Study and Professional Development Opportunities in New Zealand Tertiary Education Institutions

ERIC Educational Resources Information Center

Macpherson, Reynold

2010-01-01

This paper reports a review of the professionalization services in educational leadership available from New Zealand's tertiary institutions at a time of accelerating retirements and turnover. Case studies of current programs identified six urgent policy issues: the need for research-based provisions in early childhood education (ECE); potential…

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study.

PubMed

Sun, Jing; Lin, Qian; Zhao, Pengyu; Zhang, Qiongyao; Xu, Kai; Chen, Huiying; Hu, Cecile Jia; Stuntz, Mark; Li, Hong; Liu, Yuanli

2017-08-22

It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients' satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. The monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = -0.71, P = 0.004). The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This

Inside stories: maternal representations of first time mothers from pre-pregnancy to early pregnancy.

PubMed

Hopkins, Julia; Clarke, David; Cross, Wendy

2014-03-01

According to the psychoanalytical literature, it is during pregnancy that maternal representations of the mother-infant relationship become activated. Midwives who are engaged with the mother and the baby have not drawn upon this concept in their practice. In order for this to happen, it is important to understand better the nature of maternal representations and when they are activated from empirical studies. The research question is: what are the maternal representations of a group of first time mothers from pre-pregnancy, early pregnancy and to the first ultrasound. A narrative approach was used to gain insight into the maternal representations of first time pregnant womens' account of their representations. The analysis method was based on thematic approach. Fifteen women aged between 23 and 38 years. A midwives clinic attached to a tertiary hospital in Melbourne, Australia. First-time pregnant women's maternal representations were activated when a woman begins to plan her pregnancy ('the time is right'), again at the onset of physical changes to her body as a result of conception ('my body is changing'), and at the first early ultrasound at around twelve weeks ('it' is a real baby). Maternal representations are important for the midwife and pregnant women because this concept provides another understanding in relation to the psychological dimension of pregnancy. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Cooperative Tertiary Interaction Network Guides RNA Folding

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

Behrouzi, Reza; Roh, Joon Ho; Kilburn, Duncan

2013-04-08

Noncoding RNAs form unique 3D structures, which perform many regulatory functions. To understand how RNAs fold uniquely despite a small number of tertiary interaction motifs, we mutated the major tertiary interactions in a group I ribozyme by single-base substitutions. The resulting perturbations to the folding energy landscape were measured using SAXS, ribozyme activity, hydroxyl radical footprinting, and native PAGE. Double- and triple-mutant cycles show that most tertiary interactions have a small effect on the stability of the native state. Instead, the formation of core and peripheral structural motifs is cooperatively linked in near-native folding intermediates, and this cooperativity depends onmore » the native helix orientation. The emergence of a cooperative interaction network at an early stage of folding suppresses nonnative structures and guides the search for the native state. We suggest that cooperativity in noncoding RNAs arose from natural selection of architectures conducive to forming a unique, stable fold.« less

Striped tertiary storage arrays

NASA Technical Reports Server (NTRS)

Drapeau, Ann L.

1993-01-01

Data stripping is a technique for increasing the throughput and reducing the response time of large access to a storage system. In striped magnetic or optical disk arrays, a single file is striped or interleaved across several disks; in a striped tape system, files are interleaved across tape cartridges. Because a striped file can be accessed by several disk drives or tape recorders in parallel, the sustained bandwidth to the file is greater than in non-striped systems, where access to the file are restricted to a single device. It is argued that applying striping to tertiary storage systems will provide needed performance and reliability benefits. The performance benefits of striping for applications using large tertiary storage systems is discussed. It will introduce commonly available tape drives and libraries, and discuss their performance limitations, especially focusing on the long latency of tape accesses. This section will also describe an event-driven tertiary storage array simulator that is being used to understand the best ways of configuring these storage arrays. The reliability problems of magnetic tape devices are discussed, and plans for modeling the overall reliability of striped tertiary storage arrays to identify the amount of error correction required are described. Finally, work being done by other members of the Sequoia group to address latency of accesses, optimizing tertiary storage arrays that perform mostly writes, and compression is discussed.

Mortality in newborns referred to tertiary hospital: An introspection

PubMed Central

Aggarwal, Kailash Chandra; Gupta, Ratan; Sharma, Shobha; Sehgal, Rachna; Roy, Manas Pratim

2015-01-01

Background: India is one of the largest contributors in the pool of neonatal death in the world. However, there are inadequate data on newborns referred to tertiary care centers. The present study aimed to find out predictors of mortality among newborns delivered elsewhere and admitted in a tertiary hospital in New Delhi between February and September 2014. Materials and Methods: Hospital data for were retrieved and analyzed for determining predictors for mortality of the newborns. Time of admission, referral and presenting clinical features were considered. Results: Out of 1496 newborns included in the study, there were 300 deaths. About 43% deaths took place in first 24 hours of life. Asphyxia and low birth weight were the main causes of death in early neonatal period, whereas sepsis had maximum contribution in deaths during late neonatal period. Severe hypothermia, severe respiratory distress, admission within first 24 hours of life, absence of health personnel during transport and referral from any hospital had significant correlation with mortality. Conclusions: There is need for ensure thermoregulation, respiratory sufficiency and presence of health personnel during transport. PMID:26288788

Barriers to Early Initiation and Continuation of Breastfeeding in a Tertiary care Institute of Haryana: A Qualitative Study in Nursing Care Providers.

PubMed

Majra, Jai Pal; Silan, Vijay Kumar

2016-09-01

Ever increasing institutional deliveries in India has shifted the responsibility of timely initiation and continuation of breastfeeding from peripheral health workers and families to the nursing care providers of health facilities where the births take place. While institutional deliveries have increased to 72.6%, only 44.6% of the newborns enjoy early breastfeeding in India. To study the barriers to early initiation of breastfeeding in institutional delivery. A total 34 nursing care providers were selected randomly and five Focus Group Discussions (FGDs) were carried out. This Qualitative Study was conducted through FGDs among the nursing care providers of a tertiary care institute in the Indian State of Haryana, India. The analyses continued throughout the group discussions as the newly emerged themes were tested in the subsequent discussion. FGDs transcripts were analysed to enhance the robustness of the emerged domain. Major barriers to initiation of breast feeding identified included: lack of awareness regarding proper technique of breastfeeding and benefits of colostrum; breast abnormality like inverted/retracted nipples; obstetric/neonatal complications requiring specialised care; and cultural practices like giving pre-lacteals and gender discrimination. It was further reported that the manpower has not been rationalised with ever increasing number of institutional deliveries. The respondents though willing to promote early initiation and continuation of breastfeeding felt excessive workload as one of the major barriers due to multi-tasking nature of their job. The new challenges to the early initiation and continuation of breastfeeding are emerging due to change in the place of delivery which needs to be addressed at the policy level.

Reductive amination of tertiary anilines and aldehydes.

PubMed

Lv, Yunhe; Zheng, Yiying; Li, Yan; Xiong, Tao; Zhang, Jingping; Liu, Qun; Zhang, Qian

2013-10-09

An unprecedented oxidant-mediated reductive amination of tertiary anilines and aldehydes without external reducing agents was developed via the nucleophilic attack of the oxygen atom of the carbonyl group to in situ generated iminium ions, in which tertiary anilines were used as both nitrogen source and reducing agent for the first time.

Leaf Assemblages across the Cretaceous-Tertiary Boundary in the Raton Basin, New Mexico and Colorado

NASA Astrophysics Data System (ADS)

Wolfe, Jack A.; Upchurch, Garland R., Jr.

1987-08-01

Analyses of leaf megafossil and dispersed leaf cuticle assemblages indicate that major ecologic disruption and high rates of extinction occurred in plant communities at the Cretaceous-Tertiary boundary in the Raton Basin. In diversity increase, the early Paleocene vegetational sequence mimics normal short-term ecologic succession, but on a far longer time scale. No difference can be detected between latest Cretaceous and early Paleocene temperatures, but precipitation markedly increased at the boundary. Higher survival rate of deciduous versus evergreen taxa supports occurrence of a brief cold interval (<1 year), as predicted in models of an “impact winter.”

Spatio-temporal observations of tertiary ozone maximum

NASA Astrophysics Data System (ADS)

Sofieva, V. F.; Kyrölä, E.; Verronen, P. T.; Seppälä, A.; Tamminen, J.; Marsh, D. R.; Smith, A. K.; Bertaux, J.-L.; Hauchecorne, A.; Dalaudier, F.; Fussen, D.; Vanhellemont, F.; Fanton D'Andon, O.; Barrot, G.; Guirlet, M.; Fehr, T.; Saavedra, L.

2009-03-01

We present spatio-temporal distributions of tertiary ozone maximum (TOM), based on GOMOS (Global Ozone Monitoring by Occultation of Stars) ozone measurements in 2002-2006. The tertiary ozone maximum is typically observed in the high-latitude winter mesosphere at altitude ~72 km. Although the explanation for this phenomenon has been found recently - low concentrations of odd-hydrogen cause the subsequent decrease in odd-oxygen losses - models have had significant deviations from existing observations until recently. Good coverage of polar night regions by GOMOS data has allowed for the first time obtaining spatial and temporal observational distributions of night-time ozone mixing ratio in the mesosphere. The distributions obtained from GOMOS data have specific features, which are variable from year to year. In particular, due to a long lifetime of ozone in polar night conditions, the downward transport of polar air by the meridional circulation is clearly observed in the tertiary ozone maximum time series. Although the maximum tertiary ozone mixing ratio is achieved close to the polar night terminator (as predicted by the theory), TOM can be observed also at very high latitudes, not only in the beginning and at the end, but also in the middle of winter. We have compared the observational spatio-temporal distributions of tertiary ozone maximum with that obtained using WACCM (Whole Atmosphere Community Climate Model) and found that the specific features are reproduced satisfactorily by the model. Since ozone in the mesosphere is very sensitive to HOx concentrations, energetic particle precipitation can significantly modify the shape of the ozone profiles. In particular, GOMOS observations have shown that the tertiary ozone maximum was temporarily destroyed during the January 2005 and December 2006 solar proton events as a result of the HOx enhancement from the increased ionization.

Eclipsing Binaries with Possible Tertiary Components

NASA Astrophysics Data System (ADS)

Snyder, LeRoy F.

2013-05-01

Many eclipsing binary star systems (EBS) show long-term variations in their orbital periods which are evident in their O-C (observed minus calculated period) diagrams. This research carried out an analysis of 324 eclipsing binary systems taken from the systems analyzed in the Bob Nelson's O-C Files database. Of these 18 systems displayed evidence of periodic variations of the arrival times of the eclipses. These rates of period changes are sinusoidal variations. The sinusoidal character of these variations is suggestive of Keplerian motion caused by an orbiting companion. The reason for these changes is unknown, but mass loss, apsidal motion, magnetic activity and the presence of a third body have been proposed. This paper has assumed light time effect as the cause of the sinusoidal variations caused by the gravitational pull of a tertiary companion orbiting around the eclipsing binary systems. An observed minus calculated (O-C) diagram of the 324 systems was plotted using a quadratic ephemeris to determine if the system displayed a sinusoidal trend in theO-C residuals. After analysis of the 18 systems, seven systems, AW UMa, BB PEG, OO Aql, V508 Oph, VW Cep, WCrv and YY ERI met the benchmark of the criteria of a possible orbiting companion. The other 11 systems displayed a sinusoidal variation in the O-C residuals of the primary eclipses but these systems in the Bob Nelson's O-C Files did not contain times of minimum (Tmin) of the secondary eclipses and therefore not conclusive in determining the presents of the effects of a tertiary companion. An analysis of the residuals of the seven systems yields a light-time semi-amplitude, orbital period, eccentricity and mass of the tertiary companion as the amplitude of the variation is proportional to the mass, period and inclination of the 3rd orbiting body. Knowing the low mass of the tertiary body in the seven cases the possibility of five of these tertiary companions being brown dwarfs is discussed.

Adolescent smoking and tertiary education: opposing pathways linking socio-economic background to alcohol consumption.

PubMed

Green, Michael J; Leyland, Alastair H; Sweeting, Helen; Benzeval, Michaela

2016-08-01

If socio-economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations. Comparing cohort studies. United Kingdom. Participants were from the 1958 National Child Development Study (NCDS58; n = 15 672), the British birth cohort study (BCS70; n = 12 735) and the West of Scotland Twenty-07 1970s cohort (T07; n = 1515). Participants self-reported daily smoking and weekly drinking in adolescence (age 16 years) and heavy drinking (> 14/21 units in past week) in early adulthood (ages 22-26 years). Parental occupational class (manual versus non-manual) indicated socio-economic background. Education beyond age 18 was coded as tertiary. Models were adjusted for parental smoking and drinking, family structure and adolescent psychiatric distress. Respondents from a manual class were more likely to smoke and less likely to enter tertiary education (e.g. in NCDS58, probit coefficients were 0.201 and -0.765, respectively; P < 0.001 for both) than respondents from a non-manual class. Adolescent smokers were more likely to drink weekly in adolescence (0.346; P < 0.001) and more likely to drink heavily in early adulthood (0.178; P < 0.001) than adolescent non-smokers. Respondents who participated in tertiary education were more likely to drink heavily in early adulthood (0.110 for males, 0.182 for females; P < 0.001 for both) than respondents with no tertiary education. With some variation in magnitude, these associations were consistent across all three cohorts. In Britain, young adults are more likely to drink heavily both if they smoke and participate in tertiary education (college and university) despite socio-economic background being associated in opposite directions with these risk

Spatio-temporal observations of the tertiary ozone maximum

NASA Astrophysics Data System (ADS)

Sofieva, V. F.; Kyrölä, E.; Verronen, P. T.; Seppälä, A.; Tamminen, J.; Marsh, D. R.; Smith, A. K.; Bertaux, J.-L.; Hauchecorne, A.; Dalaudier, F.; Fussen, D.; Vanhellemont, F.; Fanton D'Andon, O.; Barrot, G.; Guirlet, M.; Fehr, T.; Saavedra, L.

2009-07-01

We present spatio-temporal distributions of the tertiary ozone maximum (TOM), based on GOMOS (Global Ozone Monitoring by Occultation of Stars) ozone measurements in 2002-2006. The tertiary ozone maximum is typically observed in the high-latitude winter mesosphere at an altitude of ~72 km. Although the explanation for this phenomenon has been found recently - low concentrations of odd-hydrogen cause the subsequent decrease in odd-oxygen losses - models have had significant deviations from existing observations until recently. Good coverage of polar night regions by GOMOS data has allowed for the first time to obtain spatial and temporal observational distributions of night-time ozone mixing ratio in the mesosphere. The distributions obtained from GOMOS data have specific features, which are variable from year to year. In particular, due to a long lifetime of ozone in polar night conditions, the downward transport of polar air by the meridional circulation is clearly observed in the tertiary ozone maximum time series. Although the maximum tertiary ozone mixing ratio is achieved close to the polar night terminator (as predicted by the theory), TOM can be observed also at very high latitudes, not only in the beginning and at the end, but also in the middle of winter. We have compared the observational spatio-temporal distributions of the tertiary ozone maximum with that obtained using WACCM (Whole Atmosphere Community Climate Model) and found that the specific features are reproduced satisfactorily by the model. Since ozone in the mesosphere is very sensitive to HOx concentrations, energetic particle precipitation can significantly modify the shape of the ozone profiles. In particular, GOMOS observations have shown that the tertiary ozone maximum was temporarily destroyed during the January 2005 and December 2006 solar proton events as a result of the HOx enhancement from the increased ionization.

Latitudinal gradients in tertiary molluscan faunas of the Pacific coast

USGS Publications Warehouse

Addicott, W.O.

1970-01-01

Tertiary molluscan faunas of the middle latitudes of the marginal eastern North Pacific are characterized by warm-water taxa whose descendants now live in more southerly latitudes. A series of profiles in which cumulative percentages of warm-water faunal elements are plotted against latitude show progressive northward decreases in the percentage of these elements in the faunas of Pacific coast Tertiary stages. Systematic changes in the relative position of these latitudinal gradients during the Middle and Late Tertiary are related to climatic change in the Pacific Basin. Widespread tropical marine climate in the middle latitudes of the eastern North Pacific during the Eocene is indicated by widespread faunal units characterized by high levels of taxonomic diversity. Succeeding Early Oligocene faunas are less diverse, suggesting cooler climatic conditions. Unusually low representations of warm-water genera characterize the molluscan faunas of the Acila shumardi Zone in central California (latitude 34??-37??N). The anomalously cool-water aspect of these faunas may record the occurrence of upwelling along a bold linear segment of the Pacific coast. During the Late Oligocene or the Early Miocene, they are replaced by faunas of unusually warm-water aspect resulting in positive anomalies in Miocene latitudinal faunal gradients in central California. The Miocene anomalies seem to result from the development of an irregular Neogene coastline with extensive, newly established shallow-water embayments. ?? 1970.

Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

ERIC Educational Resources Information Center

Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

2015-01-01

This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

ERIC Educational Resources Information Center

Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

2015-01-01

This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary First Step was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

Time in Early Childhood: Creative Possibilities with Different Conceptions of Time

ERIC Educational Resources Information Center

Farquhar, Sandy

2016-01-01

Time is an important driver of pedagogy which is often overlooked in the busy atmosphere of an early childhood centre. Engaging philosophically with three different concepts of time, and drawing examples from literature and art to focus attention on how time is constituted in early childhood centres, this article argues that we inhabit the…

Late Cretaceous and early Tertiary plutonism and deformation in the Skagit Gneiss Complex, north Cascade Range, Washington and British Columbia

USGS Publications Warehouse

Haugerud, R.A.; Van Der Heyden, P.; Tabor, R.W.; Stacey, J.S.; Zartman, R.E.

1991-01-01

The Skagit Gneiss Complex forms a more-or-less continuous terrane within the North Cascade Range. The complex comprises abundant plutons intruded at mid-crustal depths into a variety of metamorphosed supracrustal rocks of both oceanic and volcanic-arc origin. U-Pb zircon ages from gneissis plutons within and near the Skagit Gneiss Complex indicate magmatic crystallziations between 75 and 60 Ma. Deformation, recrystallization, and migmatization in part postdate intrusion of the 75-60 Ma plutons. This latest Cretaceous and earliest Tertiary plutonism and migmatization may reflect thermal relaxation following early Late Cretaceous orogeny. The complex was ductilely extended northwest-southeast shortly after intrusion of granite dikes at ~45 Ma, but before emplacement of the earliest (~34 Ma) plutons of the Cascade arc. -from Authors

Breast Self Examination Practice among Female Students of Tertiary Institutions

ERIC Educational Resources Information Center

Agbonifoh, Julia Adesua

2016-01-01

Against the background of the dangers posed by breast cancer world-wide, and the importance of its early detection and therefore breast self examination (BSE), this study investigated the practice of BSE among female students in tertiary institutions in Edo state. A sample of 723 participants selected through a combination of multi-stage,…

Correlation of tertiary formations of Alaska

USGS Publications Warehouse

MacNeil, F.S.; Wolfe, J.A.; Miller, D.J.; Hopkins, D.M.

1961-01-01

Recent stratigraphic and paleontologic studies have resulted in substantial revision of the age assignments and inter-basin correlations of the Tertiary formations of Alaska as given in both an earlier compilation by P. S. Smith (1939) and a tentative chart prepared for distribution at the First International Symposium on Arctic Geology at Calgary, Alberta (Miller, MacNeil, and Wahrhaftig, 1960). Current work in Alaska by the U. S. Geological Survey and several oil companies is furnishing new information at a rapid rate and further revisions may be expected. The correlation chart (Fig. 1), the first published chart to deal exclusively with the Tertiary of Alaska, had the benefit of a considerable amount of stratigraphic data and fossil collections from some oil companies, but recent surface mapping and drilling by other oil companies in several Tertiary basins undoubtedly must have produced much more information. Nevertheless, the extent of available data justifies the publication of a revised correlation chart at this time.

Tertiary creep test by ring shear apparatus in predicting initiation time of rainfall-induced-shallow landslide

NASA Astrophysics Data System (ADS)

Dok, A.; Fukuoka, H.

2010-12-01

Landslides are complex geo-disaters that frequently occur due to certain causes, but only one trigger such as earthquake or heavy rainfall or other related natural phenomenas. A slope failure seldom occurs without any creep deformation. Failure time of a slope as found by Fukuzono (1985) and Siato (1965) based on graphical analysis of extensometer monitoring data through large scale flume test for landslide studies, logarithm of acceleration is proportional to the logarithm of velocity of surface displacement immediately before the failure. It is expressed as d2x/dt2 = A(dx/dt)α, where x is surface displacement, t is time, and A and α are constant. And, Fukuzono (1985, 1989) proposed a simple method of predicting the time of falure by the inverse velocity (1/v) mean. The curve of inverse velocity is concave at 1< α<2, linear at α=2, and convex at α>2. Recently, Minamitani (2007) have researched on mechanism of Tertiary Creep deformation for landslide failure time prediction by increasing shear-stress development in order to understand the story behind the empirical relationship found by senior researcher Fukozono. He found a strong relationshp between constants A and α, expressed as α = 0.1781A+ 1.814. For deeper understanding, this study aims at learning in more detail on mechanism of landslides in tropical soils by ring shear apparatus (invented by DPRI, Disaster Prevention Research Institute) based on Tertiary Creep deformation theory in help issue warning on rainfall-induced landslides through back (pore-water) pressure control tests under combined conditions of particular normal stress and shear stress with pore-water pressure changes to simulate the potential sliding surface condition in the heavy rainfall, which no body experiences conducting such a test series, particularly by applying cyclic and actual groundwater change pattern to the soils. To reach the archivement, serie of back pressure control test were implemented by utilising stress

Stereoinversion of tertiary alcohols to tertiary-alkyl isonitriles and amines.

PubMed

Pronin, Sergey V; Reiher, Christopher A; Shenvi, Ryan A

2013-09-12

The SN2 reaction (bimolecular nucleophilic substitution) is a well-known chemical transformation that can be used to join two smaller molecules together into a larger molecule or to exchange one functional group for another. The SN2 reaction proceeds in a very predictable manner: substitution occurs with inversion of stereochemistry, resulting from the 'backside attack' of the electrophilic carbon by the nucleophile. A significant limitation of the SN2 reaction is its intolerance for tertiary carbon atoms: whereas primary and secondary alcohols are viable precursor substrates, tertiary alcohols and their derivatives usually either fail to react or produce stereochemical mixtures of products. Here we report the stereochemical inversion of chiral tertiary alcohols with a nitrogenous nucleophile facilitated by a Lewis-acid-catalysed solvolysis. The method is chemoselective against secondary and primary alcohols, thereby complementing the selectivity of the SN2 reaction. Furthermore, this method for carbon-nitrogen bond formation mimics a putative biosynthetic step in the synthesis of marine terpenoids and enables their preparation from the corresponding terrestrial terpenes. We expect that the general attributes of the methodology will allow chiral tertiary alcohols to be considered viable substrates for stereoinversion reactions.

A Comparative Appraisal of the Investment in Tertiary Education by Students in New Zealand Adjusted for the Opportunity Cost of Time.

ERIC Educational Resources Information Center

Bird, Kelly B.

1991-01-01

Investment of time and funds by New Zealand students was appraised in five specific tertiary education courses, namely Accountancy, Dentistry, Law, Medicine, and Pharmacy. The study used the Internal Rate of Return Method and data from the 1981 census on income and hours of work. Results indicated the courses were "profitable" even when…

The relationship of angiosperms and oleanane in petroleum through geologic time

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

Moldowan, J.M.; Dahl, J.E.; Huizinga, B.J.

1993-02-01

The biological marker oleanane has been suggested as an indicator of angiosperm (flowering plant) input into source rocks and their derived oils. Parallels should therefore be evident between the angiosperm fossil record and oleanane occurrence and abundance. A global selection of more than 50 core samples from marine rocks of different ages and from different locations was quantitatively analyzed for oleanane to determine its abundance over geologic time relative to the bacterial marker hopane. Oleanane was recognized using Metastable Reaction Monitoring (MRM) GC-MS. A parallel was observed between the oleanane/hopane ratio and angiosperm diversity in the fossil record through time.more » The first fossil evidence of angiosperms is during the Early Cretaceous with radiation during the Late Cretaceous and Tertiary. Occurrences of oleanane are confirmed throughout the Cretaceous system. Early-to-middle Cretaceous (Berriasian-Cenomanian) occurrences are sporadic and oleanan/hopane ratios are less than 0.07. Late Cretaceous (Turonian-Maastrichtian) oleanane/hopane ratios range up to 0.15 with higher ratios in many Tertiary samples. It appears that oleanane/hopane ratios of oils can restrict the age of their unavailable or unknown source rocks. High ratios indicate Tertiary age and lower ratios can indicate Cretaceous or Tertiary age, depending on depositional environment. While these data do not rule out pre-Cretaceous oleanane, preliminary data show that oleanane/hopane ratios for Jurassic and older rock extracts are typically below our detection limits (<0.03). While oleanane precursors are abundant in angiosperms, they also occur, rarely, in other modern plant groups. We identified oleanane in low abundances in three Early Cretaceous fossil benettitialeans, an extinct plant group (Late Triassic to Late Cretaceous) thought to be related to angiosperms. These findings suggest that oleanane could be present in low abundance in some pre-Cretaceous rocks and oils.« less

Transfer from primary maternity unit to tertiary hospital in New Zealand - timing, frequency, reasons, urgency and outcomes: Part of the Evaluating Maternity Units study.

PubMed

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Schmied, Virginia; Monk, Amy

2015-09-01

to examine the transfers from primary maternity units to a tertiary hospital in New Zealand by describing the frequency, timing, reasons and outcomes of those who had antenatal or pre-admission birthplace plan changes, and transfers in labour or postnatally. mixed methods prospective (concurrent) cohort study, which analysed transfer and clinical outcome data (407 primary unit cohort, 285 tertiary hospital cohort), and data from the six week postpartum survey (571 respondents). well, pregnant women booked to give birth in a tertiary maternity hospital or primary maternity unit in one region in New Zealand (2010-2012). All women received midwifery continuity of care, regardless of their intended or actual birthplace. fewer than half of the women who planned a primary unit birth gave birth there (191 or 46.9%). A change of plan may have been made either antenatally or before admission in labour; and transfers were made after admission to the primary unit in labour or during the postnatal stay (about 48 hours). Of the 117 (28.5%) planning a primary unit birth who changed their planned birthplace type antenatally 73 (62.4%) were due to a clinical indication. Earthquakes accounted for 28.1% of birthplace change (during the research period major earthquakes occurred in the study region). Most (73.8%) labour changes occurred before admission in labour to the primary unit. For the 76 women who changed plan at this stage the most common reasons to do so were a rapid labour (25.0%) or prolonged rupture of membranes (23.7%). Transfers in labour from primary unit to tertiary hospital occurred for 27 women (12.6%) of whom 26 (96.3%) were having their first baby. "Slow progress" of labour accounted for 21 (77.8%) of these and 17 (62.9%) were classified as 'non-emergency'. The average transfer time for 'emergency' transfers was 58 minutes. The average time for all labour transfers from specialist consultation to birth was 4.5 hours. Nine postnatal transfers (maternal or neonatal

An analytic model for limiting high density LH transition by the onset of the tertiary instability

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

Singh, Raghvendra, E-mail: rsingh129@gmail.com; Jhang, Hogun; Kaang, Helen H.

2016-07-15

We perform an analytic study of the tertiary instability driven by a strong excitation of zonal flows during high density low to high (LH) mode transition. The drift resistive ballooning mode is assumed to be a dominant edge turbulence driver. The analysis reproduces main qualitative features of early computational results [Rogers and Drake, Phys. Rev. Lett. 81, 4396 (1998); Guzdar et al., Phys. Plasmas 14, 020701 (2007)], as well as new characteristics of the maximum edge density due to the onset of the tertiary instability. An analytical scaling indicates that the density scaling of LH transition power may be determinedmore » by the onset condition of the tertiary instability when the operating density approaches to the Greenwald density.« less

Progress Report on Alloy 617 Time Dependent Allowables

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

Wright, Julie Knibloe

2015-06-01

Time dependent allowable stresses are required in the ASME Boiler and Pressure Vessel Code for design of components in the temperature range where time dependent deformation (i.e., creep) is expected to become significant. There are time dependent allowable stresses in Section IID of the Code for use in the non-nuclear construction codes, however, there are additional criteria that must be considered in developing time dependent allowables for nuclear components. These criteria are specified in Section III NH. St is defined as the lesser of three quantities: 100% of the average stress required to obtain a total (elastic, plastic, primary andmore » secondary creep) strain of 1%; 67% of the minimum stress to cause rupture; and 80% of the minimum stress to cause the initiation of tertiary creep. The values are reported for a range of temperatures and for time increments up to 100,000 hours. These values are determined from uniaxial creep tests, which involve the elevated temperature application of a constant load which is relatively small, resulting in deformation over a long time period prior to rupture. The stress which is the minimum resulting from these criteria is the time dependent allowable stress St. In this report data from a large number of creep and creep-rupture tests on Alloy 617 are analyzed using the ASME Section III NH criteria. Data which are used in the analysis are from the ongoing DOE sponsored high temperature materials program, form Korea Atomic Energy Institute through the Generation IV VHTR Materials Program and historical data from previous HTR research and vendor data generated in developing the alloy. It is found that the tertiary creep criterion determines St at highest temperatures, while the stress to cause 1% total strain controls at low temperatures. The ASME Section III Working Group on Allowable Stress Criteria has recommended that the uncertainties associated with determining the onset of tertiary creep and the lack of significant

Burial history of Upper Cretaceous and Tertiary rocks interpreted from vitrinite reflectance, northern Green River basin, Wyoming

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

Dickinson, W.W.; Law, B.E.

1985-05-01

The burial history of Upper Cretaceous and Tertiary rocks in the northern Green River basin is difficult to reconstruct for three reasons: (1) most of these rocks do not crop out, (2) there are few stratigraphic markers in the subsurface, and (3) regional uplift beginning during the Pliocene caused erosion that removed most upper Tertiary rocks. To understand better the burial and thermal history of the basin, published vitrinite reflectance (R/sub o/) data from three wells were compared to TTI (time-temperature index) maturation units calculated from Lopatin reconstructions. For each well, burial reconstructions were made as follows. Maximum depth ofmore » burial was first estimated by stratigraphic and structural evidence and by extrapolation to a paleosurface intercept of R/sub o/ = 0.2%. This burial was completed by early Oligocene (35 Ma), after which there was no net deposition. The present geothermal gradient in each well as used because there is no geologic evidence for elevated paleotemperature gradients. Using these reconstructions, calculated TTI units agreed with measured R/sub o/ values when minor adjustments were made to the estimated burial depths. Reconstructed maximum burials were deeper than present by 2500-3000 ft (762-914 m) in the Pacific Creek area, by 4000-4500 ft (1219-1372 m) in the Pinedale area, and by 0-1000 ft (0-305 m) in the Merna area. However, at Pinedale geologic evidence can only account for about 3000 ft (914 m) of additional burial. This discrepancy is explained by isoreflectance lines, which parallel the Pinedale anticline and indicate that approximately 2000 ft (610 m) of structural relief occurred after maximum burial. In other parts of the basin, isoreflectance lines also reveal significant structural deformation after maximum burial during early Oligocene to early Pliocene time.« less

Precambrian Time - The Story of the Early Earth

USGS Publications Warehouse

Lindsey, D.A.

2007-01-01

The Precambrian is the least-understood part of Earth history, yet it is arguably the most important. Precambrian time spans almost nine-tenths of Earth history, from the formation of the Earth to the dawn of the Cambrian Period. It represents time so vast and long ago that it challenges all comprehension. The Precambrian is the time of big questions. How old is the Earth? How old are the oldest rocks and continents? What was the early Earth like? What was the early atmosphere like? When did life appear, and what did it look like? And, how do we know this? In recent years, remarkable progress has been made in understanding the early evolution of the Earth and life itself. Yet, the scientific story of the early Earth is still a work in progress, humankind's latest attempt to understand the planet. Like previous attempts, it too will change as we learn more about the Earth. Read on to discover what we know now, in the early 21st century.

The emergence of modern type rain forests and mangroves and their traces in the palaeobotanical record during the Late Cretaceous and early Tertiary

NASA Astrophysics Data System (ADS)

Mohr, Barbara; Coiffard, Clément

2014-05-01

The origin of modern rain forests is still very poorly known. This ecosystem could have potentially fully evolved only after the development of relatively high numbers of flowering plant families adapted to rain forest conditions. During the early phase of angiosperm evolution in the early Cretaceous the palaeo-equatorial region was located in a seasonally dry climatic belt, so that during this phase, flowering plants often show adaptations to drought, rather than to continuously wet climate conditions. Therefore it is not surprising that except for the Nymphaeales, the most basal members of extant angiosperm families have members that do not necessarily occur in the continuously wet tropics today. However, during the late Early Cretaceous several clades emerged that later would give rise to families that are typically found today mostly in (shady) moist places in warmer regions. This is especially seen among the monocotyledons, a group of the mesangiosperms, that developed in many cases large leaves often with very specific venation patterns that make these leaves very unique and well recognizable. Especially members of three groups are here of interest: the arum family (Araceae), the palms (Arecaceae) and the Ginger and allies (Zingiberales). The earliest fossil of Araceae are restricted to low latitudes during the lower Cretaceous. Arecaceae and Zingiberales do not appear in the fossil record before the early late Cretaceous and occur at mid latitudes. During the Late Cretaceous, Araceae are represented at mid latitudes by non-tropical early diverging members and at low latitudes by derived rainforest members. Palms became widespread during the Late Cretataceous and also Nypa, a typical element of tropical to subtropical mangrove environments evolved during this time period. During the Paleocene Arecaceae appear to be restricted to lower latitudes as well as Zingiberales. All three groups are again widespread during the Eocene, reaching higher latitudes and

Neonatal exchange transfusions in tertiary and non-tertiary hospital settings, New South Wales, 2001-2012.

PubMed

Chessman, Julia C; Bowen, Jennifer R; Ford, Jane B

2017-05-01

To describe neonatal exchange transfusions in New South Wales (NSW) before and after release in January 2007 of a NSW Health guideline regarding exchange transfusions in tertiary and non-tertiary hospitals. The study population included neonates receiving exchange transfusion in NSW hospitals, 2001-2012. Linked birth and hospital data for mothers and babies were used to describe birth characteristics and maternal and neonatal conditions. Exchange transfusions were identified in hospital data and compared for 2001-2006 and 2007-2012. Maternal and neonatal characteristics were compared with χ 2 and Wilcoxon signed-rank tests. Between 2001 and 2012, there were 286 exchange transfusions performed for 281 neonates in NSW hospitals. The number of exchange transfusions decreased from 187 in 184 neonates for 2001-2006 to 99 in 97 neonates 2007-2012 (P < 0.001). The percentage of exchange transfusions performed at tertiary hospitals increased from 85% in 2001-2006 to 91% in 2007-2012, although this was not statistically significant (P = 0.16). Most neonates requiring exchange transfusion were born in tertiary hospitals: 62% for 2001-2006 and 69% for 2007-2012. Among those born in a non-tertiary hospital, the percentage transferred or admitted to a tertiary hospital for exchange transfusion was 63% in 2001-2006 and 77% in 2007-2012. Between 2001 and 2012, there was a decrease in neonatal exchange transfusions in NSW. After the 2007 guideline there was a non-significant increase in the proportion of exchange transfusions performed at tertiary hospitals. Although rare, exchange transfusions are still expected to occur occasionally in non-tertiary hospitals, requiring continuing support for this procedure in these settings. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Ethiopian Tertiary dike swarms

NASA Technical Reports Server (NTRS)

Mohr, P. A.

1971-01-01

Mapping of the Ethiopian rift and Afar margins revealed the existence of Tertiary dike swarms. The structural relations of these swarms and the fed lava pile to monoclinal warping of the margins partly reflect a style of continental margin tectonics found in other parts of the world. In Ethiopia, however, conjugate dike trends appear to be unusually strongly developed. Relation of dikes to subsequent margin faulting is ambiguous, and there are instances where the two phenomena are spatially separate and of differing trends. There is no evidence for lateral migration with time of dike injection toward the rift zone. No separate impingement of Red Sea, Gulf of Aden, and African rift system stress fields on the Ethiopian region can be demonstrated from the Tertiary dike swarms. Rather, a single, regional paleostress field existed, suggestive of a focus beneath the central Ethiopian plateau. This stress field was dominated by tension: there is no cogent evidence for shearing along the rift margins. A gentle compression along the rift floor is indicated. A peculiar sympathy of dike hade directions at given localities is evident.

Tertiary Excess of Fibroblast Growth Factor 23 and Hypophosphatemia Following Kidney Transplantation

PubMed Central

Seeherunvong, Wacharee; Wolf, Myles

2010-01-01

Hypophosphatemia due to inappropriate urinary phosphate wasting is a frequent metabolic complication of the early period following kidney transplantation. Although previously considered to be caused by tertiary hyperparathyroidism, recent evidence suggests a primary role for persistently elevated circulating levels of the phosphorus-regulating hormone, fibroblast growth factors 23 (FGF23). In the setting of a healthy renal allograft, markedly increased FGF23 levels from the dialysis period induce renal phosphate wasting and inhibition of calcitriol production, which contribute to hypophosphatemia. While such tertiary FGF23 excess and resultant hypophosphatemia typically abates within the first few weeks to months post-transplant, some recipients manifest persistent renal phosphate wasting. Furthermore, increased FGF23 levels have been associated with increased risk of kidney disease progression, cardiovascular disease and death outside of the transplant setting. Whether tertiary FGF23 excess is associated with adverse transplant outcomes is unknown. In this article, we review the physiology of FGF23, summarize its relationship with hypophosphatemia after kidney transplantation, and speculate on its potential impact on long term outcomes of renal allograft recipients. PMID:20946192

Timing of Orphanhood, Early Sexual Debut, and Early Marriage in Four Sub-Saharan African Countries

PubMed Central

Chae, Sophia

2014-01-01

According to a growing body of literature, some orphans are at heightened risk of early sexual debut and early marriage. This study examines a rarely explored aspect of orphanhood: the timing and type of parental death and their relationship to these outcomes. The study also explores whether education mediates orphans’ risk of early sexual initiation and early marriage. The data are drawn from the 2004 National Survey of Adolescents, which includes interviews with 12–19-year-old adolescents in Burkina Faso, Ghana, Malawi, and Uganda. Results from discrete-time event history analysis indicate that female double orphans, regardless of timing of orphanhood, have greater odds of early sexual debut than do nonorphans. Education explains little of their increased risk. In contrast, male orphans of any type reveal no increased vulnerability to early sexual debut. Uganda is the only country where female orphans, specifically double orphans and those who are paternal orphans before age 10, have greater odds of early marriage, with education accounting for a small portion of the risk. PMID:23719999

Centralisation for resection of the pancreatic head: A comparison of operative factors and early outcomes during the evolving unit and tertiary unit phases at a UK institution.

PubMed

Kostalas, M; Nageswaran, H; Froghi, S; Riga, A; Kumar, R; Menezes, N; Worthington, T R; Karanjia, N D

2017-08-19

To assess impact of centralisation on patients undergoing pancreatic head resections at a tertiary hepatobiliary (HPB) centre in the UK. Data were analysed from a prospectively maintained database from 1998 to 2014 on all patients undergoing pancreatic head resections. Two specific time periods were defined; these were the evolving unit phase (EU) from 1998 to 2009 and finally the established tertiary unit phase (TU) from 2010 to 2014. Peri-operative factors and post-operative outcomes were analysed. 395 resections were undertaken during the study period. Following establishment of our tertiary HPB unit, the volume of resections undertaken increased greater than three-fold with an associated increase in case-complexity (p = 0.004). Operating time was found to increase in the TU phase compared with EU phase (p=>0.0005) whilst there was no significant difference in the rate of peri-operative transfusion, or in post-operative morbidity rates. There was a significant reduction in the post-operative length of stay in the TU phase (p = 0.003) with a significantly higher proportion of patients being discharged within 9 days of their procedure (p=<0.0005). There was also a significant reduction in 30-day post-operative mortality in the TU phase (0.5%) compared with the EU phase (3%) (p = 0.029). Data from our series of 395 cases suggests that centralisation of pancreatic cancer services to a tertiary centre does result in improved patient outcomes. The benefits of a multi-disciplinary and specialist HPB service results in a high volume, high quality unit with improved patient outcomes. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Six Sigma process utilization in reducing door-to-balloon time at a single academic tertiary care center.

PubMed

Kelly, Elizabeth W; Kelly, Jonathan D; Hiestand, Brian; Wells-Kiser, Kathy; Starling, Stephanie; Hoekstra, James W

2010-01-01

Rapid reperfusion in patients with ST-elevation myocardial infarction (STEMI) is associated with lower mortality. Reduction in door-to-balloon (D2B) time for percutaneous coronary intervention requires multidisciplinary cooperation, process analysis, and quality improvement methodology. Six Sigma methodology was used to reduce D2B times in STEMI patients presenting to a tertiary care center. Specific steps in STEMI care were determined, time goals were established, and processes were changed to reduce each step's duration. Outcomes were tracked, and timely feedback was given to providers. After process analysis and implementation of improvements, mean D2B times decreased from 128 to 90 minutes. Improvement has been sustained; as of June 2010, the mean D2B was 56 minutes, with 100% of patients meeting the 90-minute window for the year. Six Sigma methodology and immediate provider feedback result in significant reductions in D2B times. The lessons learned may be extrapolated to other primary percutaneous coronary intervention centers. Copyright © 2010 Elsevier Inc. All rights reserved.

Early Detection of Chronic Obstructive Pulmonary Disease in Apparently Healthy Attendants of Tertiary Care Hospital and Assessment of its Severity.

PubMed

Zubair, Tahira; Abbassi, Amanullah; Khan, Osama Ahsan

2017-05-01

Early detection of Chronic Obstructive Pulmonary Disease in apparently healthy attendants of tertiary care hospital and assessment of its severity. Cross-sectional, observational study. Study was conducted from January 2015 to July 2015 at Dow University Hospital, Ojha campus. Ascreening method was designed for apparently healthy individuals including attendants of patients, hospital staff, faculty and students, belonging to age group 18-60 years after excluding severe obesity and already diagnosed respiratory and cardiovascular diseases by means of history. Each participant performed pulmonary function tests via spirometer after filling a questionnaire based on various risk factors and symptoms of chronic obstructive pulmonary disease (COPD). Data was entered and analysed by SPSS-20. Out of the 517 participants, 122 (23.6%) were found to have COPD diagnosed by means of spirometry. Out of these, 23 (4.4%) had COPD stage I, 42 (8.1%) had COPD II, 34 (6.6%) had COPD III, and 23 (4.4%) had COPD IV. Exposure to smoking, wooden stoves, pesticides, biomass fuel, aerosol sprays, gas grill and vehicle exhaust were found to be statistically significant factors in relation to development of COPD. Apparently healthy individuals may have underlying COPD and active screening by means of spirometry plays vital role in early detection of COPD. Smoking and exposure to certain hazardous environmental pollutants are responsible for the development and progression of COPD.

Total donor ischemic time: relationship to early hemodynamics and intensive care morbidity in pediatric cardiac transplant recipients.

PubMed

Rodrigues, Warren; Carr, Michelle; Ridout, Deborah; Carter, Katherine; Hulme, Sara Louise; Simmonds, Jacob; Elliott, Martin; Hoskote, Aparna; Burch, Michael; Brown, Kate L

2011-11-01

Single-center studies have failed to link modest increases in total donor ischemic time to mortality after pediatric orthotopic heart transplant. We aimed to investigate whether prolonged total donor ischemic time is linked to pediatric intensive care morbidity after orthotopic heart transplant. Retrospective cohort review. Tertiary pediatric transplant center in the United Kingdom. Ninety-three pediatric orthotopic heart transplants between 2002 and 2006. Total donor ischemic time was investigated for association with early post-orthotopic heart transplant hemodynamics and intensive care unit morbidities. Of 43 males and 50 females with median age 7.2 (interquartile range 2.2, 13.0) yrs, 62 (68%) had dilated cardiomyopathy, 20 (22%) had congenital heart disease, and nine (10%) had restrictive cardiomyopathy. The mean total donor ischemic time was 225.9 (sd 65.6) mins. In the first 24 hrs after orthotopic heart transplant, age-adjusted mean arterial blood pressure increased (p < .001), mean pulmonary arterial pressure fell (p = .012), but central venous pressure (p = .58) and left atrial pressure (p = .20) were unchanged. After adjustment for age, primary diagnosis, pre-orthotopic heart transplant mechanical support, and marginal donor factors, longer total donor ischemic time was significantly associated with lower mean arterial blood pressure (p < .001) in the first 24 hrs after orthotopic heart transplant, longer post-orthotopic heart transplant mechanical ventilation (p = .03), longer post-orthotopic heart transplant stay in the intensive care unit (p = .004), and longer post-orthotopic heart transplant stay in hospital (p = .02). Total donor ischemic time was not related to levels of mean pulmonary arterial pressure (p = .62), left atrial pressure (p = .38), or central venous pressure (p = .76) early after orthotopic heart transplant. Prolonged total donor ischemic time has an adverse effect on the donor organ, contributing to lower mean arterial blood

Timely Healthcare Checkup Catches Melanoma Early

MedlinePlus

... please turn Javascript on. Feature: Skin Cancer Timely Healthcare Checkup Catches Melanoma Early Past Issues / Summer 2013 ... left the Congress and starting working as a healthcare consultant, when I finally decided to have a ...

The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital.

PubMed

Tan, Timothy Xin Zhong; Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Wong, Ting Hway

2016-01-01

For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7-207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department.

Peracetic acid (PAA) disinfection of primary, secondary and tertiary treated municipal wastewaters.

PubMed

Koivunen, J; Heinonen-Tanski, H

2005-11-01

The efficiency of peracetic acid (PAA) disinfection against enteric bacteria and viruses in municipal wastewaters was studied in pilot-scale. Disinfection pilot-plant was fed with the primary or secondary effluent of Kuopio municipal wastewater treatment plant or tertiary effluent from the pilot-scale dissolved air flotation (DAF) unit. Disinfectant doses ranged from 2 to 7 mg/l PAA in the secondary and tertiary effluents, and from 5 to 15 mg/l PAA in the primary effluents. Disinfection contact times were 4-27 min. Disinfection of secondary and tertiary effluents with 2-7 mg/l PAA and 27 min contact time achieved around 3 log reductions of total coliforms (TC) and enterococci (EC). PAA disinfection also significantly improved the hygienic quality of the primary effluents: 10-15 mg/l PAA achieved 3-4 log reductions of TC and EC, 5 mg/l PAA resulting in below 2 log reductions. F-RNA coliphages were more resistant against the PAA disinfection and around 1 log reductions of these enteric viruses were typically achieved in the disinfection treatments of the primary, secondary and tertiary effluents. Most of the microbial reductions occurred during the first 4-18 min of contact time, depending on the PAA dose and microorganism. The PAA disinfection efficiency remained relatively constant in the secondary and tertiary effluents, despite of small changes of wastewater quality (COD, SS, turbidity, 253.7 nm transmittance) or temperature. The disinfection efficiency clearly decreased in the primary effluents with substantially higher microbial, organic matter and suspended solids concentrations. The results demonstrated that PAA could be a good alternative disinfection method for elimination of enteric microbes from different wastewaters.

Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

PubMed

Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

2009-04-01

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

Role of hydraulic retention time and granular medium in microbial removal in tertiary treatment reed beds.

PubMed

García, Joan; Vivar, Joan; Aromir, Maria; Mujeriego, Rafael

2003-06-01

The main objective of this paper is to evaluate the role of hydraulic retention time (HRT) and granular medium in faecal coliform (FC) and somatic coliphage (SC) removal in tertiary reed beds. Experiments were carried out in a pilot plant with four parallel reed beds (horizontal subsurface flow constructed wetlands), each one containing a different type of granular medium. This pilot plant is located in a wastewater treatment plant in Montcada i Reixac, near Barcelona, in northeastern Spain. The microbial inactivation ratios obtained in the different beds are compared as a function of three selected HRTs. Secondary effluent from the wastewater treatment plant was used as the influent of the pilot system. The microbial inactivation ratio ranged between 0.1 and 2.7 log-units for FC and from 0.5 to 1.7 log-units for SC in beds with coarser granular material (5-25mm), while it ranged between 0.7 and 3.4 log-units for FC and from 0.9 to 2.6 log-units for SC in the bed with finer material (2-13mm). HRT and granular medium are both key factors in microbial removal in the tertiary reed beds. The microbial inactivation ratio rises as the HRT increases until it reaches a saturation value (in general at an HRT of 3 days). The value of the microbial inactivation ratio at the saturation level depends on the granular medium contained in the bed. The specific surface area necessary to reach 2-3 log-units of FC and SC is approximately 3m(2)/person-equivalent.

Buckets and Fire: Metaphors in Tertiary Teaching

ERIC Educational Resources Information Center

Emerson, Lisa; Mansvelt, Juliana

2015-01-01

This paper examines New Zealand tertiary teachers' use of metaphor and their attitudes to the consumer metaphor in relation to teaching. Based on interviews with 16 tertiary teachers, this study shows that although teachers believe the consumer metaphor is accepted by students, tertiary institutions and policy makers, and that it has affected…

Pubertal timing and educational careers: a longitudinal study.

PubMed

Koivusilta, L; Rimpelä, A

2004-01-01

Pubertal timing is related to several dimensions of adolescent development. No studies concern its associations with educational careers. To investigate whether pubertal timing predicts attained educational level and how school achievement, educational track and sociodemographic background in adolescence mediate this relationship. Survey data (1981, 1983, 1985) from samples of 12-16-year-old Finns (n = 7674) were linked with the respondents' attained education in 1998 (ages 27-33). Ages of menarche and of first ejaculation were indicators of pubertal timing. Among boys who by age 16 had experienced early, average or late pubertal timing, 13%, 12%, and 6% reached upper tertiary educational level, respectively. Boys with early or average puberty often came from high social strata and selected educational tracks with good prospects. In girls, sociodemographic factors rather than pubertal timing predicted attained educational level. Early or average onset of puberty plays a role in dividing boys into educational tracks after compulsory schooling. Support should be given to boys, whose delayed pubertal development makes them immature to making appropriate educational decisions and to boys who may have experienced early puberty but fail to exploit educational opportunities available for them.

The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital

PubMed Central

Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock

2016-01-01

Background For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. Methods From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Results Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7–207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Conclusion Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department. PMID:27136299

Expansion tunnel performance with and without an electromagnetically opened tertiary diaphragm

NASA Technical Reports Server (NTRS)

Miller, C. G.

1977-01-01

A study was conducted to examine the effect of synchronization of an electromagnetically opened tertiary diaphragm with flow arrival at the diaphragm on the pitot pressure measured at the test section of an expansion tunnel. The effect of tertiary diaphragm pressure ratio (ratio of initial nozzle pressure to quiescent acceleration section pressure) on the pitot pressure time history is also determined. The inadequacy of a pressure transducer protection arrangement used in previous expansion tube and expansion tunnel tests was revealed.

Modern Quaternary plant lineages promote diversity through facilitation of ancient Tertiary lineages

PubMed Central

Valiente-Banuet, Alfonso; Rumebe, Adolfo Vital; Verdú, Miguel; Callaway, Ragan M.

2006-01-01

One of the most important floristic sorting periods to affect modern plant communities occurred during the shift from the wet Tertiary period to the unusually dry Quaternary, when most global deserts developed. During this time, a wave of new plant species emerged, presumably in response to the new climate. Interestingly, most Tertiary species that have been tracked through the fossil record did not disappear but remained relatively abundant despite the development of a much more unfavorable climate for species adapted to moist conditions. Here we find, by integrating paleobotanical, ecological, and phylogenetic analyses, that a large number of ancient Tertiary species in Mediterranean-climate ecosystems appear to have been preserved by the facilitative or “nurse” effects of modern Quaternary species. Our results indicate that these interdependent relationships among plants have played a central role in the preservation of the global biodiversity and provided a mechanism for stabilizing selection and the conservation of ecological traits over evolutionary time scales. PMID:17068126

Tertiary structure-related activity of tick defensin (persulcatusin) in the taiga tick, Ixodes persulcatus.

PubMed

Isogai, Emiko; Isogai, Hiroshi; Okumura, Kazuhiko; Hori, Hatsuhiro; Tsuruta, Hiroki; Kurebayashi, Yoichi

2011-01-01

Defensins are small cysteine-rich cationic proteins found in both vertebrates and invertebrates constituting the front line of host innate immunity. To examine the importance of the tertiary structure of tick defensin in its antimicrobial activity, we synthesized two types of the peptides with tertiary structure or primary one on basis of the information of the sequence in the defensin originated from the taiga tick, Ixodes persulcatus. Chemically synthesized peptides were used to investigate the activity spectrum against Staphylococcus aureus, Borrelia garinii and flora-associated bacteria. Both synthetic peptides showed antimicrobial activity against S. aureus in short-time killing within 1 h, but they do not show the activity against B. garinii, Stenotrophomonas maltophila and Bacillus spp., which were frequently isolated from the midgut of I. persulcatus. The teriary structure brought more potent activity to S. aureus than primary one in short-time killing. We also examined its antimicrobial activity by evaluation of growth inhibition in the presence of the synthetic peptides. Minimum inhibitory concentration (MIC) was ranged from 1.2 to 5.0 μg/ml in tertiary peptide and from 10 to 40 μg/ml in primary peptide, when 10 strains of S. aureus were used. From the curve of cumulative inhibition rates, MIC50 (MIC which half of the strains showed) to S. aureus is about 1.2 μg/ml in the peptide with tertiary structure and about 10 μg/ml in the linear one. Corynebacterium renale is 10 times or more sensitive to tertiary peptide than primary one. In conclusion, the presence of 3 disulfide bridges, which stabilize the molecule and maintain the tertiary structure, is considered to have an effect on their antimicrobial activities against Gram-positive bacteria such as S. aureus.

English as a Foreign Language Instructors' Induction: Early Practices of Language Teachers Teaching at Tertiary Level

ERIC Educational Resources Information Center

Ozturk, Mustafa; Yildirim, Ali

2012-01-01

This study aimed to investigate the nature of the induction process of English as a foreign language (EFL) teachers teaching at tertiary level through individual interviews. In order to gather intended data, fifteen novice instructors teaching at four different public universities in Ankara were interviewed on a basis of two criteria: (a) having 1…

Delay in presentation to the hospital and factors affecting it in breast cancer patients attending tertiary care center in Central India.

PubMed

Thakur, N A; Humne, A Y; Godale, L B

2015-01-01

Despite lower incidence of breast cancer in India, the total number of cases and the net mortality is high. To reduce this increasing load of mortality due to breast cancer we need to lay emphasis on early detection and increased use of systemic therapy. Early detection itself depends on early presentation to a health facility; thus, it is important to identify factors affecting delay in a presentation to hospital. To study the clinico-social profile of breast carcinoma patients attending a tertiary care hospital and to study the time lag since detection of lump by women and presentation to the hospital and factors affecting them. A total of 120 primary breast cancer patients visiting a tertiary care hospital over a period of 7 months (August 2010 to February 2011) were taken up for study. A detailed retrospective analysis of patients was done according to planned proforma. Maximum study subjects were in the age group of 41-50 years. Right and left breasts were equally affected. The most common histo-pathological type of breast carcinoma observed was invasive ductal carcinoma (NOS) in 105 (87.50%) cases. Majority of the cases were in stage III or stage II. The median time lag self-detection of lump in the breast by women and presentation to the hospital was 6 months. Women living in a rural area, those with lower socio-economic status and those with older age tend to assess health-care late. Carcinoma of the breast is a common cancer affecting young to middle age group with invasive ductal carcinoma being the most common histological type. Delay in presentation and late stage presentation is a major concern. Hence, proper awareness and screening programmers are needed to identify, inform and educate these categories of women.

Isotopic and anatomical evidence of an herbivorous diet in the Early Tertiary giant bird Gastornis. Implications for the structure of Paleocene terrestrial ecosystems

NASA Astrophysics Data System (ADS)

Angst, D.; Lécuyer, C.; Amiot, R.; Buffetaut, E.; Fourel, F.; Martineau, F.; Legendre, S.; Abourachid, A.; Herrel, A.

2014-04-01

The mode of life of the early Tertiary giant bird Gastornis has long been a matter of controversy. Although it has often been reconstructed as an apex predator feeding on small mammals, according to other interpretations, it was in fact a large herbivore. To determine the diet of this bird, we analyze here the carbon isotope composition of the bone apatite from Gastornis and contemporaneous herbivorous mammals. Based on 13C-enrichment measured between carbonate and diet of carnivorous and herbivorous modern birds, the carbonate δ13C values of Gastornis bone remains, recovered from four Paleocene and Eocene French localities, indicate that this bird fed on plants. This is confirmed by a morphofunctional study showing that the reconstructed jaw musculature of Gastornis was similar to that of living herbivorous birds and unlike that of carnivorous forms. The herbivorous Gastornis was the largest terrestrial tetrapod in the Paleocene biota of Europe, unlike the situation in North America and Asia, where Gastornis is first recorded in the early Eocene, and the largest Paleocene animals were herbivorous mammals. The structure of the Paleocene terrestrial ecosystems of Europe may have been similar to that of some large islands, notably Madagascar, prior to the arrival of humans.

Management for the children with otitis media with effusion in the tertiary hospital.

PubMed

Choung, Yun-Hoon; Shin, You Ree; Choi, Seong Jun; Park, Keehyun; Park, Hun Yi; Lee, Jong Bin; Han, Dong Hee; Kahng, Hison

2008-12-01

Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study. Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months. Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05). In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.

Early Earth(s) Across Time and Space

NASA Astrophysics Data System (ADS)

Mojzsis, S.

2014-04-01

The geochemical and cosmochemical record of our solar system is the baseline for exploring the question: "when could life appear on a world similar to our own?" Data arising from direct analysis of the oldest terrestrial rocks and minerals from the first 500 Myr of Earth history - termed the Hadean Eon - inform us about the timing for the establishment of a habitable silicate world. Liquid water is the key medium for life. The origin of water, and its interaction with the crust as revealed in the geologic record, guides our exploration for a cosmochemically Earth-like planets. From the time of primary planetary accretion to the start of the continuous rock record on Earth at ca. 3850 million years ago, our planet experienced a waning bolide flux that partially or entirely wiped out surface rocks, vaporized oceans, and created transient serpentinizing atmospheres. Arguably, "Early Earths" across the galaxy may start off as ice planets due to feeble insolation from their young stars, occasionally punctuated by steam atmospheres generated by cataclysmic impacts. Alternatively, early global environments conducive to life spanned from a benign surface zone to deep into crustal rocks and sediments. In some scenarios, nascent biospheres benefit from the exogenous delivery of essential bio-elements via leftovers of accretion, and the subsequent establishment of planetary-scale hydrothermal systems. If what is now known about the early dynamical regime of the Earth serves as any measure of the potential habitability of worlds across space and time, several key boundary conditions emerge. These are: (i) availability and long-term stability of liquid water; (ii) presence of energy resources; (iii) accessibility of organic raw materials; (iv) adequate inventory of radioisotopes to drive internal heating; (v) gross compositional parameters such as mantle/core mass ratio, and (vi) P-T conditions at or near the surface suitable for sustaining biological activity. Life could

Diversification Management at Tertiary Education Level: A Review

ERIC Educational Resources Information Center

Takwate, Kwaji Tizhe

2016-01-01

This paper examines the concept of management of diversification at tertiary education level in view of the growth of national secondary education system which vested high scramble for tertiary education was made in relation to question of access and expansion. This paper examines management of diversification at tertiary education level as a…

Impact of social media usage on daytime sleepiness: A study in a sample of tertiary students in Singapore.

PubMed

Nasirudeen, A M A; Lee Chin Adeline, Lau; Wat Neo Josephine, Koh; Lay Seng, Lim; Wenjie, Li

2017-01-01

Many tertiary students access social networking sites on a daily basis. With the increased usage of smartphones, accessing social networking sites while commuting, in schools, waiting for friends, television commercial breaks has become prevalent among tertiary students. What started as a lifestyle choice has now become a daily necessity. Such behavior among tertiary students raises an important question for educators: how does social media usage affect tertiary students' sleep patterns and daytime sleepiness, their attention difficulties, especially in school? Thus, the aim of this study was to examine the relationships between tertiary students' self-reports of social media usage and daytime sleepiness. The design was a cross-sectional, quantitative research study. We used a survey that contained questions concerning demographic data, daytime sleepiness, total sleep time and social media usage and a version of the Cleveland Adolescent Sleepiness Questionnaire, modified for use in tertiary students, were used for data collection ( n  = 969). The most preferred tool for accessing social networking sites was smartphones and WhatsApp was the most accessed site. Results indicated that nocturnal technology use has a weak, negative impact on tertiary students' quantity of sleep that may lead to daytime sleepiness. Local Singapore students spent significantly more time on social networking sites at night compared to foreign students. As a result, local students experienced more daytime sleepiness compared to foreign students. Prolonged social media usage, especially in bed, has a negative impact on tertiary students' daytime sleepiness. Since the technology is such an integral part of most tertiary students' lives, it is important to understand the impact it has on their sleep and daytime sleepiness.

How Do Early Career Agriculture Teachers Talk about Their Time?

ERIC Educational Resources Information Center

Lambert, Misty D.; Henry, Anna L.; Tummons, John D.

2011-01-01

This phenomenological study of early career agriculture teachers sought to determine the meaning early career agriculture teachers ascribe to their time. Seven teachers with a range of experience from mid-first year to beginning of sixth year were chosen. Interviews were used to make meaning of their time. Five themes were found in the…

Causal effects of transitions to adult roles on early adult smoking and drinking: Evidence from three cohorts.

PubMed

Green, Michael J; Leyland, Alastair H; Sweeting, Helen; Benzeval, Michaela

2017-08-01

Transitions into work and family roles have become increasingly delayed as participation in tertiary education widens. Such transitions may have adverse or beneficial effects on health behaviours such as smoking and drinking (alcohol). Role socialisation effects may reduce smoking or drinking, but clustering of transitions may lead to role overload, weakening or reversing any role socialisation effects. Effects of transitions were examined in three UK cohorts: the 1958 National Child Development Study, the 1970 British Birth Cohort Study, and the West of Scotland: Twenty-07 Youth Cohort (from around Glasgow, growing up in the same time period as the 1970 cohort). Latent class analysis was employed to identify heterogeneous patterns of transition timing for leaving education, entering employment, starting cohabitation, having a first child, and leaving the parental home. Propensity weighting was then used to estimate causal effects of transition patterns (relative to tertiary education) on smoking and heavy drinking in early adulthood (ages 22-26), adjusting for background confounders (gender, parental socioeconomic position, family structure, parental and adolescent health behaviours, adolescent distress and school performance). Three groups made early (age 16) transitions from education to employment and then either delayed other transitions, made other transitions quickly, or staggered transitions with cohabitation beginning around ages 19-21; a fourth group transitioned from education to employment around ages 17-18. Compared to those in tertiary education with similar background characteristics, those in these groups generally had higher levels of smoking, especially where transitions were more clustered, but less heavy drinking (except those who delayed other transitions after moving into employment). Results partially supported role socialisation effects for drinking, and role overload effects for smoking. Wider participation in tertiary education could have

Diversification of Tertiary Education in Switzerland.

ERIC Educational Resources Information Center

Crausaz, Roselyne

The structure of Switzerland's educational system is described including the types of secondary schools and/or courses and the system of tertiary education. Fields of study, types of institutions, and characteristics of tertiary education in Switzerland are discussed. The chapter on students covers admission procedures, trends in enrollment,…

The Misis-Andırın Complex: a Mid-Tertiary melange related to late-stage subduction of the Southern Neotethys in S Turkey

NASA Astrophysics Data System (ADS)

Robertson, Alastair; Unlügenç, Ülvi Can; İnan, Nurdan; Ta ṡli, Kemal

2004-01-01

The Mid-Tertiary (Mid-Eocene to earliest Miocene) Misis-Andırın Complex documents tectonic-sedimentary processes affecting the northerly, active margin of the South Tethys (Neotethys) in the easternmost Mediterranean region. Each of three orogenic segments, Misis (in the SW), Andırın (central) and Engizek (in the NE) represent parts of an originally continuous active continental margin. A structurally lower Volcanic-Sedimentary Unit includes Late Cretaceous arc-related extrusives and their Lower Tertiary pelagic cover. This unit is interpreted as an Early Tertiary remnant of the Mesozoic South Tethys. The overlying melange unit is dominated by tectonically brecciated blocks (>100 m across) of Mesozoic neritic limestone that were derived from the Tauride carbonate platform to the north, together with accreted ophiolitic material. The melange matrix comprises polymict debris flows, high- to low-density turbidites and minor hemipelagic sediments. The Misis-Andırın Complex is interpreted as an accretionary prism related to the latest stages of northward subduction of the South Tethys and diachronous continental collision of the Tauride (Eurasian) and Arabian (African) plates during Mid-Eocene to earliest Miocene time. Slivers of Upper Cretaceous oceanic crust and its Early Tertiary pelagic cover were accreted, while blocks of Mesozoic platform carbonates slid from the overriding plate. Tectonic mixing and sedimentary recycling took place within a trench. Subduction culminated in large-scale collapse of the overriding (northern) margin and foundering of vast blocks of neritic carbonate into the trench. A possible cause was rapid roll back of dense downgoing Mesozoic oceanic crust, such that the accretionary wedge taper was extended leading to gravity collapse. Melange formation was terminated by underthrusting of the Arabian plate from the south during earliest Miocene time. Collision was diachronous. In the east (Engizek Range and SE Anatolia) collision generated

Tertiary Education in Britian. National Report.

ERIC Educational Resources Information Center

Eggleston, J.

Some of the major trends in British Tertiary education are reviewed. Types of schools and/or courses in British secondary education are examined in relation to student preparation for tertiary education. The present system of higher Education in Britian is described including types of institutions and academic structures, admission requirements,…

Influence of first-time mothers' early employment on severe early childhood caries in their child.

PubMed

Plutzer, Kamila; Keirse, Marc J N C

2012-01-01

Aim. To examine whether mothers' early employment status is related to the development of severe early childhood caries in their child. Methods. Questionnaire survey of 429 first-time mothers in metropolitan Adelaide, South Australia, and dental examinations of their child at 20 months of age. Results. At 20 ± 2.5 months of age, 5.6% of children exhibited caries defined as one or more demineralized or cavitated lesions on the upper incisors. Of the mothers, 52.2% had no paid employment, 39.6% were part-time and 8.2% full-time employed. Overall, mothers' participation in the workforce had no influence on the frequency of severe early childhood caries in their child, but there was a significant interaction with family structure. For mothers without employment there was no difference between single, and two-parent families, but children with an employed single mother more frequently had caries than those with a working mother in a two-parent family (P < 0.04). However, there were no significant differences in children's reported general health. Conclusions. The data indicate a need to explore strategies that may assist single mothers and especially those in the workforce to prevent severe early childhood caries in their child.

Migraine disability, healthcare utilization, and expenditures following treatment in a tertiary headache center.

PubMed

Freitag, Frederick G; Lyss, Heidi; Nissan, George R

2013-10-01

Headache is among the most common disabling pain complaints. While many patients are managed in primary care or referral neurology practices, some patients have refractive situations that necessitate referral to a tertiary headache center. Increasing frequency of headache is strongly associated with increasing disability and workplace absenteeism as well as increased healthcare utilization. Previous studies have demonstrated that headache care in a dedicated tertiary center is associated with a decrease in headache frequency and improvement in other characteristics that persist over extended periods of time. Previous studies have not examined the impact of this treatment on subsequent healthcare utilization and associated expenditures. In this study we examined the changes in healthcare utilization and expenditures as well as the impact on disability and workplace productivity with treatment in a tertiary headache care center that used initial treatment settings of inpatient and outpatient care and considered the difference between those with episodic migraine and those with chronic migraine and its complications. Tertiary care was found to produce positive reductions in disability, healthcare utilization, and expenditures. These results suggest that earlier tertiary-level intervention may avoid the complications of migraine that occur in some patients and the increasing costs and utilization of care associated with higher disability.

Migraine disability, healthcare utilization, and expenditures following treatment in a tertiary headache center

PubMed Central

Lyss, Heidi; Nissan, George R.

2013-01-01

Headache is among the most common disabling pain complaints. While many patients are managed in primary care or referral neurology practices, some patients have refractive situations that necessitate referral to a tertiary headache center. Increasing frequency of headache is strongly associated with increasing disability and workplace absenteeism as well as increased healthcare utilization. Previous studies have demonstrated that headache care in a dedicated tertiary center is associated with a decrease in headache frequency and improvement in other characteristics that persist over extended periods of time. Previous studies have not examined the impact of this treatment on subsequent healthcare utilization and associated expenditures. In this study we examined the changes in healthcare utilization and expenditures as well as the impact on disability and workplace productivity with treatment in a tertiary headache care center that used initial treatment settings of inpatient and outpatient care and considered the difference between those with episodic migraine and those with chronic migraine and its complications. Tertiary care was found to produce positive reductions in disability, healthcare utilization, and expenditures. These results suggest that earlier tertiary-level intervention may avoid the complications of migraine that occur in some patients and the increasing costs and utilization of care associated with higher disability. PMID:24082410

Pylephlebitis: incidence and prognosis in a tertiary hospital.

PubMed

Belhassen-García, Moncef; Gomez-Munuera, Mercedes; Pardo-Lledias, Javier; Velasco-Tirado, Virginia; Perez-Persona, Ernesto; Galindo-Perez, Inmaculada; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Muñoz-Bellvis, Luis; Cordero-Sánchez, Miguel

2014-01-01

Septic thrombophlebitis of the portal vein or its branches, most often secondary to intra-abdominal infection is known as pylephlebitis. The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease. An observational retrospective study was conducted in a tertiary care hospital (University Hospital of Salamanca, Spain) from January 1999 to December 2008. A total of 7796 patients with intra-abdominal infection were evaluated, of whom 13 (0.6%) had been diagnosed with pylephlebitis. Diverticulitis was the most frequent underlying process, followed by biliary infection. Early mortality was 23%. Survivors had no recurrences, but one of them developed portal cavernomatosis. Pylephlebitis is a rare complication of intra-abdominal infection, with a high early mortality, but with a good prognosis for survivors. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Tertiary Hyperparathyroidism

PubMed Central

Davies, D. R.; Dent, C. E.; Watson, Lyal

1968-01-01

In our first 200 cases of primary hyperparathyroidism confirmed by operation 12 were also shown to have a long history either of a malabsorption syndrome or of chronic renal-glomerular failure. We consider that they first went through a phase of secondary hyperparathyroidism, during which one or more of the glands became autonomous adenamata. This then produced the biochemical changes of “primary” hyperparathyroidism, necessitating excision of the adenoma. This condition is best described as “tertiary” hyperparathyroidism. The transition from secondary to tertiary hyperparathyroidism occurred in four of the 12 patients while under our observation. We think the same process can be traced retrospectively in the other eight cases. The concept of tertiary hyperparathyroidism may help to explain the high incidence of other diseases in association with primary hyperparathyroidism. The behaviour of the parathyroid glands provides a valuable model for the investigation of tumour formation in man. All states occurred in our patients with primary hyperparathyroidism, from normal through hyperplasia to adenoma formation and finally to parathyroid carcinoma. PMID:5691200

An atmospheric pCO2 reconstruction across the Cretaceous-Tertiary boundary from leaf megafossils

PubMed Central

Beerling, D. J.; Lomax, B. H.; Royer, D. L.; Upchurch, G. R.; Kump, L. R.

2002-01-01

The end-Cretaceous mass extinctions, 65 million years ago, profoundly influenced the course of biotic evolution. These extinctions coincided with a major extraterrestrial impact event and massive volcanism in India. Determining the relative importance of each event as a driver of environmental and biotic change across the Cretaceous-Tertiary boundary (KTB) crucially depends on constraining the mass of CO2 injected into the atmospheric carbon reservoir. Using the inverse relationship between atmospheric CO2 and the stomatal index of land plant leaves, we reconstruct Late Cretaceous-Early Tertiary atmospheric CO2 concentration (pCO2) levels with special emphasis on providing a pCO2 estimate directly above the KTB. Our record shows stable Late Cretaceous/Early Tertiary background pCO2 levels of 350–500 ppm by volume, but with a marked increase to at least 2,300 ppm by volume within 10,000 years of the KTB. Numerical simulations with a global biogeochemical carbon cycle model indicate that CO2 outgassing during the eruption of the Deccan Trap basalts fails to fully account for the inferred pCO2 increase. Instead, we calculate that the postboundary pCO2 rise is most consistent with the instantaneous transfer of ≈4,600 Gt C from the lithic to the atmospheric reservoir by a large extraterrestrial bolide impact. A resultant climatic forcing of +12 W⋅m−2 would have been sufficient to warm the Earth's surface by ≈7.5°C, in the absence of counter forcing by sulfate aerosols. This finding reinforces previous evidence for major climatic warming after the KTB impact and implies that severe and abrupt global warming during the earliest Paleocene was an important factor in biotic extinction at the KTB. PMID:12060729

Tertiary Education and Training in Australia, 2010

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2012

2012-01-01

This publication presents information on tertiary education and training during 2010, including statistics on participation and outcomes. The definition of tertiary education and training adopted for this publication is formal study in vocational education and training (VET) and higher education, including enrolments in Australian Qualifications…

Predicting loop–helix tertiary structural contacts in RNA pseudoknots

PubMed Central

Cao, Song; Giedroc, David P.; Chen, Shi-Jie

2010-01-01

Tertiary interactions between loops and helical stems play critical roles in the biological function of many RNA pseudoknots. However, quantitative predictions for RNA tertiary interactions remain elusive. Here we report a statistical mechanical model for the prediction of noncanonical loop–stem base-pairing interactions in RNA pseudoknots. Central to the model is the evaluation of the conformational entropy for the pseudoknotted folds with defined loop–stem tertiary structural contacts. We develop an RNA virtual bond-based conformational model (Vfold model), which permits a rigorous computation of the conformational entropy for a given fold that contains loop–stem tertiary contacts. With the entropy parameters predicted from the Vfold model and the energy parameters for the tertiary contacts as inserted parameters, we can then predict the RNA folding thermodynamics, from which we can extract the tertiary contact thermodynamic parameters from theory–experimental comparisons. These comparisons reveal a contact enthalpy (ΔH) of −14 kcal/mol and a contact entropy (ΔS) of −38 cal/mol/K for a protonated C+•(G–C) base triple at pH 7.0, and (ΔH = −7 kcal/mol, ΔS = −19 cal/mol/K) for an unprotonated base triple. Tests of the model for a series of pseudoknots show good theory–experiment agreement. Based on the extracted energy parameters for the tertiary structural contacts, the model enables predictions for the structure, stability, and folding pathways for RNA pseudoknots with known or postulated loop–stem tertiary contacts from the nucleotide sequence alone. PMID:20100813

[Relevant factors of early puberty timing in urban primary schools in Chongqing].

PubMed

Luo, Yan; Liu, Qin; Wen, Yi; Liu, Shudan; Lei, Xun; Wang, Hong

2016-05-01

To investigate the status of puberty timing and relevant factors of early puberty timing in children from grade one to four in urban primary schools of Chongqing. According to the purposive sample method, four urban primary schools in Chongqing were selected and of which 1471 children from grade one to four who have obtained informed consent were recruited. Questionnaire survey on social-demographic characteristics and family environment (e.g., age, parents' relationship, diet and lifestyle, etc), and Pubertal Development Scale (PDS) survey and physical examination (measurements of height, weight, pubertal development status, etc) were conducted. P25, P50, P75 ages of each important pubertal event were calculated by probit regression. Univariate and multivariate analysis were used to analyze relevant factors. The detection rate of early puberty timing was 17.7%, and the median ages of the onset of breast and testicular development were 10.77 and 11.48 years old, respectively. Multivariate logistic regression showed that early puberty timing occurred more likely in girls than in boys (OR = 0.561, 95% CI 0.406-0.774), and bad relationship between parents (OR = 1.320, 95% CI 1.007-1.729) and hair-products-use (OR = 1.685, 95%, CI 1.028-2.762) were risk factors of early puberty timing. Early onset of puberty in urban Chongqing is still exist. Gender, parents' relationship, and hair-products-use have an essential impact on early puberty timing.

Changing Tertiary Education in Modern European Society.

ERIC Educational Resources Information Center

Council for Cultural Cooperation, Strasbourg (France).

Reports on recent developments and problems in the diversification of tertiary education in seven Western European countries are presented by members of the Working Party on the Diversification of Tertiary Education. Policy analysis and evaluation and recommendations for future policy are also provided. As a policy, diversification refers to the…

First-Time Mothers' Knowledge and Beliefs Regarding Early Communication Development

ERIC Educational Resources Information Center

Williams, Vicki; Pearce, Wendy M.; Devine, Sue

2014-01-01

Limited literature exists in the Australian context about first-time mothers' knowledge of early communication milestones, their strategies to facilitate speech and language development and understanding of the relationship between early communication skills and future development. A cross-sectional online survey was administered to 53 first-time…

Group Time in Early Childhood Centers: An Exploratory Study.

ERIC Educational Resources Information Center

McAfee, Oralie

To investigate the current status of group time in early childhood centers, a small-scale exploratory study was designed and executed. Results of interviews with 35 teachers and observations in five classrooms serving children ages 2 1/2 through kindergarten revealed that all classrooms had at least one group time or circle time, usually in the…

Early Prevention of Childhood Disability in Developing Countries.

ERIC Educational Resources Information Center

Simeonsson, Rune J.

1991-01-01

This paper presents a disability prevention framework for community-based rehabilitation services, by conceptualizing early intervention in terms of primary, secondary, and tertiary levels of prevention. The framework views prevention as the effort to reduce a disability's expression, duration, or extended impact. (Author/JDD)

Numerical Modelling of Tertiary Tides

NASA Astrophysics Data System (ADS)

Gao, Yan; Correia, Alexandre C. M.; Eggleton, Peter P.; Han, Zhanwen

2018-06-01

Stellar systems consisting of multiple stars tend to undergo tidal interactions when the separations between the stars are short. While tidal phenomena have been extensively studied, a certain tidal effect exclusive to hierarchical triples (triples in which one component star has a much wider orbit than the others) has hardly received any attention, mainly due to its complexity and consequent resistance to being modelled. This tidal effect is the tidal perturbation of the tertiary by the inner binary, which in turn depletes orbital energy from the inner binary, causing the inner binary separation to shrink. In this paper, we develop a fully numerical simulation of these "tertiary tides" by modifying established tidal models. We also provide general insight as to how close a hierarchical triple needs to be in order for such an effect to take place, and demonstrate that our simulations can effectively retrieve the orbital evolution for such systems. We conclude that tertiary tides are a significant factor in the evolution of close hierarchical triples, and strongly influence at least ˜1% of all multiple star systems.

Background experiences, time allocation, time on teaching and perceived support of early-career college science faculty

NASA Astrophysics Data System (ADS)

Sagendorf, Kenneth S.

The purposes of this research were to create an inventory of the research, teaching and service background experiences of and to document the time allocation and time spent on teaching by early-career college science faculty members. This project is presented as three distinct papers. Thirty early-career faculty in the science disciplines from sixteen different institutions in their first year of employment participated in this study. For the first two papers, a new survey was developed asking participants to choose which experiences they had acquired prior to taking their current faculty position and asking them to document their time allocation and time spent on teaching activities in an average work week. In addition, a third component documents the support early-career college faculty in the sciences are receiving from the perspective of faculty members and their respective department chairpersons and identifies areas of disagreement between these two different groups. Twenty early-career college science faculty and their respective department chairpersons completed a newly-designed survey regarding the support offered to new faculty. The survey addressed the areas of feedback on performance, clarity of tenure requirements, mentoring, support for teaching and scholarship and balancing faculty life. This dissertation presents the results from these surveys, accounting for different demographic variables such as science discipline, gender and institutional category.

Factors Associated with the Time of Admission among Notified Dengue Fever Cases in Region VIII Philippines from 2008 to 2014

PubMed Central

Gil Cuesta, Julita; Cerro, Boyd Roderick; Guha-Sapir, Debarati

2016-01-01

In cases of Dengue fever, late hospital admission can lead to treatment delay and even death. In order to improve early disease notification and management, it is essential to investigate the factors affecting the time of admission of Dengue cases. This study determined the factors associated with the time of admission among notified Dengue cases. The study covered the period between 2008 and 2014 in Region VIII, Philippines. The factors assessed were age, sex, hospital sector, hospital level, disease severity based on the 1997 WHO Dengue classification, and period of admission (distinguishing between the 2010 Dengue epidemic and non-epidemic time). We analysed secondary data from the surveillance of notified Dengue cases. We calculated the association through chi-square test, ordinal logistic regression and linear regression at p value < 0.05. The study included 16,357 admitted Dengue cases. The reported cases included a majority of children (70.09%), mild cases of the disease (64.00%), patients from the public sector (69.82%), and non-tertiary hospitals (62.76%). Only 1.40% of cases had a laboratory confirmation. The epidemic period in 2010 comprised 48.68% of all the admitted cases during this period. Late admission was more likely among adults than children (p<0.05). The severe type of the disease was more likely to be admitted late than the mild type (p<0.05). Late admission was also more likely in public hospitals than in private hospitals (p<0.05); and within tertiary level hospitals than non-tertiary hospitals (p<0.05). Late admission was more likely during the non-epidemic period than the 2010 epidemic period (p<0.05). A case fatality rate of 1 or greater was significantly associated with children, severe diseases, tertiary hospitals and public hospitals when admitted late (p<0.05). Data suggests that early admission among child cases was common in Region VIII. This behavior is encouraging, and should be continued. However, further study is needed on the

Nodular tertiary syphilis in an immunocompetent patient*

PubMed Central

Bittencourt, Maraya de Jesus Semblano; de Brito, Arival Cardoso; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães

2016-01-01

Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (Etbe) ...

EPA Pesticide Factsheets

In September 2016, the U.S. Environmental Protection Agency's (USEPA) released the draft Integrated Risk Information System (IRIS) Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE). Consistent with the 2013 IRIS Enhancements, draft IRIS assessments are released prior to external peer review for a 60-day public comment period and discussed at an upcoming public science meeting. Accordingly, the toxicological review, supplementary information, and other materials pertaining to this draft assessment are posted on this site. This material is being released for public viewing and comment prior to a public meeting, providing an opportunity for the IRIS Program to engage in early discussions with stakeholders and the public on data that may be used to identify adverse health effects and characterize exposure-response relationships.

Mid-tertiary ash flow tuff cauldrons, southwestern New Mexico

NASA Technical Reports Server (NTRS)

Elston, W. E.

1984-01-01

Characteristics of 28 known or suspected mid-Tertiary ash-flow tuff cauldrons in New Mexico are described. The largest region is 40 km in diameter, and erosional and block faulting processes have exposed levels as far down as the plutonic roots. The study supports a five-stage process: precursor, caldera collapse, early post-collapse, volcanism, major ring-fracture volcanism, and hydrothermal activity. The stages can repeat or the process can stop at any stage. Post-collapse lavas fell into two categories: cauldron lavas, derived from shallow defluidized residues of caldera-forming ash flow tuff eruption, and framework lavas, evolved from a siliceous pluton below the cauldron complex. The youngest caldera was shallow and formed from asymmetric subsidence and collapse of the caldera walls.

A New Synthesis of Tertiary Alkyl N-Arylcarbamates from Isocyanates.

ERIC Educational Resources Information Center

Bailey, William J.; Griffith, James R.

1978-01-01

The method involves the dissolution of a small piece of metallic lithium in a small quantity of tertiary alcohol followed by addition to a mixture of the isocyanate and the tertiary alcohol in ether. This should be useful in organic chemistry laboratory courses for the identification of tertiary alcohols. (Author/BB)

Impact cratering calculations. Part 1: Early time results

NASA Technical Reports Server (NTRS)

Thomsen, J. M.; Sauer, F. N.; Austin, M. G.; Ruhl, S. F.; Shultz, P. H.; Orphal, D. L.

1979-01-01

Early time two dimensional finite difference calculations of laboratory scale hypervelocity impact of 0.3 g spherical 2024 aluminum projectiles into homogeneous plasticene clay targets were performed. Analysis of resulting material motions showed that energy and momentum were coupled quickly from the aluminum projectile to the target material. In the process of coupling, some of the plasticene clay target was vaporized while the projectile become severely deformed. The velocity flow field developed within the target was shown to have features similar to those found in calculations of near surface explosion cratering. Specific application of Maxwell's analytic Z-Model showed that this model can be used to describe the early time flow fields resulting from the impact cratering calculations as well, provided the flow field centers are located beneath the target surface and most of the projectile momentum is dissipated before the model is applied.

Offset of Tertiary arcs on the Alaska Peninsula: A section in Geological Survey research, fiscal year 1981

USGS Publications Warehouse

,

1984-01-01

Geologic mapping and potassium-argon dating by R. L. Detterman, F. H. Wilson, J. E. Case, and Nora Shew in the Ugashik and western part of the Karluk quadrangles have shown that the Eocene and Oligocene volcanic arc continues into these quadrangles from the south in the Chignik and Sutwik Island quadrangles. Surface exposures of the arc extend northward to approximately 57°30'N., or midway through the Ugashik quadrangle, but none are observed north of that point. Subsurface drill-hole data (Brockway and others, 1975) indicate continuation of the arc, possibly offset to the northwest of the northernmost known surface exposures.In the extreme northern part of the Ugashik and Karluk quadrangles, volcanic rocks again become important. These volcanic rocks are as yet undated; however, they may be related to the Katmai late Tertiary volcanic centers.Like the early Tertiary volcanic arc, the present-day Aleutian arc is also offset to the northwest in the northern part of the Ugashik and Karluk quadrangles. No major offset of the Mesozoic rocks is indicated through the offset zone; this fact suggests a change in the Tertiary tectonic regime in the area of the offset.

Global discourses and experiential speculation: Secondary and tertiary graduate Malawians dissect the HIV/AIDS epidemic

PubMed Central

2011-01-01

Background Since the beginning of the HIV/AIDS epidemic, the perspectives of secondary and tertiary school graduates in sub-Saharan Africa regarding the effectiveness of government and international HIV/AIDS policies and programmes have not been thoroughly examined. When extensive monetary aid is directed toward "development" in a country like Malawi, it is the educated elites - secondary and tertiary graduates who are heavily involved and influential in the domestic re-distribution and implementation of millions of dollars worth of aid - on whom international expectations fall to decrease the transmission of HIV. Many Malawian jobs related to public health and HIV/AIDS are created as a direct result of this funding and are occupied by the few secondary and tertiary graduates. Thus, it is a practical venture to understand their perspectives on highly contentious and heavily funded HIV/AIDS issues that affect their nation. Methods Qualitative data was collected in this study in efforts to discover in-depth perspectives on the HIV/AIDS epidemic. Thirty-eight secondary and tertiary graduate Malawians took part in semi-structured interviews. Data was analysed using an early grounded theory approach and subsequent themes of "global discourses" and "experiential knowledge of HIV/AIDS" emerged. Results This group of Malawians frequently responded to questions regarding healthcare and access to medicine, sexual behaviours and methods of reducing the spread of HIV/AIDS by citing and explaining the widespread, international and "proper" responses. The secondary and tertiary graduate Malawians also discussed these same topics in terms of what they perceive or have experienced. Experiential responses, such as the counter-productivity of circumcision and condoms, the overestimation of HIV/AIDS prevalence, and calls for more authoritarian policing of commercial sex work, were remarkably divergent from the HIV/AIDS discourse. Conclusions The opinions of this group of secondary

Global discourses and experiential speculation: Secondary and tertiary graduate Malawians dissect the HIV/AIDS epidemic.

PubMed

Myroniuk, Tyler W

2011-10-04

Since the beginning of the HIV/AIDS epidemic, the perspectives of secondary and tertiary school graduates in sub-Saharan Africa regarding the effectiveness of government and international HIV/AIDS policies and programmes have not been thoroughly examined. When extensive monetary aid is directed toward "development" in a country like Malawi, it is the educated elites - secondary and tertiary graduates who are heavily involved and influential in the domestic re-distribution and implementation of millions of dollars worth of aid - on whom international expectations fall to decrease the transmission of HIV. Many Malawian jobs related to public health and HIV/AIDS are created as a direct result of this funding and are occupied by the few secondary and tertiary graduates. Thus, it is a practical venture to understand their perspectives on highly contentious and heavily funded HIV/AIDS issues that affect their nation. Qualitative data was collected in this study in efforts to discover in-depth perspectives on the HIV/AIDS epidemic. Thirty-eight secondary and tertiary graduate Malawians took part in semi-structured interviews. Data was analysed using an early grounded theory approach and subsequent themes of "global discourses" and "experiential knowledge of HIV/AIDS" emerged. This group of Malawians frequently responded to questions regarding healthcare and access to medicine, sexual behaviours and methods of reducing the spread of HIV/AIDS by citing and explaining the widespread, international and "proper" responses. The secondary and tertiary graduate Malawians also discussed these same topics in terms of what they perceive or have experienced. Experiential responses, such as the counter-productivity of circumcision and condoms, the overestimation of HIV/AIDS prevalence, and calls for more authoritarian policing of commercial sex work, were remarkably divergent from the HIV/AIDS discourse. The opinions of this group of secondary and tertiary graduate Malawians do not

Effectiveness of early part-time sick leave in musculoskeletal disorders.

PubMed

Martimo, Kari-Pekka; Kaila-Kangas, Leena; Kausto, Johanna; Takala, Esa-Pekka; Ketola, Ritva; Riihimäki, Hilkka; Luukkonen, Ritva; Karppinen, Jaro; Miranda, Helena; Viikari-Juntura, Eira

2008-02-25

The importance of staying active instead of bed rest has been acknowledged in the management of musculoskeletal disorders (MSDs). This emphasizes the potential benefits of adjusting work to fit the employee's remaining work ability. Despite part-time sick leave being an official option in many countries, its effectiveness has not been studied yet. We have designed a randomized controlled study to assess the health effects of early part-time sick leave compared to conventional full-day sick leave. Our hypothesis is that if work time is temporarily reduced and work load adjusted at the early stages of disability, employees with MSDs will have less disability days and faster return to regular work duties than employees on a conventional sick leave. The study population will consist of 600 employees, who seek medical advice from an occupational physician due to musculoskeletal pain. The inclusion requires that they have not been on a sick leave for longer than 14 days prior to the visit. Based on the physician's judgement, the severity of the symptoms must indicate a need for conventional sick leave, but the employee is considered to be able to work part-time without any additional risk. Half of the employees are randomly allocated to part-time sick leave group and their work time is reduced by 40-60%, whereas in the control group work load is totally eliminated with conventional sick leave. The main outcomes are the number of days from the initial visit to return to regular work activities, and the total number of sick leave days during 12 and 24 months of follow-up. The costs and benefits as well as the feasibility of early part-time sick leave will also be evaluated. This is the first randomised trial to our knowledge on the effectiveness of early part-time sick leave compared to conventional full-time sick leave in the management of MSDs. The data collection continues until 2011, but preliminary results on the feasibility of part-time sick leave will be available

Timing and nature of tertiary plutonism and extension in the Grouse Creek Mountains, Utah

USGS Publications Warehouse

Egger, A.E.; Dumitru, T.A.; Miller, E.L.; Savage, C.F.I.; Wooden, J.L.

2003-01-01

The Grouse Creek-Albion-Raft River metamorphic core complex in northwestern Utah and southern Idaho is characterized by several Tertiary plutons with a range of ages and crosscutting relations that help constrain the timing of extensional deformation. In the Grouse Creek Mountains, at least three distinct, superimposed, extension-related Tertiary deformational events are bracketed by intrusive rocks, followed by a fourth event: motion on range-bounding faults. The Emigrant Pass plutonic complex was emplaced at depths of less than 10 km into Permianage rocks. SHRIMP U-Pb zircon analysis indicates a three-stage intrusion of the complex at 41.3 ?? 0.3 Ma, 36.1 ?? 0.2 Ma, and 34.3 ?? 0.3 Ma. The two youngest phases represent distinctly younger intrusive event(s) than the oldest phase, separated by more than 5 m.y. The oldest phase cuts several metamorphosed and deformed younger-on-older faults, providing a pre-41 Ma age bracket for oldest extension-related deformation in the region. The youngest phase(s) are interpreted to have been intruded during delelopment of a map-scale. N-S-trending recumbent fold, the Bovine Mountain fold, formed during vertical shortening of roof rocks during intrusion. This second event folded older normal faults that are likely pre-41 Ma. Zircons from the youngest part of the pluton show inheritance from Archean basement (???2.5 Ga) and from its Proterozoic sedimentary cover (???1.65 Ga). The Red Butte pluton, emplaced at 15-20 km depth, intruded highly metamorphosed Archean orthogneiss at 25.3 ?? 0.5 Ma; cores of some zircons yield latest Archean ages of 2.55 Ga. The pluton is interpreted to have been intruded during a third deformational and metamorphic event that resulted in vertical flattening fabrics formed during NW to EW stretching, ultimately leading to thinning of cover and top-to-the west motion on the Ingham Pass fault. The Ingham Pass fault represents an important structure in the Grouse Creek Mountains, as it juxtaposes two parts

Optimal timing for early surgery in infective endocarditis: a meta-analysis†

PubMed Central

Liang, Fuxiang; Song, Bing; Liu, Ruisheng; Yang, Liu; Tang, Hanbo; Li, Yuanming

2016-01-01

To systematically review early surgery and the optimal timing of surgery in patients with infective endocarditis (IE), a search for foreign and domestic articles on cohort studies about the association between early surgery and infective endocarditis published from inception to January 2015 was conducted in the PubMed, EMBASE, Chinese Biomedical Literature (CBM), Wanfang and Chinese National Knowledge Infrastructure (CNKI) databases. The studies were screened according to the inclusion and exclusion criteria, the data were extracted and the quality of the method of the included studies was assessed. Then, the meta-analysis was performed using the Stata 12.0 software. Sixteen cohort studies, including 8141 participants were finally included. The results of the meta-analysis revealed that, compared with non-early surgery, early surgery in IE lowers the incidence of in-hospital mortality [odds ratio (OR) = 0.57, 95% confidence interval (CI) (0.42, 0.77); P = 0.000, I2 = 73.1%] and long-term mortality [OR = 0.57, 95% CI (0.43, 0.77); P = 0.001, I2 = 67.4%]. Further, performing operation within 2 weeks had a more favourable effect on long-term mortality [OR = 0.63, 95% CI (0.41, 0.97); P = 0.192, I2 = 39.4%] than non-early surgery. In different kinds of IE, we found that early surgery for native valve endocarditis (NVE) had a lower in-hospital [OR = 0.46, 95% CI (0.31, 0.69); P = 0.001, I2 = 73.0%] and long-term [OR = 0.57, 95% CI (0.40, 0.81); P = 0.001, I2 = 68.9%] mortality than the non-early surgery group. However, for prosthetic valve endocarditis (PVE), in-hospital mortality did not differ significantly [OR = 0.83, 95% CI (0.65, 1.06); P = 0.413, I2 = 0.0%] between early and non-early surgery. We concluded that early surgery was associated with lower in-hospital and long-term mortality compared with non-early surgical treatment for IE, especially in NVE. However, the optimal timing of surgery remains unclear. Additional larger prospective clinical trials will be

HIGH LEVELS OF MONOAROMATIC COMPOUNDS LIMIT THE USE OF SOLID-PHASE MICROEXTRACTION OF METHYL TERTIARY BUTYL ETHER AND TERTIARY BUTYL ALCOHOL

EPA Science Inventory

Recently, two papers reported the use of solid-phase microextraction (SPME) with polydimethylsiloxane(PDMS)/Carboxen fibers to determine trace levels of methyl tertiary butyl ether (MTBE) and tertiary butyl alcohol (tBA) in water. Attempts were made to apply this technique to th...

Time Series Modelling of Syphilis Incidence in China from 2005 to 2012.

PubMed

Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau

2016-01-01

The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis.

Time trends in Staphylococcus aureus bacteremia, 1988-2010, in a tertiary center with high methicillin resistance rates.

PubMed

Yahav, Dafna; Shaked, Hila; Goldberg, Elad; Yassin, Sharief; Eliakim-Raz, Noa; Paul, Mical; Bishara, Jihad; Leibovici, Leonard

2017-02-01

Changes in the epidemiology of Staphylococcus aureus bacteremia (SAB) have been described in recent decades. Decreased mortality has been reported over time, mostly from countries with low methicillin resistance rates. We aimed to describe time trends in SAB in a tertiary center with high methicillin resistance rates. We retrospectively analyzed 1692 patients with SAB, and compared between three time periods: 1988-1994 (342 patients), 1998-2004 (597 patients) and 2005-2010 (753 patients). In our cohort, 30 days mortality increased significantly with time, reaching 42.9 % during 2005-2010. The latter period was characterized by higher rates of older patients (35.1 % aged 80 years and older), with lower functional capacity (46.5 % bedridden) and higher rates of comorbidities (33.6 % renal disease, 24.8 % heart failure, 19.0 % dementia). These patients were more likely to be ventilated (18.7 %) and carry a urinary catheter at presentation (46.6 %); present with septic shock (15.9 %) and have pneumonia (20.5 %) or endocarditis (7.2 %) as source. Similar characteristics were found among patients younger than 50 years and with independent functional status. No significant increase in methicillin resistant Staph aureus (MRSA) rates or inappropriate empirical therapy was demonstrated during 2005-2010. In our cohort, increased mortality in recent years in patients with SAB can be explained by baseline condition of patients. MRSA or inappropriate empiric therapy did not explain the increase in mortality. The patients afflicted with SAB changed over time. Epidemiology and outcomes of SAB vary with time and according to geographical location. External validity of studies should be taken into consideration.

Mixed La-Li heterobimetallic complexes for tertiary nitroaldol resolution.

PubMed

Tosaki, Shin-ya; Hara, Keiichi; Gnanadesikan, Vijay; Morimoto, Hiroyuki; Harada, Shinji; Sugita, Mari; Yamagiwa, Noriyuki; Matsunaga, Shigeki; Shibasaki, Masakatsu

2006-09-13

A kinetic resolution of tertiary nitroaldols derived from simple ketones is described. Mixed BINOL/biphenol La-Li heterobimetallic complexes gave the best selectivity in retro-nitroaldol reactions of racemic tertiary nitroaldols. By using a mixture of La-Li3-(1a)3 complex (LLB 2a) and La-Li3-(1b)3 (LLB* 2b) complex in a ratio of 2/1, chiral tertiary nitroaldols were obtained in 80-97% ee and 30-47% recovery yield.

Time and Temporality in Early Childhood Educators' Work

ERIC Educational Resources Information Center

Nuttall, Joce; Thomas, Louise

2015-01-01

This article reports on the persistence and significance of notions of time and temporality in interviews with early childhood educators in Victoria and Queensland, Australia, in two studies designed to explore the concept of "pedagogical leadership". Interpretive analysis of the interview transcripts of the 19 participants identified…

Time scale controversy: Accurate orbital calibration of the early Paleogene

NASA Astrophysics Data System (ADS)

Roehl, U.; Westerhold, T.; Laskar, J.

2012-12-01

Timing is crucial to understanding the causes and consequences of events in Earth history. The calibration of geological time relies heavily on the accuracy of radioisotopic and astronomical dating. Uncertainties in the computations of Earth's orbital parameters and in radioisotopic dating have hampered the construction of a reliable astronomically calibrated time scale beyond 40 Ma. Attempts to construct a robust astronomically tuned time scale for the early Paleogene by integrating radioisotopic and astronomical dating are only partially consistent. Here, using the new La2010 and La2011 orbital solutions, we present the first accurate astronomically calibrated time scale for the early Paleogene (47-65 Ma) uniquely based on astronomical tuning and thus independent of the radioisotopic determination of the Fish Canyon standard. Comparison with geological data confirms the stability of the new La2011 solution back to 54 Ma. Subsequent anchoring of floating chronologies to the La2011 solution using the very long eccentricity nodes provides an absolute age of 55.530 ± 0.05 Ma for the onset of the Paleocene/Eocene Thermal Maximum (PETM), 54.850 ± 0.05 Ma for the early Eocene ash -17, and 65.250 ± 0.06 Ma for the K/Pg boundary. The new astrochronology presented here indicates that the intercalibration and synchronization of U/Pb and 40Ar/39Ar radioisotopic geochronology is much more challenging than previously thought.

Time scale controversy: Accurate orbital calibration of the early Paleogene

NASA Astrophysics Data System (ADS)

Westerhold, Thomas; RöHl, Ursula; Laskar, Jacques

2012-06-01

Timing is crucial to understanding the causes and consequences of events in Earth history. The calibration of geological time relies heavily on the accuracy of radioisotopic and astronomical dating. Uncertainties in the computations of Earth's orbital parameters and in radioisotopic dating have hampered the construction of a reliable astronomically calibrated time scale beyond 40 Ma. Attempts to construct a robust astronomically tuned time scale for the early Paleogene by integrating radioisotopic and astronomical dating are only partially consistent. Here, using the new La2010 and La2011 orbital solutions, we present the first accurate astronomically calibrated time scale for the early Paleogene (47-65 Ma) uniquely based on astronomical tuning and thus independent of the radioisotopic determination of the Fish Canyon standard. Comparison with geological data confirms the stability of the new La2011 solution back to ˜54 Ma. Subsequent anchoring of floating chronologies to the La2011 solution using the very long eccentricity nodes provides an absolute age of 55.530 ± 0.05 Ma for the onset of the Paleocene/Eocene Thermal Maximum (PETM), 54.850 ± 0.05 Ma for the early Eocene ash -17, and 65.250 ± 0.06 Ma for the K/Pg boundary. The new astrochronology presented here indicates that the intercalibration and synchronization of U/Pb and 40Ar/39Ar radioisotopic geochronology is much more challenging than previously thought.

Pubertal timing and early sexual intercourse in the offspring of teenage mothers.

PubMed

De Genna, Natacha M; Larkby, Cynthia; Cornelius, Marie D

2011-10-01

Early puberty is associated with stressful family environments, early sexual intercourse, and teenage pregnancy. We examined pubertal timing and sexual debut among the 14-year-old offspring of teenage mothers. Mothers (71% Black, 29% White) were recruited as pregnant teenagers (12-18 years old). Data were collected during pregnancy and when offspring were 6, 10 and 14 years old (n = 318). Adolescents (50% male) compared the timing of their pubertal maturation to same-sex peers. There was a significant 3-way interaction effect of race, sex, and pubertal timing on sexual debut (n = 305). This effect remained significant in a model controlling for maternal age at first intercourse, substance use, exposure to trauma, authoritative parenting, and peer sexual activity (n = 255). Early maturation was associated with early sex in daughters, and may be one pathway for the inter-generational transfer of risk for teenage pregnancy among daughters of teenage mothers.

The Changing Nature of the Hawaiian Hotspot in the Late Cretaceous-Early Tertiary: Evidence From Helium Isotopes and Melt Inclusion Compositions

NASA Astrophysics Data System (ADS)

Keller, R.; Graham, D.; Duncan, R.; Regelous, M.

2002-12-01

Ocean Drilling Program Leg 197 recovered basaltic basement from three of the Late Cretaceous-Paleogene Emperor seamounts: Detroit (Sites 1203 and 1204), Nintoku (Site 1205), and Koko (Site 1206) seamounts. The depths of penetration into basement achieved by this drilling (140-450 m), the range of rock types recovered (hawaiites, alkalic basalts, and tholeiitic basalts), and the age range (48-76 Ma) makes this one of the most comprehensive collections of the volcanic products of the Hawaiian hotspot available, and opens up new opportunities to study the temporal evolution of the Hawaiian hotspot during the Late Cretaceous and early Tertiary. Previous studies of the chemical evolution of the Hawaiian hotspot (Lanphere et al., 1980; Keller et al., 2000) found significant temporal variations. For example, Sr isotopic ratios of the tholeiitic basalts remain fairly constant along the Hawaiian Islands/Ridge between Kilauea volcano on Hawaii and the Hawaiian-Emperor bend, but then decrease steadily northward along the Emperor seamounts. Trace element compositions (especially the rare earth element patterns) also show limited variations along the Hawaiian Islands/Ridge, but change toward more depleted values northward along the Emperor seamounts. The trend to more MORB-like compositions back in time was attributed to a decrease in distance between the hotspot and the nearest spreading center, although a more comprehensive study suggests that variations in lithospheric thickness also caused changes in the composition of the plume melts (Regelous et al., 2002). We will complement these previous studies and the ongoing work of the other Leg 197 scientists by studying two aspects of the Emperor seamount basalts: helium isotopes and melt inclusion compositions. We will measure the helium isotopic ratios of selected olivine separates from three of the Leg 197 drill sites and from DSDP Site 433 on Suiko seamount (65 Ma) to determine if the composition of the Hawaiian "plume signal

Cretaceous-Tertiary findings, paradigms and problems

NASA Technical Reports Server (NTRS)

Officer, C. B.; Drake, C. L.

1988-01-01

The asteroid hypothesis has stimulated numerous studies of the paleontological record at Cretaceous/Tertiary time as well as of geological indicators of environmental crisis preserved in the rock record. Both extinctions and geological anomalies often occur at times that do not appear to be synchronous or instantaneous. The record includes paleontological indicators of dinosaurs, terrestrial flora, marine planktonic organisms, and shallow water marine macrofauna and geological phenomena include occurrences of iridium and other platinum metals, trace elements, clay mineralogy, shocked minerals, soot, microspherules, and isotopes of osmium, strontium and carbon. These findings are reviewed in the context of the alternate hypotheses of an exogenic cause, involving either a single asteroid impact or multiple commentary impacts, and an endogenic cause, involving intense global volcanism and major sea level regression.

The Wage Premium on Tertiary Education: New Estimates for 21 OECD Countries Countries. OECD Economics Department Working Papers, No. 589

ERIC Educational Resources Information Center

Strauss, Hubert; de la Maisonneuve, Christine

2007-01-01

This paper presents cross-section estimates of gross hourly wage premia on tertiary education. They are based on a unified framework for 21 OECD countries from the 1990s to the early 2000s and use international household surveys to maximise international comparability. The results of the "augmented" Mincerian wage equations point to an…

Time to presentation, pattern and immediate health effects of alleged child sexual abuse at two tertiary hospitals in Addis Ababa, Ethiopia

PubMed Central

2014-01-01

Background Children are vulnerable to abuse and violence because their level of development makes them unable to protect themselves. Such adversities during early childhood may have a negative impact on the future lives of the victims. This study was done to determine the delay to hospital presentation, clinical manifestations and immediate health effects of child sexual abuse in two tertiary care hospitals in Ethiopia. Methods We reviewed records of all cases of child sexual and physical abuse between January 2011 and December 2012. Bivariate and multivariate logistic regression models were used to test the presence and strength of association between time to reporting to hospital and, age and sex of the victim, place of residence and relation of the victim to the perpetrator. Odds ratio and 95% confidence intervals were generated. Significance was taken as p-value < 0.05. Results During the study period, we identified records of 275 children who were seen for alleged physical and sexual abuse; they accounted for 0.6% of the outpatient department (OPD) visits. The majority of the victims were cases of sexual abuse (97.3%) and most of them were female (75.7%). The mean age of the victims was 9.5 years (standard deviation (SD) = 4.2 years). The majority of the abusers were known to the victim (73.0%) and male (98.8%). Neighbors (38.95%), teachers (7.9%) and relatives (13.4%) were the most commonly reported perpetrators. The median length of time taken to present to hospital after the abuse incident was 4 days (range = 2 hours to 3 years). Male victims were 2.4 times more likely to have a delay of greater than one week to present to hospital (Adjusted Odds Ratio (AOR), 2.40; 95% Confidence interval (CI), 1.34-4.31; P-value = 0.002). Sexual abuse was associated with various immediate health effects, for example, hymenal tear, urinary tract infection and, perineal laceration or tear. Conclusion Presentation for care was often delayed. Male sex was

Diversification of Tertiary Education in Norway, Case Study.

ERIC Educational Resources Information Center

Ottosen, Kristian

The educational system of Norway, which is organized into primary, secondary and higher education, is reviewed. Types of schools and/or courses in secondary education are listed including present enrollment figures by main types of secondary education and transfer rates of secondary to tertiary education. The system of tertiary education is…

Evaluation of the Special Tertiary Admissions Test (STAT)

ERIC Educational Resources Information Center

Coates, Hamish; Friedman, Tim

2010-01-01

This paper reports findings from the first national Australian study of the predictive validity of the Special Tertiary Admissions Test (STAT). Background on tertiary admissions procedures in Australia is presented, followed by information on STAT and the research methods. The results affirm that STAT, through the provision of baseline and…

Pubertal Timing and Early Sexual Intercourse in the Offspring of Teenage Mothers

PubMed Central

De Genna, Natacha M.; Larkby, Cynthia; Cornelius, Marie D.

2011-01-01

Early puberty is associated with stressful family environments, early sexual intercourse, and teenage pregnancy. We examined pubertal timing and sexual debut among the 14-year-old offspring of teenage mothers. Mothers (71% Black, 29% White) were recruited as pregnant teenagers (12–18 years old). Data were collected during pregnancy and when offspring were 6, 10 and 14 years old (n = 318). Adolescents (50% male) compared the timing of their pubertal maturation to same-sex peers. There was a significant 3-way interaction effect of race, sex, and pubertal timing on sexual debut (n = 305). This effect remained significant in a model controlling for maternal age at first intercourse, substance use, exposure to trauma, authoritative parenting, and peer sexual activity (n = 255). Early maturation was associated with early sex in daughters, and may be one pathway for the inter-generational transfer of risk for teenage pregnancy among daughters of teenage mothers. PMID:21279428

Early Discharge and Home Care After Unplanned Cesarean Birth: Nursing Care Time

PubMed Central

Brooten, Dorothy; Knapp, Helen; Borucki, Lynne; Jacobsen, Barbara; Finkler, Steven; Arnold, Lauren; Mennuti, Michael

2013-01-01

Objective This study examined the mean nursing time spent providing discharge planning and home care to women who delivered by unplanned cesarean birth and examined differences in nursing time required by women with and without morbidity. Design A secondary analysis of nursing time from a randomized trial of transitional care (discharge planning and home follow-up) provided to women after cesarean delivery. Setting An urban tertiary-care hospital. Patients The sample (N = 61) of black and white women who had unplanned cesarean births and their full-term newborns was selected randomly. Forty-four percent of the women had experienced pregnancy complications. Interventions Advanced practice nurses provided discharge planning and 8-week home follow-up consisting of home visits, telephone outreach, and daily telephone availability. Outcome Measure Nursing time required was dictated by patient need and provider judgment rather than by reimbursement plan. Results More than half of the women required more than two home visits; mean home visit time was 1 hour. For women who experienced morbidity mean discharge planning time was 20 minutes more and mean home visit time 40 minutes more. Conclusions Current health care services that provide one or two 1-hour home visits to childbearing women at high risk may not be meeting the education and resource needs of this group. PMID:8892128

Double Morphology: Tertiary Syphilis and Acquired Immunodeficiency Syndrome-A Rare Association.

PubMed

Ngwanya, R M; Kakande, B; Khumalo, N P

2017-01-01

Human immunodeficiency virus (HIV) and Treponema pallidum coinfection is relatively common and accounts for about 25% of primary and secondary syphilis. Tertiary syphilis in HIV-uninfected and HIV-infected patients is vanishingly rare. This is most likely due to early treatment of cases of primary and secondary syphilis. There is rapid progression to tertiary syphilis in HIV-infected patients. A 49-year-old woman diagnosed with HIV Type 1 infection and cluster of differentiation 4 (CD4) count of 482 presented with a four-week history of multiple crusted plaques, nodules, and ulcers on her face, arms, and abdomen. Her past history revealed red painful eyes six months prior to this presentation. She had generalized lymphadenopathy, no alopecia, and no palmar-plantar or mucosal lesions. There were no features suggestive of secondary syphilis. Neurological examination was normal. Her rapid plasma reagin test was positive to a titer of 64. She was treated with Penicillin G 20 mu IVI daily for 2 weeks. Penicillin remains the treatment of choice in syphilitic infected HIV negative and HIV-infected individuals. In neurosyphilis, the dose of Penicillin GIVI is 18-24 mu daily for 10-14 days. This case report demonstrates the importance of excluding syphilis in any HIV-infected patient.

A Glimpse at Late Mesozoic to Early Tertiary Offshore Stratigraphy from Wilkes Land, East Antarctica: Results of Strategic Dredging of the Mertz-Ninnis Trough

NASA Astrophysics Data System (ADS)

Schrum, H.; Domack, E.; Desantis, L.; Leventer, A.; McMullen, K.; Escutia, C.

2004-12-01

infilling a rifted basin of late Cretaceous age. Seaward dipping reflectors above the syn-rift strata represent post-rift deposits ranging from Paleogene to Quaternary. Included within this stratigraphy are lithified diamictites containing Mesozoic palynomorphs in addition to palynomorphs of Early Tertiary age (including dinoflagellates). Seaward dipping reflectors in the deep axis of the Mertz-Ninnis Trough were not sampled directly by our dredges, but are believed to be Lower Cretaceous siltstones by extrapolation to core DF-79-38, 100 km along strike to the southeast (Domack et al., 1980). Furthermore, the thermal maturity of the lignite samples recovered in our collections suggests that the coal is of Early Tertiary age, as are numerous organic-rich mudstones, which contain Paleogene palynomorphs. These results indicate that sedimentary strata in this portion of the Wilkes Land Margin contain significantly thick (greater than 2.7 km) post-rift (drift phase) marine sequences of both pre- and synglacial character. Strategic dredging is a promising methodology by which to sample stratigraphic succession in a cost effective manner along the East Antarctic margin in the absence of, or preparation for, International Ocean Drilling Projects on the shelf. Domack, E. W., Fairchild, W. W., and Anderson, J. B. (1980) Lower Cretaceous sediment from the East Antarctic continental shelf, Nature, 287, 625-626.

Optimal timing for early surgery in infective endocarditis: a meta-analysis.

PubMed

Liang, Fuxiang; Song, Bing; Liu, Ruisheng; Yang, Liu; Tang, Hanbo; Li, Yuanming

2016-03-01

To systematically review early surgery and the optimal timing of surgery in patients with infective endocarditis (IE), a search for foreign and domestic articles on cohort studies about the association between early surgery and infective endocarditis published from inception to January 2015 was conducted in the PubMed, EMBASE, Chinese Biomedical Literature (CBM), Wanfang and Chinese National Knowledge Infrastructure (CNKI) databases. The studies were screened according to the inclusion and exclusion criteria, the data were extracted and the quality of the method of the included studies was assessed. Then, the meta-analysis was performed using the Stata 12.0 software. Sixteen cohort studies, including 8141 participants were finally included. The results of the meta-analysis revealed that, compared with non-early surgery, early surgery in IE lowers the incidence of in-hospital mortality [odds ratio (OR) = 0.57, 95% confidence interval (CI) (0.42, 0.77); P = 0.000, I(2) = 73.1%] and long-term mortality [OR = 0.57, 95% CI (0.43, 0.77); P = 0.001, I(2) = 67.4%]. Further, performing operation within 2 weeks had a more favourable effect on long-term mortality [OR = 0.63, 95% CI (0.41, 0.97); P = 0.192, I(2) = 39.4%] than non-early surgery. In different kinds of IE, we found that early surgery for native valve endocarditis (NVE) had a lower in-hospital [OR = 0.46, 95% CI (0.31, 0.69); P = 0.001, I(2) = 73.0%] and long-term [OR = 0.57, 95% CI (0.40, 0.81); P = 0.001, I(2) = 68.9%] mortality than the non-early surgery group. However, for prosthetic valve endocarditis (PVE), in-hospital mortality did not differ significantly [OR = 0.83, 95% CI (0.65, 1.06); P = 0.413, I(2) = 0.0%] between early and non-early surgery. We concluded that early surgery was associated with lower in-hospital and long-term mortality compared with non-early surgical treatment for IE, especially in NVE. However, the optimal timing of surgery remains unclear. Additional larger prospective clinical

10 CFR 212.78 - Tertiary incentive crude oil.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

10 CFR 212.78 - Tertiary incentive crude oil.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

10 CFR 212.78 - Tertiary incentive crude oil.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

Crime and Crime Management in Nigeria Tertiary Institutions

ERIC Educational Resources Information Center

Adebanjo, Margaret Adewunmi

2014-01-01

This paper examines crime and its management in Nigerian tertiary institutions. Tertiary institutions today have become arenas for crime activities such as rape, cultism, murder, theft, internet fraud, drug abuse, and examination malpractices. This paper delves into what crime is, and its causes; and the positions of the law on crime management.…

10 CFR 212.78 - Tertiary incentive crude oil.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operator with respect to any enhanced oil recovery project for which a report had been filed previously... 10 Energy 3 2010-01-01 2010-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary...

Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care

PubMed Central

Cranwell, Kate; Polacsek, Meg

2016-01-01

Abstract Medical comorbidity in people with long‐term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health‐care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video‐recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers’ experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments. PMID:26735771

Integrating powdered activated carbon into wastewater tertiary filter for micro-pollutant removal.

PubMed

Hu, Jingyi; Aarts, Annelies; Shang, Ran; Heijman, Bas; Rietveld, Luuk

2016-07-15

Integrating powdered activated carbon (PAC) into wastewater tertiary treatment is a promising technology to reduce organic micro-pollutant (OMP) discharge into the receiving waters. To take advantage of the existing tertiary filter, PAC was pre-embedded inside the filter bed acting as a fixed-bed adsorber. The pre-embedding (i.e. immobilization) of PAC was realized by direct dosing a PAC solution on the filter top, which was then promoted to penetrate into the filter media by a down-flow of tap water. In order to examine the effectiveness of this PAC pre-embedded filter towards OMP removal, batch adsorption tests, representing PAC contact reactor (with the same PAC mass-to-treated water volume ratio as in the PAC pre-embedded filter) were performed as references. Moreover, as a conventional dosing option, PAC was dosed continuously with the filter influent (i.e. the wastewater secondary effluent with the investigated OMPs). Comparative results confirmed a higher OMP removal efficiency associated with the PAC pre-embedded filter, as compared to the batch system with a practical PAC residence time. Furthermore, over a filtration period of 10 h (approximating a realistic filtration cycle for tertiary filters), the continuous dosing approach resulted in less OMP removal. Therefore, it was concluded that the pre-embedding approach can be preferentially considered when integrating PAC into the wastewater tertiary treatment for OMP elimination. Copyright © 2016 Elsevier Ltd. All rights reserved.

MEASUREMENT OF EXHALED BREATH AND VENOUS BLOOD TO DEVELOP A PHYSIOLOGICALLY BASED PHARMACOKINETIC MODEL FOR HUMAN EXPOSURE TO METHYL TERTIARY-BUTYL ETHER AND THE PRODUCTION OF THE BIOMARKER TERTIARY-BUTYL ALCOHOL

EPA Science Inventory

Methyl tertiary-butyl ether (MTBE) is a common fuel additive used to increase the availability of oxygen in gasoline to reduce winter-time carbon monoxide emissions from automobiles. Also, MTBE boosts gasoline "octane" rating and, as such, allows reduction of benzene...

Policy Innovation and Tertiary Education Graduation Rates: A Cross-Country Analysis

ERIC Educational Resources Information Center

Delaney, Jennifer A.; Yu, Patricia

2013-01-01

This study extends Trow's theory of higher education development to examine changes in national-level tertiary education graduation rates. Applying Trow's framework we arrive at three stages: (1) elite systems with gross tertiary graduation rates less than 15%, (2) massified systems with gross tertiary graduation rates between 15% and 50%, and (3)…

Addressing indigenous health workforce inequities: A literature review exploring 'best' practice for recruitment into tertiary health programmes

PubMed Central

2012-01-01

Introduction Addressing the underrepresentation of indigenous health professionals is recognised internationally as being integral to overcoming indigenous health inequities. This literature review aims to identify 'best practice' for recruitment of indigenous secondary school students into tertiary health programmes with particular relevance to recruitment of Māori within a New Zealand context. Methodology/methods A Kaupapa Māori Research (KMR) methodological approach was utilised to review literature and categorise content via: country; population group; health profession ffocus; research methods; evidence of effectiveness; and discussion of barriers. Recruitment activities are described within five broad contexts associated with the recruitment pipeline: Early Exposure, Transitioning, Retention/Completion, Professional Workforce Development, and Across the total pipeline. Results A total of 70 articles were included. There is a lack of published literature specific to Māori recruitment and a limited, but growing, body of literature focused on other indigenous and underrepresented minority populations. The literature is primarily descriptive in nature with few articles providing evidence of effectiveness. However, the literature clearly frames recruitment activity as occurring across a pipeline that extends from secondary through to tertiary education contexts and in some instances vocational (post-graduate) training. Early exposure activities encourage students to achieve success in appropriate school subjects, address deficiencies in careers advice and offer tertiary enrichment opportunities. Support for students to transition into and within health professional programmes is required including bridging/foundation programmes, admission policies/quotas and institutional mission statements demonstrating a commitment to achieving equity. Retention/completion support includes academic and pastoral interventions and institutional changes to ensure safer

Addressing indigenous health workforce inequities: a literature review exploring 'best' practice for recruitment into tertiary health programmes.

PubMed

Curtis, Elana; Wikaire, Erena; Stokes, Kanewa; Reid, Papaarangi

2012-03-15

Addressing the underrepresentation of indigenous health professionals is recognised internationally as being integral to overcoming indigenous health inequities. This literature review aims to identify 'best practice' for recruitment of indigenous secondary school students into tertiary health programmes with particular relevance to recruitment of Māori within a New Zealand context. METHODOLOGY/METHODS: A Kaupapa Māori Research (KMR) methodological approach was utilised to review literature and categorise content via: country; population group; health profession focus; research methods; evidence of effectiveness; and discussion of barriers. Recruitment activities are described within five broad contexts associated with the recruitment pipeline: Early Exposure, Transitioning, Retention/Completion, Professional Workforce Development, and Across the total pipeline. A total of 70 articles were included. There is a lack of published literature specific to Māori recruitment and a limited, but growing, body of literature focused on other indigenous and underrepresented minority populations.The literature is primarily descriptive in nature with few articles providing evidence of effectiveness. However, the literature clearly frames recruitment activity as occurring across a pipeline that extends from secondary through to tertiary education contexts and in some instances vocational (post-graduate) training. Early exposure activities encourage students to achieve success in appropriate school subjects, address deficiencies in careers advice and offer tertiary enrichment opportunities. Support for students to transition into and within health professional programmes is required including bridging/foundation programmes, admission policies/quotas and institutional mission statements demonstrating a commitment to achieving equity. Retention/completion support includes academic and pastoral interventions and institutional changes to ensure safer environments for indigenous

PROPERTIES OF THE CLOSE-IN TERTIARY IN THE QUADRUPLE SYSTEM V401 CYG

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

Zhu, L.-Y.; Qian, S.-B.; Zhou, X.

2013-08-01

V401 Cyg is a quadruple system in which the spectroscopic signature of a close-in tertiary and a distant visual companion star were reported. Orbital properties of the close-in companion should provide valuable information on the formation of close binaries and stellar dynamical interaction. By analyzing new times of minimum light together with those collected from the literature, we discovered that the observed-calculated (O - C) curve of V401 Cyg shows a cyclic change with a short period of 3.5 yr and a semi-amplitude of 0.00436 days while it undergoes an upward parabolic variation. Those photoelectric and CCD data covered moremore » than two cycles and were analyzed for the light-travel time effect via the presence of the tertiary companion. The mass of the third body was determined to be M{sub 3}sin i' = 0.65({+-} 0.08) M{sub Sun }, which is close to the value estimated from the spectroscopic data (M{sub 3} {approx} 0.64 M{sub Sun }). This reveals that the orbital inclination of the tertiary was about i' {approx} 90 Degree-Sign , indicating that the contact components of V401 Cyg have the possibility of being eclipsed by the tertiary at an orbital distance of about 3.0 AU, and it may be a triply eclipsing hierarchical triple system. The upward parabolic change indicates a period increase at a rate of (P-dot{sub 2} = 1.5 x 10{sup -7} revealing a mass transfer from the secondary to the primary (M-dot{sub 2} = 5.9 x 10{sup -8} M{sub Sun} yr{sup -1}). This is consistent with the predictions of the theory of thermal relaxation oscillation (TRO) suggesting that V401 Cyg is undergoing an expanding-orbit stage in the TRO cycles.« less

Towards the 21st Century. Facilities for Tertiary Education.

ERIC Educational Resources Information Center

Corbett, Anne, Ed.

This report presents observations of experts in planning, design, construction or management of tertiary educational facilities about the emerging issues and the appropriate planning and architectural solutions for higher education facilities as the new millennium approaches. Specific topics discuss the current context of tertiary education…

Time Series Modelling of Syphilis Incidence in China from 2005 to 2012

PubMed Central

Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau

2016-01-01

Background The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. Methods In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). Results The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Conclusion Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis. PMID:26901682

Novel Algorithms Enabling Rapid, Real-Time Earthquake Monitoring and Tsunami Early Warning Worldwide

NASA Astrophysics Data System (ADS)

Lomax, A.; Michelini, A.

2012-12-01

We have introduced recently new methods to determine rapidly the tsunami potential and magnitude of large earthquakes (e.g., Lomax and Michelini, 2009ab, 2011, 2012). To validate these methods we have implemented them along with other new algorithms within the Early-est earthquake monitor at INGV-Rome (http://early-est.rm.ingv.it, http://early-est.alomax.net). Early-est is a lightweight software package for real-time earthquake monitoring (including phase picking, phase association and event detection, location, magnitude determination, first-motion mechanism determination, ...), and for tsunami early warning based on discriminants for earthquake tsunami potential. In a simulation using archived broadband seismograms for the devastating M9, 2011 Tohoku earthquake and tsunami, Early-est determines: the epicenter within 3 min after the event origin time, discriminants showing very high tsunami potential within 5-7 min, and magnitude Mwpd(RT) 9.0-9.2 and a correct shallow-thrusting mechanism within 8 min. Real-time monitoring with Early-est givess similar results for most large earthquakes using currently available, real-time seismogram data. Here we summarize some of the key algorithms within Early-est that enable rapid, real-time earthquake monitoring and tsunami early warning worldwide: >>> FilterPicker - a general purpose, broad-band, phase detector and picker (http://alomax.net/FilterPicker); >>> Robust, simultaneous association and location using a probabilistic, global-search; >>> Period-duration discriminants TdT0 and TdT50Ex for tsunami potential available within 5 min; >>> Mwpd(RT) magnitude for very large earthquakes available within 10 min; >>> Waveform P polarities determined on broad-band displacement traces, focal mechanisms obtained with the HASH program (Hardebeck and Shearer, 2002); >>> SeisGramWeb - a portable-device ready seismogram viewer using web-services in a browser (http://alomax.net/webtools/sgweb/info.html). References (see also: http

Rapid search for tertiary fragments reveals protein sequence–structure relationships

PubMed Central

Zhou, Jianfu; Grigoryan, Gevorg

2015-01-01

Finding backbone substructures from the Protein Data Bank that match an arbitrary query structural motif, composed of multiple disjoint segments, is a problem of growing relevance in structure prediction and protein design. Although numerous protein structure search approaches have been proposed, methods that address this specific task without additional restrictions and on practical time scales are generally lacking. Here, we propose a solution, dubbed MASTER, that is both rapid, enabling searches over the Protein Data Bank in a matter of seconds, and provably correct, finding all matches below a user-specified root-mean-square deviation cutoff. We show that despite the potentially exponential time complexity of the problem, running times in practice are modest even for queries with many segments. The ability to explore naturally plausible structural and sequence variations around a given motif has the potential to synthesize its design principles in an automated manner; so we go on to illustrate the utility of MASTER to protein structural biology. We demonstrate its capacity to rapidly establish structure–sequence relationships, uncover the native designability landscapes of tertiary structural motifs, identify structural signatures of binding, and automatically rewire protein topologies. Given the broad utility of protein tertiary fragment searches, we hope that providing MASTER in an open-source format will enable novel advances in understanding, predicting, and designing protein structure. PMID:25420575

Cognitive Vulnerabilities Amplify the Effect of Early Pubertal Timing on Interpersonal Stress Generation During Adolescence

PubMed Central

Stange, Jonathan P.; Kleiman, Evan M.; Hamlat, Elissa J.; Abramson, Lyn Y.; Alloy, Lauren B.

2013-01-01

Early pubertal timing has been found to confer risk for the occurrence of interpersonal stressful events during adolescence. However, pre-existing vulnerabilities may exacerbate the effects of early pubertal timing on the occurrence of stressors. Thus, the current study prospectively examined whether cognitive vulnerabilities amplified the effects of early pubertal timing on interpersonal stress generation. In a diverse sample of 310 adolescents (M age = 12.83 years, 55 % female; 53 % African American), early pubertal timing predicted higher levels of interpersonal dependent events among adolescents with more negative cognitive style and rumination, but not among adolescents with lower levels of these cognitive vulnerabilities. These findings suggest that cognitive vulnerabilities may heighten the risk of generating interpersonal stress for adolescents who undergo early pubertal maturation, which may subsequently place adolescents at greater risk for the development of psychopathology. PMID:24061858

Area/latency optimized early output asynchronous full adders and relative-timed ripple carry adders.

PubMed

Balasubramanian, P; Yamashita, S

2016-01-01

This article presents two area/latency optimized gate level asynchronous full adder designs which correspond to early output logic. The proposed full adders are constructed using the delay-insensitive dual-rail code and adhere to the four-phase return-to-zero handshaking. For an asynchronous ripple carry adder (RCA) constructed using the proposed early output full adders, the relative-timing assumption becomes necessary and the inherent advantages of the relative-timed RCA are: (1) computation with valid inputs, i.e., forward latency is data-dependent, and (2) computation with spacer inputs involves a bare minimum constant reverse latency of just one full adder delay, thus resulting in the optimal cycle time. With respect to different 32-bit RCA implementations, and in comparison with the optimized strong-indication, weak-indication, and early output full adder designs, one of the proposed early output full adders achieves respective reductions in latency by 67.8, 12.3 and 6.1 %, while the other proposed early output full adder achieves corresponding reductions in area by 32.6, 24.6 and 6.9 %, with practically no power penalty. Further, the proposed early output full adders based asynchronous RCAs enable minimum reductions in cycle time by 83.4, 15, and 8.8 % when considering carry-propagation over the entire RCA width of 32-bits, and maximum reductions in cycle time by 97.5, 27.4, and 22.4 % for the consideration of a typical carry chain length of 4 full adder stages, when compared to the least of the cycle time estimates of various strong-indication, weak-indication, and early output asynchronous RCAs of similar size. All the asynchronous full adders and RCAs were realized using standard cells in a semi-custom design fashion based on a 32/28 nm CMOS process technology.

Early tracheostomy in trauma patients saves time and money.

PubMed

Hyde, Glendon A; Savage, Stephanie A; Zarzaur, Ben L; Hart-Hyde, Jensen E; Schaefer, Candace B; Croce, Martin A; Fabian, Timothy C

2015-01-01

Patients suffering traumatic brain and chest wall injuries are often difficult to liberate from the ventilator yet best timing of tracheostomy remains ill-defined. While prior studies have addressed early versus late tracheostomy, they generally suffer from the use of historical controls, which cannot account for variations in management over time. Propensity scoring can be utilized to identify controls from the same patient population, minimizing impact of confounding variables. The purpose of this study was to determine outcomes associated with early versus late tracheostomy by application of propensity scoring. Patients requiring intubation within 48h and receiving tracheostomy from January 2010 to June 2012 were identified. Early tracheostomy (ET) was a tracheostomy performed by the fifth hospital day. ET patients were matched to late tracheostomy patients (LT, tracheostomy after day 5) using propensity scoring and compared for multiple outcomes. Cost for services was calculated using average daily billing rates at our institution. One hundred and six patients were included, 53 each in the ET (mean day tracheostomy=4) and the LT (mean day tracheostomy=10) cohorts. The average age was 47 years and 94% suffered blunt injury, with an average NISS of 23.7. Patients in the ET group had significantly shorter TICU LOS (21.4 days vs. 28.6 days, p<0.0001) and significantly fewer ventilator days (16.7 days vs. 21.9, p<0.0001) compared to the LT group. ET patients also had significantly less VAP (34% vs. 64.2%, p=0.0019). In the current era of increased health-care costs, early tracheostomy significantly decreased both pulmonary morbidity and critical care resource utilization. This translates to an appreciable cost savings, at minimum $52,173 per patient and a potential total savings of $2.8million/year for the entire LT cohort. For trauma patients requiring prolonged ventilator support, early tracheostomy should be performed. Copyright © 2014 Elsevier Ltd. All rights

American Tertiary mollusks of the genus Clementia

USGS Publications Warehouse

Woodring, W.P.

1927-01-01

Aside from its value as an aid in determining the age of Tertiary beds, the chief interest of the genus Clementia lies in the anomalous features of its present and former distribution. An attempt is made in this paper to trace its geologic history, to point out its paleobiologic significance, and to describe all the known American Tertiary species. The fossils from Colombia used in preparing this report were collected during explorations made under the direction of Dr. 0. B. Hopkins, chief geologist of the Imperial Oil Co. (Ltd.), who kindly donated them to the United States National Museum. Dr. T. Wayland Vaughan, of the Scripps Institution of Oceanography, furnished information relating to specimens collected by him in Mexico. Dr. Bruce L. Clark, of the University of California; Dr. G. Dallas Hanna, of the California Academy of Sciences; Dr. H. A. Pilsbry, of the Philadelphia Academy of Natural Sciences; and Dr. W. D. Matthew, of the American Museum of Natural History, generously loaned type specimens and other material. Doctor Clark and Doctor Hanna also gave information concerning the Tertiary species from California. Mr. Ralph B. Stewart, of the University of California, read the manuscript, and I have taken advantage of his suggestions. I am also indebted to Mr. L. R. Cox, of the British Museum, for information relating to the fossil species from Persia, Zanzibar, and Burma, and to Dr. Axel A. Olsson, of the International Petroleum Co., for data concerning undescribed Tertiary species from Peru.

Early Childhood Maltreatment and Girls' Sexual Behavior: The Mediating Role of Pubertal Timing.

PubMed

Ryan, Rebecca M; Mendle, Jane; Markowitz, Anna J

2015-09-01

Although links between early childhood maltreatment and girls' sexual behavior in adolescence have been well established, it is unclear whether different forms of maltreatment are differentially associated with sexual outcomes and whether distinct mechanisms explain associations across maltreatment types. Using data from National Longitudinal Study of Adolescent Health (Add Health), the present study examines whether physical abuse, sexual abuse, and physical neglect in early childhood differentially predict girls' age at first intercourse and number of sexual partners in early adulthood. The study also tests whether early pubertal timing mediates the link between early maltreatment and sexual behavior (N = 6,364). Findings indicate that early sexual and physical abuse were equally predictive of earlier age at first intercourse and a greater number of sexual partners, but that only the sexual abuse-age at first intercourse link was mediated by early puberty. These results suggest that sexual abuse and physical abuse are associated with earlier and riskier sexual behavior in girls relative to no maltreatment and to similar degrees. However, only the link between sexual abuse and sexual behavior involves a biological mechanism manifested in early pubertal timing. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Secondary structure encodes a cooperative tertiary folding funnel in the Azoarcus ribozyme

PubMed Central

Mustoe, Anthony M.; Al-Hashimi, Hashim M.; Brooks, Charles L.

2016-01-01

A requirement for specific RNA folding is that the free-energy landscape discriminate against non-native folds. While tertiary interactions are critical for stabilizing the native fold, they are relatively non-specific, suggesting additional mechanisms contribute to tertiary folding specificity. In this study, we use coarse-grained molecular dynamics simulations to explore how secondary structure shapes the tertiary free-energy landscape of the Azoarcus ribozyme. We show that steric and connectivity constraints posed by secondary structure strongly limit the accessible conformational space of the ribozyme, and that these so-called topological constraints in turn pose strong free-energy penalties on forming different tertiary contacts. Notably, native A-minor and base-triple interactions form with low conformational free energy, while non-native tetraloop/tetraloop–receptor interactions are penalized by high conformational free energies. Topological constraints also give rise to strong cooperativity between distal tertiary interactions, quantitatively matching prior experimental measurements. The specificity of the folding landscape is further enhanced as tertiary contacts place additional constraints on the conformational space, progressively funneling the molecule to the native state. These results indicate that secondary structure assists the ribozyme in navigating the otherwise rugged tertiary folding landscape, and further emphasize topological constraints as a key force in RNA folding. PMID:26481360

Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time

PubMed Central

Wijtzes, Anne; van de Bongardt, Daphne; van de Looij-Jansen, Petra; Bannink, Rienke; Raat, Hein

2016-01-01

Objectives To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents. Methods We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls. Results The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex. Conclusion These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents’ early sexual initiation is needed to further contribute to

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

PubMed

Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

First Inversion: A Rationale for Implementing the "Flipped Approach" in Tertiary Music Courses

ERIC Educational Resources Information Center

Grant, Catherine

2013-01-01

For several reasons, current models of tertiary education seem unviable. A shifting educational landscape with rising student numbers, an increasingly diverse student cohort, and high levels of student disengagement have led to concerns about the continued relevance of "traditional" teaching and learning methods. At the same time, the…

Tertiary Student Transitions: Sectors, Fields, Impacts of and Reasons for Study--Support Document

ERIC Educational Resources Information Center

Fredman, Nick

2012-01-01

This paper examines the relationships between post-school educational fields and sectors and labour market considerations that appear to shape students' study decisions. It was found that pathways taken vary considerably by age, suggesting changes over time to patterns in tertiary education towards greater participation overall, a greater extent…

Tertiary and Quaternary tectonic faulting in southernmost Illinois

USGS Publications Warehouse

Nelson, W.J.; Denny, F.B.; Devera, J.A.; Follmer, L.R.; Masters, J.M.

1997-01-01

Tertiary and/or Quaternary tectonic faulting is documented in three areas of southernmost Illinois: the Fluorspar Area Fault Complex (FAFC) in Pope and Massac Counties, the Ste. Genevieve Fault Zone (SGFZ) in Alexander and Union Counties, and the Commerce Fault Zone (CFZ) in Alexander County. In the FAFC, faults that strike NE and NNE displace Mounds Gravel (late Miocene to early Pleistocene) and, locally, the Metropolis terrace gravel (Pleistocene; pre-Woodfordian). No Woodfordian or younger deposits are deformed. Faults typically outline narrow, linear grabens that formed under tension with a component of strike slip. North-south to NW-trending vertical faults near the southeast end of the SGFZ displace Eocene sediments. Again, faults outline narrow grabens and show indications of strike slip. Deformed Quaternary sediments have not been observed. The CFZ, which trends northeast, displaces Mounds Gravel in Illinois and units as young as Peoria Silt (Woodfordian) in Missouri. Quaternary movement has been interpreted as right-lateral strike-slip. The CFZ coincides with a subtle gravity and magnetic lineament and seems to reflect a major feature in the basement. Surface expression in Illinois is subtle, but mafic and ultramafic intrusions, hydrothermal alteration and small faults align with the Commerce geophysical lineament. Earthquake foci in Missouri and Illinois lie on or close to the CFZ; some focal mechanisms fit the fault trend. Among these structures, only the CFZ exhibits slip that conforms to the current stress field (principal compressive stress axis E-W to ENE-WSW). Possibly, the stress field changed during Neogene time. Alternatively, high fluid pressures or local stress concentrations may have induced slip on less favorably oriented fractures. Tighter constraints are needed on timing, magnitude, and direction of Neogene displacement. ?? 1997 Elsevier Science B.V.

Tertiary Education Policy in Ghana. An Assessment: 1988-1998.

ERIC Educational Resources Information Center

Girdwood, Alison

This study was one of several activities conducted at the end of a 5-year World Bank/Government of Ghana project, the Tertiary Education Project (TEP). This project was designed to assist the government of Ghana with the restructuring and quality enhancement of its tertiary education sector. Although the government had prepared an ambitious reform…

Alcohol consumption in tertiary education students.

PubMed

Reavley, Nicola J; Jorm, Anthony F; McCann, Terence V; Lubman, Dan I

2011-07-09

Heavy alcohol consumption among adolescents and young adults is an issue of significant public concern. With approximately 50% of young people aged 18-24 attending tertiary education, there is an opportunity within these settings to implement programs that target risky drinking. The aim of the current study was to survey students and staff within a tertiary education institution to investigate patterns of alcohol use, alcohol-related problems, knowledge of current National Health and Medical Research Council (NHMRC) guidelines for alcohol consumption and intentions to seek help for alcohol problems. Students of an Australian metropolitan university (with staff as a comparison group) participated in a telephone interview. Questions related to knowledge of NHMRC guidelines, drinking behaviour, alcohol-related problems and help-seeking intentions for alcohol problems. Level of psychological distress was also assessed. Of the completed interviews, 774 (65%) were students and 422 (35%) were staff. While staff were more likely to drink regularly, students were more likely to drink heavily. Alcohol consumption was significantly higher in students, in males and in those with a history of earlier onset drinking. In most cases, alcohol-related problems were more likely to occur in students. The majority of students and staff had accurate knowledge of the current NHMRC guidelines, but this was not associated with lower levels of risky drinking. Psychological distress was associated with patterns of risky drinking in students. Our findings are consistent with previous studies of tertiary student populations, and highlight the disconnect between knowledge of relevant guidelines and actual behaviour. There is a clear need for interventions within tertiary education institutions that promote more effective means of coping with psychological distress and improve help-seeking for alcohol problems, particularly among young men.

Endosymbiotic gene transfer in tertiary plastid-containing dinoflagellates.

PubMed

Burki, Fabien; Imanian, Behzad; Hehenberger, Elisabeth; Hirakawa, Yoshihisa; Maruyama, Shinichiro; Keeling, Patrick J

2014-02-01

Plastid establishment involves the transfer of endosymbiotic genes to the host nucleus, a process known as endosymbiotic gene transfer (EGT). Large amounts of EGT have been shown in several photosynthetic lineages but also in present-day plastid-lacking organisms, supporting the notion that endosymbiotic genes leave a substantial genetic footprint in the host nucleus. Yet the extent of this genetic relocation remains debated, largely because the long period that has passed since most plastids originated has erased many of the clues to how this process unfolded. Among the dinoflagellates, however, the ancestral peridinin-containing plastid has been replaced by tertiary plastids on several more recent occasions, giving us a less ancient window to examine plastid origins. In this study, we evaluated the endosymbiotic contribution to the host genome in two dinoflagellate lineages with tertiary plastids. We generated the first nuclear transcriptome data sets for the "dinotoms," which harbor diatom-derived plastids, and analyzed these data in combination with the available transcriptomes for kareniaceans, which harbor haptophyte-derived plastids. We found low level of detectable EGT in both dinoflagellate lineages, with only 9 genes and 90 genes of possible tertiary endosymbiotic origin in dinotoms and kareniaceans, respectively, suggesting that tertiary endosymbioses did not heavily impact the host dinoflagellate genomes.

Rage against the Machine? Symbolic Violence in E-Learning Supported Tertiary Education

ERIC Educational Resources Information Center

Johnson, Nicola F.; Macdonald, David; Brabazon, Tara

2008-01-01

The move toward online course facilitation in tertiary education has the intent of providing education at any time in any place to any person. However, the advent of blended learning and e-learning innovations has ostracised, marginalised or ignored those who cannot afford or who are unable to access the latest hardware and software to take…

Pubertal Timing and Early Sexual Intercourse in the Offspring of Teenage Mothers

ERIC Educational Resources Information Center

De Genna, Natacha M.; Larkby, Cynthia; Cornelius, Marie D.

2011-01-01

Early puberty is associated with stressful family environments, early sexual intercourse, and teenage pregnancy. We examined pubertal timing and sexual debut among the 14-year-old offspring of teenage mothers. Mothers (71% Black, 29% White) were recruited as pregnant teenagers (12-18 years old). Data were collected during pregnancy and when…

On the Early-Time Excess Emission in Hydrogen-Poor Superluminous Supernovae

NASA Technical Reports Server (NTRS)

Vreeswijk, Paul M.; Leloudas, Giorgos; Gal-Yam, Avishay; De Cia, Annalisa; Perley, Daniel A.; Quimby, Robert M.; Waldman, Roni; Sullivan, Mark; Yan, Lin; Ofek, Eran O.;

On The Early-Time Excess Emission In Hydrogen-Poor Superluminous Supernovae

DOE PAGES

Vreeswijk, Paul M.; Leloudas, Giorgos; Gal-Yam, Avishay; ...

2017-01-18

Here, we present the light curves of the hydrogen-poor superluminous supernovae (SLSNe I) PTF 12dam and iPTF 13dcc, discovered by the (intermediate) Palomar Transient Factory. Both show excess emission at early times and a slowly declining light curve at late times. The early bump in PTF 12dam is very similar in duration (~10 days) and brightness relative to the main peak (2-3 mag fainter) compared to that observed in other SLSNe I. In contrast, the long-duration ( > 30 days) early excess emission in iPTF 13dcc, whose brightness competes with that of the main peak, appears to be of amore » different nature. We construct bolometric light curves for both targets, and fit a variety of light-curve models to both the early bump and main peak in an attempt to understand the nature of these explosions. Even though the slope of the late-time decline in the light curves of both SLSNe is suggestively close to that expected from the radioactive decay of 56Ni and 56Co, the amount of nickel required to power the full light curves is too large considering the estimated ejecta mass. The magnetar model including an increasing escape fraction provides a reasonable description of the PTF 12dam observations. However, neither the basic nor the double-peaked magnetar model is capable of reproducing the light curve of iPTF 13dcc. A model combining a shock breakout in an extended envelope with late-time magnetar energy injection provides a reasonable fit to the iPTF 13dcc observations. Finally, we find that the light curves of both PTF 12dam and iPTF 13dcc can be adequately fit with the model involving interaction with the circumstellar medium.« less

ON THE EARLY-TIME EXCESS EMISSION IN HYDROGEN-POOR SUPERLUMINOUS SUPERNOVAE

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

Vreeswijk, Paul M.; Leloudas, Giorgos; Gal-Yam, Avishay

2017-01-20

We present the light curves of the hydrogen-poor superluminous supernovae (SLSNe I) PTF 12dam and iPTF 13dcc, discovered by the (intermediate) Palomar Transient Factory. Both show excess emission at early times and a slowly declining light curve at late times. The early bump in PTF 12dam is very similar in duration (∼10 days) and brightness relative to the main peak (2–3 mag fainter) compared to that observed in other SLSNe I. In contrast, the long-duration (>30 days) early excess emission in iPTF 13dcc, whose brightness competes with that of the main peak, appears to be of a different nature. Wemore » construct bolometric light curves for both targets, and fit a variety of light-curve models to both the early bump and main peak in an attempt to understand the nature of these explosions. Even though the slope of the late-time decline in the light curves of both SLSNe is suggestively close to that expected from the radioactive decay of {sup 56}Ni and {sup 56}Co, the amount of nickel required to power the full light curves is too large considering the estimated ejecta mass. The magnetar model including an increasing escape fraction provides a reasonable description of the PTF 12dam observations. However, neither the basic nor the double-peaked magnetar model is capable of reproducing the light curve of iPTF 13dcc. A model combining a shock breakout in an extended envelope with late-time magnetar energy injection provides a reasonable fit to the iPTF 13dcc observations. Finally, we find that the light curves of both PTF 12dam and iPTF 13dcc can be adequately fit with the model involving interaction with the circumstellar medium.« less

The Cretaceous/Tertiary Extinction Controversy.

ERIC Educational Resources Information Center

McCartney, Kevin

1984-01-01

The cause of the Cretaceous/Tertiary extinction has become a major geologic controversy. Current evidence for the two opposing views is reviewed to provide an introduction to the controversy and to form the basis for a seminar of discussion topic. (Author/JN)

Employee Engagement and Performance of Lecturers in Nigerian Tertiary Institutions

ERIC Educational Resources Information Center

Agbionu, Uchenna Clementina; Anyalor, Maureen; Nwali, Anthony Chukwuma

2018-01-01

The study investigated employee engagement and performance of lecturers in Nigerian Tertiary Institutions. It employed descriptive and correlation research designs. Stratified random sampling was used to select three tertiary institutions in Nigeria and the sample size of 314 lecturers was obtained through Taro Yamane. Questionnaires were…

Strategies for Teaching Business Education Students in Nigerian Tertiary Institutions for Cooperate Governance

ERIC Educational Resources Information Center

Obiete, Innocent Anthony; Nwazor, Joseph Chukwudi; Ifeoma, Vin-Mbah Fidelia

2015-01-01

In recent time, graduates from the nation's tertiary institution of learning most especially the business education graduates have been plagued by the inability to get jobs in corporate industries and companies in Nigeria. Many authors and researchers have related this problem to the quality of training received by these graduates while in school…

Parathyroid carcinoma presenting as tertiary hyperparathyroidism.

PubMed Central

Sherlock, D. J.; Newman, J.; Holl-Allen, R. T.

1985-01-01

A case of malignant transformation in established secondary hyperparathyroidism presenting as tertiary hyperparathyroidism is reported. Although rare, this occurrence has important medical and surgical implications. Images Figure 1 PMID:3983057

Tertiary Gleason patterns and biochemical recurrence after prostatectomy: proposal for a modified Gleason scoring system.

PubMed

Trock, Bruce J; Guo, Charles C; Gonzalgo, Mark L; Magheli, Ahmed; Loeb, Stacy; Epstein, Jonathan I

2009-10-01

We investigated the relationship between the tertiary Gleason component in radical prostatectomy specimens and biochemical recurrence in what is to our knowledge the largest single institution cohort to date. We evaluated data on 3,230 men who underwent radical prostatectomy at our institution from 2000 to 2005. Tertiary Gleason component was defined as Gleason grade pattern 4 or greater for Gleason score 6 and Gleason grade pattern 5 for Gleason score 7 or 8. Biochemical recurrence curves for cancer with tertiary Gleason component were intermediate between those of cancer without a tertiary Gleason component in the same Gleason score category and cancer in the next higher Gleason score category. The only exception was that Gleason score 4 + 3 = 7 with a tertiary Gleason component behaved like Gleason score 8. The tertiary Gleason component independently predicted recurrence when factoring in radical prostatectomy Gleason score, radical prostatectomy stage and prostate specific antigen (HR 1.45, p = 0.029). Furthermore, the magnitude of the tertiary Gleason component effect on recurrence did not differ by Gleason score category (p = 0.593). Although the tertiary Gleason component is frequently included in pathology reports, it is routinely omitted in other situations, such as predictive nomograms, research studies and patient counseling. The current study adds to a growing body of evidence highlighting the importance of the tertiary Gleason component in radical prostatectomy specimens. Accordingly consideration should be given to a modified radical prostatectomy Gleason scoring system that incorporates tertiary Gleason component in intuitive fashion, including Gleason score 6, 6.5 (Gleason score 6 with tertiary Gleason component), 7 (Gleason score 3 + 4 = 7), 7.25 (Gleason score 3 + 4 = 7 with tertiary Gleason component), 7.5 (Gleason score 4 + 3), 8 (Gleason score 4 + 3 with tertiary Gleason component or Gleason score 8), 8.5 (Gleason score 8 with tertiary Gleason

Prelude and Fugue, predicting local protein structure, early folding regions and structural weaknesses.

PubMed

Kwasigroch, Jean Marc; Rooman, Marianne

2006-07-15

Prelude&Fugue are bioinformatics tools aiming at predicting the local 3D structure of a protein from its amino acid sequence in terms of seven backbone torsion angle domains, using database-derived potentials. Prelude(&Fugue) computes all lowest free energy conformations of a protein or protein region, ranked by increasing energy, and possibly satisfying some interresidue distance constraints specified by the user. (Prelude&)Fugue detects sequence regions whose predicted structure is significantly preferred relative to other conformations in the absence of tertiary interactions. These programs can be used for predicting secondary structure, tertiary structure of short peptides, flickering early folding sequences and peptides that adopt a preferred conformation in solution. They can also be used for detecting structural weaknesses, i.e. sequence regions that are not optimal with respect to the tertiary fold. http://babylone.ulb.ac.be/Prelude_and_Fugue.

An Exploratory Study of Collaboration in New Zealand Tertiary Libraries

ERIC Educational Resources Information Center

Finnerty, Colleen

2005-01-01

The shift in policy from market driven behaviour towards a more cooperative tertiary sector is having an effect on New Zealand academic libraries and their relationships. Despite this, there has been no investigation of collaboration specifically targeting New Zealand tertiary libraries. This research project examine the state of collaboration…

The Impediments Facing Community Engagement in Omani Educational Tertiary Institutions

ERIC Educational Resources Information Center

Issa, Jinan Hatem

2016-01-01

Prior to the vital role that social capital plays in accomplishing prosperity for any educational tertiary institution, it was emphasised in several countries' agendas, including the Sultanate of Oman. This study endeavours to explore the impediments facing the enhancement of the social capital in Omani educational tertiary institutions through…

Mantle source volumes and the origin of the mid-Tertiary ignimbrite flare-up in the southern Rocky Mountains, western U.S.

NASA Astrophysics Data System (ADS)

Farmer, G. Lang; Bailley, Treasure; Elkins-Tanton, Linda T.

2008-04-01

Voluminous intermediate to silicic composition volcanic rocks were generated throughout the southern Rocky Mountains, western U.S., during the mid-Tertiary "ignimbrite flare-up", principally at the San Juan and Mogollon-Datil volcanic fields. At both volcanic centers, radiogenic isotope data have been interpreted as evidence that 50% or more of the volcanic rocks (by mass) were derived from mantle-derived, mafic parental magmas, but no consensus exists as to whether melting was largely of lithospheric or sub-lithospheric mantle. Recent xenolith studies, however, have revealed that thick (> 100 km), fertile, and hydrated continental lithosphere was present beneath at least portions of the southern Rocky Mountains during the mid-Tertiary. The presence of such thick mantle lithosphere, combined with an apparent lack of syn-magmatic extension, leaves conductive heating of lithospheric mantle as a plausible method of generating the mafic magmas that fueled the ignimbrite flare-up in this inland region. To further assess this possibility, we estimated the minimum volume of mantle needed to generate the mafic magmas parental to the preserved mid-Tertiary igneous rocks. Conservative estimates of the mantle source volumes that supplied the Mogollon-Datil and San Juan volcanic fields are ˜ 2 M km 3 and ˜ 7 M km 3, respectively. These volumes could have comprised only lithospheric mantle if at least the lower ˜ 20 km of the mantle lithosphere beneath the entire southern Rocky Mountains region underwent partial melting during the mid-Tertiary and if the resulting mafic magmas were drawn laterally for distances of up to ˜ 300 km into each center. Such widespread melting of lithospheric mantle requires that the lithospheric mantle have been uniformly fertile and primed for melting in the mid-Tertiary, a possibility if the lithospheric mantle had experienced widespread hydration and refrigeration during early Tertiary low angle subduction. Exposure of the mantle lithosphere

The Relationship between Feedback and Change in Tertiary Student Writing in the Disciplines

ERIC Educational Resources Information Center

Vardi, Iris

2008-01-01

This study examined the relationship between teacher written feedback and change in the disciplinary writing of tertiary students in their final year of undergraduate study. The student texts and teacher written feedback examined arose naturally out of a third year disciplinary-based unit in which each student submitted a text three times over the…

Increased proximal acid reflux is associated with early readmission following lung transplantation.

PubMed

Lo, W-K; Goldberg, H J; Burakoff, R; Feldman, N; Chan, W W

2016-02-01

Gastroesophageal reflux disease has been associated with poor outcomes following lung transplantation. However, the association between pretransplant reflux and post-transplant readmission, an indicator of early clinical outcome, has not been previously assessed. This was a retrospective cohort study of lung transplant recipients undergoing pretransplant multichannel intraluminal impedance and pH (MII-pH) study off acid suppression at a tertiary care center since 2007. Subjects with pretransplant fundoplication were excluded. Time to readmission was defined as duration from post-transplant discharge to next hospital admission for any reason. Subgroup analysis was performed to exclude elective readmissions. Time-to-event analysis was performed using Cox proportional hazards model, with appropriate censoring. Forty-three subjects (60% men, mean age: 57, median follow-up: 1.7 years) met inclusion criteria for the study. Patient demographics and pretransplant cardiopulmonary function were similar between readmission cohorts. Time to all-cause readmission was associated with increased distal acid episodes (HR: 3.15, p = 0.04) and proximal acid episodes (HR: 3.61, p = 0.008) on impedance, increased acid exposure on pH (HR: 2.22, p = 0.04), and elevated Demeester score (HR: 2.26, p = 0.03). When elective readmissions were excluded, early readmission remained significantly associated with increased proximal acid reflux episodes (HR: 2.49, p = 0.04). All findings were confirmed on Kaplan-Meier analysis. Elevated proximal acid reflux on pretransplant MII-pH testing was associated with early readmission following lung transplantation, even after excluding elective readmissions. Exposure to severe acid reflux has measurable effects on early postoperative outcomes such as readmission, and aggressive early antireflux therapy should be considered. © 2015 John Wiley & Sons Ltd.

Auditing surgical service provision at a South African tertiary institution: Implications for the development of district services.

PubMed

Laing, G L; Skinner, D L; Bruce, J L; Aldous, C; Govindasamy, V; Thomson, S R; Clarke, D L

2017-11-01

The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013. Inpatient data pertaining to surgical admissions and operative interventions were captured prospectively. Following an 18-month study period, the data were extracted, aggregated and analysed. The district referral hospitals were mapped, and district surgical procedures performed within the tertiary center were identified and quantified. Results: 7314 patients were admitted and managed by the tertiary surgical service during the study period. The median patient age was 33 years (IQR 6.5-42.4 years). 59.7% were male and 40.3% were female. General, trauma and paediatric surgical admissions constituted 54.8%, 28.6% and 16.6% respectively. Emergency admissions constituted 62.4% and elective admissions 37.6%. Referral sources were captured for 6653 (91%) of the cohort. 4338 (65.2%) patients were referred from district hospitals. The district hospital (Northdale) closest to Greys Hospital was responsible for 1675 (25.2%) of surgical referrals. 4174 operative procedures were performed during the study period, 54.7% performed as an emergency, 34.1% electively and 11.2% semi-electively. The median waiting time for emergency operative intervention was 535 minutes (IQR 130-663). A total of 1272 (30.5%) operative procedures performed were assessed as district-level operations. The time intervals of 07:00-07:59 and 17:00-17:59 were identified as the time periods during which the least number of

Tertiary-amine-containing thermo- and pH-sensitive hydrophilic ABA triblock copolymers: effect of different tertiary amines on thermally induced sol-gel transitions.

PubMed

Henn, Daniel M; Wright, Roger A E; Woodcock, Jeremiah W; Hu, Bin; Zhao, Bin

2014-03-11

This Article reports on the synthesis of a series of well-defined, tertiary-amine-containing ABA triblock copolymers, composed of a poly(ethylene oxide) (PEO) central block and thermo- and pH-sensitive outer blocks, and the study of the effect of different tertiary amines on thermally induced sol-gel transition temperatures (T(sol-gel)) of their 10 wt % aqueous solutions. The doubly responsive ABA triblock copolymers were prepared from a difunctional PEO macroinitiator by atom transfer radical polymerization of methoxydi(ethylene glycol) methacrylate and ethoxydi(ethylene glycol) methacrylate at a feed molar ratio of 30:70 with ∼5 mol % of either N,N-diethylaminoethyl methacrylate (DEAEMA), N,N-diisopropylaminoethyl methacrylate, or N,N-di(n-butyl)aminoethyl methacrylate. The chain lengths of thermosensitive outer blocks and the molar contents of tertiary amines were very similar for all copolymers. Using rheological measurements, we determined the pH dependences of T(sol-gel) of 10 wt % aqueous solutions of these copolymers in a phosphate buffer. The T(sol-gel) versus pH curves of all polymers exhibited a sigmoidal shape. The T(sol-gel) increased with decreasing pH; the changes were small on both high and low pH sides. At a specific pH, the T(sol-gel) decreased with increasing the hydrophobicity of the tertiary amine, and upon decreasing pH the onset pH value for the T(sol-gel) to begin to increase noticeably was lower for the more hydrophobic tertiary amine-containing copolymer. In addition, we studied the effect of different tertiary amines on the release behavior of FITC-dextran from 10 wt % micellar gels in an acidic medium at 37 and 27 °C. The release profiles for three studied hydrogels at 37 °C were essentially the same, suggesting that the release was dominated by the diffusion of FITC-dextran. At 27 °C, the release was significantly faster for the DEAEMA-containing copolymer, indicating that both diffusion and gel dissolution contributed to the

Equity in an Educational Boom: Lessons from the Expansion and Marketisation of Tertiary Schooling in Poland

ERIC Educational Resources Information Center

Herbst, Mikolaj; Rok, Jakub

2014-01-01

This article shows how the probability of enrolment in tertiary schools has evolved for different social groups in Poland during the period of the educational boom. It also analyses how the socio-economic status influences the choices between full-time and part-time studies (the latter being of relatively low quality), and the probability of…

A Comparison of Career Success between Graduates of Vocational and Academic Tertiary Education

ERIC Educational Resources Information Center

Backes-Gellner, Uschi; Geel, Regula

2014-01-01

This paper analyses whether tertiary education of different types, i.e., academic or vocational tertiary education, leads to more or less favorable labor market outcomes. We study the problem for Switzerland, where more than two thirds of the workforce gain vocational secondary degrees and a substantial number go on to a vocational tertiary degree…

[The application of the prospective space-time statistic in early warning of infectious disease].

PubMed

Yin, Fei; Li, Xiao-Song; Feng, Zi-Jian; Ma, Jia-Qi

2007-06-01

To investigate the application of prospective space-time scan statistic in the early stage of detecting infectious disease outbreaks. The prospective space-time scan statistic was tested by mimicking daily prospective analyses of bacillary dysentery data of Chengdu city in 2005 (3212 cases in 102 towns and villages). And the results were compared with that of purely temporal scan statistic. The prospective space-time scan statistic could give specific messages both in spatial and temporal. The results of June indicated that the prospective space-time scan statistic could timely detect the outbreaks that started from the local site, and the early warning message was powerful (P = 0.007). When the merely temporal scan statistic for detecting the outbreak was sent two days later, and the signal was less powerful (P = 0.039). The prospective space-time scan statistic could make full use of the spatial and temporal information in infectious disease data and could timely and effectively detect the outbreaks that start from the local sites. The prospective space-time scan statistic could be an important tool for local and national CDC to set up early detection surveillance systems.

The Cretaceous/Tertiary Extinction Controversy Reconsidered.

ERIC Educational Resources Information Center

McCartney, Kevin; Nienstedt, Jeffrey

1986-01-01

Reviews varying positions taken in the Cretaceous/Tertiary (K/Y) extinction controversy. Analyzes and contests the meteoritic impact theory known as the Alvarez Model. Presents an alternative working hypothesis explaining the K/T transition. (ML)

Microstructural Characterization of Alloy 617 Crept into the Tertiary Regime

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

Lillo, Thomas Martin; Wright, Richard Neil

2015-07-01

The microstructure of Alloy 617 was characterized following creep tests interrupted at total creep strains ranging from 2-20%. A range of creep temperatures (750-1000oC) and initial creep stresses (10-145 MPa) produced creep test durations ranging from 1 to 5800 hours. Image analysis of optical photomicrographs on longitudinal sections of the gage length was used to document the fraction of creep porosity as a function of creep parameters. Creep porosity was negligible below tertiary creep strains of 10% and increased with tertiary creep strain, thereafter. For a given temperature and total creep strain, creep porosity increased with decreasing creep stress. Creepmore » porosity increased linearly with duration of the creep experiment. TEM performed on the gage sections did not reveal significant creep cavity formation on grain boundaries at the sub-micron level. It was concluded that the onset of tertiary creep did not result from creep cavitation and more likely arose due to the formation of low energy dislocation substructures with increasing tertiary strain.« less

Assessing uncertainty in outsourcing clinical services at tertiary health centers.

PubMed

Billi, John E; Pai, Chih-Wen; Spahlinger, David A

2007-01-01

When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract. Copyright (c) 2006 John Wiley & Sons, Ltd.

Elucidating the mechanisms linking early pubertal timing, sexual activity, and substance use for maltreated versus nonmaltreated adolescents.

PubMed

Negriff, Sonya; Brensilver, Matthew; Trickett, Penelope K

2015-06-01

To test models linking pubertal timing, peer substance use, sexual behavior, and substance use for maltreated versus comparison adolescents. Three theoretical mechanisms were tested: (1) peer influence links early pubertal timing to later sexual behavior and substance use; (2) early maturers engage in substance use on their own and then select substance-using friends; or (3) early maturers initiate sexual behaviors which lead them to substance-using peers. The data came from a longitudinal study of the effects of child maltreatment on adolescent development (303 maltreated and 151 comparison adolescents; age, 9-13 years at initial wave). Multiple-group structural equation models tested the hypotheses across three time points including variables of pubertal timing, perception of peer substance use, sexual behavior, and self-reported substance use. Early pubertal timing was associated with substance-using peers only for maltreated adolescents, indicating the mediation path from early pubertal timing through substance-using peers to subsequent adolescent substance use and sexual behavior only holds for maltreated adolescents. Mediation via sexual behavior was significant for both maltreated and comparison adolescents. This indicates that sexual behavior may be a more universal mechanism linking early maturation with risky friends regardless of adverse life experiences. The findings are a step toward elucidating the developmental pathways from early puberty to risk behavior and identifying early experiences that may alter mediation effects. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Tertiary syphilis in the lumbar spine: a case report.

PubMed

Bai, Yang; Niu, Feng; Liu, Lidi; Sha, Hui; Wang, Yimei; Zhao, Song

2017-07-24

The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.

Biochemical methane potential (BMP) tests: Reducing test time by early parameter estimation.

PubMed

Da Silva, C; Astals, S; Peces, M; Campos, J L; Guerrero, L

2018-01-01

Biochemical methane potential (BMP) test is a key analytical technique to assess the implementation and optimisation of anaerobic biotechnologies. However, this technique is characterised by long testing times (from 20 to >100days), which is not suitable for waste utilities, consulting companies or plants operators whose decision-making processes cannot be held for such a long time. This study develops a statistically robust mathematical strategy using sensitivity functions for early prediction of BMP first-order model parameters, i.e. methane yield (B 0 ) and kinetic constant rate (k). The minimum testing time for early parameter estimation showed a potential correlation with the k value, where (i) slowly biodegradable substrates (k≤0.1d -1 ) have a minimum testing times of ≥15days, (ii) moderately biodegradable substrates (0.1times between 8 and 15 days, and (iii) rapidly biodegradable substrates (k≥0.2d -1 ) have testing times lower than 7days. Copyright © 2017 Elsevier Ltd. All rights reserved.

Geologic and geomorphic controls of coal development in some Tertiary Rocky Mountain basins, USA

USGS Publications Warehouse

Flores, R.M.

1993-01-01

Previous investigations have not well defined the controls on the development of minable coals in fluvial environments. This study was undertaken to provide a clearer understanding of these controls, particularly in of the lower Tertiary coal-bearing deposits of the Raton and Powder River basins in the Rocky Mountain region of the United States. In this region, large amounts of coals accumulated in swamps formed in the flow-through fluvial systems that infilled these intermontane basins. Extrabasinal and intrabasinal tectonism partly controlled the stratigraphic and facies distributions of minable coal deposits. The regional accumulation of coals was favored by the rapid basin subsidence coupled with minimal uplift of the source area. During these events, coals developed in swamps associated with anastomosed and meandering fluvial systems and alluvial fans. The extensive and high rate of sediment input from these fluvial systems promoted the formation of ombrotrophic, raised swamps, which produced low ash and anomalously thick coals. The petrology and palynology of these coals, and the paleobotany of the associated sediments, suggest that ombrotrophic, raised swamps were common in the Powder River Basin, where the climate during the early Tertiary was paratropical. The paleoecology of these swamps is identical to that of the modern ombrotrophic, raised swamps of the Baram and Mahakam Rivers of Borneo. ?? 1993.

Elucidating the mechanisms linking early pubertal timing, sexual activity, and substance use for maltreated versus nonmaltreated adolescents

PubMed Central

Negriff, Sonya; Brensilver, Matthew; Trickett, Penelope K.

2015-01-01

Purpose To test models linking pubertal timing, peer substance use, sexual behavior, and substance use for maltreated versus comparison adolescents. Three theoretical mechanisms were tested: 1) peer influence links early pubertal timing to later sexual behavior and substance use, 2) early maturers engage in substance use on their own and then select substance-using friends, or 3) early maturers initiate sexual behaviors which leads them to substance-using peers. Methods The data came from a longitudinal study of the effects of child maltreatment on adolescent development (303 maltreated and 151 comparison adolescents; age: 9–13 years at initial wave). Multiple-group structural equation models tested the hypotheses across three timepoints including variables of pubertal timing, perception of peer substance use, sexual behavior, and self-reported substance use. Results Early pubertal timing was associated with substance-using peers only for maltreated adolescents, indicating the mediation path from early pubertal timing through substance-using peers to subsequent adolescent substance use and sexual behavior only holds for maltreated adolescents. Mediation via sexual behavior was significant for both maltreated and comparison adolescents. This indicates that sexual behavior may be a more universal mechanism linking early maturation with risky friends regardless of adverse life experiences. Conclusions The findings are a step toward elucidating the developmental pathways from early puberty to risk behavior and identifying early experiences that may alter mediation effects. PMID:26003577

The Impact of HECS Debt on Australian Students' Tertiary Academic Performance

ERIC Educational Resources Information Center

Birch, Elisa R.; Miller, Paul W.

2006-01-01

The Australian literature suggests that students' academic success in tertiary education is principally influenced by their university entrance score. Personal, secondary school and university characteristics have more minor impacts on tertiary outcomes. Little research has been undertaken into the relationship between students' marks and the…

Basin analysis of tertiary strata in the Pattani Basin, Gulf of Thailand

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

Chonchawalit, A.; Bustin, R.M.

The stratigraphic and structural evolution of the Pattani basin, the most prolific petroleum basin in Thailand, reflects the extensional tectonics of continental southeast Asia. East-west extension, a product of the northward collision of India with Eurasia since the early Tertiary resulted in the formation of a series of north-south-trending sedimentary basins including the Pattani basin. Subsidence and thermal histories of the basin can generally be accounted for by nonuniform lithospheric stretching. The validity of nonuniform lithospheric stretching as a mechanic for the formation of the Pattani basin is confirmed by a reasonably good agreement between modeled and observed vitrinite reflectancemore » at various depths and locations. The amount of stretching and surface heat flow generally increases from the basin margin to the basin center. Crustal stretching factor ([beta]) ranges from 1.3 at the basin margin to 2.8 in the center. Subcrustal stretching factor ([sigma]) ranges from 1.3 at the margin to more than 3.0 in the center. The stretching of the lithosphere may have extended basement rocks as much as 45 to 90 km and may have caused the upwelling of asthenosphere, resulting in high heat flow. The sedimentary succession in the Pattani basin is divisible into synrift and postrift sequences. The synrift sequences comprise (1) late Eocene ( ) to early Oligocene alluvial fan, braided river, and flood-plain deposits; (2) late Oligocene to early Miocene floodplain and channel deposits; and (3) an early Miocene regressive package of marine to nonmarine sediments. Deposition of synrift sequences corresponded to rifting and extension, which included episodic block faulting and rapid subsidence. Postrift succession comprises (1) an early to middle Miocene regressive package of shallow marine to nonmarine sediments, (2) a late early Miocene transgressive package; and (3) a late Miocene to Pleistocene transgression succession.« less

Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital

PubMed Central

Aher, Vidhya; Gadhiya, Suchi; Jagtap, Swati Sunil

2017-01-01

Introduction Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. Aim To study the clinicopathologic characteristics and prevalence of different forms of gestational trophoblastic disease in a tertiary care hospital. Materials and Methods The present study was descriptive, observational, analytical type done in Department of Pathology at tertiary care hospital from May 2012 to April 2016. All cases clinically suspected of GTD were included and confirmation was done by histopathological study on H&E stained slides. The cases of GTD were classified according to WHO classification. Detailed histomorphological features and beta human Chorionic Gonadotropin (hCG) levels were correlated. Results During study period, 18345 deliveries were reported; out of which 77 cases were diagnosed as GTD. Almost 97.40% cases were of hydatidiform moles, 1.30% cases of choriocarcinoma and 1.30% cases of Placental Site Trophoblastic Tumour (PSTT). Among the cases of hydatidiform mole 57.34% were complete mole and 41.33% cases were of partial mole. The common clinical presentation was per vaginal bleeding and amenorrhea. The blood group A was most commonly observed in patient (49.35%). In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD were done. Conclusion Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination is helpful for confirmatory diagnosis. Follow up of such patients is essential for early detection of malignant trophoblastic tumours. PMID:28969138

The Tertiary and Quaternary pectens of California

USGS Publications Warehouse

Arnold, Ralph

1906-01-01

This paper consists of two parts. The first is a brief outline of the different Tertiary and Pleistocene formations of California, giving the type localities, where, when, and by whom first described, their salient characters, where they and their supposed equiyalents are known to occur, the species of Pecten found in them, and their typical fauna as far as known. The second is devoted to the description and illustration of all of the known Tertiary, Pleistocene, and Recent Pectens of the western coast of North America from Alaska to and including the Gulf of California. With the description of each species is also given an account of its geologic and geographic range and, where practicable, its associated fauna.

Financial impact of tertiary care in an academic medical center.

PubMed

Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

2000-06-01

To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

Rethinking the Tertiary Mathematics Curriculum

ERIC Educational Resources Information Center

Petocz, Peter; Reid, Anna

2005-01-01

Mathematics curriculum at the tertiary level is located within a range of social and cultural theories, and is often constructed by academics seeking to promulgate a particular view of mathematics. We argue that such a curriculum should incorporate a real acknowledgement of the different ways in which students understand the nature of mathematics…

An Investigation of Tertiary-Level Learning in Some Practical Physics Courses

ERIC Educational Resources Information Center

Wang, Weili; Coll, Richard K.

2005-01-01

Experimental physics is seen as an essential part of tertiary physics education. Students are supposed to develop practical skills and advance from closed "cookbook" experiments to open experiment and design experiment procedures independently. As a consequence tertiary practical physics courses increase in the level of challenge…

[Decomposition model of energy-related carbon emissions in tertiary industry for China].

PubMed

Lu, Yuan-Qing; Shi, Jun

2012-07-01

Tertiary industry has been developed in recent years. And it is very important to find the factors influenced the energy-related carbon emissions in tertiary industry. A decomposition model of energy-related carbon emissions for China is set up by adopting logarithmic mean weight Divisia method based on the identity of carbon emissions. The model is adopted to analyze the influence of energy structure, energy efficiency, tertiary industry structure and economic output to energy-related carbon emissions in China from 2000 to 2009. Results show that the contribution rate of economic output and energy structure to energy-related carbon emissions increases year by year. Either is the contribution rate of energy efficiency or the tertiary industry restraining to energy-related carbon emissions. However, the restrain effect is weakening.

Listeriosis in pregnancy: a secular trend in a tertiary referral hospital in Barcelona.

PubMed

Sisó, C; Goncé, A; Bosch, J; Salvia, M D; Hernández, S; Figueras, F

2012-09-01

The purpose of this study was to describe the variation in listeriosis infection incidence during pregnancy over a 25-year period based on salient clinical and laboratory features compiled in a tertiary referral hospital and to depict the clinical characteristics of these cases. A cohort was created of all cases of listeriosis in pregnant women or their neonates (early-onset form) diagnosed between 1985 and 2010. Forty-three cases of perinatal listeriosis were diagnosed among the 82,320 hospitalised pregnant women (incidence 0.5‰). Whereas the incidence remained almost constant at 0.24‰ until 2000, an increasing incidence was observed from then on, reaching 0.86‰ during the last years of the study period. A four-fold increase in listeriosis rate during pregnancy has occurred in recent years, with poorer outcome for those cases occurring before 28 weeks and for those in which early antibiotic treatment was not provided. These results should raise the awareness of the agencies and professionals involved in prenatal care.

Three-dimensional tertiary structure of yeast phenylalanine transfer RNA

NASA Technical Reports Server (NTRS)

Kim, S. H.; Sussman, J. L.; Suddath, F. L.; Quigley, G. J.; Mcpherson, A.; Wang, A. H. J.; Seeman, N. C.; Rich, A.

1974-01-01

Results of an analysis and interpretation of a 3-A electron density map of yeast phenylalanine transfer RNA. Some earlier detailed assignments of nucleotide residues to electron density peaks are found to be in error, even though the overall tracing of the backbone conformation of yeast phenylalanine transfer RNA was generally correct. A new, more comprehensive interpretation is made which makes it possible to define the tertiary interactions in the molecule. The new interpretation makes it possible to visualize a number of tertiary interactions which not only explain the structural role of most of the bases which are constant in transfer RNAs, but also makes it possible to understand in a direct and simple fashion the chemical modification data on transfer RNA. In addition, this pattern of tertiary interactions provides a basis for understanding the general three-dimensional folding of all transfer RNA molecules.

Pregnancy of unknown location: Outcome in a tertiary care hospital.

PubMed

Amer, Nuzhat; Amer, Muhammad; Kolkaila, Mohamed Abdoh; Yaqoob, Shahida

2015-10-01

To find out the outcome of a cohort of women with pregnancy of unknown location presenting to a tertiary care hospital. The prospective study was conducted from January to December, 2011, at Early Pregnancy Assessment Unit, King Faisal Military Hospital, Khamis Mushait, Saudi Arabia. Data was collected for women with early pregnancy or with history of amenorrhoea, bleeding or pain. These women were investigated with serum beta-human chorionic gonadotrophin levels twice weekly and transvaginal ultrasonography weekly. Expectant management was done for failing pregnancy of unknown location while medical or surgical management was considered for persistent pregnancy of unknown location and ectopic pregnancy. During study period, 7215 patients were admitted, and, of them, 2212(30.6%) were patients with early pregnancy. Meeting the inclusion criteria were 183(2.53%) patients who formed the study sample. There were 131(71.6%) patients presenting with amenorrhoea, 90(49.2%) had bleeding and 93(50.8%) presented with pain. Outcome of 100(54.6%) patients was failing pregnancy of unknown location, 58(31.7%) had intrauterine pregnancy, 14(7.7%) converted to ectopic pregnancy, while 11(6%) had persistent pregnancy of unknown location. All patients with persistent pregnancy of unknown location and 5(36%) patients with ectopic pregnancy were medically treated. Five (36%) patients having ectopic pregnancy were managed surgically. Management of choice for asymptomatic patients having pregnancy of unknown location is expectant management. Most of the patients suspected to have Most of the patients with persistent pregnancy of unknown location and ectopic pregnancy can be managed medically.

Seismic-Reflection Technology Defines Potential Vertical Bypass in Hydrogeologic Confinement within Tertiary Carbonates of the Southeastern Florida Platform

NASA Astrophysics Data System (ADS)

Cunningham, K. J.; Walker, C.; Westcott, R. L.

2011-12-01

Continuous improvements in shallow-focused, high-resolution, marine seismic-reflection technology has provided the opportunity to evaluate geologic structures that breach confining units of the Floridan aquifer system within the southeastern Florida Platform. The Floridan aquifer system is comprised mostly of Tertiary platform carbonates. In southeastern Florida, hydrogeologic confinement is important to sustainable use of the Floridan aquifer system, where the saline lower part is used for injection of wastewater and the brackish upper part is an alternative source of drinking water. Between 2007 and 2011, approximately 275 km of 24- and 48-channel seismic-reflection profiles were acquired in canals of peninsular southeastern Florida, Biscayne Bay, present-day Florida shelf margin, and the deeply submerged Miami Terrace. Vertical to steeply dipping offsets in seismic reflections indicate faults, which range from Eocene to possible early Pliocene age. Most faults are associated with karst collapse structures; however, a few tectonic faults of early Miocene to early Pliocene age are present. The faults may serve as a pathway for vertical groundwater flow across relatively low-permeability carbonate strata that separate zones of regionally extensive high-permeability in the Floridan aquifer system. The faults may collectively produce a regional confinement bypass system. In early 2011, twenty seismic-reflection profiles were acquired near the Key Biscayne submarine sinkhole located on the seafloor of the Miami Terrace. Here the water depth is about 365 m. A steeply dipping (eastward) zone of mostly deteriorated quality of seismic-reflection data underlies the sinkhole. Correlation of coherent seismic reflections within and adjacent to the disturbed zone indicates a series of faults occur within the zone. It is hypothesized that upward movement of groundwater within the zone contributed to development of a hypogenic karst system and the resultant overlying sinkhole

The Missing Link in Australian Tertiary Education: Short-Cycle Higher Education

ERIC Educational Resources Information Center

Moodie, Gavin

2003-01-01

The blurring of the boundary between Australian vocational education and training and higher education is leading to a reconsideration of the current structure of Australian tertiary education. This paper starts with the main overlap of the Australian tertiary education sectors, diplomas and advanced diplomas. The ambiguous treatment of these…

The Petasis Reaction: Microscale Synthesis of a Tertiary Amine Antifungal Analog

ERIC Educational Resources Information Center

Koroluk, Katherine J.; Jackson, Derek A.; Dicks, Andrew P.

2012-01-01

Students prepare a tertiary amine antifungal analog in an upper-level undergraduate organic laboratory. A microscale Petasis reaction is performed to generate a liquid compound readily characterized via IR and proton NMR spectroscopy. The biological relevance of the product is highlighted, with the tertiary amine scaffold being an important…

Smart Utilization of Tertiary Instructional Modes

ERIC Educational Resources Information Center

Hamilton, John; Tee, Singwhat

2010-01-01

This empirical research surveys first year tertiary business students across different campuses regarding their perceived views concerning traditional, blended and flexible instructional approaches. A structural equation modeling approach shows traditional instructional modes deliver lower levels of student-perceived learning quality, learning…

Ignition of global wildfires at the Cretaceous/Tertiary boundary

NASA Technical Reports Server (NTRS)

Melosh, H. J.; Schneider, N. M.; Zahnle, K. J.; Latham, D.

1990-01-01

The recent discovery of an apparently global soot layer at the Cretaceous/Tertiary boundary indicates that global wildfires were somehow ignited by the impact of a comet or asteroid. It is shown here that the thermal radiation produced by the ballistic reentry of ejecta condensed from the vapor plume of the impact could have increased the global radiation flux by factors of 50 to 150 times the solar input for periods ranging from one to several hours. This great increase in thermal radiation may have been responsible for the ignition of global wildfires, as well as having deleterious effects on unprotected animal life.

Automated extraction and classification of RNA tertiary structure cyclic motifs

PubMed Central

Lemieux, Sébastien; Major, François

2006-01-01

A minimum cycle basis of the tertiary structure of a large ribosomal subunit (LSU) X-ray crystal structure was analyzed. Most cycles are small, as they are composed of 3- to 5 nt, and repeated across the LSU tertiary structure. We used hierarchical clustering to quantify and classify the 4 nt cycles. One class is defined by the GNRA tetraloop motif. The inspection of the GNRA class revealed peculiar instances in sequence. First is the presence of UA, CA, UC and CC base pairs that substitute the usual sheared GA base pair. Second is the revelation of GNR(Xn)A tetraloops, where Xn is bulged out of the classical GNRA structure, and of GN/RA formed by the two strands of interior-loops. We were able to unambiguously characterize the cycle classes using base stacking and base pairing annotations. The cycles identified correspond to small and cyclic motifs that compose most of the LSU RNA tertiary structure and contribute to its thermodynamic stability. Consequently, the RNA minimum cycles could well be used as the basic elements of RNA tertiary structure prediction methods. PMID:16679452

Topological constraints are major determinants of tRNA tertiary structure and dynamics and provide basis for tertiary folding cooperativity

PubMed Central

Mustoe, Anthony M.; Brooks, Charles L.; Al-Hashimi, Hashim M.

2014-01-01

Recent studies have shown that basic steric and connectivity constraints encoded at the secondary structure level are key determinants of 3D structure and dynamics in simple two-way RNA junctions. However, the role of these topological constraints in higher order RNA junctions remains poorly understood. Here, we use a specialized coarse-grained molecular dynamics model to directly probe the thermodynamic contributions of topological constraints in defining the 3D architecture and dynamics of transfer RNA (tRNA). Topological constraints alone restrict tRNA's allowed conformational space by over an order of magnitude and strongly discriminate against formation of non-native tertiary contacts, providing a sequence independent source of folding specificity. Topological constraints also give rise to long-range correlations between the relative orientation of tRNA's helices, which in turn provides a mechanism for encoding thermodynamic cooperativity between distinct tertiary interactions. These aspects of topological constraints make it such that only several tertiary interactions are needed to confine tRNA to its native global structure and specify functionally important 3D dynamics. We further show that topological constraints are conserved across tRNA's different naturally occurring secondary structures. Taken together, our results emphasize the central role of secondary-structure-encoded topological constraints in defining RNA 3D structure, dynamics and folding. PMID:25217593

Epilepsy in Ireland: towards the primary-tertiary care continuum.

PubMed

Varley, Jarlath; Delanty, Norman; Normand, Charles; Coyne, Imelda; McQuaid, Louise; Collins, Claire; Boland, Michael; Grimson, Jane; Fitzsimons, Mary

2010-01-01

Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. To explore the interface between primary care and specialist epilepsy services in Ireland. Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland. There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system. Copyright 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Discordance between 'actual' and 'scheduled' check-in times at a heart failure clinic.

PubMed

Gorodeski, Eiran Z; Joyce, Emer; Gandesbery, Benjamin T; Blackstone, Eugene H; Taylor, David O; Tang, W H Wilson; Starling, Randall C; Hachamovitch, Rory

2017-01-01

A 2015 Institute Of Medicine statement "Transforming Health Care Scheduling and Access: Getting to Now", has increased concerns regarding patient wait times. Although waiting times have been widely studied, little attention has been paid to the role of patient arrival times as a component of this phenomenon. To this end, we investigated patterns of patient arrival at scheduled ambulatory heart failure (HF) clinic appointments and studied its predictors. We hypothesized that patients are more likely to arrive later than scheduled, with progressively later arrivals later in the day. Using a business intelligence database we identified 6,194 unique patients that visited the Cleveland Clinic Main Campus HF clinic between January, 2015 and January, 2017. This clinic served both as a tertiary referral center and a community HF clinic. Transplant and left ventricular assist device (LVAD) visits were excluded. Punctuality was defined as the difference between 'actual' and 'scheduled' check-in times, whereby negative values (i.e., early punctuality) were patients who checked-in early. Contrary to our hypothesis, we found that patients checked-in late only a minority of the time (38% of visits). Additionally, examining punctuality by appointment hour slot we found that patients scheduled after 8AM had progressively earlier check-in times as the day progressed (P < .001 for trend). In both a Random Forest-Regression framework and linear regression models the most important risk-adjusted predictors of early punctuality were: later in the day appointment hour slot, patient having previously been to the hospital, age in the early 70s, and white race. Patients attending a mixed population ambulatory HF clinic check-in earlier than scheduled times, with progressive discrepant intervals throughout the day. This finding may have significant implications for provider utilization and resource planning in order to maximize clinic efficiency. The impact of elective early arrival on

[Nutritional status at the time of admission among patients admitted to a tertiary-care paediatric hospital].

PubMed

Durá Travé, Teodoro; San Martín García, Isabel; González Benavides, Aida; Vaquero Iñigo, Ibone; Herranz Aguirre, Mercedes; Iceta Elízaga, Ainhoa

2015-06-01

To analyze the nutrition status of the pediatric patients at the time of hospital admission throughout a calendar year in a tertiary level hospital and to identify those patients and/or groups of pathologies with a higher risk of malnutrition. Retrospective evaluation of nutrition status of 852 patients hospitalized in 2013 in a pediatric hospital (462 males and 390 females). Sex, age, body mass index at the moment of admission and days of hospitalization and diagnosis codified according to the International Classification of Diseases were registered. The prevalence of malnutrition patients registered at the moment of admission was 8.2%. Excess body weight (overweight and obesity) was detected in 18% of the patients. The diseases of the nervous system (22.9%), together with the diseases of the respiratory system, the infectious diseases (18.6%), the congenital malformations (11.4%) and the diseases of the genitorurinary system (8.6%) account for 84.4% of the cases with malnutrition. The overall prevalence rate for malnutrition in pediatric patients at the moment of admission in our hospital was 8.2%, being this figure similar to those published in occidental countries. It should be mandatory to accomplish an initial screening and follow up during hospitalization of younger patients and those suffering from diseases of the nervous and/or respiratory system and, especially, from congenital diseases. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Factors associated with diabetes-related distress over time among patients with T2DM in a tertiary hospital in Singapore.

PubMed

Tan, Maudrene L; Tan, Chuen S; Griva, Konstadina; Lee, Yung S; Lee, Jeannette; Tai, E S; Khoo, Eric Y; Wee, Hwee-Lin

2017-06-23

Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts. A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011-2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time. Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p < 0.05) and change score of EDS (OR = 1.22, p < 0.05) was significantly associated with DRD over time. EDS might be a surrogate marker for persistent DRD and should be explored in larger samples of population to confirm the findings from this study.

First-time mothers' experiences of early labour in Italian maternity care services.

PubMed

Cappelletti, Giulia; Nespoli, Antonella; Fumagalli, Simona; Borrelli, Sara E

2016-03-01

The aim of this study is to explore first-time mothers' experiences of early labour in Italian maternity care services when admitted to hospital or advised to return home after maternity triage assessment. The study was conducted in a second-level maternity hospital in northern Italy with an obstetric unit for both low- and high-risk women. The participants included 15 first-time mothers in good general health with spontaneous labour at term of a low-risk pregnancy who accessed maternity triage during early labour, and were either admitted to hospital or advised to return home. A qualitative interpretive phenomenological study was conducted. A face-to-face recorded semi-structured interview was conducted with each participant 48-72h after birth. Four key themes emerged from the interviews: (a) recognising signs of early labour; (b) coping with pain at home; (c) seeking reassurance from healthcare professionals; and (d) being admitted to hospital versus returning home. Uncertainty about the progression of labour and the need for reassurance were cited by women as the main reasons for hospital visit in early labour. An ambivalent feeling was reported by the participants when admitted to hospital in early labour. In fact, while the women felt reassured in the first instance, some women subsequently felt dissatisfied due to the absence of one-to-one dedicated care during early labour. When advised to return home, a number of women reported feelings of disappointment, anger, fear, discouragement and anxiety about not being admitted to hospital; however, some of these women reported a subsequent feeling of comfort due to being at home and putting in place the suggestions made by the midwives during the maternity triage assessment. The guidance provided by midwives during triage assessment seemed to be the key factor influencing women׳s satisfaction when advised either to return home or to stay at the hospital during early labour. During antenatal classes and clinics

Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency.

PubMed

Lin, Sandra Y; Gavney, Dean; Ishman, Stacey L; Cady-Reh, Julie

2013-11-01

To apply Lean Sigma, a quality-improvement strategy supported by tactical tools to eliminate waste and reduce variation, to improve efficiency of patient flow in a large tertiary otolaryngology clinic. The project goals were to decrease overall lead time from patient arrival to start of interaction with care provider, improve on-time starts of patient visits, and decrease excess staff/patient motion. Prospective observational study. Patient flow was mapped through the clinic, including preregistration processes. A time-stamp observation study was performed on 188 patient visits over 5 days. Using Lean Sigma principles, time stamps were analyzed to identify patient flow constraints and areas for potential interventions. Interventions were evaluated and adjusted based on feedback from shareholders: removal of bottlenecks in clinic flow, elimination of non-value added registration staff tasks, and alignment of staff hours to accommodate times of high patient census. A postintervention time observation study of 141 patients was performed 5 months later. Patient lead time from clinic arrival to exam start time decreased by 12.2% on average (P = .042). On-time starts for patient exams improved by 34% (χ(2) = 16.091, P < .001). Excess patient motion was reduced by 74 feet per patient, which represents a 34% reduction in motion per visit. Use of Lean Sigma principles in a large tertiary otolaryngology clinic led to decreased patient wait time and significant improvements in on-time patient exam start time. Process mapping, engagement of leadership and staff, and elimination of non-value added steps or processes were key to improvement. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Developing Identity and Agency as an Early Career Academic: Lessons from Alice

ERIC Educational Resources Information Center

Monk, Sue; McKay, Loraine

2017-01-01

This paper draws on Lewis Carroll's character of Alice as a metaphor for interrogating identity construction and agency amongst early career academics, a process which can seem like Alice's pursuit of the White Rabbit in a strange land. Keeping in mind the effects of neoliberalism on the tertiary sector, we recognise the centrality of personal…

Mothers' Time with Infant and Time in Employment as Predictors of Mother-Child Relationships and Children's Early Development

ERIC Educational Resources Information Center

Huston, Aletha C.; Rosenkrantz Aronson, Stacey

2005-01-01

This study tested predictions from economic and developmental theories that maternal time with an infant is important for mother-child relationships and children's development, using time-use diaries for mothers of 7- to 8-month-old infants from the National Institute of Child Health and Human Development Study of Early Child Care (N=1,053).…

Problem-Based Learning in Tertiary Education: Teaching Old "Dogs" New Tricks?

ERIC Educational Resources Information Center

Yeo, Roland K.

2005-01-01

Purpose--The paper sets out to explore the challenges of problem-based learning (PBL) in tertiary education and to propose a framework with implications for practice and learning. Design/Methodology/Approach--A total of 18 tertiary students divided into three groups participated in the focus group discussions. A quantitative instrument was used as…

Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

ERIC Educational Resources Information Center

AbdulAzeez, Abbas Tunde

2016-01-01

This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

PubMed

Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

2012-09-21

To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P < 0.01). All of these patients were treated conservatively. On the other hand, three (0.01%) perforation cases were observed among the 24  361 diagnostic procedures performed, and these cases were treated with surgery in a tertiary hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital

Exploring the utility of real-time hydrologic data for landslide early warning

NASA Astrophysics Data System (ADS)

Mirus, B. B.; Smith, J. B.; Becker, R.; Baum, R. L.; Koss, E.

2017-12-01

Early warning systems can provide critical information for operations managers, emergency planners, and the public to help reduce fatalities, injuries, and economic losses due to landsliding. For shallow, rainfall-triggered landslides early warning systems typically use empirical rainfall thresholds, whereas the actual triggering mechanism involves the non-linear hydrological processes of infiltration, evapotranspiration, and hillslope drainage that are more difficult to quantify. Because hydrologic monitoring has demonstrated that shallow landslides are often preceded by a rise in soil moisture and pore-water pressures, some researchers have developed early warning criteria that attempt to account for these antecedent wetness conditions through relatively simplistic storage metrics or soil-water balance modeling. Here we explore the potential for directly incorporating antecedent wetness into landslide early warning criteria using recent landslide inventories and in-situ hydrologic monitoring near Seattle, WA, and Portland, OR. We use continuous, near-real-time telemetered soil moisture and pore-water pressure data measured within a few landslide-prone hillslopes in combination with measured and forecasted rainfall totals to inform easy-to-interpret landslide initiation thresholds. Objective evaluation using somewhat limited landslide inventories suggests that our new thresholds based on subsurface hydrologic monitoring and rainfall data compare favorably to the capabilities of existing rainfall-only thresholds for the Seattle area, whereas there are no established rainfall thresholds for the Portland area. This preliminary investigation provides a proof-of-concept for the utility of developing landslide early warning criteria in two different geologic settings using real-time subsurface hydrologic measurements from in-situ instrumentation.

Determinants and influencing mechanism of outpatient satisfaction: a survey on tertiary hospitals in the People’s Republic of China

PubMed Central

Yu, Wenya; Li, Meina; Xue, Chen; Wang, Jingrui; Liu, Jiazhen; Chen, Haiping; Zhang, Lulu

2016-01-01

Objective Most patients in the People’s Republic of China prefer tertiary hospitals when seeking medical services. The aim of this study was to assess outpatient satisfaction with tertiary hospitals in the People’s Republic of China, test overall and subscale satisfaction, and explore whether sociodemographic characteristics lead to different degrees of satisfaction and whether subscale outpatient satisfaction contributes to overall satisfaction. Methods A closed questionnaire was given out to investigate outpatients’ sociodemographic characteristics, overall satisfaction, and various subtypes of satisfaction, and a 5-point Likert scale was employed to measure the degree of outpatient satisfaction. Descriptive analysis, Kruskal–Wallis test, Spearman’s rank correlation coefficient, and logistic regression analysis were employed for statistical analysis. Results Response rate was 92.48% (971/1,050). Outpatients’ sociodemographic characteristics (including sex, age, occupation, monthly income, residence, and marital status) were related to various subtypes of satisfaction to varying degrees. Outpatients who were male, older, married, with low or middle incomes, living in Shanghai or other areas of the People’s Republic of China, medical staff, or students were more satisfied with various subtypes of satisfaction than those without these characteristics. In further analyses, satisfaction with their medical needs being met by doctors had the strongest relation to overall satisfaction, followed by satisfaction with doctors’ service attitudes, medical costs, waiting time, prescription, and diagnosis and treatment time. Satisfaction with environment had the weakest contribution to overall satisfaction. Conclusion This study gave some suggestions for tertiary hospitals in advanced areas of the People’s Republic of China. Outpatient sociodemographic characteristics should be paid more attention by medical staff to improve the degree of satisfaction

Frozen Chirality of Tertiary Aromatic Amides: Access to Enantioenriched Tertiary α-Amino Acid or Amino Alcohol without Chiral Reagent.

PubMed

Mai, Thi Thoa; Viswambharan, Baby; Gori, Didier; Guillot, Régis; Naubron, Jean-Valère; Kouklovsky, Cyrille; Alezra, Valérie

2017-04-27

One of the fundamental and intriguing aspects of life is the homochirality of the essential molecules. In this field, the absolute asymmetric synthesis of α-amino acids is a major challenge. Herein, we report access, by chemical means, to tertiary α-amino acid derivatives in up to 96 % ee without using any chiral reagent. In our strategy, the dynamic axial chirality of tertiary aromatic amides is frozen in a crystal and is responsible for the stereoselectivity of the subsequent steps. Furthermore, we could control the configuration of the final product by manually sorting and selecting the initial crystals. Based on vibrational circular dichroism studies, we could rationalize the observed stereoselectivity. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Determinants of mortality and prolonged hospital stay among dengue patients attending tertiary care hospital: a cross-sectional retrospective analysis

PubMed Central

Khan, Amer Hayat; Sarriff, Azmi; Adnan, Azreen Syazril; Khan, Yusra Habib

2017-01-01

Objectives Dengue imposes substantial economic, societal and personal burden in terms of hospital stay, morbidity and mortality. Early identification of dengue cases with high propensity of increased hospital stay and death could be of value in isolating patients in need of early interventions. The current study was aimed to determine the significant factors associated with dengue-related prolonged hospitalisation and death. Design Cross-sectional retrospective study. Setting Tertiary care teaching hospital. Participants Patients with confirmed dengue diagnosis were stratified into two categories on the basis of prolonged hospitalisation (≤3 days and >3 days) and mortality (fatal cases and non-fatal cases). Clinico-laboratory characteristics between these categories were compared by using appropriate statistical methods. Results Of 667 patients enrolled, 328 (49.2%) had prolonged hospitalisation. The mean hospital stay was 4.88±2.74 days. Multivariate analysis showed that dengue haemorrhagic fever (OR 2.3), elevated alkaline phosphatase (ALP) (OR 2.3), prolonged prothrombin time (PT) (OR 1.7), activated partial thromboplastin time (aPTT) (OR 1.9) and multiple-organ dysfunctions (OR 2.1) were independently associated with prolonged hospitalisation. Overall case fatality rate was 1.1%. Factors associated with dengue mortality were age >40 years (p=0.004), secondary infection (p=0.040), comorbidities (p<0.05), acute kidney injury (p<0.001), prolonged PT (p=0.022), multiple-organ dysfunctions (p<0.001), haematocrit >20% (p=0.001), rhabdomyolosis (p<0.001) and respiratory failure (p=0.007). Approximately half of the fatal cases in our study had prolonged hospital stay of greater than three days. Conclusions The results underscore the high proportion of dengue patients with prolonged hospital stay. Early identification of factors relating to prolonged hospitalisation and death will have obvious advantages in terms of appropriate decisions about treatment and

Tertiary evolution of the northeastern Venezuela offshore

NASA Astrophysics Data System (ADS)

Ysaccis B., Raul

1998-12-01

On the northeastern offshore Venezuela, the pre-Tertiary basement consists of a deeply subducted accretionary complex of a Cretaceous island arc system that formed far to the west of its present location. The internal structure of this basement consists of metamorphic nappes that involve passive margin sequences, as well as oceanic (ophiolitic) elements. The Tertiary evolution of the northeastern Venezuela offshore is dominated by Paleogene (Middle Eocene-Oligocene) extension and Neogene transtension, interrupted by Oligocene to Middle Miocene inversions. The Paleogene extension is mainly an arc-normal extension associated with a retreating subduction boundary. It is limited to the La Tortuga and the La Blanquilla Basins and the southeastern Margarita and Caracolito subbasins. All of these basins are farther north of and not directly tied to the El Pilar fault system. On a reconstruction, these Paleogene extensional systems were located to the north of the present day Maracaibo Basin. By early Miocene the leading edge of the now overall transpressional system had migrated to a position to the north of the Ensenada de Barcelona. This relative to South America eastward migration is responsible for the Margarita strike-slip fault and the major inversions that began during the Oligocene and lasted into the Middle Miocene. The Bocono-El Pilar-Casanay-Warm Springs and the La Tortuga-Coche-North Coast fault systems are exclusively Neogene with major transtension occurring during the Late Miocene to Recent and act independently from the earlier Paleogene extensional system. They are responsible for the large Neogene transtensional basins of the area: the Cariaco trough, the Northern Tuy-Cariaco and the Paria sub-basins, and the Gulf of Paria Basin. This latest phase is characterized by strain-partitioning into strike slip faults, a transtensional northern domain and a transpressional southern domain that is responsible for the decollement tectonics and/or inversions of the

The Policy Determinants of Investment in Tertiary Education. OECD Economics Department Working Papers, No. 576

ERIC Educational Resources Information Center

Martins, Joaquim Oliveira; Boarini, Romina; Strauss, Hubert; de la Maisonneuve, Christine; Saadi, Clarice

2007-01-01

This paper assesses how policies and institutions affect private returns to invest in tertiary human capital, the ability of individuals to finance this investment and the institutional characteristics of tertiary education systems. Focusing on core tertiary education services, the paper presents new measures of private returns to tertiary…

A needs-based workforce model to deliver tertiary-level community mental health care for distressed infants, children, and adolescents in South Australia: a mixed-methods study.

PubMed

Segal, Leonie; Guy, Sophie; Leach, Matthew; Groves, Aaron; Turnbull, Catherine; Furber, Gareth

2018-06-01

High-quality mental health services for infants, children, adolescents, and their families can improve outcomes for children exposed to early trauma. We sought to estimate the workforce needed to deliver tertiary-level community mental health care to all infants, children, adolescents, and their families in need using a generalisable model, applied to South Australia (SA). Workforce estimates were determined using a workforce planning model. Clinical need was established using data from the Longitudinal Study of Australian Children and the Young Minds Matter survey. Care requirements were derived by workshopping clinical pathways with multiprofessional panels, testing derived estimates through an online survey of clinicians. Prevalence of tertiary-level need, defined by severity and exposure to childhood adversities, was estimated at 5-8% across infancy and childhood, and 16% in mid-adolescence. The derived care pathway entailed reception, triage, and follow-up (mean 3 h per patient), core clinical management (mean 27 h per patient per year), psychiatric oversight (mean 4 h per patient per year), specialised clinical role (mean 12 h per patient per year), and socioeconomic support (mean 12 h per patient per year). The modelled clinical full-time equivalent was 947 people and budget was AU$126 million, more than five times the current service level. Our novel needs-based workforce model produced actionable estimates of the community workforce needed to address tertiary-level mental health needs in infants, children, adolescents, and their families in SA. A considerable expansion in the skilled workforce is needed to support young people facing current distress and associated family-based adversities. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits. National Health and Medical Research Council (Australia), Department of Health SA. Copyright © 2018 The Authors. Published by Elsevier

The equity imperative in tertiary education: Promoting fairness and efficiency

NASA Astrophysics Data System (ADS)

Salmi, Jamil; Bassett, Roberta Malee

2014-06-01

While the share of the tertiary education age cohort (19-25) which is being given the opportunity to study has increased worldwide over the past two decades, this does not in fact translate into reduced inequality. For many young people, especially in the developing world, major obstacles such as disparities in terms of gender, minority population membership or disabilities as well as academic and financial barriers are still standing in their way. The authors of this article propose a conceptual framework to analyse equity issues in tertiary education and document the scope, significance and consequences of disparities in tertiary education opportunities. They throw some light on the main determinants of these inequalities and offer suggestions about effective equity promotion policies directed towards widening participation and improving the chances of success of underprivileged youths in order to create societies which uphold humanistic values.

Generic Features of Tertiary Chromatin Structure as Detected in Natural Chromosomes

PubMed Central

Müller, Waltraud G.; Rieder, Dietmar; Kreth, Gregor; Cremer, Christoph; Trajanoski, Zlatko; McNally, James G.

2004-01-01

Knowledge of tertiary chromatin structure in mammalian interphase chromosomes is largely derived from artificial tandem arrays. In these model systems, light microscope images reveal fibers or beaded fibers after high-density targeting of transactivators to insertional domains spanning several megabases. These images of fibers have lent support to chromonema fiber models of tertiary structure. To assess the relevance of these studies to natural mammalian chromatin, we identified two different ∼400-kb regions on human chromosomes 6 and 22 and then examined light microscope images of interphase tertiary chromatin structure when the regions were transcriptionally active and inactive. When transcriptionally active, these natural chromosomal regions elongated, yielding images characterized by a series of adjacent puncta or “beads”, referred to hereafter as beaded images. These elongated structures required transcription for their maintenance. Thus, despite marked differences in the density and the mode of transactivation, the natural and artificial systems showed similarities, suggesting that beaded images are generic features of transcriptionally active tertiary chromatin. We show here, however, that these images do not necessarily favor chromonema fiber models but can also be explained by a radial-loop model or even a simple nucleosome affinity, random-chain model. Thus, light microscope images of tertiary structure cannot distinguish among competing models, although they do impose key constraints: chromatin must be clustered to yield beaded images and then packaged within each cluster to enable decondensation into adjacent clusters. PMID:15485905

Thioesterases: A new perspective based on their primary and tertiary structures

PubMed Central

Cantu, David C; Chen, Yingfei; Reilly, Peter J

2010-01-01

Thioesterases (TEs) are classified into EC 3.1.2.1 through EC 3.1.2.27 based on their activities on different substrates, with many remaining unclassified (EC 3.1.2.–). Analysis of primary and tertiary structures of known TEs casts a new light on this enzyme group. We used strong primary sequence conservation based on experimentally proved proteins as the main criterion, followed by verification with tertiary structure superpositions, mechanisms, and catalytic residue positions, to accurately define TE families. At present, TEs fall into 23 families almost completely unrelated to each other by primary structure. It is assumed that all members of the same family have essentially the same tertiary structure; however, TEs in different families can have markedly different folds and mechanisms. Conversely, the latter sometimes have very similar tertiary structures and catalytic mechanisms despite being only slightly or not at all related by primary structure, indicating that they have common distant ancestors and can be grouped into clans. At present, four clans encompass 12 TE families. The new constantly updated ThYme (Thioester-active enzYmes) database contains TE primary and tertiary structures, classified into families and clans that are different from those currently found in the literature or in other databases. We review all types of TEs, including those cleaving CoA, ACP, glutathione, and other protein molecules, and we discuss their structures, functions, and mechanisms. PMID:20506386

Impact of long-stay beds on the performance of a tertiary hospital in emergencies

PubMed Central

Pazin, Antonio; de Almeida, Edna; Cirilo, Leni Peres; Lourençato, Frederica Montanari; Baptista, Lisandra Maria; Pintyá, José Paulo; Capeli, Ronaldo Dias; da Silva, Sonia Maria Pirani Felix; Wolf, Claudia Maria; Dinardi, Marcelo Marcos; Scarpelini, Sandro; Damasceno, Maria Cecília

2015-01-01

ABSTRACT OBJECTIVE To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index – 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) – the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors. PMID:26603353

Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia.

PubMed

Al-Talib, Ayman A

2016-01-01

To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7%) were older than 35 years, and were nulliparous (45.5%). The commonest symptom was vaginal bleeding (86.4%) followed by hyperemesis gravidarum (41.0%); Hyperthyroidism was seen in 1 patient (4.5%). Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%). The majority of patients (63.6%) had normal BhCG within 9 weeks (63 days) after suction curettage. The majority of the cases followed a benign course. Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.

Early adolescence behavior problems and timing of poverty during childhood: A comparison of lifecourse models.

PubMed

Mazza, Julia Rachel S E; Lambert, Jean; Zunzunegui, Maria Victoria; Tremblay, Richard E; Boivin, Michel; Côté, Sylvana M

2017-03-01

Poverty is a well-established risk factor for the development of behavior problems, yet little is known about how timing of exposure to childhood poverty relates to behavior problems in early adolescence. To examine the differential effects of the timing of poverty between birth and late childhood on behavior problems in early adolescence by modeling lifecourse models, corresponding to sensitive periods, accumulation of risk and social mobility models. We used the Quebec Longitudinal Study of Child Development (N = 2120). Poverty was defined as living below the low-income thresholds defined by Statistics Canada and grouped into three time periods: between ages 0-3 years, 5-7 years, and 8-12 years. Main outcomes were teacher's report of hyperactivity, opposition and physical aggression at age 13 years. Structured linear regression analyses were conducted to estimate the contribution of poverty during the three selected time periods to behavior problems. Partial F-tests were used to compare nested lifecourse models to a full saturated model (all poverty main effects and possible interactions). Families who experienced poverty at all time periods were 9.3% of the original sample. Those who were poor at least one time period were 39.2%. The accumulation of risk model was the best fitting model for hyperactivity and opposition. The risk for physical aggression problems was associated only to poverty between 0 and 3 years supporting the sensitive period. Early and prolonged exposure to childhood poverty predicted higher levels of behavior problems in early adolescence. Antipoverty policies targeting the first years of life and long term support to pregnant women living in poverty are likely to reduce behavior problems in early adolescence. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diversification of Tertiary Education in France.

ERIC Educational Resources Information Center

Didier, Paul

Following an outline of education, particularly secondary education, the French system of tertiary education is described. The orientation of studies offered in the three two-year cycles of study is described. The differences between the national institutes and the universities are explained. The remainder of the report contains admission…

Early years neurosurgical training in the era of the European Working Time Directive.

PubMed

Kirkman, Matthew A; Watkins, Laurence D; Kitchen, Neil D; Sethi, Huma

2013-10-01

The past decade has seen significant changes to the face of neurosurgical training in the United Kingdom, driven in part by an increasing focus on patient safety and the introduction of Modernising Medical Careers and the European Working Time Directive (EWTD). Recent reforms to neurosurgical training over the past few years have resulted in creation of an 8-year 'run-through' training programme. In this programme, early years (ST1 and ST2) trainees often lack dedicated time for elective theatre lists and outpatient clinics. Further, any time spent in theatre and clinics is often with different teams. Here we describe a training model for early years trainees at the National Hospital for Neurology and Neurosurgery, who are given the responsibilities traditionally associated with a more senior trainee including dedicated weekly theatre and clinic time under the supervision of a single consultant, in addition to out of hours experience. The advantages and considerations for implementing this model are discussed, including the benefit of guidance under a single consultant in the early stages of training, along with key educational concepts necessary for understanding its utility. We feel that this is an effective model for junior neurosurgical training in the EWTD era, expediting the trainee's development of key technical and non-technical skills, with potentially significant rewards for patient, trainee and trainer. National implementation of this model should be considered.

Early diagnosis and multidisciplinary care reduce the hospitalization time and duration of tube feeding and prevent early obesity in PWS infants.

PubMed

Bacheré, N; Diene, G; Delagnes, V; Molinas, C; Moulin, P; Tauber, M

2008-01-01

To describe and evaluate the impact of very early diagnosis and multidisciplinary care on the evolution and care of infants presenting with Prader-Willi syndrome (PWS). 19 infants diagnosed with PWS before the second month of life were followed by a multidisciplinary team. Median age at the time of analysis was 3.1 years [range 0.4-6.5]. The data were compared with data collected in 1997 from 113 questionnaires filled out by members of the French PWS Association. The patients from this latter data set were 12.0 years [range 4 months to 41 years] at the time of analysis, with a median age of 36 months at diagnosis. The duration of their hospitalization time was significantly reduced from 30.0 [range 0-670] to 21 [range 0-90] days (p = 0.043). The duration of gastric tube feeding was significantly reduced from 30.5 [range 0-427] to 15 [range 0-60] days (p = 0.017). Growth hormone treatment was started at a mean age of 1.9 +/- 0.5 years in 10 infants and L-thyroxine in 6 infants. Only 1 infant became obese at 2.5 years. Early diagnosis combined with multidisciplinary care decreases the hospitalization time, duration of gastric tube feeding and prevents early obesity in PWS infants. (c) 2007 S. Karger AG, Basel.

Standardized Symptom Measurement of Individuals with Early Lyme Disease Over Time.

PubMed

Bechtold, Kathleen T; Rebman, Alison W; Crowder, Lauren A; Johnson-Greene, Doug; Aucott, John N

2017-03-01

Understanding the Lyme disease (LD) literature is challenging given the lack of consistent methodology and standardized measurement of symptoms and the impact on functioning. This prospective study incorporates well-validated measures to capture the symptom picture of individuals with early LD from time of diagnosis through 6-months post-treatment. One hundred seven patients with confirmed early LD and 26 healthy controls were evaluated using standardized instruments for pain, fatigue, depressive symptoms, functional impact, and cognitive functioning. Prior to antibiotic treatment, patients experience notable symptoms of fatigue and pain statistically higher than controls. After treatment, there are no group differences, suggesting that symptoms resolve and that there are no residual cognitive impairments at the level of group analysis. However, using subgroup analyses, some individuals experience persistent symptoms that lead to functional decline and these individuals can be identified immediately post-completion of standard antibiotic treatment using well-validated symptom measures. Overall, the findings suggest that ideally-treated early LD patients recover well and experience symptom resolution over time, though a small subgroup continue to suffer with symptoms that lead to functional decline. The authors discuss use of standardized instruments for identification of individuals who warrant further clinical follow-up. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Complementation of biotransformations with chemical C-H oxidation: copper-catalyzed oxidation of tertiary amines in complex pharmaceuticals.

PubMed

Genovino, Julien; Lütz, Stephan; Sames, Dalibor; Touré, B Barry

2013-08-21

The isolation, quantitation, and characterization of drug metabolites in biological fluids remain challenging. Rapid access to oxidized drugs could facilitate metabolite identification and enable early pharmacology and toxicity studies. Herein, we compared biotransformations to classical and new chemical C-H oxidation methods using oxcarbazepine, naproxen, and an early compound hit (phthalazine 1). These studies illustrated the low preparative efficacy of biotransformations and the inability of chemical methods to oxidize complex pharmaceuticals. We also disclose an aerobic catalytic protocole (CuI/air) to oxidize tertiary amines and benzylic CH's in drugs. The reaction tolerates a broad range of functionalities and displays a high level of chemoselectivity, which is not generally explained by the strength of the C-H bonds but by the individual structural chemotype. This study represents a first step toward establishing a chemical toolkit (chemotransformations) that can selectively oxidize C-H bonds in complex pharmaceuticals and rapidly deliver drug metabolites.

Investigation of Times of Minima of Selected Early-Type Eclipsing Binaries

NASA Astrophysics Data System (ADS)

Mayer, Pavel; Wolf, Marek; Niarchos, P. G.; Gazeas, K. D.; Manimanis, V. N.; Chochol, Drahomír

2006-08-01

New precise times of minimum light for several early-type eclipsing binaries were obtained at three observatories. The changes of period of the following measured binaries are discussed: V1182 Aql, LY Aur, SZ Cam, FZ CMa, QZ Car, LZ Cen, V606 Cen, AH Cep and TU~Mus.

Early Life Factors and Adult Leisure Time Physical Inactivity Stability and Change.

PubMed

Pinto Pereira, Snehal M; Li, Leah; Power, Chris

2015-09-01

Physical inactivity has a high prevalence and associated disease burden. A better understanding of influences on sustaining and changing inactive lifestyles is needed. We aimed to establish whether leisure time inactivity was stable in midadulthood and whether early life factors were associated with inactivity patterns. In the 1958 British birth cohort (n = 12,271), leisure time inactivity (frequency, less than once a week) assessed at 33 and 50 yr was categorized as "never inactive," "persistently inactive," "deteriorating," or "improving." Early life factors (birth to 16 yr) were categorized into three (physical, social, and behavioral) domains. Using multinomial logistic regression, we assessed associations with inactivity persistence and change of factors within each early life domain and the three domains combined with and without adjustment for adult factors. Inactivity prevalence was similar at 33 and 50 yr (approximately 31%), but 17% deteriorated and 18% improved with age. In models adjusted for all domains simultaneously, factors associated with inactivity persistence versus never inactive were prepubertal stature (8% lower risk/height SD), poor hand control/coordination (17% higher risk/increase on four-point scale), cognition (16% lower/SD in ability) (physical); parental divorce (25% higher), class at birth (7% higher/reduction on four-point scale), minimal parental education (16% higher), household amenities (2% higher/increase in 19-point score (high = poor)) (social); and inactivity (22% higher/reduction in activity on four-point scale), low sports aptitude (47% higher), smoking (30% higher) (behavioral). All except stature, parental education, sports aptitude, and smoking were associated also with inactivity deterioration. Poor hand control/coordination was the only factor associated with improved status (13% lower/increase on four-point scale) versus persistently inactive. Adult leisure time inactivity is moderately stable. Early life factors are

Sexual harassment experiences of female graduates of Nigerian tertiary institutions.

PubMed

Owoaje, Eme T; Olusola-Taiwo, Omolara

The sexual harassment experiences of female graduates from tertiary institutions in Nigeria, were explored using self-administered questionnaires. Information was obtained on the respondents' socio-demographic characteristics and experiences of sexual harassment while in their various tertiary institutions. The majority (69.8%) of the respondents had been sexually harassed, with the main perpetrators being male classmates and lecturers. About two-thirds experienced the non-physical type of sexual harassment; 48.2% experienced the physical type. Non-physical harassment included sexual comments (57.8%) and requests to do something sexual in exchange for academic favors (32.2%). Physical forms of sexual harassment included unwanted sexual touching (29.4%) and being intentionally brushed against in a sexual way (28.9%). The effects experienced by victims were depression and perceived insecurity on campus. Sexual harassment is a common occurrence in Nigerian tertiary institutions. Appropriate institutional interventions should be developed to reduce these occurrences.

Structure-Function Study of Tertiary Amines as Switchable Polarity Solvents

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

Aaron D. Wilson; Frederick F. Stewart

2014-02-01

A series of tertiary amines have been screened for their function as switchable polarity solvents (SPS). The relative ratios of tertiary amine and carbonate species as well as maximum possible concentration were determined through quantitative 1H and 13C NMR spectroscopy. The viscosities of the polar SPS solutions were measured and ranged from near water in dilute systems through to gel formation at high concentrations. The van't Hoff indices for SPS solutions were measured through freezing point depression studies as a proxy for osmotic pressures. A new form of SPS with an amine : carbonate ratio significantly greater than unity hasmore » been identified. Tertiary amines that function as SPS at ambient pressures appear to be limited to molecules with fewer than 12 carbons. The N,N-dimethyl-n-alkylamine structure has been identified as important to the function of an SPS.« less

A Collaborative Governance Approach to Improving Tertiary Education in Papua New Guinea

ERIC Educational Resources Information Center

Eldridge, Kaye; Larry, Lisa; Baird, Jeanette; Kavanamur, David

2018-01-01

Tertiary education in Papua New Guinea (PNG) is in a critical state, as the sector struggles to address increased demand for student places with severely curtailed capacity. Recent thinking about improving public services in PNG has emphasized "whole of sector" or collaborative governance. Such an approach in tertiary education has the…

Towards a High-resolution Time Scale for the Early Devonian

NASA Astrophysics Data System (ADS)

Dekkers, M. J.; da Silva, A. C.

2017-12-01

High-resolution time scales are crucial to understand Earth's history in detail. The construction of a robust geological time scale, however, inevitably becomes increasingly harder further back in time. Uncertainties associated with anchor radiometric ages increase in size, not speaking of the mere presence of suitable datable strata. However, durations of stages can be tightly constrained by making use of cyclic expressions in sediments, an approach that revolutionized the Cenozoic time scale. When precisely determined durations are stitched together, ultimately, a very precise time scale is the result. For the Mesozoic and Paleozoic an astronomical solution as a tuning target is not available but the dominant periods of eccentricity, obliquity and precession are reasonably well constrained for the entire Phanerozoic which enables their detection by means of spectral analysis. Eccentricity is time-invariant and is used as the prime building block. Here we focus on the Early Devonian, on its lowermost three stages: the Lochkovian, Pragian and Emsian. The uncertainties on the Devonian stage boundaries are currently in the order of several millions of years. The preservation of climatic cycles in diagenetically or even anchimetamorphically affected successions, however, is essential. The fit of spectral peak ratios with those calculated for orbital cycles, is classically used as a strong argument for a preserved climatic signal. Here we use primarily the low field magnetic susceptibility (MS) as proxy parameter, supported by gamma-ray spectrometry to test for consistency. Continuous Wavelet Transform, Evolutive Harmonic Analysis, Multitaper Method, and Average Spectral Misfit are used to reach an optimal astronomical interpretation. We report on classic Early Devonian sections from the Czech Republic: the Pozar-CS (Lochkovian and Pragian), Pod Barrandovem (Pragian and Lower Emsian), and Zlichov (Middle-Upper Emsian). Also a Middle-Upper Emsian section from the US

Narratives from Aotearoa New Zealand: Building Communities in Early Childhood through the Visual Arts

ERIC Educational Resources Information Center

Fuemana-Foa'i, Lisa; Pohio, Lesley; Terreni, Lisa

2009-01-01

This article reflects the voices of the authors who are three early childhood tertiary educators and who have presented at the Aotearoa New Zealand Association of Arts Educators Conference held in Wellington in July 2007. The authors revealed many common threads that interwove throughout their individual presentations and made visible an emerging…

Timing of First Antenatal Care (ANC) and Inequalities in Early Initiation of ANC in Nepal.

PubMed

Paudel, Yuba Raj; Jha, Trishna; Mehata, Suresh

2017-01-01

The provision and uptake of quality and timely antenatal care (ANC) is an essential element of efforts to improve health outcomes for women and newborn babies. Antenatal consultations assist in early identification and treatment of complications during pregnancy. This study aimed to provide an information on distribution and inequalities in early initiation of ANC in Nepal. The distribution and inequalities in the early initiation of ANC were examined using Nepal Demographic and Health Surveys 2011. Bivariate and multivariate logistic regression was used to assess inequalities. Overall, 70% of the women had started their first ANC at 4 month or earlier. Among participants who had never attended school, just more than half (52%) received first ANC at 4 months or earlier, while majority of participants (97%) who had received higher education received first ANC at recommended time. Similarly, 89% of those from richest quintile and 48% of those from poorest quintile received first ANC at recommended time. In adjusted analysis, women from richest wealth quintile were significantly more likely to initiate ANC early (AOR: 3.74, 95% CI: 2.31-6.05) compared to the poorest. Similarly, women with higher level education were significantly more likely (AOR: 11.40, 95% CI: 5.05-25.73) to initiate ANC early compared to women who had never attended school. A significantly lower odds of early ANC take up was observed among madhesi other caste (AOR: 0.56, 95% CI: 0.35-0.90) compared to brahmin/chhetri women. Women whose pregnancy was unwanted were significantly less likely to attend first ANC at 4 months or early (AOR: 0.73, 95% CI: 0.58-0.93) in comparison to women whose pregnancy was wanted. The differences in the recommended timing of initiation of ANC were evident among women with different educational, economic levels, and caste/ethnic groups. Rural women were less likely to have checkups as per guidelines. The findings suggest to a need of interventions to raise female

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (Etbe) ...

EPA Pesticide Factsheets

The IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) was released for external peer review in June 2017. EPA’s Science Advisory Board’s (SAB) Chemical Assessment Advisory Committee (CAAC) will conduct a peer review of the scientific basis supporting the ETBE assessment and release a final report of their review. Information regarding the peer review can be found on the SAB website. EPA is conducting an Integrated Risk Information System (IRIS) health assessment for Ethyl Tertiary Butyl Ether (ETBE). The outcome of this project is a Toxicological Review and IRIS Summary for ETBE that will be entered into the IRIS database.

Policy and Practice of Tertiary Literacy. Selected Proceedings of the First National Conference on Tertiary Literacy: Research and Practice, Volume 1 (1st, Melbourne, Australia, March 14-16, 1996).

ERIC Educational Resources Information Center

Golebiowski, Zofia, Ed.

This selection of papers from the First Conference on Tertiary Literacy, which examined the role of literacy as a foundation for knowledge acquisition and dissemination that influences the academic success of tertiary students, presents a number of case studies of policy and practice in Australian universities. Keynote addresses included:…

Who Has to Pay for Their Education? Evidence from European Tertiary Education

ERIC Educational Resources Information Center

Lim, Gieyoung; Kim, Chong-Uk

2013-01-01

In this article, we investigate a positive tertiary education externality in 18 European countries. Using a simple Cobb-Douglas-type production function with constant returns to scale, we find that there are positive spillover effects from tertiary education in European countries. According to our model prediction, on average, 72,000 new employed…

Understanding and Enhancing Learning Communities in Tertiary Education in Science and Engineering

ERIC Educational Resources Information Center

Forret, Michael; Eames, Chris; Coll, Richard

2007-01-01

This research aims to build upon current research in the area of teaching and learning at tertiary level and explore the nature of learning communities in tertiary science and engineering. This study uses a sociocultural approach to address the following question: "What are teachers' and learners' perceptions of the nature of the learning…

Prevalence of malnutrition at the time of admission among patients admitted to a Canadian tertiary-care paediatric hospital

PubMed Central

Baxter, Jo-Anna B; Al-Madhaki, Fatma Ibrahim; Zlotkin, Stanley H

2014-01-01

BACKGROUND: Malnutrition among hospitalized children is known to negatively influence their response to therapy and to prolong their admission. It also has short- and long-term consequences for growth, development and well-being. It is commonly regarded as a condition affecting children in low-income countries; however, malnutrition has been found to be variably prevalent among hospitalized children in higher-income countries. At the time the present study was conducted, it had been >30 years since the nutritional status of Canadian hospitalized children was last published. OBJECTIVES: To determine and communicate the prevalence of malnutrition among children in a Canadian tertiary-care paediatric hospital at the time of their admission. METHODS: In the present cross-sectional study, anthropometric measures were obtained from 322 children admitted to The Hospital for Sick Children in Toronto, Ontario. Nutritional indexes (BMI for age, weight for age, weight for length/height and length/height for age) were generated from anthropometric measures using the WHO igrowup software, and summarized according to WHO definitions. RESULTS: The overall prevalence of malnutrition using BMI for age was 39.6% (95% CI 33% to 46%), of which 8.8% and 30.8% of participants were under- and overnourished, respectively. Furthermore, 6.9% (95% CI 3% to 13%) were determined to be acutely malnourished (weight for length/height <−2 SD) and 13.4% (95% CI 10% to 18%) chronically malnourished (length/height for age <−2 SD). CONCLUSION: The high prevalence of overall malnutrition observed among study participants suggests that initial screening using simple anthropometric measures should be conducted on hospital admission so that patients can receive appropriate nutrition-specific care. PMID:25382997

Management of ST-segment elevation myocardial infarction in predominantly rural central China: A retrospective observational study.

PubMed

Zhang, You; Yang, Shuyan; Liu, Xinyun; Li, Muwei; Zhang, Weidong; Yang, Haiyan; Hu, Dayi; Gao, Chuanyu; Duan, Guangcai

2016-12-01

The degree of adherence to current guidelines for clinical management of ST-segment elevation myocardial infarction (STEMI) is known in developed countries and large Chinese cities, but in predominantly rural areas information is lacking. We assessed the application of early reperfusion therapy for STEMI in secondary and tertiary hospitals in Henan province in central China.Data were retrospectively collected from 5 secondary and 4 tertiary hospitals in Henan concerning STEMI patients treated from January 2011 to January 2012, including management strategy, delay time, and inhospital mortality.Among 1311 STEMI patients, 613 and 698 were treated at secondary and tertiary hospitals, respectively. Overall, 460 (35.1%) patients received early reperfusion therapy including thrombolysis in 383 patients and primary percutaneous coronary intervention in 77. Compared with secondary centers, early (37.2% vs 32.6%) and successful reperfusion (34.5% vs 25.1%) was significantly higher, whereas thrombolysis was lower in the tertiary hospitals (26.4% vs 32.5%). Median symptom onset-to-first medical contact, and door-to-needle and door-to-balloon time was 168, 18, and 60 minutes, respectively. Delay times closely approached recommended guidelines, especially in secondary centers. Use of recommended pharmacotherapy was low, particularly in secondary hospitals. Inhospital mortality was 5.8%, and similar between secondary and tertiary hospitals (6.0% vs 5.6%; P = 0.183).Two-thirds of STEMI patients did not receive early reperfusion, and tertiary hospitals mostly failed to take advantage of around-the-clock primary percutaneous coronary intervention. Actions such as referrals are warranted to shorten prehospital delay, and the concerns of patients and doctors regarding reperfusion risk should be addressed.

An overview of the Tertiary geology and hydrogeology of the northern part of the Arabian Gulf region with special reference to Kuwait

NASA Astrophysics Data System (ADS)

Mukhopadhyay, A.; Al-Sulaimi, J.; Al-Awadi, E.; Al-Ruwaih, F.

1996-06-01

Tertiary sediments constitute the main source of usable groundwater in Kuwait. Tectonics, depositional environment, lithology and the hydrogeology of these sediments have been reviewed on a regional scale, with special reference to Kuwait. The review showed that Kuwait was situated at the boundary of the stable shelf towards southwest and the unstable shelf towards northeast throughout the Tertiary period. The Tertiary sedimentation started in this area with a marine transgression in the Palaeocene. Shallow marine to sabkha conditions prevailed in the area until the end of the Eocene; a carbonate-evaporite sequence (Umm Er-Radhuma, Rus and Dammam Formation) was deposited during this period. The sea regressed at the end of Eocene, and a widespread unconformity, causing the absence of Oligocene deposits over most of the area, marked the event. The karstification of the Dammam Limestone Formation, that provides localized easier pathways for ground water, took place during this period. The deposition of the clastic sediments of the Kuwait Group and its equivalents on the stable shelf, under mostly continental conditions, started in the early Miocene. The Tertiary aquifers of the area are recharged by occasional rainstorms in the outcrops of Saudi Arabia and Iraq. The water flows towards the north and east in the direction of the regional dip and discharges along the present-day coast of the Gulf. The water quality deteriorates in the same direction, being more mineralized as it flows through the aquifers. The aquifers are presently being exploited at a comparatively high rate. Since the aquifers extend beyond the political boundaries, cooperation among the countries of the region is recommended to ensure the optimum utilization of the scarce water resources of this desert environment.

Listening to Students: Studying for a Part-Time Degree in Early Childhood Studies.

ERIC Educational Resources Information Center

Burn, Elizabeth

For this study, 12 part-time students in an early childhood studies program were interviewed and videotaped concerning their personal stories as students. Initial analysis of their responses revealed main themes: (1) economic barriers to full-time degree study; (2) domestic responsibilities/gender issues (for example, the stress of juggling…

Destructive bone disease in early syphilis.

PubMed

Dismukes, W E; Delgado, D G; Mallernee, S V; Myers, T C

1976-12-06

Although destructive bone disease is a well-known complication of tertiary syphilis, osteitis or osteomyelitis are not commonly recognized as complications of early (primary or secondary) syphillis. A patient with secondary syphilis characterized by generalized lymphadenopathy, perianal condyloma lata, and positive rapid plasma reagin (RPR) and fluorescent treponemal antibody-absorption (FTA-ABS) tests also complained of headache, right should pain, and right anterior chest pain and swelling. Roentgenograms showed mottled osteolytic lesions consistent with previously described luetic bone disease. Biopsy confirmed the diagnosis of syphilitic osteomyelitis, and treatment with penicillin resulted in prompt resolution of symptoms.

Tertiary instability of zonal flows within the Wigner-Moyal formulation of drift turbulence

NASA Astrophysics Data System (ADS)

Zhu, Hongxuan; Ruiz, D. E.; Dodin, I. Y.

2017-10-01

The stability of zonal flows (ZFs) is analyzed within the generalized-Hasegawa-Mima model. The necessary and sufficient condition for a ZF instability, which is also known as the tertiary instability, is identified. The qualitative physics behind the tertiary instability is explained using the recently developed Wigner-Moyal formulation and the corresponding wave kinetic equation (WKE) in the geometrical-optics (GO) limit. By analyzing the drifton phase space trajectories, we find that the corrections proposed in Ref. to the WKE are critical for capturing the spatial scales characteristic for the tertiary instability. That said, we also find that this instability itself cannot be adequately described within a GO formulation in principle. Using the Wigner-Moyal equations, which capture diffraction, we analytically derive the tertiary-instability growth rate and compare it with numerical simulations. The research was sponsored by the U.S. Department of Energy.

Feasibility of real-time echocardiographic evaluation during patient transport.

PubMed

Garrett, Paul D; Boyd, Sheri Y N; Bauch, Terry D; Rubal, Bernard J; Bulgrin, James R; Kinkler, E Sterling

2003-03-01

Echocardiography is a key diagnostic tool in evaluating patients with cardiac emergencies and chest trauma. The lack of qualified real-time interpretation limits its use by emergency first responders. Early diagnosis of cardiac emergencies has the potential to facilitate triage and medical intervention to improve outcomes. We investigated the feasibility of remote, real-time interpretation of echocardiograms during patient transport. Echocardiograms using a hand-carried ultrasound device were transmitted from an ambulance in transit to a tertiary care facility using a distributed mobile local area network. Transmitted studies were reviewed by a cardiologist for ability to interpret predefined features. Transmission quality and reliability were assessed. Echocardiographic images were successfully transmitted greater than 88% of transport time. The evaluation of left-ventricular size and function, and presence of pericardial effusion were greater than 90% concordant, but only 66% of all echocardiographic features were concordant. Most transmission losses were brief (time transmission of echocardiograms during patient transport of adequate quality for accurate interpretation.

Understanding Australian Aboriginal Tertiary Student Needs

ERIC Educational Resources Information Center

Oliver, Rhonda; Rochecouste, Judith; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon; Exell, Mike

2013-01-01

Drawing from a study of the experiences of Australian Aboriginal and Torres Strait Islander university students, this paper presents an overview of the specific needs of these students as they enter and progress through their tertiary education. Extracts from a set of case studies developed from both staff and student interviews and an online…

An Effective Preparation for Tertiary Mathematics

ERIC Educational Resources Information Center

Parnell, Sheena; Statham, Moira

2007-01-01

The University of Auckland offers a one-year pre-degree Tertiary Foundation Certificate (TFC) Programme, for up to 200 students who are under-prepared for university study. The students may come straight from school without having gained a university entrance qualification, or they may be students returning to education who lack the confidence to…

Cost-Sharing Reform of Tertiary Education in China and Its Equity Impact

ERIC Educational Resources Information Center

Wang, Catherine Yan

2013-01-01

China has made huge strides in expanding access to higher education since the 1980s. The main approach to achieve mass higher education was cost-sharing reforms of tertiary education. This article examines the policy reforms that affected tuition, fees and subsidies for tertiary students since the end of the 1980s and looks at the effects in terms…

On Progress of Mass Tertiary Education: Case of Lebanon, Kenya and Oman

ERIC Educational Resources Information Center

Liu, Zhimin; Mutinda, Gladys

2016-01-01

Mass higher education is a huge force to be reckoned with and its existence, already in the expansion of tertiary institutions is undeniable. This study will focus on three countries: Lebanon, Kenya and Oman. The purpose of this study is to evaluate mass tertiary education progress in these countries. It will synthesize data results of gross…

First report of tertiary syphilis presenting as lipoatrophic panniculitis in an immunocompetent patient.

PubMed

Drago, Francesco; Ciccarese, Giulia; Tomasini, Carlo F; Calamaro, Paola; Boggio, Maurizio; Rebora, Alfredo; Parodi, Aurora

2017-03-01

We describe herein a woman who developed subcutaneous gummas in her trochanteric regions, bilaterally, although she had been treated for syphilis two decades earlier. Evidence of Treponema pallidum latent late infection was the presence of IgG antibodies against T. pallidum and the positive non-treponemal and treponemal tests. Moreover, immunohistochemical staining for T. pallidum detected some spirochetes close to the atrophic adipocytes allowing the diagnosis of lypo-atrophic panniculitis tertiary syphilis. This is the first case of tertiary syphilis presenting as panniculitis in an immunocompetent patient, demonstrating that subcutaneous fat may be another organ infected in tertiary syphilis.

Incorporating Online Tools in Tertiary Education

ERIC Educational Resources Information Center

Steenkamp, Leon P.; Rudman, Riaan J.

2013-01-01

Students currently studying at tertiary institutions have developed a set of attitudes and aptitudes as a result of growing up in an IT and media-rich environment. These attitudes and aptitudes influence how they learn and in order to be effective, lecturers must adapt to address their learning preferences and use the online teaching tools that…

Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

ERIC Educational Resources Information Center

Tuapawa, Kimberley

2016-01-01

Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

Early, on-time, and late behavioural autonomy in adolescence: psychosocial correlates in young and middle adulthood.

PubMed

Pavlova, Maria K; Haase, Claudia M; Silbereisen, Rainer K

2011-04-01

Drawing on two nationally representative German studies (N(1) = 1744, N(2) = 759), we examined correlates of early, on-time, and late curfew autonomy, a retrospective indicator of behavioural autonomy, in young and middle adulthood (19-37 years of age). Adjustment in four domains was considered: educational attainment, externalizing problem behaviour, subjective well-being, and interpersonal relationships. The early group showed lower adjustment in multiple domains across young and middle adulthood. The late group reported a mixed pattern of adjustment at younger ages (lower externalizing problems, but lower positive affect, lower importance of peers, and lower likelihood to have a partner) and positive adjustment in all domains at older ages. Timing effects were controlled for sociodemographic characteristics and retrospective measures of early adversities, pubertal timing, disclosure to parents, and peer group affiliation in adolescence. Findings show that late behavioural autonomy in its correlates is not simply the opposite of early behavioural autonomy. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Isn't It a Pyrrhic Victory?: Over-Privatization and Universal Access in Tertiary Education of Korea

ERIC Educational Resources Information Center

Kim, Ki-Seok; Woo, Yong-Je

2009-01-01

This article analyzes the Korean passage to tertiary education for all. With a specific focus on traditional form of higher education, it tries to answer the questions of how and why this extra-ordinary phenomenon happens in a short period of time. Applying a historical sociology method, it attempts to explain the mechanism and consequences of the…

Disaster resilience in tertiary hospitals: a cross-sectional survey in Shandong Province, China.

PubMed

Zhong, Shuang; Hou, Xiang-Yu; Clark, Michele; Zang, Yu-Li; Wang, Lu; Xu, Ling-Zhong; FitzGerald, Gerard

2014-03-25

Hospital disaster resilience can be defined as a hospital's ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China. A stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies. A response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a 'portable hospital' function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%. This study validated the broad utility of a framework for understanding and measuring the level of hospital resilience. The survey

Indigenous Students in the Tertiary Education Sector

ERIC Educational Resources Information Center

Bandias, Susan; Fuller, Don; Larkin, Steven

2014-01-01

Important recent objectives of indigenous education policy in Australia have been aimed at redressing indigenous economic and social disadvantage through increasing student retention, progression and completion rates in both compulsory and post-compulsory education. The two sectors of the tertiary education system, vocational education and…

Discordance between 'actual' and 'scheduled' check-in times at a heart failure clinic

PubMed Central

Joyce, Emer; Gandesbery, Benjamin T.; Blackstone, Eugene H.; Taylor, David O.; Tang, W. H. Wilson; Starling, Randall C.; Hachamovitch, Rory

2017-01-01

Introduction A 2015 Institute Of Medicine statement “Transforming Health Care Scheduling and Access: Getting to Now”, has increased concerns regarding patient wait times. Although waiting times have been widely studied, little attention has been paid to the role of patient arrival times as a component of this phenomenon. To this end, we investigated patterns of patient arrival at scheduled ambulatory heart failure (HF) clinic appointments and studied its predictors. We hypothesized that patients are more likely to arrive later than scheduled, with progressively later arrivals later in the day. Methods and results Using a business intelligence database we identified 6,194 unique patients that visited the Cleveland Clinic Main Campus HF clinic between January, 2015 and January, 2017. This clinic served both as a tertiary referral center and a community HF clinic. Transplant and left ventricular assist device (LVAD) visits were excluded. Punctuality was defined as the difference between ‘actual’ and ‘scheduled’ check-in times, whereby negative values (i.e., early punctuality) were patients who checked-in early. Contrary to our hypothesis, we found that patients checked-in late only a minority of the time (38% of visits). Additionally, examining punctuality by appointment hour slot we found that patients scheduled after 8AM had progressively earlier check-in times as the day progressed (P < .001 for trend). In both a Random Forest-Regression framework and linear regression models the most important risk-adjusted predictors of early punctuality were: later in the day appointment hour slot, patient having previously been to the hospital, age in the early 70s, and white race. Conclusions Patients attending a mixed population ambulatory HF clinic check-in earlier than scheduled times, with progressive discrepant intervals throughout the day. This finding may have significant implications for provider utilization and resource planning in order to maximize clinic

Comparing physical activity and sedentary time among overweight and nonoverweight preschoolers enrolled in early learning programs: a cross-sectional study.

PubMed

Tucker, Patricia; Maltby, Alana M; Burke, Shauna M; Vanderloo, Leigh M; Irwin, Jennifer D

2016-09-01

Establishing appropriate physical activity and sedentary behaviours during early childhood is important to ensure children accrue the many associated health benefits. While physical activity levels have been reported as low within early learning programs, little research has explored the physical activity and sedentary time of Canadian preschoolers classified as overweight within these facilities. The purpose of this study was to compare objectively measured physical activity and sedentary time among preschoolers classified as overweight and nonoverweight in early learning programs. Direct assessment of physical activity and sedentary time of 216 preschool-aged children was collected via Actical accelerometers during early learning hours, while body mass index percentile was calculated based on preschoolers' objectively measured height and weight. Results of three 3-way ANOVAs suggest that rates of moderate to vigorous physical activity, total physical activity, and sedentary time (p > 0.05) did not significantly differ based on weight status, sex, and type of early learning facility. This study is one of few that has examined differences in overweight and nonoverweight preschoolers' sedentary time, and adds to the limited research exploring physical activity levels among overweight and nonoverweight preschoolers during early learning hours. Given the high rates of sedentary time reported, programming within early learning facilities is necessary to support preschoolers, regardless of weight status, to achieve increased physical activity levels and decreased sedentary time.

The Performance in Context Model: A 21st Century Tertiary Dance Teaching Pedagogy

ERIC Educational Resources Information Center

Stevens, Kym; Huddy, Avril

2016-01-01

Despite tertiary institutions acknowledging that reflective practice is an essential component of undergraduate dance teacher training, there is often a disparity between the tertiary students' reflective skills and the more sophisticated reflective ability needed to navigate the twenty-first-century workforce. This paper charts the evolution of a…

The Developmental Pathway From Pubertal Timing to Delinquency and Sexual Activity From Early to Late Adolescence

PubMed Central

Negriff, Sonya; Elizabeth, J. Susman; Trickett, Penelope K.

2013-01-01

There is strong evidence that early pubertal timing is associated with adolescent problem behaviors. However, there has been limited investigation of the mechanisms or developmental relationships. The present study examined longitudinal models incorporating pubertal timing, delinquency, and sexual activity in a sample of 454 adolescents (9–13 years old at enrollment; 47% females). Participants were seen for three assessments approximately 1 year apart. Characteristics of friendship networks (older friends, male friends, older male friends) were examined as mediators. Structural equation modeling was used to test these associations as well as temporal relationships between sexual activity and delinquency. Results showed that early pubertal timing at Time 1 was related to more sexual activity at Time 2, which was related to higher delinquency at Time 3, a trend mediation effect. None of the friendship variables mediated these associations. Gender or maltreatment status did not moderate the meditational pathways. The results also supported the temporal sequence of sexual activity preceding increases in delinquency. These findings reveal that early maturing adolescents may actively seek out opportunities to engage in sexual activity which appears to be risk for subsequent delinquency. PMID:21191640

The developmental pathway from pubertal timing to delinquency and sexual activity from early to late adolescence.

PubMed

Negriff, Sonya; Susman, Elizabeth J; Trickett, Penelope K

2011-10-01

There is strong evidence that early pubertal timing is associated with adolescent problem behaviors. However, there has been limited investigation of the mechanisms or developmental relationships. The present study examined longitudinal models incorporating pubertal timing, delinquency, and sexual activity in a sample of 454 adolescents (9-13 years old at enrollment; 47% females). Participants were seen for three assessments approximately 1 year apart. Characteristics of friendship networks (older friends, male friends, older male friends) were examined as mediators. Structural equation modeling was used to test these associations as well as temporal relationships between sexual activity and delinquency. Results showed that early pubertal timing at Time 1 was related to more sexual activity at Time 2, which was related to higher delinquency at Time 3, a trend mediation effect. None of the friendship variables mediated these associations. Gender or maltreatment status did not moderate the meditational pathways. The results also supported the temporal sequence of sexual activity preceding increases in delinquency. These findings reveal that early maturing adolescents may actively seek out opportunities to engage in sexual activity which appears to be risk for subsequent delinquency.

Tertiary carbonate-dissolution cycles on the Sierra Leone Rise, eastern equatorial Atlantic Ocean

USGS Publications Warehouse

Dean, W.E.; Gardner, J.V.; Cepek, P.

1981-01-01

Most of the Tertiary section on Sierra Leone Rise off northwest Africa consists of chalk, marl, and limestone that show cyclic alterations of clay-rich and clay-poor beds about 20-60 cm thick. On the basis of biostratigraphic accumulation rates, the cycles in Oligocene and Miocene chalk have periods which average about 44,000 years, and those in Eocene siliceous limestone have periods of 4000-27,000 years. Several sections were sampled in detail to further define the cycles in terms of content of CaCO3, clay minerals, and relative abundances of calcareous nannofossils. Extending information gained by analyses of Pleistocene cores from the continental margin of northwest Africa to the Tertiary cycles on Sierra Leone Rise, both dilution by noncarbonate material and dissolution of CaCO3 could have contributed to the observed relative variations in clay and CaCO3. However, dissolution of CaCO3 as the main cause of the carbonate-clay cycles on the Sierra Leone Rise, rather than dilution by clay, is suggested by the large amount of change (several thousand percent) in terrigenous influx required to produce the observed variations in amount of clay and by the marked increase in abundance of dissolution-resistant discoasters relative to more easily dissolved coccoliths in low-carbonate parts of cycles. The main cause of dissolution of CaCO3 was shoaling of the carbonate compensation depth (CCD) during the early Neogene and climatically induced fluctuations in the thickness of Antarctic Bottom Water. ?? 1981.

Sequence stratigraphy, tectonics and hydrocarbon trap geometries of Middle Tertiary strata in the southern San Joaquin Basin, California

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

Phillips, S.; Hewlett, J.S.; Bazeley, W.J.M.

1996-01-01

Tectonic evolution of the southern San Joaquin basin exerted a fundamental control on Cenozoic sequence boundary development, reservoir, source and seal facies distribution, and hydrocarbon trap development. Spatial and temporal variations in Tertiary sequence architecture across the basin reflect differences in eastside versus westside basin-margin geometries and deformation histories. Deposition of Tertiary sequences initiated in a forearc basin setting, bounded on the east by a ramp-margin adjacent to the eroded Sierran arc complex and on the west by the imbricated accretionary wedge of the Coast Ranges thrust. The major stages of Cenozoic basin evolution are: (1) Episodic compressional folding andmore » thrusting associated with oblique convergence of the Farallon and North American plates (Late Cretaceous to Oligocene), (2) localized folding and onset of basin subsidence related to Pacific Plate reorganization, microplate formation and rotation (Oligocene to Early Miocene), (3) transtensional faulting, folding basin subsidence associated with initiation of the San Andreas transform and continued microplate rotation (Micocene to Pliocene), and (4) compressional folding, extensional and strike- slip faulting related to evolution of the Pacific-North American transform boundary (Plio- Pleistocene). Complex stratigraphic relationships within Eocene to Middle Miocene rocks provide examples of tectonic influences on sequence architecture. These include development of: (1) Tectonically enhanced sequence boundaries (Early Eocene base Domengine unconformity) and local mid-sequence angular unconformities, (2) westside-derived syntectonic [open quotes]lowstand[close quotes] systems (Yokut/Turitella Silt wedge and Leda Sand/Cymric/Salt Creek wedge), (3) regional seals associated with subsidence-related transgressions (Round Mountain Silt), and (4) combination traps formed by structural inversion of distal lowstand delta reservoirs (e.g. Coalinga East Extension field).« less

Sequence stratigraphy, tectonics and hydrocarbon trap geometries of Middle Tertiary strata in the southern San Joaquin Basin, California

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

Phillips, S.; Hewlett, J.S.; Bazeley, W.J.M.

1996-12-31

Tectonic evolution of the southern San Joaquin basin exerted a fundamental control on Cenozoic sequence boundary development, reservoir, source and seal facies distribution, and hydrocarbon trap development. Spatial and temporal variations in Tertiary sequence architecture across the basin reflect differences in eastside versus westside basin-margin geometries and deformation histories. Deposition of Tertiary sequences initiated in a forearc basin setting, bounded on the east by a ramp-margin adjacent to the eroded Sierran arc complex and on the west by the imbricated accretionary wedge of the Coast Ranges thrust. The major stages of Cenozoic basin evolution are: (1) Episodic compressional folding andmore » thrusting associated with oblique convergence of the Farallon and North American plates (Late Cretaceous to Oligocene), (2) localized folding and onset of basin subsidence related to Pacific Plate reorganization, microplate formation and rotation (Oligocene to Early Miocene), (3) transtensional faulting, folding basin subsidence associated with initiation of the San Andreas transform and continued microplate rotation (Micocene to Pliocene), and (4) compressional folding, extensional and strike- slip faulting related to evolution of the Pacific-North American transform boundary (Plio- Pleistocene). Complex stratigraphic relationships within Eocene to Middle Miocene rocks provide examples of tectonic influences on sequence architecture. These include development of: (1) Tectonically enhanced sequence boundaries (Early Eocene base Domengine unconformity) and local mid-sequence angular unconformities, (2) westside-derived syntectonic {open_quotes}lowstand{close_quotes} systems (Yokut/Turitella Silt wedge and Leda Sand/Cymric/Salt Creek wedge), (3) regional seals associated with subsidence-related transgressions (Round Mountain Silt), and (4) combination traps formed by structural inversion of distal lowstand delta reservoirs (e.g. Coalinga East Extension field).« less

Correlation between the radiological observation of isolated tertiary waves on an esophagram and findings on high-resolution esophageal manometry.

PubMed

Halland, M; Ravi, K; Barlow, J; Arora, A

2016-01-01

Barium esophagrams are a frequently performed test, and radiological observations about potential abnormal esophageal motility, such as tertiary contractions, are commonly reported. We sought to assess the correlation between tertiary waves, and in particular isolated tertiary waves, on esophagrams and findings on non-synchronous high-resolution esophageal manometry. We retrospectively reviewed reports of esophagrams performed at a tertiary referral center and identified patients in whom tertiary waves were observed and a high-resolution esophageal manometry had been performed. We defined two groups; group 1 was defined as patients with isolated tertiary waves, whereas group 2 had tertiary waves and evidence of achalasia or an obstructing structural abnormality on the esophagram. We collected data on demographics, dysphagia score, associated findings on esophagram, and need for intervention. We reviewed the reports of 2100 esophagrams of which tertiary waves were noted as an isolated abnormality in 92, and in association with achalasia or a structural obstruction in 61. High-resolution manometry was performed in 17 patients in group 1, and five had evidence of a significant esophageal motility disorder and 4 required any intervention. Twenty-one patients in group 2 underwent manometry, and 18 had a significant esophageal motility disorder. An isolated finding of tertiary waves on an esophagram is rarely associated with a significant esophageal motility disorder that requires intervention. All patients with isolated tertiary waves who required intervention had a dysphagia to liquids. Tertiary contractions, in the absence of dysphagia to liquids, indicate no significant esophageal motility disorder. © 2014 International Society for Diseases of the Esophagus.

Formation Mechanism of NDMA from Ranitidine, Trimethylamine, and Other Tertiary Amines during Chloramination: A Computational Study

PubMed Central

2015-01-01

Chloramination of drinking waters has been associated with N-nitrosodimethylamine (NDMA) formation as a disinfection byproduct. NDMA is classified as a probable carcinogen and thus its formation during chloramination has recently become the focus of considerable research interest. In this study, the formation mechanisms of NDMA from ranitidine and trimethylamine (TMA), as models of tertiary amines, during chloramination were investigated by using density functional theory (DFT). A new four-step formation pathway of NDMA was proposed involving nucleophilic substitution by chloramine, oxidation, and dehydration followed by nitrosation. The results suggested that nitrosation reaction is the rate-limiting step and determines the NDMA yield for tertiary amines. When 45 other tertiary amines were examined, the proposed mechanism was found to be more applicable to aromatic tertiary amines, and there may be still some additional factors or pathways that need to be considered for aliphatic tertiary amines. The heterolytic ONN(Me)2–R+ bond dissociation energy to release NDMA and carbocation R+ was found to be a criterion for evaluating the reactivity of aromatic tertiary amines. A structure–activity study indicates that tertiary amines with benzyl, aromatic heterocyclic ring, and diene-substituted methenyl adjacent to the DMA moiety are potentially significant NDMA precursors. The findings of this study are helpful for understanding NDMA formation mechanism and predicting NDMA yield of a precursor. PMID:24968236

Formation mechanism of NDMA from ranitidine, trimethylamine, and other tertiary amines during chloramination: a computational study.

PubMed

Liu, Yong Dong; Selbes, Meric; Zeng, Chengchu; Zhong, Rugang; Karanfil, Tanju

2014-01-01

Chloramination of drinking waters has been associated with N-nitrosodimethylamine (NDMA) formation as a disinfection byproduct. NDMA is classified as a probable carcinogen and thus its formation during chloramination has recently become the focus of considerable research interest. In this study, the formation mechanisms of NDMA from ranitidine and trimethylamine (TMA), as models of tertiary amines, during chloramination were investigated by using density functional theory (DFT). A new four-step formation pathway of NDMA was proposed involving nucleophilic substitution by chloramine, oxidation, and dehydration followed by nitrosation. The results suggested that nitrosation reaction is the rate-limiting step and determines the NDMA yield for tertiary amines. When 45 other tertiary amines were examined, the proposed mechanism was found to be more applicable to aromatic tertiary amines, and there may be still some additional factors or pathways that need to be considered for aliphatic tertiary amines. The heterolytic ONN(Me)2-R(+) bond dissociation energy to release NDMA and carbocation R(+) was found to be a criterion for evaluating the reactivity of aromatic tertiary amines. A structure-activity study indicates that tertiary amines with benzyl, aromatic heterocyclic ring, and diene-substituted methenyl adjacent to the DMA moiety are potentially significant NDMA precursors. The findings of this study are helpful for understanding NDMA formation mechanism and predicting NDMA yield of a precursor.

Medical tourism in India: perceptions of physicians in tertiary care hospitals.

PubMed

Qadeer, Imrana; Reddy, Sunita

2013-12-17

Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

Medical tourism in india: perceptions of physicians in tertiary care hospitals

PubMed Central

2013-01-01

Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

PubMed Central

Neill, Sara; Haithcock, Sarah; Smith, P. Brian; Goldberg, Ronald; Bidegain, Margarita; Tanaka, David; Carriker, Charlene; Ericson, Jessica E.

2015-01-01

Purpose Reduction of bloodstream infections (BSI) has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line care protocols, and health care provider education programs have reduced BSI in neonatal intensive care units (NICUs) around the country. The ability of large tertiary care centers to decrease nosocomial infections, including BSI, has been demonstrated. However, long-term BSI reductions in infants are not well documented. We sought to demonstrate that a low incidence of BSI can be maintained over time in a tertiary care NICU. Subjects 6,790 infants admitted to a large, tertiary care NICU between 2005 and 2013. Design Retrospective intervention study. Methods A staged, multifaceted infection prevention plan was implemented beginning in October 2007 under nursing leadership. The incidence of BSI was determined annually for 2005-2013. Results Baseline BSI incidence for infants admitted to the NICU was 5.15 and 6.08 episodes per 1,000 infant-days in 2005 and 2006, respectively. After protocol implementation, the incidence of BSI decreased to 2.14/1,000 infant-days and 2.44/1,000 infant-days in 2008 and 2009, respectively. Yearly incidence remained low over the next 4 years and decreased even further to 0.20-0.45 infections/1,000 infant days. This represents a 92% decrease in BSI over a period of >5 years. Conclusions Implementation of a nursing-led comprehensive infection control initiative can effectively produce and maintain a reduction in the incidence of BSI in infants at a large tertiary care NICU. What this study adds Long term reductions in neonatal BSI are possible with implementation of a multidisciplinary team approach and strong nursing leadership. PMID:25915573

Effect of a 5-Month Worksite Physical Activity Program on Tertiary Employees Overall Health and Fitness.

PubMed

Genin, Pauline Manon; Degoutte, Fabrice; Finaud, Julien; Pereira, Bruno; Thivel, David; Duclos, Martine

2017-02-01

This pilot study questions the effects of a worksite physical activity program on health and fitness in tertiary employees. Ninety-five employees were randomly assigned to Control (CON); Novice (NOV); Experienced group (EXP). The NOV and EXP groups followed a 5-month worksite physical activity program (at least two sessions/week). Body composition, physical activity level and physical fitness, eating habits, health perception, sleep quality, pain, and quality of life were assessed. Fat mass decreased in NOV and EXP; the distance covered during the 6-minute walking test, push-ups, squat jump increased for NOV and EXP group. Physical activity level, health perception, quality of sleep, and eating habits were improved in NOV. This study underlines for the first time the beneficial effects of such worksite programs among tertiary employees on overall health and the feasibility of its design.

Coupling in the absence of tertiary amines.

PubMed

Bodanszky, M; Bednarek, M A; Bodanszky, A

1982-10-01

In order to avoid base catalyzed side reactions during coupling, attempts were made to render superfluous the addition of tertiary amines to the reaction mixture. Weak acids were applied for the removal of acid labile protecting groups. Acetic acid and other carboxylic acids were considered unsuitable for this purpose coupling step. Pentachlorophenol and 2,4-dinitrophenol cleaved the Bpoc, Nps and Trt groups but more practical rates were reached with solutions of 1-hydroxybenzotriazole (HOBt) in trifluoroethanol, in acetic acid, or in a mixture of phenol and p-cresol. In addition to acidolysis, HOBt salts of amino components could also be obtained through hydrogenolysis of the Z group or thiolysis of the Nps group in the presence of HOBt, or by the displacement of acetic acid from acetate salts with HOBt. Acylation of HOBt salts of amino components with symmetrical or mixed anhydrides or with active esters did not require the addition of tertiary amine.

Between Charity and Education: Orphans and Orphanages in Early Modern Times

ERIC Educational Resources Information Center

Jacobi, Juliane

2009-01-01

In early modern times orphans have been children who could not expect sufficient support from their family because of lack of at least one parent, in most cases the father. This article will clarify of whom we are talking if we talk about orphans and what have been the conditions of living in a society which was organised by a high variety of…

Is Tertiary Education Expansion Observable in Private Returns to Education? (Evidence for Middle and Eastern European Countries)

ERIC Educational Resources Information Center

Štefánik, Miroslav; Horvát, Peter

2015-01-01

This article provides evidence about differences in the recent tertiary education expansion in Austria, Germany, the Czech Republic, Poland and Slovakia. Focusing on these differences, we have examined private returns to tertiary education acquired before and after the tertiary education expansion. We compare these returns as follows: Austria with…

Singular F(R) cosmology unifying early- and late-time acceleration with matter and radiation domination era

NASA Astrophysics Data System (ADS)

Odintsov, S. D.; Oikonomou, V. K.

2016-06-01

We present some cosmological models which unify the late- and early-time acceleration eras with the radiation and the matter domination era, and we realize the cosmological models by using the theoretical framework of F(R) gravity. Particularly, the first model unifies the late- and early-time acceleration with the matter domination era, and the second model unifies all the evolution eras of our Universe. The two models are described in the same way at early and late times, and only the intermediate stages of the evolution have some differences. Each cosmological model contains two Type IV singularities which are chosen to occur one at the end of the inflationary era and one at the end of the matter domination era. The cosmological models at early times are approximately identical to the R 2 inflation model, so these describe a slow-roll inflationary era which ends when the slow-roll parameters become of order one. The inflationary era is followed by the radiation era and after that the matter domination era follows, which lasts until the second Type IV singularity, and then the late-time acceleration era follows. The models have two appealing features: firstly they produce a nearly scale invariant power spectrum of primordial curvature perturbations and a scalar-to-tensor ratio which are compatible with the most recent observational data and secondly, it seems that the deceleration-acceleration transition is crucially affected by the presence of the second Type IV singularity which occurs at the end of the matter domination era. As we demonstrate, the Hubble horizon at early times shrinks, as expected for an initially accelerating Universe, then during the matter domination era, it expands and finally after the Type IV singularity, the Hubble horizon starts to shrink again, during the late-time acceleration era. Intriguingly enough, the deceleration-acceleration transition, occurs after the second Type IV singularity. In addition, we investigate which F(R) gravity

Freezing-Induced Perturbation of Tertiary Structure of a Monoclonal Antibody

PubMed Central

LIU, LU; BRAUN, LATOYA JONES; WANG, WEI; RANDOLPH, THEODORE W.; CARPENTER, JOHN F.

2014-01-01

We studied the effects of pH and solution additives on freezing-induced perturbations in the tertiary structure of a monoclonal antibody (mAb) by intrinsic tryptophan fluorescence spectroscopy. In general, freezing caused perturbations in the tertiary structure of the mAb, which were reversible or irreversible depending on the pH or excipients present in the formulation. Protein aggregation occurred in freeze–thawed samples in which perturbations of the tertiary structure were observed, but the levels of protein aggregates formed were not proportional to the degree of structural perturbation. Protein aggregation also occurred in freeze–thawed samples without obvious structural perturbations, most likely because of freeze concentration of protein and salts, and thus reduced protein colloidal stability. Therefore, freezing-induced protein aggregation may or may not first involve the perturbation of its native structure, followed by the assembly processes to form aggregates. Depending on the solution conditions, either step can be rate limiting. Finally, this study demonstrates the potential of fluorescence spectroscopy as a valuable tool for screening therapeutic protein formulations subjected to freeze–thaw stress. PMID:24832730

Stratigraphy and characteristic mollusks of the Pamunkey Group (lower Tertiary) and the Old Church Formation of the Chesapeake Group; Virginia Coastal Plain

USGS Publications Warehouse

Ward, Lauck W.

1985-01-01

Along the Pamunkey River and its tributaries can be found a very complete, well-preserved, Tertiary stratigraphic record that reflects the sea-level changes as well as the local tectonic history of the central Virginia Coastal Plain. Using this record, I have described the lower Tertiary units and proposed a sequential model for their occurrence. Sediments examined in this study range in age from early Paleocene to latest Oligocene or earliest Miocene. Upper Tertiary units are described where they occur in the same sections with the lower Tertiary beds. The Brightseat Formation (lower Paleocene), Aquia Formation (upper Paleocene), Marlboro Clay (upper Paleocene), Nanjemoy Formation (lower Eocene), Piney Point Formation (middle Eocene) and Old Church Formation (new unit, upper Oligocene and lower Miocene) were studied. The definitions of the Piscataway and Paspotansa Members of the Aquia are amended, and a lectostratotype (principal reference section) is designated for those units as well as the Aquia on the Potomac River just below the mouth of Aquia Creek. A lectostratotype section is also designated for the Nanjemoy and its two members, the Potapaco and the Woodstock. That section is on the Potomac above Popes Creek. Beds assigned to the Piney Point and Old Church Formations, previously known only in the subsurface, crop out extensively on the Pamunkey River. A hypostratotype (reference section) is selected for the Piney Point Formation on the Pamunkey River at Horseshoe. The Old Church Formation (named herein) is included in the Chesapeake Group. Areal extent of the stratigraphic units was determined by correlation of outcropping beds on the Pamunkey, Patuxent, Potomac, Rappahannock, Mattaponi, Chickahominy, and James Rivers supplemented by well data. Comparisons of the onlap histories of the Salisbury, Albemarle, and Charleston Embayments indicate a number of simultaneous transgressive events implying global sea-level rises. More restricted transgressions

Distinguishing between tertiary and secondary facilities: a case study of cardiac diagnostic-related groups (DRGs).

PubMed

Rouse, Paul; Arulambalam, Ajit; Correa, Ralph; Ullman, Cornelia

2010-05-14

To develop a classification of tertiary cardiac DRGs in order to investigate differences in tertiary/secondary product mix across New Zealand district health boards (DHBs). 67 DRGs from 85,442 cardiac cases were analysed using cost weights and patient comorbidity complexity levels, which were used as a proxy for complexity. The research found high variability of severity within some DRGs. 5 DHBs are the main providers of 27 DRGs which are high cost and identified as tertiary by several ADHB clinicians; the same 5 DHBs have on average higher severity by DRG than the other DHBs. NZ tertiary hospitals have a product mix of DRGs with higher complexity than secondary hospitals. Funding based on case weights needs to recognise the additional resource requirements for this higher complexity.

Must a Developed Democratic State Fully Resource Any Tertiary Education for Its Citizens?

ERIC Educational Resources Information Center

Scholes, Vanessa

2014-01-01

This article takes a parsimonious conception of a developed State operating under a minimalist conception of democracy and asks whether such a State must fully resource any tertiary (post-compulsory) education for its citizens A key public policy barrier to arguing an absolute obligation for the State to resource any tertiary education is…

ProteMiner-SSM: a web server for efficient analysis of similar protein tertiary substructures.

PubMed

Chang, Darby Tien-Hau; Chen, Chien-Yu; Chung, Wen-Chin; Oyang, Yen-Jen; Juan, Hsueh-Fen; Huang, Hsuan-Cheng

2004-07-01

Analysis of protein-ligand interactions is a fundamental issue in drug design. As the detailed and accurate analysis of protein-ligand interactions involves calculation of binding free energy based on thermodynamics and even quantum mechanics, which is highly expensive in terms of computing time, conformational and structural analysis of proteins and ligands has been widely employed as a screening process in computer-aided drug design. In this paper, a web server called ProteMiner-SSM designed for efficient analysis of similar protein tertiary substructures is presented. In one experiment reported in this paper, the web server has been exploited to obtain some clues about a biochemical hypothesis. The main distinction in the software design of the web server is the filtering process incorporated to expedite the analysis. The filtering process extracts the residues located in the caves of the protein tertiary structure for analysis and operates with O(nlogn) time complexity, where n is the number of residues in the protein. In comparison, the alpha-hull algorithm, which is a widely used algorithm in computer graphics for identifying those instances that are on the contour of a three-dimensional object, features O(n2) time complexity. Experimental results show that the filtering process presented in this paper is able to speed up the analysis by a factor ranging from 3.15 to 9.37 times. The ProteMiner-SSM web server can be found at http://proteminer.csie.ntu.edu.tw/. There is a mirror site at http://p4.sbl.bc.sinica.edu.tw/proteminer/.

The Role of Present Time Perspective in Predicting Early Adolescent Violence.

PubMed

Kruger, Daniel J; Carrothers, Jessica; Franzen, Susan P; Miller, Alison L; Reischl, Thomas M; Stoddard, Sarah A; Zimmerman, Marc A

2018-06-01

This study investigated the role of present and future time perspectives, and their relationships with subjective norms and beliefs regarding violence, in predicting violent behaviors among urban middle school students in the Midwestern United States. Although present time perspective covaried with subjective norms and beliefs, each made a unique prediction of self-reported violent behaviors. Future time perspective was not a significant predictor when accounting for these relationships. In addition, present orientation moderated the relationship between subjective norms and beliefs and rates of violent behaviors; those with higher present orientations exhibited stronger associations. We replicated this pattern of results in data from new participants in a subsequent wave of the study. Interventions that explicitly address issues related to time perspective may be effective in reducing early adolescent violence.

Design and characterization of a dead-time regime enhanced early photon projection imaging system

NASA Astrophysics Data System (ADS)

Sinha, L.; Fogarty, M.; Zhou, W.; Giudice, A.; Brankov, J. G.; Tichauer, K. M.

2018-04-01

Scattering of visible and near-infrared light in biological tissue reduces spatial resolution for imaging of tissues thicker than 100 μm. In this study, an optical projection imaging system is presented and characterized that exploits the dead-time characteristics typical of photon counting modules based on single photon avalanche diodes (SPADs). With this system, it is possible to attenuate the detection of more scattered late-arriving photons, such that detection of less scattered early-arriving photons can be enhanced with increased light intensity, without being impeded by the maximum count rate of the SPADs. The system has the potential to provide transmittance-based anatomical information or fluorescence-based functional information (with slight modification in the instrumentation) of biological samples with improved resolution in the mesoscopic domain (0.1-2 cm). The system design, calibration, stability, and performance were evaluated using simulation and experimental phantom studies. The proposed system allows for the detection of very-rare early-photons at a higher frequency and with a better signal-to-noise ratio. The experimental results demonstrated over a 3.4-fold improvement in the spatial resolution using early photon detection vs. conventional detection, and a 1000-fold improvement in imaging time using enhanced early detection vs. conventional early photon detection in a 4-mm thick phantom with a tissue-equivalent absorption coefficient of μa = 0.05 mm-1 and a reduced scattering coefficient of μs' = 5 mm-1.

Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center.

PubMed

Valsangkar, Nakul P; Eppstein, Andrew C; Lawson, Rick A; Taylor, Amber N

2017-01-01

There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center. All patients evaluated by the general surgery department through outpatient clinics, clinical video teleconferencing, and e-consultations from October 2011 through September 2014 were included. Patients evaluated through the emergency department or as inpatient consults were excluded. The surgery service and systems redesign service held a value stream analysis in FY 2013, culminating in multiple rapid process improvement workshops. Multidisciplinary teams identified systemic inefficiencies and strategies to improve interdepartmental and patient communication to reduce canceled consultations and cases, diagnostic rework, and no-shows. High-priority triage with enhanced operating room flexibility was instituted to reduce scheduling wait times. General surgery department pilot projects were then implemented mid-FY 2013. Planned outcome measures included wait time, clinic and telehealth volume, number of no-shows, and operative volume. Paired t tests were used to identify differences in outcome measures after the institution of reforms. Following rapid process improvement workshop project rollouts, mean

Tertiary paediatric emergency department use in children and young people with cerebral palsy.

PubMed

Meehan, Elaine; Reid, Susan M; Williams, Katrina; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Rawicki, Barry; Reddihough, Dinah S

2015-10-01

The aim of this study was to describe the pattern of tertiary paediatric emergency department (ED) use in children and young people with cerebral palsy (CP). A retrospective analysis of ED data routinely collected at the two tertiary paediatric hospitals in Victoria, Australia, cross-matched with the Victorian Cerebral Palsy Register. Data pertaining to the ED presentations of 2183 registered individuals born 1993-2008 were obtained. Between 2008 and 2012, 37% (n = 814) of the CP cohort had 3631 tertiary paediatric ED presentations. Overall, 40% (n = 332) of presenters were residing in inner metropolitan Melbourne; 44% (n = 356) in outer Melbourne; and 13% (n = 108) in regional Victoria. Presenters were more likely than non-presenters to be younger, non-ambulant and have epilepsy. In total, 71% of presentations were triaged as Australasian Triage Scale 1-3 (urgent), and 44% resulted in a hospital admission. Disorders of the respiratory, neurological and gastrointestinal systems, and medical device problems were responsible for 72% of presentations. Many of the tertiary paediatric ED presentations in this group were appropriate based on the high admission rate and the large proportion triaged as urgent. However, there is evidence that some families are bypassing local services and travelling long distances to attend the tertiary paediatric ED, even for less urgent complaints that do not require hospital admission. Alternative pathways of care delivery, and strategies to promote the management of common problems experienced by children and young people with CP in non-paediatric EDs or primary care settings, may go some way towards reducing unnecessary tertiary paediatric ED use in this group. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Detrimental Psychological Outcomes Associated with Early Pubertal Timing in Adolescent Girls

PubMed Central

Mendle, Jane; Turkheimer, Eric; Emery, Robert E.

2010-01-01

Though often discussed as though it were a discrete event, puberty comprises one segment of a larger developmental continuum and is notable for rapid transformation across a multitude of domains. Research suggests that an earlier rate of pubertal maturation in girls correlates with a number of detrimental outcomes compared with on-time or later maturation. The present review synthesizes the research on negative psychological sequelae of early pubertal timing in adolescent girls. Emphasis is on three theoretical perspectives by which precocious development is believed to affect the emergence of adverse outcomes: biological, psychosocial, and selection effects. PMID:20740062

Discovery of Tertiary Sulfonamides as Potent Liver X Receptor Antagonists

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

Zuercher, William J.; Buckholz†, Richard G.; Campobasso, Nino

2010-08-12

Tertiary sulfonamides were identified in a HTS as dual liver X receptor (LXR, NR1H2, and NR1H3) ligands, and the binding affinity of the series was increased through iterative analogue synthesis. A ligand-bound cocrystal structure was determined which elucidated key interactions for high binding affinity. Further characterization of the tertiary sulfonamide series led to the identification of high affinity LXR antagonists. GSK2033 (17) is the first potent cell-active LXR antagonist described to date. 17 may be a useful chemical probe to explore the cell biology of this orphan nuclear receptor.

Discovery of tertiary sulfonamides as potent liver X receptor antagonists.

PubMed

Zuercher, William J; Buckholz, Richard G; Campobasso, Nino; Collins, Jon L; Galardi, Cristin M; Gampe, Robert T; Hyatt, Stephen M; Merrihew, Susan L; Moore, John T; Oplinger, Jeffrey A; Reid, Paul R; Spearing, Paul K; Stanley, Thomas B; Stewart, Eugene L; Willson, Timothy M

2010-04-22

Tertiary sulfonamides were identified in a HTS as dual liver X receptor (LXR, NR1H2, and NR1H3) ligands, and the binding affinity of the series was increased through iterative analogue synthesis. A ligand-bound cocrystal structure was determined which elucidated key interactions for high binding affinity. Further characterization of the tertiary sulfonamide series led to the identification of high affinity LXR antagonists. GSK2033 (17) is the first potent cell-active LXR antagonist described to date. 17 may be a useful chemical probe to explore the cell biology of this orphan nuclear receptor.

Transmembrane Segments Form Tertiary Hairpins in the Folding Vestibule of the Ribosome.

PubMed Central

Tu, LiWei; Khanna, Pooja; Deutsch, Carol

2013-01-01

Folding of membrane proteins begins in the ribosome as the peptide is elongated. During this process, the nascent peptide navigates along 100 Å of tunnel from the peptidyltransferase center to the exit port. Proximal to the exit port is a ‘folding vestibule’ that permits the nascent peptide to compact and explore conformational space for potential tertiary folding partners. The latter occurs for cytosolic subdomains, but has not yet been shown for transmembrane segments. We now demonstrate, using an accessibility assay and an improved, intramolecular crosslinking assay, that the helical transmembrane S3b-S4 hairpin (‘paddle’) of a voltage-gated potassium (Kv) channel, a critical region of the Kv voltage sensor, forms in the vestibule. S3-S4 hairpin interactions are detected at an early stage of Kv biogenesis. Moreover, this vestibule hairpin is consistent with a closed-state conformation of the Kv channel in the plasma membrane. PMID:24055377

Diachronism between extinction time of terrestrial and marine dinosaurs

NASA Technical Reports Server (NTRS)

Hansen, H. J.

1988-01-01

The dinosaur eggs of southern France occur in continental, fine-grained red-beds, rich in carbonate. The last eggs in the region occur in the magnetic polarity interval 30 normal. Estimates of the accumulation rate of these sediments on the basis of the magneto-stratigraphy leads to placement of the time of disappearance of the dinosaurs in this region of 200,000 to 400,000 years earlier than the Cretaceous-Tertiary boundary. In the Red Deer Valley, Canada, estimates of average accumulation rate lead to a time of disappearance of the dinosaurs of 135,000 to 157,000 years earlier than the Cretaceous-Tertiary boundary. In the central part of Poland, in the Nasilow Quarry, the paleomagnetic pattern shows 7 m of chalk of reversed polarity containing in its upper part the marine Cretaceous-Tertiary biostratigraphic boundary. A greensand deposit contains numerous re-deposited Maastrichtian fossils. The fossils show no signs of wear and are of very different sizes including 1 mm thick juvenile belemnites. The deposit was described as a lag-sediment. Among the various fossils are teeth of mosasaurs. Thus there is coincidence in time between the extinction of mosasaurs and other Cretaceous organisms. This leads to the conclusion, that extinction of terrestrial dinosaurs took place earlier than extinction of marine dinosaurs at the Cretaceous-Tertiary boundary.

Tertiary work-up of apparent treatment-resistant hypertension.

PubMed

Heimark, Sondre; Eskås, Per Anders; Mariampillai, Julian Eek; Larstorp, Anne Cecilie K; Høieggen, Aud; Fadl Elmula, Fadl Elmula M

2016-10-01

Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of tertiary work-up and also investigate reasons for poor BP control and evaluate how work-up can be performed in general practice and secondary care. In this cohort study, we characterize a study population from Oslo Renal Denervation (RDN) Study. Patients (n = 83) were referred for RDN from secondary care. All patients underwent thorough medical investigation and 24-h ambulatory blood pressure measurements (24ABPM) after directly observed therapy (DOT). We then assessed reasons for lack of BP control. Fifty-three of 83 patients did not have true TRH. Main reasons for non-TRH were poor drug adherence (32%), secondary hypertension (30%) and white coat hypertension (15%). Forty-seven percent achieved blood pressure control after DOT with subsequent 24ABPM. There were otherwise no statistically significant differences in patient characteristics between the true TRH and the non-TRH group. Despite being a highly selected cohort referred for tertiary work-up of apparent TRH, BP control was achieved or secondary causes were identified in almost two thirds of the patients. Thorough investigation according to guidelines and DOT with subsequent 24ABPM is needed in work-up of apparent TRH.

Physiological responses of three deciduous conifers (Metasequoia glyptostroboides, Taxodium distichum and Larix laricina) to continuous light: adaptive implications for the early Tertiary polar summer.

PubMed

Equiza, M Alejandra; Day, Michael E; Jagels, Richard

2006-03-01

Polar regions were covered with extensive forests during the Cretaceous and early Tertiary, and supported trees comparable in size and productivity to those of present-day temperate forests. With a winter of total or near darkness and a summer of continuous, low-angle illumination, these temperate, high-latitude forests were characterized by a light regime without a contemporary counterpart. Although maximum irradiances were much lower than at mid-latitudes, the 24-h photoperiod provided similar integrated light flux. Taxodium, Larix and Metasequoia, three genera of deciduous conifers that occurred in paleoarctic wet forests, have extant, closely related descendents. However, the contemporary relative abundance of these genera differs greatly from that in the paleoarctic. To provide insight into attributes that favor competitive success in a continuous-light environment, we subjected saplings of these genera to a natural photoperiod or a 24-h photoperiod and measured gas exchange, chlorophyll fluorescence, non-structural carbohydrate concentrations, biomass production and carbon allocation. Exposure to continuous light significantly decreased photosynthetic capacity and quantum efficiency of photosystem II in Taxodium and Larix, but had minimal influence in Metasequoia. In midsummer, foliar starch concentration substantially increased in both Taxodium and Larix saplings grown in continuous light, which may have contributed to end-product down-regulation of photosynthetic capacity. In contrast, Metasequoia allocated photosynthate to continuous production of new foliar biomass. This difference in carbon allocation may have provided Metasequoia with a two fold advantage in the paleoarctic by minimizing depression of photosynthetic capacity and increasing photosynthetic surface.

Examination of factors predicting secondary students' interest in tertiary STEM education

NASA Astrophysics Data System (ADS)

Chachashvili-Bolotin, Svetlana; Milner-Bolotin, Marina; Lissitsa, Sabina

2016-02-01

Based on the Social Cognitive Career Theory (SCCT), the study aims to investigate factors that predict students' interest in pursuing science, technology, engineering, and mathematics (STEM) fields in tertiary education both in general and in relation to their gender and socio-economic background. The results of the analysis of survey responses of 2458 secondary public school students in the fifth-largest Israeli city indicate that STEM learning experience positively associates with students' interest in pursuing STEM fields in tertiary education as opposed to non-STEM fields. Moreover, studying advanced science courses at the secondary school level decreases (but does not eliminate) the gender gap and eliminates the effect of family background on students' interest in pursuing STEM fields in the future. Findings regarding outcome expectations and self-efficacy beliefs only partially support the SCCT model. Outcome expectations and self-efficacy beliefs positively correlate with students' entering tertiary education but did not differentiate between their interests in the fields of study.

Benchmarking Australian and New Zealand University Meta-Policy in an Increasingly Regulated Tertiary Environment

ERIC Educational Resources Information Center

Freeman, Brigid

2014-01-01

The agencies responsible for tertiary education quality assurance in Australia and New Zealand have established regulatory regimes that increasingly intersect with tertiary institution policy management. An examination of university meta-policies identified good practices guiding university policy and policy management. Most Australian and half of…

Early Pubertal Timing as a Vulnerability to Depression Symptoms: Differential Effects of Race and Sex

PubMed Central

Hamlat, Elissa J.; Stange, Jonathan P.; Alloy, Lauren B.; Abramson, Lyn Y.

2013-01-01

Robust evidence supports that girls and boys who experience early pubertal timing, maturing earlier than one’s peers, are vulnerable to developing symptoms of depression. However, it has yet to be clarified whether early pubertal timing confers vulnerability to African American as well as to Caucasian adolescents and whether this vulnerability is specific to depressive symptoms or can be generalized to symptoms of social anxiety. In previous studies, one race or one sex was examined in isolation or sample sizes were too small to examine racial differences. Our longitudinal study consisted of a sample of 223 adolescents (Mean age = 12.42, 54.3% female, 50.2% African American, and 49.8% Caucasian). At baseline, depressive symptoms, social anxiety symptoms, and pubertal timing were assessed by self-report. Nine months later, we assessed depressive symptoms, social anxiety symptoms, body esteem, and stressful life events that occurred between baseline and follow-up. Analyses indicated that early pubertal timing interacted with stressful life events to predict increased symptoms of depression, but only for Caucasian girls and African American boys. Results were found to be specific to depressive symptoms and did not generalize to symptoms of social anxiety. Additionally, there was a significant positive indirect effect of pubertal timing on symptoms of depression through body esteem for Caucasian females. PMID:24014162

Time to hospitalization for suicide attempt by the timing of parental suicide during offspring early development

PubMed Central

Kuramoto, S. Janet; Runeson, Bo; Stuart, Elizabeth A.; Lichtenstein, Paul; Wilcox, Holly C.

2013-01-01

Context Previous studies have suggested that children who experience parental suicide at earlier ages are at higher risk of future hospitalization for suicide attempt. However, how the trajectories of risk differ by offspring age at the time of parental suicide is currently unknown. Objective To study time at risk to hospitalization for suicide attempt among offspring after experiencing parental suicide or accidental death by offspring developmental period at the time of parental death. Design Population-based retrospective cohort study Setting Sweden Participants 26,096 offspring who experienced parental suicide and 32,395 offspring of accident decedents prior to age 25 from 1973-2003. Main Outcome Measures Hospitalization for suicide attempt. Parametric survival analysis was used to model the time to hospitalization for suicide attempt across offspring who lost a parent during early childhood (0-5 years old), later childhood (6-12), adolescence (13-17) and young adulthood (18-24). Results The risk in offspring who lost a parent during early or late childhood surpassed the other two age groups’ hazards approximately 5 years after the origin and, for the youngest group, continued to rise over the course of decades. Offspring who lost a parent during adolescence or young adulthood were at greatest risk within 1 to 2 years after parental suicide, and risk declined over time. The shape of hospitalization risk was similar among those who experienced parental fatal accident. When the shape of hospitalization for suicide attempt at each developmental period was fixed to be the same between the two groups, offspring who lost a parent to suicide had earlier risk to hospitalization for suicide attempt hospitalization than offspring who lost a parent to an accident. Conclusion The hospitalization risk for suicide attempt in offspring who lost a parent during their childhood is different from those who lost a parent during adolescence or young adulthood. The results suggest

Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

ERIC Educational Resources Information Center

Heng, Chan Swee; Ziguang, Yan

2015-01-01

In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be…

Students' Conceptions of the Particulate Nature of Matter at Secondary and Tertiary Level

ERIC Educational Resources Information Center

Ayas, Alipasa; Ozmen, Haluk; Calik, Muammer

2010-01-01

The aim of the present study is to elicit students' understanding of the particulate nature of matter via a cross-age study ranging from secondary to tertiary educational levels. A questionnaire with five-item open-ended questions was administered to 166 students from the secondary to tertiary levels of education. In light of the findings, it can…

Disaster resilience in tertiary hospitals: a cross-sectional survey in Shandong Province, China

PubMed Central

2014-01-01

Background Hospital disaster resilience can be defined as a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China. Methods A stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies. Results A response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a ‘portable hospital’ function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%. Conclusions This study validated the broad utility of a framework for understanding and measuring the

Major structural controls on the distribution of pre-Tertiary rocks, Nevada Test Site vicinity, southern Nevada

USGS Publications Warehouse

Cole, James C.

1997-01-01

The lateral and vertical distributions of Proterozoic and Paleozoic sedimentary rocks in southern Nevada are the combined products of original stratigraphic relationships and post-depositional faults and folds. This map compilation shows the distribution of these pre-Tertiary rocks in the region including and surrounding the Nevada Test Site. It is based on considerable new evidence from detailed geologic mapping, biostratigraphic control, sedimentological analysis, and a review of regional map relationships.Proterozoic and Paleozoic rocks of the region record paleogeographic transitions between continental shelf depositional environments on the east and deeper-water slopefacies depositional environments on the west. Middle Devonian and Mississippian sequences, in particular, show strong lateral facies variations caused by contemporaneous changes in the western margin of North America during the Antler orogeny. Sections of rock that were originally deposited in widely separated facies localities presently lie in close proximity. These spatial relationships chiefly result from major east- and southeastdirected thrusts that deformed the region in Permian or later time.Somewhat younger contractional structures are identified within two irregular zones that traverse the region. These folds and thrusts typically verge toward the west and northwest and overprint the relatively simple pattern of the older contractional terranes. Local structural complications are significant near these younger structures due to the opposing vergence and due to irregularities in the previously folded and faulted crustal section.Structural and stratigraphic discontinuities are identified on opposing sides of two north-trending fault zones in the central part of the compilation region north of Yucca Flat. The origin and significance of these zones are enigmatic because they are largely covered by Tertiary and younger deposits. These faults most likely result from significant lateral offset

Aquatic Life Criteria - Methyl Tertiary-Butyl Ether (MTBE)

EPA Pesticide Factsheets

Information pertaining to the 1999 Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Methyl Tertiary-Butyl Ether (MTBE) for freshwater and salt water. Information includes the safe levels of MTBE that should protect the majority of species.

The Cretaceous-Tertiary boundary biotic crisis in the Basque country

NASA Technical Reports Server (NTRS)

Lamolda, M. A.

1988-01-01

The Zumaya section has been selected as a classic locality for the study of the Cretaceous-Tertiary (K-T) boundary due to its richness in microfaune, macrofaune, and nannoflora. The sections present similar good conditions for the study of the K-T boundary. The sedimentary rocks of the Uppermost Maastrichtian from the Basque Country are purple or pink marls and marls-tones. Above it is found a clayed bed, 40 to 29 cm thick, grey or dark grey in its basal part, of Lowermost Danian age. Above there is alternation of micritic grey-pink limestones and thin clay beds of Dano-Montian age. The average sedimentation is 7 to 8 times higher during the Upper Maastrichtian than in the Dano-Montian. The macrofauna underwent a decrease since the Campanian and was not found in the last 11 m of the Zumaya section; it was associated with changes in paleoceanographic conditions and primary productivity of the oceans. The microfossil assemblages in the K-T transition allows the recognition of several phases of a complex crisis between two well established planktonic ecosystems. In the Mayaroensis Zone there is a stable ecosystem with 45 to 47 planktonic foraminifera species. The disappearance of A. mayaroensis starts a degradation of the ecosystem. The number of planktonic foraminiera species decreases between 20 and 45 percent. The next phase of the crisis was the result of main extinction events in the planktonic calcareous ecosystem. There are several cretaceous planktonic foraminifera species, probably reworked, whose numbers decrease upward. The next and last phase of the biotic crisis shows a diversification of the ecosystem; the number of planktonic foraminifera is 2 to 3 times higher than before and it is noted the first appearance of Tertiary nannoflora species, while Cretaceous species decrease and persisting species are still the main ones.

The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.

PubMed

Benninger, Michael S; Derakhshan, Adeeb; Milstein, Claudio F

2015-07-01

Retrospective chart review. To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis. The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis. Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations. The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23). The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important. © The Author(s) 2015.

Discovering Tertiary Education through Others' Eyes and Words: Exploring Submissions to New Zealand's Review of Its Tertiary Education Sector

ERIC Educational Resources Information Center

Shephard, Kerry

2017-01-01

A general inductive analysis was applied to 98 submissions made to a recent review of New Zealand's tertiary education system, primarily to enable those interested to engage with multiple viewpoints about this highly complex educational system. The analysis yielded three substantial themes that reoccur throughout the submissions and that may…

Impact of real-time notification of Clostridium difficile test results and early initiation of effective antimicrobial therapy.

PubMed

Polen, Christian B; Judd, William R; Ratliff, Patrick D; King, Gregory S

2018-05-01

Clostridium difficile is a prominent nosocomial pathogen and is the most common causative organism of health care-associated diarrhea. To our knowledge, no studies have investigated the impact of real-time notification of culture results with rapid antimicrobial stewardship program (ASP) intervention in the setting of C difficile infection (CDI). The purpose of this study was to assess the impact of real-time notification of detection of toxigenic C difficile by DNA amplification results in patients with confirmed CDI. This is a single-center, retrospective cohort study at a 433-bed tertiary medical center in central Kentucky. The study consisted of 2 arms: patients treated for CDI prior to implementation of real-time provider notification and patients postimplementation. The primary outcome was time to initiation of effective antimicrobial therapy. The median time to initiation of effective antimicrobial therapy decreased from 5.75 hours in the preimplementation cohort to 2.05 hours in the postimplementation cohort (P = .001). ASP intervention also resulted in a shorter time from detection of CDI to order entry of effective antimicrobial therapy in the patient's electronic medical record (3.0 vs 0.6 hours; P = .001). The implementation of a real-time notification system to alert a pharmacist-led ASP of toxigenic CDI resulted in statistically significant shorter times to order entry and subsequent initiation of effective antimicrobial therapy and contact precautions. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Forecasting Tidal Disruption Events for Binary Black Holes with an Outer Tertiary.

PubMed

Seto, Naoki; Kyutoku, Koutarou

2017-04-14

We discuss the gravitational wave (GW) emission and the orbital evolution of a hierarchical triple system composed of an inner binary black hole (BBH) and an outer tertiary. Depending on the kick velocity at the merger, the merged BBH could tidally disrupt the tertiary. Even though the fraction of BBH mergers accompanied by such disruptions is expected to be much smaller than unity, the existence of a tertiary and its basic parameters (e.g., semimajor axis, projected mass) can be examined for more than 10^{3} BBHs with the follow-on missions to the space GW detector LISA. This allows us to efficiently prescreen the targets for the follow-up searches for the tidal disruption events (TDEs). The TDE probability would be significantly higher for triple systems with aligned orbital- and spin-angular momenta, compared with random configurations.

Detection of early postseismic deformation from high-rate GNSS time series

NASA Astrophysics Data System (ADS)

Twardzik, C.; Vergnolle, M.; Avallone, A.; Sladen, A.

2017-12-01

Postseismic processes after an earthquake contribute to the redistribution of stresses in addition to that induced by the coseismic rupture. With the exception of very few studies (e.g., Miyazaki and Larson, 2008), most postseismic analyses only start one or two days following the mainshock. This leaves a critical part of postseismic phase unexplored, from a few minutes up to a few hours after the earthquake. In this study, we use kinematic precise point positioning (K-PPP) to analyze continuous GNSS data in order to obtain 30s position time series. These time series provide information on the surface displacements a soon as the dynamic response of the earthquake is over. Our first analysis focuses on the 2016 Pedernales, Ecuador, earthquake (Mw7.8). Using spectral analysis, we show that the typical logarithmic postseismic displacement trend can be detected as early as one to six hours after the earthquake depending on the station location and the level of noise. This analysis also allows to estimate the bias on the coseismic offsets usually based on daily pre- and post- earthquake positions. We use the early postseismic time series to test whether rate-and-state friction laws, traditionally used to explain postseismic processes days after the earthquake, still hold right after the mainshock. This study is being extended to two other subduction earthquakes: the 2010 Maule, Chile, earthquake (Mw8.8) and the 2015 Illapel, Chile, earthquake (Mw8.2).

Early mechanical stimulation only permits timely bone healing in sheep.

PubMed

Tufekci, Pelin; Tavakoli, Aramesh; Dlaska, Constantin; Neumann, Mirjam; Shanker, Mihir; Saifzadeh, Siamak; Steck, Roland; Schuetz, Michael; Epari, Devakar

2018-06-01

Bone fracture healing is sensitive to the fixation stability. However, it is unclear which phases of healing are mechano-sensitive and if mechanical stimulation is required throughout repair. In this study, a novel bone defect model, which isolates an experimental fracture from functional loading, was applied in sheep to investigate if stimulation limited to the early proliferative phase is sufficient for bone healing. An active fixator controlled motion in the fracture. Animals of the control group were unstimulated. In the physiological-like group, 1 mm axial compressive movements were applied between day 5 and 21, thereafter the movements were decreased in weekly increments and stopped after 6 weeks. In the early stimulatory group, the movements were stopped after 3 weeks. The experimental fractures were evaluated with mechanical and micro-computed tomography methods after 9 weeks healing. The callus strength of the stimulated fractures (physiological-like and early stimulatory) was greater than the unstimulated control group. The control group was characterized by minimal external callus formation and a lack of bone bridging at 9 weeks. In contrast, the stimulated groups exhibited advanced healing with solid bone formation across the defect. This was confirmed quantitatively by a lower bone volume in the control group compared to the stimulated groups.The novel experimental model permits the application of a well-defined load history to an experimental bone fracture. The poor healing observed in the control group is consistent with under-stimulation. This study has shown early mechanical stimulation only is sufficient for a timely healing outcome. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1790-1796, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Digital surfaces and hydrogeologic data for the Mesozoic through early Tertiary rocks in the Southeastern Coastal Plain in parts of Mississippi, Alabama, Georgia, South Carolina, and Florida

USGS Publications Warehouse

Cannon, Debra M.; Bellino, Jason C.; Williams, Lester J.

2012-01-01

A digital dataset of hydrogeologic data for Mesozoic through early Tertiary rocks in the Southeastern Coastal Plain was developed using data from five U.S. Geological Survey (USGS) reports published between 1951 and 1996. These reports contain maps and data depicting the extent and elevation of the Southeast Coastal Plain stratigraphic and hydrogeologic units in Florida and parts of Mississippi, Alabama, Georgia, and South Carolina. The reports are: Professional Paper 1410-B (Renken, 1996), Professional Paper 1088 (Brown and others, 1979), Professional Paper 524-G (Applin and Applin, 1967), Professional Paper 447 (Applin and Applin, 1965), and Circular 91 (Applin, 1951). The digital dataset provides hydrogeologic data for the USGS Energy Resources Program assessment of potential reservoirs for carbon sequestration and for the USGS Groundwater Resource Program assessment of saline aquifers in the southeastern United States. A Geographic Information System (ArcGIS 9.3.1) was used to construct 33 digital (raster) surfaces representing the top or base of key stratigraphic and hydrogeologic units. In addition, the Geographic Information System was used to generate 102 geo-referenced scanned maps from the five reports and a geo-database containing structural and thickness contours, faults, extent polygons, and common features. The dataset also includes point data of well construction and stratigraphic elevations and scanned images of two geologic cross sections and a nomenclature chart.

Two new carnivores from an unusual late Tertiary forest biota in eastern North America.

PubMed

Wallace, Steven C; Wang, Xiaoming

2004-09-30

Late Cenozoic terrestrial fossil records of North America are biased by a predominance of mid-latitude deposits, mostly in the western half of the continent. Consequently, the biological history of eastern North America, including the eastern deciduous forest, remains largely hidden. Unfortunately, vertebrate fossil sites from this vast region are rare, and few pertain to the critically important late Tertiary period, during which intensified global climatic changes took place. Moreover, strong phylogenetic affinities between the flora of eastern North America and eastern Asia clearly demonstrate formerly contiguous connections, but disparity among shared genera (eastern Asia-eastern North America disjunction) implies significant periods of separation since at least the Miocene epoch. Lacustrine sediments deposited within a former sinkhole in the southern Appalachian Mountains provide a rare example of a late Miocene to early Pliocene terrestrial biota from a forested ecosystem. Here we show that the vertebrate remains contained within this deposit represent a unique combination of North American and Eurasian taxa. A new genus and species of the red (lesser) panda (Pristinailurus bristoli), the earliest and most primitive so far known, was recovered. Also among the fauna are a new species of Eurasian badger (Arctomeles dimolodontus) and the largest concentration of fossil tapirs ever recorded. Cladistical analyses of the two new carnivores strongly suggest immigration events that were earlier than and distinct from previous records, and that the close faunal affinities between eastern North America and eastern Asia in the late Tertiary period are consistent with the contemporaneous botanical record.

Early time evolution of a chemically produced electron depletion

NASA Technical Reports Server (NTRS)

Scales, W. A.; Bernhardt, P. A.; Ganguli, G.

1995-01-01

The early time evolution of an ionospheric electron depletion produced by a radially expanding electron attachment chemical release is studied with a two-dimensional simulation model. The model includes electron attachment chemistry, incorporates fluid electrons, particle ions and neutrals, and considers the evolution in a plane perpendicular to the geomagnetic field for a low beta plasma. Timescales considered are of the order of or less than the cyclotron period of the negative ions that result as a by-product of the electron attacment reaction. This corresponds to time periods of tenths of seconds during recent experiemts. Simulation results show that a highly sheared azimuthal electron flow velocity develops in the radially expanding depletion boundary. This sheared electron flow velocity and the steep density gradients in the boundary give rise to small-scale irregulatities in the form of electron density cavities and spikes. The nonlinear evolution of these irregularities results in trapping and ultimately turbulent heating of the negative ions.

Group-Based Modeling of Time Spent in Structured Activity Trajectories from Middle Childhood into Early Adolescence

ERIC Educational Resources Information Center

Mata, Andrea D.; van Dulmen, Manfred H. M.

2012-01-01

This study investigated trajectories of time spent in structured activities from middle childhood to early adolescence by using data from the National Institute of Child Health & Human Development (NICHD) Study of Early Child Care. We used latent class growth analyses and identified five trajectories (stable low, increasing high, decreasing low,…

r-Process Nucleosynthesis in the Early Universe Through Fast Mergers of Compact Binaries in Triple Systems

NASA Astrophysics Data System (ADS)

Bonetti, Matteo; Perego, Albino; Capelo, Pedro R.; Dotti, Massimo; Miller, M. Coleman

2018-05-01

Surface abundance observations of halo stars hint at the occurrence of r-process nucleosynthesis at low metallicity ([Fe/H] < -3), possibly within the first 108 yr after the formation of the first stars. Possible loci of early-Universe r-process nucleosynthesis are the ejecta of either black hole-neutron star or neutron star-neutron star binary mergers. Here, we study the effect of the inclination-eccentricity oscillations raised by a tertiary (e.g. a star) on the coalescence time-scale of the inner compact object binaries. Our results are highly sensitive to the assumed initial distribution of the inner binary semi-major axes. Distributions with mostly wide compact object binaries are most affected by the third object, resulting in a strong increase (by more than a factor of 2) in the fraction of fast coalescences. If instead the distribution preferentially populates very close compact binaries, general relativistic precession prevents the third body from increasing the inner binary eccentricity to very high values. In this last case, the fraction of coalescing binaries is increased much less by tertiaries, but the fraction of binaries that would coalesce within 108 yr even without a third object is already high. Our results provide additional support to the compact-binary merger scenario for r-process nucleosynthesis.

Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

PubMed

Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

2013-06-01

Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (Etbe) ...

EPA Pesticide Factsheets

In September 2016, EPA released the draft IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) for public comment and discussion. The draft assessment was reviewed internally by EPA and by other federal agencies and White House Offices before public release. Consistent with the May 2009 IRIS assessment development process, all written comments on IRIS assessments submitted by other federal agencies and White House Offices are made publicly available. Accordingly, interagency comments and the interagency science consultation materials provided to other agencies, including interagency review drafts of the IRIS Toxicological Review of Ethyl Tertiary Butyl Ether are posted on this site. EPA is undertaking an new health assessment for ethyl tertiary butyl ether (ETBE) for the Integrated Risk Information System (IRIS). The outcome of this project will be a Toxicological Review and IRIS Summary of ETBE that will be entered on the IRIS database. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment process, i.e., hazard identification and dose-response evaluation. IRIS assessments are used nationally and internationally in combination with specific situational exposure assessment infor

Ultrasonic RF time series for early assessment of the tumor response to chemotherapy.

PubMed

Lin, Qingguang; Wang, Jianwei; Li, Qing; Lin, Chunyi; Guo, Zhixing; Zheng, Wei; Yan, Cuiju; Li, Anhua; Zhou, Jianhua

2018-01-05

Ultrasound radio-frequency (RF) time series have been shown to carry tissue typing information. To evaluate the potential of RF time series for early prediction of tumor response to chemotherapy, 50MCF-7 breast cancer-bearing nude mice were randomized to receive cisplatin and paclitaxel (treatment group; n = 26) or sterile saline (control group; n = 24). Sequential ultrasound imaging was performed on days 0, 3, 6, and 8 of treatment to simultaneously collect B-mode images and RF data. Six RF time series features, slope, intercept, S1, S2, S3 , and S4 , were extracted during RF data analysis and contrasted with microstructural tumor changes on histopathology. Chemotherapy administration reduced tumor growth relative to control on days 6 and 8. Compared with day 0, intercept, S1 , and S2 were increased while slope was decreased on days 3, 6, and 8 in the treatment group. Compared with the control group, intercept, S1, S2, S3 , and S4 were increased, and slope was decreased, on days 3, 6, and 8 in the treatment group. Tumor cell density decreased significantly in the latter on day 3. We conclude that ultrasonic RF time series analysis provides a simple way to noninvasively assess the early tumor response to chemotherapy.

RESULTS OF A DATING ATTEMPT -CHEMICAL AND PHYSICAL MEASUREMENTS RELEVANT TO THE CASE OF THE CRETACEOUS TERTIARY EXTINCTIONS

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

Asaro, Frank; Michel, Helen V.; Alvarez, Luis W.

1980-09-01

In Gubbio, Italy, a l em layer of clay between extensive limestone formations marks the boundary between the Cretaceous and Tertiary Periods. This clay layer was known to have been deposited about 65 million years ago when many life forms became extinct, but the length of time associated with the deposition was not known. In an attempt to measure this time with normally deposited meteoritic material as a clock, extensive measurements of iridium abundances (and those of many other elements) were made on the Gubbio rocks. Neutron activation analysis was the principal tool used in these studies. About 50 elementsmore » are searched for in materials like the earth's crust, about 40 are detected and about 30 are measured with useful precision. We were not able to determine exactly how long the clay deposition took. Instead the laboratory studies on the chemical and physical nature of the Cretaceous-Tertiary boundary led to the theory that an asteroid collision with the earth was responsible for the extinction of many forms of life including the dinosaurs.« less

Step-wise extinctions at the Cretaceous-Tertiary boundary and their climatic implications

NASA Technical Reports Server (NTRS)

Maurrasse, Florentin J-M. R.

1988-01-01

A comparative study of planktonic foraminifera and radiolarian assemblages from the Cretaceous-Tertiary (K-T) boundary section of the Beloc Formation in the southern Peninsula of Haiti, and the lowermost Danian sequence of the Micara Formation in southern Cuba reveals a remarkable pattern of step-wise extinctions. This pattern is consistent in both places despite the widely different lithologies of the two formations. Because of a step-wise extinction and the delayed disappearance of taxa known to be more representative of cooler water realms, it is inferred that a cooling trend which characterized the close of the Maastrichtian and the onset of the Tertiary had the major adverse effect on the existing biota. Although repetitive lithologic and faunal fluctuations throughout the Maastrichtian sediments found at Deep Sea Drilling Project (DSDP) site 146/149 in the Caribbean Sea indicate variations reminiscent of known climatically induced cycles in the Cenozoic, rapid biotic succession appears to have taken place during a crisis period of a duration greater than 2 mission years. Widespread and abundant volcanic activities recorded in the Caribbean area during the crisis period gives further credence to earlier contention that intense volcanism may have played a major role in exhacerbating pre-existing climatic conditions during that time.

Tertiary Students' ICT Self-Efficacy Beliefs and the Factors Affecting Their ICT-Use

ERIC Educational Resources Information Center

Turel, Vehbi; Calik, Sinan; Doganer, Adem

2015-01-01

This study looked at tertiary (i.e. undergraduate /a four-year degree) students' information and communication technology (ICT) self-efficacy beliefs and their level in use of certain common programmes at a newly established (i.e. 2007) university in Turkey in the spring of 2012. The study examined the tertiary students' (a) demographic…

Student Expectations of Tertiary Institutions: A Case Study of the Fiji National University (FNU)

ERIC Educational Resources Information Center

Khan, Shana Nigar

2012-01-01

Education is a human right and Fiji's tertiary education board recently declared that all tertiary institutions in Fiji must abide by the framework in order to meet student-customers' needs. The Fiji National University's (FNU's) destiny to be Fiji's leading higher education provider could be a reality if students and staff's expectations are…

Xeroderma pigmentosum at a tertiary care center in Saudi Arabia.

PubMed

Alwatban, Lenah; Binamer, Yousef

2017-01-01

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder caused by defective DNA repair that results in extreme sensitivity to ultraviolet (UV) rays. Depending on the type of XP, the disease may affect the skin, eyes and nervous system. Describe the dermatologic manifestations in patients suffering from XP. Retrospective, descriptive review of medical records. Dermatology clinic at tertiary care center in Riyadh. This study included Saudi patients with clinically confirmed XP. Demographic and clinical data including pathology and associated conditions and outcomes. Of 21 patients with XP, the most common manifestation was lentigines, affecting 18 patients (86%). The most common skin cancer was basal cell carcinoma followed by squamous cell carcinoma (SCC) affecting 15 (71.4%) and 9 (42.8%), respectively. Other skin findings included neurofibroma, trichilemmoma and seborrheic keratosis. Ocular involvement included photophobia, which was the most common finding followed by dryness and ocular malignancies. Two patients showed neurological involvement, which correlated with the type of mutation. Considering that XP is a rare genetic disease, this description of our patient population will aid in early recognition and diagnosis. Retrospective and small number of patients. Genetic analyses were done for only 5 of the 21 patients.

The three-dimensional feto-maternal vascular interrelationship during early bovine placental development: a scanning electron microscopical study

PubMed Central

PFARRER, CHRISTIANE; EBERT, BRIGITTE; MIGLINO, MARIA ANGELICA; KLISCH, KARL; LEISER, RUDOLF

2001-01-01

Both the fetal and maternal microvasculature of bovine placentomes was examined by scanning electron microscopy of vascular casts. So far the development of the vascular architecture of the bovine placentome in early gestation has only been studied 2-dimensionally due to technical difficulties arising from the fragility of the early placental blood vessels. Repeated experiments led to the selection of the microvascular corrosion casts presented here. The vasculature of the maternal compartment is supplied by large caruncular stalk or spiral arteries, which release short maternal stem arteries. In the 3rd month of gestation, these arteries branch into several arterioles at their base, thus providing the vascular framework for the lower part of the septal walls of the primary crypts. In the 4th month, due to progressive longitudinal growth of the stem arteries, branching into arterioles occurs not only at the base, but over the whole length of the stem arteries. These arterioles supply the capillary complexes of the septa which resemble the major part of the septal vasculature and face the secondary crypts. Further indentation results in the formation of tertiary crypt capillary complexes, encircling the earlier secondary unit. From the 6th month of gestation the architecture resembles the fully developed maternal placenta with stem arteries running directly to the fetal side to branch into 4 to 6 arterioles, which turn back to enter secondary and tertiary septa. Maternal venules, collecting the blood from the capillary bed of secondary and tertiary septa, converge onto stem veins leaving the caruncle via branches of the uterine vein. The fetal part of the placentome is supplied by the cotyledonary arteries, which branch into fetal stem arteries that are the tributary to single villous trees. Over their whole course towards the maternal side, these give off arterioles entering secondary villi. The tertiary or terminal villous vasculature consists of capillaries

Ketene reactions with tertiary amines.

PubMed

Allen, Annette D; Andraos, John; Tidwell, Thomas T; Vukovic, Sinisa

2014-01-17

Tertiary amines react rapidly and reversibly with arylketenes in acetonitrile forming observable zwitterions, and these undergo amine catalyzed dealkylation forming N,N-disubstituted amides. Reactions of N-methyldialkylamines show a strong preference for methyl group loss by displacement, as predicted by computational studies. Loss of ethyl groups in reactions with triethylamine also occur by displacement, but preferential loss of isopropyl groups in the phenylketene reaction with diisopropylethylamine evidently involves elimination. Quinuclidine rapidly forms long-lived zwitterions with arylketenes, providing a model for catalysis by cinchona and related alkaloids in stereoselective additions to ketenes.

A balancing act in an unknown territory: a metasynthesis of first-time mothers' experiences in early labour.

PubMed

Eri, Tine S; Bondas, Terese; Gross, Mechthild M; Janssen, Patricia; Green, Josephine M

2015-03-01

to integrate findings of individual studies in order to broaden the understanding of first-time mothers' experiences of early labour. the methodology was metasynthesis which is based on the interpretive meta-ethnography described by Noblit and Hare (1988). Metasynthesis is research on research which synthesises the findings of previous qualitative studies, and the focus is on interpretation and the creation of new knowledge. all included studies originated from high resource countries (USA 2, UK 4, and Scandinavia 5) and all were carried out in a context of hospital based maternity care. a total of 231 women participated in the studies. 11 articles were included. The main results are presented with the metaphor a balancing act in an unknown territory. The 'unknown territory' has a double meaning: as the personal experience of going into labour for the first time and as encountering the maternity care system. On both levels women have to make significant decisions: whether labour really has started and subsequently when to go to the hospital. A key challenge is to balance the arrival on the labour ward at the 'right' time, not too early and not too late. Arriving at the 'right' time leads to a positive path, while arriving 'too soon' might lead to a cascade of negative experiences. The results are further presented with five central themes: 'Finding out if labour has started is absorbing'; 'Dealing with labour at home'; 'Trying to arrive at the labour ward at the right time'; 'There is always a risk of being sent home'; 'Encountering health professionals arouses strong emotions'. the metasynthesis broadens the understanding of first-time mothers' experiences of early labour, and suggests that women's needs when planning a hospital birth are not being adequately met at this stage in the labour process. Three areas of future research are suggested: how to support and strengthen women during pregnancy in order to cope with early labour; women's experiences of early

Transition from Senior Secondary to Tertiary Languages Study: Student Attitudes in Three Sydney Schools

ERIC Educational Resources Information Center

Moloney, Robyn; Harbon, Lesley

2014-01-01

This paper reports on a small study of attitudes to tertiary language study amongst senior secondary language learners in three independent New South Wales schools. The study examines what elements of preparedness may be the most effective in supporting transition to tertiary study for this sample of languages students. An analysis of survey data…

Variation in Inflammatory/Regulatory Cytokines in Secondary, Tertiary, and Quaternary Challenges with Dengue Virus

PubMed Central

Sierra, Beatriz; Pérez, Ana B.; Alvarez, Mayling; García, Gissel; Vogt, Katrin; Aguirre, Eglys; Schmolke, Kathrin; Volk, Hans-Dieter; Guzmán, María G.

2012-01-01

Secondary heterologous dengue infection is a risk factor for severe disease manifestations because of the immune-enhancement phenomenon. Succeeding clinical infections are seldom reported, and the clinical course of tertiary and quaternary dengue infections is not clear. Cuba represents a unique environment to study tertiary/quaternary dengue infections in a population with known clinical and serologic dengue markers and no dengue endemicity. We took advantage of this exceptional epidemiologic condition to study the effect of primary, secondary, tertiary, and quaternary dengue infection exposure on the expression of pro-inflammatory and regulatory cytokines, critical in dengue infection pathogenesis, by using a dengue infection ex vivo model. Whereas secondary exposure induced a high cytokine response, we found a significantly lower expression of tumor necrosis factor-α, interferon-γ, interleukin-10, and tumor growth factor-β after tertiary and quaternary infectious challenge. Significant differences in expression of the cytokines were seen between the dengue immune profiles, suggesting that the sequence in which the immune system encounters serotypes may be important in determining the nature of the immune response to subsequent infections. PMID:22802438

Plants with double genomes might have had a better chance to survive the Cretaceous–Tertiary extinction event

PubMed Central

Fawcett, Jeffrey A.; Maere, Steven; Van de Peer, Yves

2009-01-01

Most flowering plants have been shown to be ancient polyploids that have undergone one or more whole genome duplications early in their evolution. Furthermore, many different plant lineages seem to have experienced an additional, more recent genome duplication. Starting from paralogous genes lying in duplicated segments or identified in large expressed sequence tag collections, we dated these youngest duplication events through penalized likelihood phylogenetic tree inference. We show that a majority of these independent genome duplications are clustered in time and seem to coincide with the Cretaceous–Tertiary (KT) boundary. The KT extinction event is the most recent mass extinction caused by one or more catastrophic events such as a massive asteroid impact and/or increased volcanic activity. These events are believed to have generated global wildfires and dust clouds that cut off sunlight during long periods of time resulting in the extinction of ≈60% of plant species, as well as a majority of animals, including dinosaurs. Recent studies suggest that polyploid species can have a higher adaptability and increased tolerance to different environmental conditions. We propose that polyploidization may have contributed to the survival and propagation of several plant lineages during or following the KT extinction event. Due to advantages such as altered gene expression leading to hybrid vigor and an increased set of genes and alleles available for selection, polyploid plants might have been better able to adapt to the drastically changed environment 65 million years ago. PMID:19325131

Secondary and tertiary isoquinoline alkaloids from Xylopia parviflora.

PubMed

Nishiyama, Yumi; Moriyasu, Masataka; Ichimaru, Momoyo; Iwasa, Kinuko; Kato, Atsushi; Mathenge, Simon G; Chalo Mutiso, Patrick B; Juma, Francis D

2006-12-01

From the secondary and tertiary alkaloidal fractions of the root and the bark of Xylopia parviflora (Annonaceae), the isoquinoline alkaloids, 10,11-dihydroxy-1,2-dimethoxynoraporphine and parvinine were isolated, along with 39 known alkaloids. Their structures were determined on the basis of analysis of spectroscopic data.

21 CFR 522.1885 - Prednisolone tertiary butylacetate suspension.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Prednisolone tertiary butylacetate suspension. 522.1885 Section 522.1885 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW...

Early deep sedation is associated with decreased in-hospital and two-year follow-up survival.

PubMed

Balzer, Felix; Weiß, Björn; Kumpf, Oliver; Treskatsch, Sascha; Spies, Claudia; Wernecke, Klaus-Dieter; Krannich, Alexander; Kastrup, Marc

2015-04-28

There is increasing evidence that deep sedation is detrimental to critically ill patients. The aim of this study was to examine effects of deep sedation during the early period after ICU admission on short- and long-term survival. In this observational, matched-pair analysis, patients receiving mechanical ventilation that were admitted to ICUs of a tertiary university hospital in six consecutive years were grouped as either lightly or deeply sedated within the first 48 hours after ICU admission. The Richmond Agitation-Sedation Score (RASS) was used to assess sedation depth (light sedation: -2 to 0; deep: -3 or below). Multivariate Cox regression was conducted to investigate the impact of early deep sedation within the first 48 hours of admission on in-hospital and two-year follow-up survival. In total, 1,884 patients met inclusion criteria out of which 27.2% (n = 513) were deeply sedated. Deeply sedated patients had longer ventilation times, increased length of stay and higher rates of mortality. Early deep sedation was associated with a hazard ratio of 1.661 (95% CI: 1.074 to 2.567; P = 0.022) for in-hospital survival and 1.866 (95% CI: 1.351 to 2.576; P < 0.001) for two-year follow-up survival. Early deep sedation during the first 48 hours of intensive care treatment was associated with decreased in-hospital and two-year follow-up survival. Since early deep sedation is a modifiable risk factor, this data shows an urgent need for prospective clinical trials focusing on light sedation in the early phase of ICU treatment.

Tertiary and Quaternary Research with Remote Sensing Methods

NASA Technical Reports Server (NTRS)

Conel, J. E.

1985-01-01

Problems encountered in mapping the Quaternary section of the Wind River Region using remote sensing methods are discussed. Analysis of the stratigraphic section is a fundamental aspect of the geologic study of sedimentary basins. Stratigraphic analysis of post-Cretaceous rocks in the Wind River Basin encounters problems of a distinctly different character from those involved in studying the pre-Cretaceous section. The interior of the basin is predominantly covered by Tertiary and Quaternary sediments. These rocks, except on the basin margin to the north, are mostly flat lying or gently dipping. The Tertiary section consists of sandstones, siltstones, and tuffaceous sediments, some variegated, but in general poorly bedded and of great lithologic similarity. The Quaternary sediments consist of terrace, fan, and debris tongue deposits, unconsolidated alluvium occupying the bottoms of modern watercourses, deposits of eolian origin and tufa. Terrace and fan deposits are compositionally diverse and reflect the lithologic diversity of the source terranes.

Standardization or Localization: A Study of Online Learning Programmes by Tertiary Institutions in Ghana

ERIC Educational Resources Information Center

Djan, Josephine; George, Babu

2016-01-01

Many universities in Ghana have had a desire to ensure equitable access to formal tertiary education for the growing number of the working public who have sought to improve or better their educational status in tertiary institutions. For many of these working public or individuals, it is almost impossible to stay off work to enrol in these…

Reaction Time Is Negatively Associated with Corpus Callosum Area in the Early Stages of CADASIL.

PubMed

Delorme, S; De Guio, F; Reyes, S; Jabouley, A; Chabriat, H; Jouvent, E

2017-11-01

Reaction time was recently recognized as a marker of subtle cognitive and behavioral alterations in the early clinical stages of CADASIL, a monogenic cerebral small-vessel disease. In unselected patients with CADASIL, brain atrophy and lacunes are the main imaging correlates of disease severity, but MR imaging correlates of reaction time in mildly affected patients are unknown. We hypothesized that reaction time is independently associated with the corpus callosum area in the early clinical stages of CADASIL. Twenty-six patients with CADASIL without dementia (Mini-Mental State Examination score > 24 and no cognitive symptoms) and without disability (modified Rankin Scale score ≤ 1) were compared with 29 age- and sex-matched controls. Corpus callosum area was determined on 3D-T1 MR imaging sequences with validated methodology. Between-group comparisons were performed with t tests or χ 2 tests when appropriate. Relationships between reaction time and corpus callosum area were tested using linear regression modeling. Reaction time was significantly related to corpus callosum area in patients (estimate = -7.4 × 10 3 , standard error = 3.3 × 10 3 , P = .03) even after adjustment for age, sex, level of education, and scores of depression and apathy (estimate = -12.2 × 10 3 , standard error = 3.8 × 10 3 , P = .005). No significant relationship was observed in controls. Corpus callosum area, a simple and robust imaging parameter, appears to be an independent correlate of reaction time at the early clinical stages of CADASIL. Further studies will determine whether corpus callosum area can be used as an outcome in future clinical trials in CADASIL or in more prevalent small-vessel diseases. © 2017 by American Journal of Neuroradiology.

Early elective cesarean delivery before 36 weeks vs late spontaneous delivery in infants with gastroschisis.

PubMed

Hadidi, Ahmed; Subotic, Ulrike; Goeppl, Maximilian; Waag, Karl-L

2008-07-01

The aim of this study is to assess the value of early elective cesarean delivery for patients with gastroschisis in comparison with late spontaneous delivery. Analysis of infants with gastroschisis admitted between 1986 and 2006 at a tertiary care center was performed. The findings were analyzed statistically. Eighty-six patients were involved in the study. This included 15 patients who underwent emergency cesarean delivery (EM CD group) because of fetal distress and/or bowel ischemia. The remaining 71 patients born electively were stratified into 4 groups. The early elective cesarean delivery (ECD) group included 23 patients born by ECD before 36 weeks; late vaginal delivery (LVD) group included 23 patients who had LVD after 36 weeks; 24 patients had LCD after 36 weeks because of delayed diagnosis that resulted in late referral; and 1 patient had early spontaneous vaginal delivery (EVD group) before 36 weeks. The mean time to start oral feeding, incidence of complications, and primary closure were significantly better in the ECD group than in the LVD group. The duration of ventilation and the length of stay were shorter in ECD group, but the difference was not statistically significant. Elective cesarean delivery before 36 weeks allows earlier enteral feeding and is associated with less complications and higher incidence of primary closure (statistically significant).

Innovating in the Real World: Exploring Institutional Effects on Tertiary Teacher Innovations in New Zealand

ERIC Educational Resources Information Center

Lawrence, Belinda

2018-01-01

Innovation is a key goal of many tertiary education and distance learning providers. This research explores how teachers and educational designers across three New Zealand tertiary institutions worked to innovatively achieve teaching goals. A longitudinal design using the Cultural Historical Activity Theory (CHAT) framework explored the influence…

Blended Learning and Team Teaching: Adapting Pedagogy in Response to the Changing Digital Tertiary Environment

ERIC Educational Resources Information Center

Crawford, Renée; Jenkins, Louise

2017-01-01

Increased accessibility of advanced technology, the targeted use of online learning platforms, student flexible learning expectations and the pressures of faculty budget constraints and priorities have called into question the effectiveness of traditional tertiary teaching and learning models. The tertiary education context must evolve at a pace…

Peri-operative management of high-risk paediatric adenotonsillectomy patients: A survey of 35 UK tertiary referral centres.

PubMed

Cheong, Ryan Chin Taw; Bowles, Philippe; Moore, Andrew; Watts, Simon

2017-05-01

Peri-operative management of high-risk paediatric patients undergoing adenotonsillectomy for treatment of obstructive sleep apnoea varies between tertiary referral hospitals. 'Day of surgery cancellation' (DoSC) rates of up to 11% have been reported due to pre-booked critical care being unavailable on the day of surgery as a result of competing needs from other hospital departments. We report the results of a survey of peri-operative management in UK tertiary care centres of high-risk paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea (OSA). An 8-point questionnaire was developed using a cloud-based software platform (www.surveymonkey.com). A web-link to the survey was embedded in a customised e-mail which was sent via secure server to the Clinical Leads for Paediatric Otolaryngology at 35 United Kingdom (UK) Tertiary referral centres. The survey response rate was 60% (n = 21). Almost all (94.1%) of centres considered paediatric critical care facilities to be limited, with 70.6% (n = 12) stating that DoSC often occurred due to unavailable paediatric critical care capacity. There was variation between tertiary referral units in the practice applied for pre-booking critical care beds (our survey identifies 6 variations) (Table 1). The most frequent selection method reported (47.1%) was at the discretion of the booking clinician at the time of listing the patient for surgery. In the context of limited critical care resources, variation in practice and difficulty in accurately predicting which patients will require post-operative critical care beds, a review and consensus on best practice in the peri-operative management of high risk paediatric adenotonsillectomy patients may offer a safe means of reducing cancellations and improving patient care, resource allocation and hospital efficiency. Copyright © 2017 Elsevier B.V. All rights reserved.

Time Outdoors at Specific Ages During Early Childhood and the Risk of Incident Myopia.

PubMed

Shah, Rupal L; Huang, Yu; Guggenheim, Jeremy A; Williams, Cathy

2017-02-01

Time outdoors during childhood is negatively associated with incident myopia. Consequently, additional time outdoors has been suggested as a public health intervention to reduce the prevalence of myopia. We investigated whether there were specific ages during early childhood when the time outdoors versus incident myopia association was strongest. Children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) were studied from age 2 to 15 years. Parentally reported time outdoors and time spent reading were assessed longitudinally in early childhood (ages 2, 3, 4, 5, 7, and 9 years). Noncycloplegic autorefraction was carried out longitudinally in later childhood (ages 10, 11, 12, and 15 years). Information was available for 2833 participants. Cox proportional hazards regression was used to test for association between time outdoors and incident myopia. From 3 years of age onward, greater time outdoors was associated with a reduced risk of incident myopia. The hazard ratio for myopia changed progressively from 0.90 (95% CI 0.83-0.98, P = 0.012) at age 3 years, to 0.86 (95% CI 0.78-0.93, P = 0.001) at age 9 years, for each additional SD of time spent outdoors per day. These associations were independent of two major risk factors for myopia: time reading and number of myopic parents. Additional time spent outdoors across the 3 to 9 years age range was associated with a reduced incidence of myopia between ages 10 and 15 years. There was a trend for the association to increase toward the older end of the 3 to 9 years range.

Healthcare resource use and costs of managing children and adults with lysosomal acid lipase deficiency at a tertiary referral centre in the United Kingdom.

PubMed

Guest, Julian F; Ingram, Andy; Ayoub, Nadia; Hendriksz, Christian J; Murphy, Elaine; Rahman, Yusof; McKiernan, Patrick; Mundy, Helen; Deegan, Patrick

2018-01-01

To estimate clinical progression and resource utilisation together with the associated costs of managing children and adults with LAL Deficiency, at a tertiary referral centre in the UK. A retrospective chart review was undertaken of patients in the UK with a confirmed diagnosis of LAL Deficiency who were managed at a LAL Deficiency tertiary referral treatment centre. Patients' pathways, treatment patterns, health outcomes and resource use were quantified over differing lengths of time for each patient enabling the NHS cost of patient management in tertiary care to be estimated. The study population comprised 19 patients of whom 58% were male. Mean age at the time of initial presentation was 15.5 years and the mean age at diagnosis was 18.0 years. 63%, 53% and 42% of patients had hepatomegaly, abnormal lipid storage and splenomegaly at a mean age of presentation of 17.8, 17.1 and 20.9 years, respectively. Over a period of 50 years there were a mean of 48.5 clinician visits and 3.4 hospital admissions per patient. The mean NHS cost of patient management at a LAL Deficiency tertiary referral treatment centre, spanning a period of over 50 years was £61,454 per patient. This study provides important insights into a number of aspects of the disease that are difficult to ascertain from published case reports. Additionally, it provides the best estimate available of NHS resource use and costs with which to inform policy and budgetary decisions pertaining to managing this ultra-orphan disease.

Irregular oscillatory patterns in the early-time region of coherent phonon generation in silicon

NASA Astrophysics Data System (ADS)

Watanabe, Yohei; Hino, Ken-ichi; Hase, Muneaki; Maeshima, Nobuya

2017-09-01

Coherent phonon (CP) generation in an undoped Si crystal is theoretically investigated to shed light on unexplored quantum-mechanical effects in the early-time region immediately after the irradiation of ultrashort laser pulses. We examine time signals attributed to an induced charge density of an ionic core, placing the focus on the effects of the Rabi frequency Ω0 c v on the signals; this frequency corresponds to the peak electric-field of the pulse. It is found that at specific Ω0 c v's, where the energy of plasmon caused by photoexcited carriers coincides with the longitudinal-optical phonon energy, the energetically resonant interaction between these two modes leads to striking anticrossings, revealing irregular oscillations with anomalously enhanced amplitudes in the observed time signals. Also, the oscillatory pattern is subject to the Rabi flopping of the excited carrier density that is controlled by Ω0 c v. These findings show that the early-time region is enriched with quantum-mechanical effects inherent in the CP generation, though experimental signals are more or less masked by the so-called coherent artifact due to nonlinear optical effects.

Geologically Controlled Isotope-Time Patterns Reveal Early Differentiation and Crust Formation Processes

NASA Astrophysics Data System (ADS)

Bennett, V. C.; Nutman, A. P.

2014-12-01

The mechanisms of continental crust production and evolution in the early Earth remain controversial, as are questions of the relative roles of early differentiation versus subsequent tectonic procssing in creating Earth's chemical signatures. Here we present geologic observations integrated with whole rock major, trace element and Sm-Nd isotopic signatures and combined with U-Pb and Lu-Hf isotopic compositions of zircon populations from the same rocks, from the most extensive early rock record comprising the 3.9 Ga to 3.6 Ga terranes of southwest Greenland. These data reveal repeated patterns of formation of juvenile TTG crust and associated mafic and ultramafic rocks in convergent margin settings followed by formation of more evolved granites [1]. Our new zircon Lu-Hf data from rare 3.6-3.7 Ga tonalites within the Itsaq Gneiss Complex, obtained from single component, non-migmatitic gneisses with simple zircon populations, limited within sample Hf isotopic variability and accurate U-Pb ages, now document extraction of juvenile tonalites from a near chondritic mantle source between 3.9 Ga and 3.6 Ga. The more evolved, granitic rocks in each area show slightly negative initial ɛHf in accord with crustal reworking of the older (3.8-3.9 Ga) gniesses. There is no evidence for Hadean material in the sources of the granitoids. The Hf isotope-time patterns are consistent with juvenile crust production from a mantle source that experienced only modest amounts of prior crustal extraction. They are distinct from those predicted by reprocessing of an enriched Hadean mafic crust, as has been proposed for this region [2] and for the source of the Hadean Jack Hills zircons [3]. The well-documented, time decreasing, positive 142Nd anomalies [e.g., 4] from these rocks are further evidence of crustal derivation from a convecting mantle source, rather than reworking of an enriched mafic lithosphere. The 143Nd isotopic -time patterns are more complex, reflecting the interplay

2-Aminoquinazolin-4(3H)-one as an Organocatalyst for the Synthesis of Tertiary Amines.

PubMed

Thakur, Maheshwar S; Nayal, Onkar S; Upadhyay, Rahul; Kumar, Neeraj; Maurya, Sushil K

2018-03-02

The potential of 2-aminoquinazolin-4(3H)-one as an organocatalyst for the activation of aldehydes via noncovalent interaction for the synthesis of tertiary amines using formic acid as a reducing agent is reported for the first time. The developed protocol demonstrated a dilated substrate scope for aromatic and aliphatic amines with aromatic and aliphatic aldehydes. Furthermore, the current method was also fruitful for the derivatization of ciprofloxacin and its derivative in good to excellent yields.

Rocky Mountain Tertiary coal-basin models and their applicability to some world basins

USGS Publications Warehouse

Flores, R.M.

1989-01-01

Tertiary intermontane basins in the Rocky Mountain region of the United States contain large amounts of coal resources. The first major type of Tertiary coal basin is closed and lake-dominated, either mud-rich (e.g., North Park Basin, Colorado) or mud plus carbonate (e.g., Medicine Lodge Basin, Montana), which are both infilled by deltas. The second major type of Tertiary coal basin is open and characterized by a preponderance of sediments that were deposited by flow-through fluvial systems (e.g., Raton Basin, Colorado and New Mexico, and Powder River Basin, Wyoming and Montana). The setting for the formation of these coals varies with the type of basin sedimentation, paleotectonism, and paleoclimate. The mud-rich lake-dominated closed basin (transpressional paleotectonism and warm, humid paleoclimate), where infilled by sandy "Gilbert-type" deltas, contains thick coals (low ash and low sulfur) formed in swamps of the prograding fluvial systems. The mud- and carbonate-rich lake-dominated closed basin is infilled by carbonate precipitates plus coarse-grained fan deltas and fine-grained deltas. Here, thin coals (high ash and high sulfur) formed in swamps of the fine-grained deltas. The coarse-clastic, open basins (compressional paleotectonism and warm, paratropical paleoclimate) associated with flow-through fluvial systems contain moderately to anomalously thick coals (high to low ash and low sulfur) formed in swamps developed in intermittently abandoned portions of the fluvial systems. These coal development patterns from the Tertiary Rocky Mountain basins, although occurring in completely different paleotectonic settings, are similar to that found in the Tertiary, Cretaceous, and Permian intermontane coal basins in China, New Zealand, and India. ?? 1989.

Textural and mineralogical study of sandstones from the onshore Gulf of Alaska Tertiary Province, southern Alaska

USGS Publications Warehouse

Winkler, Gary R.; McLean, Hugh; Plafker, George

1976-01-01

Petrographic examination of 74 outcrop samples of Paleocene through Pliocene age from the onshore Gulf of Alaska Tertiary Province indicates that sandstones of the province characteristically are texturally immature and mineralogically unstable. Diagenetic alteration of framework grains throughout the stratigraphic sequence has produced widespread zeolite cement or phyllosilicate grain coatings and pseudomatrix. Multiple deformation and deep burial of the older Tertiary sequence--the Orca Group, the shale of Haydon Peak, and the Kulthieth and Tokun Formations--caused extensive alteration and grain interpenetration, resulting in low porosity values. Less intense deformation and intermediate depth of burial of the younger Tertiary sequence--the Katalla, Poul Creek, Redwood, and Yakataga Formations--has resulted in a greater range in textural properties. Most sandstone samples in the younger Tertiary sequence are poorly sorted, tightly packed, and have strongly appressed framework grains, but some are less tightly packed and contain less matrix. Soft and mineralogically unstable framework grains have undergone considerable alteration, reducing pore space even in the youngest rocks. Measurements of porosity, permeability, grain density, and sonic velocity of outcrop samples of the younger Tertiary sequence indicate a modest up-section improvement in sandstone reservoir characteristics. Nonetheless porosity and permeability values typically are below 16 percent and 15 millidarcies respectively and grain densities are consistently high, about 2.7 gm/cc. Low permeability and porosity values, and high grain densities and sonic velocities appear to be typical of most outcrop areas throughout the onshore Gulf of Alaska Tertiary Province.

Organic geochemistry, lithology, and paleontology of Tertiary and Mesozoic rocks from wells on the Alaska Peninsula

USGS Publications Warehouse

McLean, Hugh James

1977-01-01

Core chips and drill cuttings from eight of the nine wells drilled along the Bering Sea lowlands of the Alaska Peninsula were subjected to lithologic and paleontologic analyses. Results suggest that at least locally, sedimentary rocks of Tertiary age contain oil and gas source and reservoir rocks capable of generating and accumulating liquid and gas hydrocarbons. Paleogene strata rich in organic carbon are immature. However, strata in offshore basins to the north and south may have been subjected to a more productive thermal environment. Total organic carbon content of fine grained Neogene strata appears to be significantly lower than in Paleogene rocks, possibly reflecting nonmarine or brackish water environments of deposition. Neogene sandstone beds locally yield high values of porosity and permeability to depths of about 8,000 feet (2,439 m). Below this depth, reservoir potential rapidly declines. The General Petroleum, Great Basins No. 1 well drilled along the shore of Bristol Bay reached granitic rocks. Other wells drilled closer to the axis of the present volcanic arc indicate that both Tertiary and Mesozoic sedimentary rocks have been intruded by dikes and sills of andesite and basalt. Although the Alaska Peninsula has been the locus of igneous activity throughout much of Mesozoic and Tertiary time, thermal maturity indicators such as vitrinite reflectance and coal rank suggest, that on a regional scale, sedimentary rocks have not been subjected to abnormally high geothermal gradients.

Ligand-mediated and tertiary interactions cooperatively stabilize the P1 region in the guanine-sensing riboswitch

PubMed Central

Hanke, Christian A.

2017-01-01

Riboswitches are genetic regulatory elements that control gene expression depending on ligand binding. The guanine-sensing riboswitch (Gsw) binds ligands at a three-way junction formed by paired regions P1, P2, and P3. Loops L2 and L3 cap the P2 and P3 helices and form tertiary interactions. Part of P1 belongs to the switching sequence dictating the fate of the mRNA. Previous studies revealed an intricate relationship between ligand binding and presence of the tertiary interactions, and between ligand binding and influence on the P1 region. However, no information is available on the interplay among these three main regions in Gsw. Here we show that stabilization of the L2-L3 region by tertiary interactions, and the ligand binding site by ligand binding, cooperatively influences the structural stability of terminal base pairs in the P1 region in the presence of Mg2+ ions. The results are based on molecular dynamics simulations with an aggregate simulation time of ~10 μs across multiple systems of the unbound state of the Gsw aptamer and a G37A/C61U mutant, and rigidity analyses. The results could explain why the three-way junction is a central structural element also in other riboswitches and how the cooperative effect could become contextual with respect to intracellular Mg2+ concentration. The results suggest that the transmission of allosteric information to P1 can be entropy-dominated. PMID:28640851

Chinese Tertiary Teachers' Goal Orientations for Teaching and Teaching Approaches: The Mediation of Teacher Engagement

ERIC Educational Resources Information Center

Yin, Hongbiao; Han, Jiying; Lu, Genshu

2017-01-01

This study investigated the effects of Chinese tertiary teachers' goal orientations for teaching on their approaches to teaching mediated by teacher engagement. In a survey of 597 Chinese tertiary teachers, the respondents placed particular emphasis on relational and mastery goals and expressed a preference for student-focused approaches to…

Time allocation of disabled individuals.

PubMed

Pagán, Ricardo

2013-05-01

Although some studies have analysed the disability phenomenon and its effect on, for example, labour force participation, wages, job satisfaction, or the use of disability pension, the empirical evidence on how disability steals time (e.g. hours of work) from individuals is very scarce. This article examines how disabled individuals allocate their time to daily activities as compared to their non-disabled counterparts. Using time diary information from the Spanish Time Use Survey (last quarter of 2002 and the first three quarters of 2003), we estimate the determinants of time (minutes per day) spent on four aggregate categories (market work, household production, tertiary activities and leisure) for a sample of 27,687 non-disabled and 5250 disabled individuals and decompose the observed time differential by using the Oaxaca-Blinder methodology. The results show that disabled individuals devote less time to market work (especially females), and more time to household production (e.g. cooking, cleaning, child care), tertiary activities (e.g., sleeping, personal care, medical treatment) and leisure activities. We also find a significant effect of age on the time spent on daily activities and important differences by gender and disability status. The results are consistent with the hypothesis that disability steals time, and reiterate the fact that more public policies are needed to balance working life and health concerns among disabled individuals. Copyright © 2013 Elsevier Ltd. All rights reserved.

Early and Real-Time Detection of Seasonal Influenza Onset

PubMed Central

Marques-Pita, Manuel

2017-01-01

Every year, influenza epidemics affect millions of people and place a strong burden on health care services. A timely knowledge of the onset of the epidemic could allow these services to prepare for the peak. We present a method that can reliably identify and signal the influenza outbreak. By combining official Influenza-Like Illness (ILI) incidence rates, searches for ILI-related terms on Google, and an on-call triage phone service, Saúde 24, we were able to identify the beginning of the flu season in 8 European countries, anticipating current official alerts by several weeks. This work shows that it is possible to detect and consistently anticipate the onset of the flu season, in real-time, regardless of the amplitude of the epidemic, with obvious advantages for health care authorities. We also show that the method is not limited to one country, specific region or language, and that it provides a simple and reliable signal that can be used in early detection of other seasonal diseases. PMID:28158192

Structural relationships of pre-Tertiary rocks in the Nevada Test Site region, southern Nevada

USGS Publications Warehouse

Cole, James C.; Cashman, Patricia Hughes

1999-01-01

This report contains a synthesis and interpretation of structural and stratigraphic data for pre-Tertiary rocks in a large area of southern Nevada within and near the Nevada Test Site. Its presents descriptive and interpretive information from discontinuously exposed localities in the context of a regional model that integrates stratigraphy, sedimentology, crustal structure, and deformational style and timing. Evidence is given for substantial strike-slip faults, for modest excursion on low-angle faults, and for pre-Oligocene formation of the regional oroclinal flexure in neighboring mountain ranges.

From Ramachandran Maps to Tertiary Structures of Proteins.

PubMed

DasGupta, Debarati; Kaushik, Rahul; Jayaram, B

2015-08-27

Sequence to structure of proteins is an unsolved problem. A possible coarse grained resolution to this entails specification of all the torsional (Φ, Ψ) angles along the backbone of the polypeptide chain. The Ramachandran map quite elegantly depicts the allowed conformational (Φ, Ψ) space of proteins which is still very large for the purposes of accurate structure generation. We have divided the allowed (Φ, Ψ) space in Ramachandran maps into 27 distinct conformations sufficient to regenerate a structure to within 5 Å from the native, at least for small proteins, thus reducing the structure prediction problem to a specification of an alphanumeric string, i.e., the amino acid sequence together with one of the 27 conformations preferred by each amino acid residue. This still theoretically results in 27(n) conformations for a protein comprising "n" amino acids. We then investigated the spatial correlations at the two-residue (dipeptide) and three-residue (tripeptide) levels in what may be described as higher order Ramachandran maps, with the premise that the allowed conformational space starts to shrink as we introduce neighborhood effects. We found, for instance, for a tripeptide which potentially can exist in any of the 27(3) "allowed" conformations, three-fourths of these conformations are redundant to the 95% confidence level, suggesting sequence context dependent preferred conformations. We then created a look-up table of preferred conformations at the tripeptide level and correlated them with energetically favorable conformations. We found in particular that Boltzmann probabilities calculated from van der Waals energies for each conformation of tripeptides correlate well with the observed populations in the structural database (the average correlation coefficient is ∼0.8). An alpha-numeric string and hence the tertiary structure can be generated for any sequence from the look-up table within minutes on a single processor and to a higher level of accuracy

DIRECT SYNTHESIS OF TERTIARY AMINES IN WATER USING MICROWAVES

EPA Science Inventory

A direct synthesis of tertiary amines is presented that proceeds expeditiously via N-alkylation of amines using alkyl halides in alkaline aqueous medium. This environmentally benign reaction is accelerated upon exposure to microwave irradiation resulting in shortened reaction tim...

Emotional Intelligence and the Conflict Resolution Repertoire of Couples in Tertiary Institutions in Imo State

ERIC Educational Resources Information Center

Nnodum, B. I.; Ugwuegbulam, C. N.; Agbaenyi, I. G.

2016-01-01

This study is a descriptive survey that investigated the relationship between emotional intelligence and conflict resolution repertoire of couples in tertiary institutions. A sample of 250 married people were drawn from the population of couples in tertiary institutions in Imo State. Two researcher made and validated instruments were used in…

Metamorphic facies map of Southeastern Alaska; distribution, facies, and ages of regionally metamorphosed rocks

USGS Publications Warehouse

Dusel-Bacon, Cynthia; Brew, D.A.; Douglass, S.L.

1996-01-01

Nearly all of the bedrock in Southeastern Alaska has been metamorphosed, much of it under medium-grade conditions during metamorphic episodes that were associated with widespread plutonism. The oldest metamorphisms affected probable arc rocks near southern Prince of Wales Island and occurred during early and middle Paleozoic orogenies. The predominant period of metamorphism and associated plutonism occurred during Early Cretaceous to early Tertiary time and resulted in the development of the Coast plutonic-metamorphic complex that extends along the inboard half of Southeastern Alaska. Middle Tertiary regional thermal metamorphism affected a large part of Baranof Island.

An Amino Acid Code to Define a Protein’s Tertiary Packing Surface

PubMed Central

Fraga, Keith J.; Joo, Hyun; Tsai, Jerry

2015-01-01

One difficult aspect of the protein-folding problem is characterizing the non-specific interactions that define packing in protein tertiary structure. To better understand tertiary structure, this work extends the knob-socket model by classifying the interactions of a single knob residue packed into a set of contiguous sockets, or a pocket made up of 4 or more residues. The knob-socket construct allows for a symbolic two-dimensional mapping of pockets. The two-dimensional mapping of pockets provides a simple method to investigate the variety of pocket shapes in order to understand the geometry of protein tertiary surfaces. The diversity of pocket geometries can be organized into groups of pockets that share a common core, which suggests that some interactions in pockets are ancillary to packing. Further analysis of pocket geometries displays a preferred configuration that is right-handed in α-helices and left-handed in β-sheets. The amino acid composition of pockets illustrates the importance of non-polar amino acids in packing as well as position specificity. As expected, all pocket shapes prefer to pack with hydrophobic knobs; however, knobs are not selective for the pockets they pack. Investigating side-chain rotamer preferences for certain pocket shapes uncovers no strong correlations. These findings allow a simple vocabulary based on knobs and sockets to describe protein tertiary packing that supports improved analysis, design and prediction of protein structure. PMID:26575337

Stable isotope evidence for gradual environmental changes and species survivorship across the Cretaceous/Tertiary Boundary

NASA Astrophysics Data System (ADS)

Barrera, Enriqueta; Keller, Gerta

1990-12-01

High-resolution δ13C and δ18O records have been generated from analyses of the planktonic foraminiferal species Heterohelix globulosa and the benthonic foraminiferal taxon Lenticulina spp from 3 m of a cored section spanning the Cretaceous/Tertiary (K/T) boundary at Brazos River, Texas. These are the first stable isotope records across the K/T boundary based on monospecific and monogeneric foraminiferal samples. They show a gradual decrease in δ13C values of about 2.5 permil beginning at the K/T boundary, as defined by the first appearance of Tertiary planktonic foraminifera, and continuing 17-20 cm above the boundary, approximately 40,000 years later. Gradual 13C depletion contrasts with the sudden δ13C drop at the K/T boundary observed in many deep-sea sections. The surface-to-bottom δ13C gradient decreased to less than zero approximately 25,000-30,000 years after the K/T boundary and remained negative for at least the next 140,000 years. Concomitant with change in δ13C values is a gradual decrease of about 2.5 permil in δ18C values which has not been observed at other localities. This 18O depletion suggests changes in temperature and/or salinity in the earliest Paleocene Gulf of Mexico. No extinction of foraminiferal species is associated with the K/T boundary or the onset of 18O and 13C depletions. Instead, two phases of Cretaceous species extinctions occur. One extinction phase is below the K/T boundary and below the tsunami bed of Bourgeois et al. [1988] and may be linked to sea level regression and environmental perturbations. The second extinction phase coincides with the minimum in δ13C and δ18O values in the Early Danian (Zone P0/Pla) and appears directly related to environmental changes reflected in the isotopic record. H. globulosa, which is commonly present in Maastrichtian and Danian sediments, exhibits significantly lower 18O/16O and 13C/12C ratios in Tertiary sediments relative to specimens from Maastrichtian sediments, demonstrating the

The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students

PubMed Central

2016-01-01

Background and Aims Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Methods Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. Results The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08–2.17, P < 0.05). Conclusions Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among

Calculational investigation of impact cratering dynamics - Early time material motions

NASA Technical Reports Server (NTRS)

Thomsen, J. M.; Austin, M. G.; Ruhl, S. F.; Schultz, P. H.; Orphal, D. L.

1979-01-01

Early time two-dimensional finite difference calculations of laboratory-scale hypervelocity (6 km/sec) impact of 0.3 g spherical 2024 aluminum projectiles into homogeneous plasticene clay targets were performed and the resulting material motions analyzed. Results show that the initial jetting of vaporized target material is qualitatively similar to experimental observation. The velocity flow field developed within the target is shown to have features quite similar to those found in calculations of near-surface explosion cratering. Specific application of Maxwell's analytic Z-Model (developed to interpret the flow fields of near-surface explosion cratering calculations), shows that this model can be used to describe the flow fields resulting from the impact cratering calculations, provided that the flow field center is located beneath the target surface, and that application of the model is made late enough in time that most of the projectile momentum has been dissipated.

Tandem catalytic allylic amination and [2,3]-Stevens rearrangement of tertiary amines.

PubMed

Soheili, Arash; Tambar, Uttam K

2011-08-24

We have developed a catalytic allylic amination involving tertiary aminoesters and allylcarbonates, which is the first example of the use of tertiary amines as intermolecular nucleophiles in metal-catalyzed allylic substitution chemistry. This process is employed in a tandem ammonium ylide generation/[2,3]-rearrangement reaction, which formally represents a palladium-catalyzed Stevens rearrangement. Low catalyst loadings and mild reaction conditions are compatible with an unprecedented substrate scope for the ammonium ylide functionality, and products are generated in high yields and diastereoselectivities. Mechanistic studies suggested the reversible formation of an ammonium intermediate.

Turnaround Time for Early Infant HIV Diagnosis in Rural Zambia: A Chart Review

PubMed Central

Sutcliffe, Catherine G.; van Dijk, Janneke H.; Hamangaba, Francis; Mayani, Felix; Moss, William J.

2014-01-01

Background Early infant HIV diagnosis is challenging in sub-Saharan Africa, particularly in rural areas where laboratory capacity is limited. Specimens must be transported to central laboratories for testing, leading to delays in diagnosis and initiation of antiretroviral therapy. This study was undertaken in rural Zambia to measure the turnaround time for confirmation of HIV infection and identify delays in diagnosis. Methods Chart reviews were conducted from 2010–2012 for children undergoing early infant HIV diagnosis at Macha Hospital in Zambia. Relevant dates, receipt of drugs by mother and child for the prevention of mother-to-child transmission (PMTCT), and test results were abstracted. Results 403 infants provided 476 samples for early infant diagnosis. The median age at the “6-week” and “6-month” assessments was 8.1 weeks and 7.0 months, respectively. The majority of mothers (80%) and infants (67%) received PMTCT. The median time between sample collection and arrival at the central laboratory in Lusaka was 17 days (IQR: 10, 28); arrival at the central laboratory to testing was 6 days (IQR: 5, 11); testing to return of results to the clinic was 29 days (IQR: 17, 36); arrival of results at the clinic to return of results to the caregiver was 45 days (IQR: 24, 79). The total median time from sample collection to return of results to the caregiver was 92 days (IQR: 84, 145). The proportion of HIV PCR positive samples was 12%. The total median turnaround time was shorter for HIV PCR positive as compared to negative or invalid samples (85 vs. 92 days; p = 0.08). Conclusions Delays in processing and communicating test results were identified, particularly in returning results from the central laboratory to the clinic and from the clinic to the caregiver. A more efficient process is needed so that caregivers can be provided test results more rapidly, potentially resulting in earlier treatment initiation and better outcomes for HIV-infected infants

Active Head Lifting from Supine in Early Infancy: An Indicator for Non-Optimal Cognitive Outcome in Late Infancy

ERIC Educational Resources Information Center

van Haastert, Ingrid C.; Groenendaal, Floris; van de Waarsenburg, Maria K.; Eijsermans, Maria J. C.; Koopman-Esseboom, Corine; Jongmans, Marian J.; Helders, Paul J. M.; de Vries, Linda S.

2012-01-01

Aim: To explore whether active head lifting from supine (AHLS) in early infancy is associated with cognitive outcome in the second year of life. Method: The presence of AHLS was always recorded in the notes of infants admitted to our tertiary neonatal intensive care unit. Random sampling was used to pair infants with AHLS with two comparison…

The Role of Peer Stress and Pubertal Timing on Symptoms of Psychopathology during Early Adolescence

ERIC Educational Resources Information Center

Sontag, Lisa M.; Graber, Julia A.; Clemans, Katherine H.

2011-01-01

Stress is known to amplify the link between pubertal timing and psychopathology. However, few studies have examined the role of peer stress as a context for this link. The present study examined the interaction between perceived pubertal timing and peer stress on symptoms of psychopathology in early adolescence. The sample consisted of 264…

Time perception impairment in early-to-moderate stages of Huntington's disease is related to memory deficits.

PubMed

Righi, Stefania; Galli, Luca; Paganini, Marco; Bertini, Elisabetta; Viggiano, Maria Pia; Piacentini, Silvia

2016-01-01

Huntington's disease (HD) primarily affects striatum and prefrontal dopaminergic circuits which are fundamental neural correlates of the timekeeping mechanism. The few studies on HD mainly investigated motor timing performance in second durations. The present work explored time perception in early-to-moderate symptomatic HD patients for seconds and milliseconds with the aim to clarify which component of the scalar expectancy theory (SET) is mainly responsible for HD timing defect. Eleven HD patients were compared to 11 controls employing two separate temporal bisection tasks in second and millisecond ranges. Our results revealed the same time perception deficits for seconds and milliseconds in HD patients. Time perception impairment in early-to-moderate stages of Huntington's disease is related to memory deficits. Furthermore, both the non-systematical defect of temporal sensitivity and the main impairment of timing performance in the extreme value of the psychophysical curves suggested an HD deficit in the memory component of the SET. This result was further confirmed by the significant correlations between time perception performance and long-term memory test scores. Our findings added important preliminary data for both a deeper comprehension of HD time-keeping deficits and possible implications on neuro-rehabilitation practices.

Clinical abnormalities, early intervention program of Down syndrome children: Queen Sirikit National Institute of Child Health experience.

PubMed

Fuengfoo, Adidsuda; Sakulnoom, Kim

2014-06-01

Queen Sirikit National Institute of Child Health is a tertiary institute of children in Thailand, where early intervention programs have been provided since 1990 by multidisciplinary approach especially in Down syndrome children. This aim of the present study is to follow the impact of early intervention on the outcome of Down syndrome children. The school attendance number of Down syndrome children was compared between regular early intervention and non-regular early intervention. The present study group consists of 210 Down syndrome children who attended early intervention programs at Queen Sirikit National Institute of Child Health between June 2008 and January 2012. Data include clinical features, school attendance developmental quotient (DQ) at 3 years of age using Capute Scales Cognitive Adaptive Test/Scale (CAT/CLAMS). Developmental milestones have been recorded as to the time of appearance of gross motor, fine motor, language, personal-social development compared to those non-regular intervention patients. Of 210 Down syndrome children, 117 were boys and 93 were girls. About 87% received regular intervention, 68% attended speech training. Mean DQ at 3 years of age was 65. Of the 184 children who still did follow-up at developmental department, 124 children (59%) attended school: mainstream school children 78 (63%) and special school children 46 (37%). The mean age at entrance to school was 5.8 ± 1.4 years. The school attendance was correlated with maternal education and regular early intervention attendance. Regular early intervention starts have proven to have a positive effect on development. The school attendance number of Down syndrome children receiving regular early intervention was statistically and significantly higher than the number of Down syndrome children receiving non-regular early intervention was. School attendance correlated with maternal education and attended regularly early intervention. Regular early intervention together with maternal

Time Outdoors at Specific Ages During Early Childhood and the Risk of Incident Myopia

PubMed Central

Shah, Rupal L.; Huang, Yu; Guggenheim, Jeremy A.; Williams, Cathy

2017-01-01

Purpose Time outdoors during childhood is negatively associated with incident myopia. Consequently, additional time outdoors has been suggested as a public health intervention to reduce the prevalence of myopia. We investigated whether there were specific ages during early childhood when the time outdoors versus incident myopia association was strongest. Methods Children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) were studied from age 2 to 15 years. Parentally reported time outdoors and time spent reading were assessed longitudinally in early childhood (ages 2, 3, 4, 5, 7, and 9 years). Noncycloplegic autorefraction was carried out longitudinally in later childhood (ages 10, 11, 12, and 15 years). Information was available for 2833 participants. Cox proportional hazards regression was used to test for association between time outdoors and incident myopia. Results From 3 years of age onward, greater time outdoors was associated with a reduced risk of incident myopia. The hazard ratio for myopia changed progressively from 0.90 (95% CI 0.83–0.98, P = 0.012) at age 3 years, to 0.86 (95% CI 0.78–0.93, P = 0.001) at age 9 years, for each additional SD of time spent outdoors per day. These associations were independent of two major risk factors for myopia: time reading and number of myopic parents. Conclusions Additional time spent outdoors across the 3 to 9 years age range was associated with a reduced incidence of myopia between ages 10 and 15 years. There was a trend for the association to increase toward the older end of the 3 to 9 years range. PMID:28245296

Superacid synthesized tertiary benzenesulfonamides and benzofuzed sultams act as selective hCA IX inhibitors: toward understanding a new mode of inhibition by tertiary sulfonamides.

PubMed

Métayer, Benoît; Martin-Mingot, Agnès; Vullo, Daniella; Supuran, Claudiu T; Thibaudeau, Sébastien

2013-11-21

A series of tertiary (fluorinated) benzenesulfonamides was synthesized in superacid HF-SbF5. To circumvent the problem of the in situ iminium ion formation, proved by low temperature NMR experiments, a tandem superacid catalysed cross-coupling reaction was employed to synthesize the benzofuzed sultams analogues. These tertiary benzenesulfonamides were tested as inhibitors of human carbonic anhydrases (hCAs, EC 4.2.1.1). These compounds did not inhibit the widespread off target hCA II isoform and showed strong selectivity toward tumor-associated carbonic anhydrase isoform IX. A dramatic effect of the electronic and structural shape of the inhibitors on selectivity was demonstrated, confirming the non-zinc-bonding mode of inhibition of this class of sulfonamides. This work allowed identifying a highly selective hCA IX inhibitor lead in this series.

Self-Assessment in Professional Programmes within Tertiary Institutions

ERIC Educational Resources Information Center

Bourke, Roseanna

2014-01-01

Self-assessment at tertiary level is a critical pedagogical and assessment tool to support students in their transition to professional careers where on-going learning and assessment is required. Beyond the safety-net of course content, external assessment and pre-determined criteria, novice professionals need to find ways to self-assess their…

Pedagogical Practices of Reflection in Tertiary Dance Education

ERIC Educational Resources Information Center

Leijen, Ali; Lam, Ineke; Simons, P. Robert-Jan; Wildschut, Liesbeth

2008-01-01

The three different perspectives on reflection in education are embedded in the philosophical traditions of pragmatism, critical social theory and Kant. We aimed to describe the pedagogical practices of reflection, and to develop a descriptive model of the practices of reflection in tertiary dance education which can be used by dance educators to…

Tertiary Educational Institutions for Teaching, Research and Development

ERIC Educational Resources Information Center

Amoo, Sikiru A.

2014-01-01

This paper examines the quality of teaching and research in developing human resources to facilitate the development of tertiary education in the nation. It discusses the challenges and the roles of research in higher education. The author argues that the combination of content and pedagogical knowledge could help to develop human resources for…

Perioperative Management Difficulties in Parathyroidectomy for Primary Versus Secondary and Tertiary Hyperparathyroidism

PubMed Central

CORNECI, Marioara; STANESCU, Bogdan; TRIFANESCU, Raluca; NEACSU, Elena; CORNECI, Dan; POIANA, Catalina; HORVAT, Teodor

2012-01-01

ABSTRACT Background: In patients with hyperparathyroidism, parathyroidectomy is the only curative therapy. Anaesthetic management differs function of etiology (primary vs. secondary or tertiary hyperparathyroidism) and surgical technique (minimally invasive or classic parathyroidectomy). Objectives: To evaluate peri-operative management (focusing on hemodynamic changes, cardiac arrhythmias and patients’ awakening quality) in parathyroidectomy for hyperparathyroidism of various etiologies, in a tertiary center. Material and methods: 292 patients who underwent surgery for hyperparathyroidism between 2000-2011 were retrospectively reviewed; 96 patients (19M/77F) presented with primary hyperparathyroidism (group A) and 196 (80M/116F) with secondary and tertiary hyperparathyroidism due to renal failure (group B). Biochemical parameters (serum calcium, phosphate, creatinine) were determined by automated standard laboratory methods. Serum intact PTH was measured by ELISA (iPTH - normal range: 15-65 pg/mL). Outcomes: Median surgery duration was 30 minutes in group A (minimally invasive or classic parathyroidectomy) and 75 minutes in group B (total parathyroidectomy and re implantation of a small parathyroid fragment into the sternocleidomastoid muscle). During anaesthesia induction, arterial hypotension developed significantly more frequent in group B (57 out of 196 pts, 29.1%) than in group A (8 out of 96 pts, 8.34%), p<0.0001, especially in patients receiving Fentanyl-Propofol. During surgery and anaesthesia maintenance, bradycardia was significantly more frequent in group A (67 out of 96 pts, 69.8%) than in group B (26 out of 196 pts, 13.3%), p<0.0001, especially during searching of parathyroid glands. By contrary, ventricular premature beats were less frequent in group A (25 out of 96 pts, 25.25%) than in group B (84 out of 196 pts, 42.85%), p=0.003. There were no statistically significant differences between the studied group regarding frequency of arterial

Satisfaction among early and mid-career dentists in a metropolitan dental hospital in China.

PubMed

Cui, Xiaoxi; Dunning, David G; An, Na

2017-01-01

A growing body of research has examined career satisfaction among dentists using a standardized instrument, dentist satisfaction survey (DSS). This project examined career satisfaction of early to mid-career dentists in China, a population whose career satisfaction, heretofore, has not been studied. This is an especially critical time to examine career satisfaction because of health care reform measures being implemented in China. A culturally sensitive Chinese-language version of the DSS (CDSS) was developed and electronically administered to 367 early and mid-career dentists in a tertiary dental hospital in Beijing, China. One hundred and seventy respondents completed the survey. The average total career score was 123, with a range of 82-157. Data analysis showed some significant differences in total career score and several subscales based on gender, working hours per week, and years in practice. A stepwise regression model revealed that two variables predicted total career score: working hours per week and gender. Stepwise regression also demonstrated that four subscales significantly predicted the overall professional satisfaction subscale score: respect, delivery of care, income and patient relations. Implications of these results are discussed in light of the health care delivery system and dentist career paths in China.

Subduction of Young Oceanic Lithosphere and Extensional Orogeny in Southwestern North America during Mid-Tertiary Time

NASA Astrophysics Data System (ADS)

Elston, Wolfgang E.

1984-04-01

An "extensional orogeny" deformed the Basin and Range province, probably beginning in the late Eocene (about 40 ± 3 Ma). Its characteristics include partial melting of the continental lithosphere during the "ignimbrite flareup," massive ductile extension (including detachment faulting), and rise of metamorphic core complexes. The affected zone became about 1200 km wide, possibly double its original width. It rose an average of 1-2 km, despite crustal thinning. Locally, some of the highest mountains of North America, up to 4.3 km high, rose through resurgence of ignimbrite cauldrons and isostatic uplift of underlying plutons. The climax of extension occurred prior to the development of the present basin and range topography. Modeling of major and trace elements and Sr and Pb isotopes strongly suggests that mid-Tertiary volcanic magmas equilibrated, and probably originated, in the continental lithosphere. Components attributable to subducted oceanic lithosphere have not yet been identified. The rocks seem to belong to two provinces, separated by the quartz diorite boundary line of Moore (1959), which also marks the western limit of North America at the end of the late Paleozoic Sonoman orogeny. To the west, low-K rocks rest on a basement of predominantly oceanic accreted terranes; to the east, high-K rocks rest on an autochthonous sialic basement. Within the high-K province, potassium variations can be correlated with crustal thickness; there is no need to invoke a K-h relationship. Conventional models of plate convergence and back arc extension which involve subduction of old, rigid, cool, and dense oceanic lithosphere may not apply to the mid-Tertiary Basin and Range province. The overridden Farallon plate is more likely to have been young, hot, ductile, buoyant, and no denser than continental asthenosphere, having been generated in a spreading center close to North America. Under these conditions, motion of the subducting plate slows and slab-pull is likely to

Leaf evolution in early-diverging ferns: insights from a new fern-like plant from the Late Devonian of China

PubMed Central

Wang, De-Ming; Xu, Hong-He; Xue, Jin-Zhuang; Wang, Qi; Liu, Le

2015-01-01

Background and Aims With the exception of angiosperms, the main euphyllophyte lineages (i.e. ferns sensu lato, progymnosperms and gymnosperms) had evolved laminate leaves by the Late Devonian. The evolution of laminate leaves, however, remains unclear for early-diverging ferns, largely represented by fern-like plants. This study presents a novel fern-like taxon with pinnules, which provides new insights into the early evolution of laminate leaves in early-diverging ferns. Methods Macrofossil specimens were collected from the Upper Devonian (Famennian) Wutong Formation of Anhui and Jiangsu Provinces, South China. A standard degagement technique was employed to uncover compressed plant portions within the rock matrix. Key Results A new fern-like taxon, Shougangia bella gen. et sp. nov., is described and represents an early-diverging fern with highly derived features. It has a partially creeping stem with adventitious roots only on one side, upright primary and secondary branches arranged in helices, tertiary branches borne alternately or (sub)oppositely, laminate and usually lobed leaves with divergent veins, and complex fertile organs terminating tertiary branches and possessing multiple divisions and numerous terminal sporangia. Conclusions Shougangia bella provides unequivocal fossil evidence for laminate leaves in early-diverging ferns. It suggests that fern-like plants, along with other euphyllophyte lineages, had independently evolved megaphylls by the Late Devonian, possibly in response to a significant decline in atmospheric CO2 concentration. Among fern-like plants, planate ultimate appendages are homologous with laminate pinnules, and in the evolution of megaphylls, fertile organs tend to become complex. PMID:25979918

Tertiary Educators' Voices in Australia and South Africa: Experiencing and Engaging in African Music and Culture

ERIC Educational Resources Information Center

Joseph, Dawn

2015-01-01

Music tertiary educators can foster positive experiences that promote diversity, enhance intercultural and cross-cultural understanding through our teaching. Through findings of interview data of tertiary music educators' understandings of multicultural music practice at two South African universities and at an Australia university, I used…

Factors Influencing Changes in Eating Patterns Among Hong Kong Young Adults Transitioning to Tertiary Education.

PubMed

Kwok, Sin Tung; Capra, Sandra; Leveritt, Michael

2016-05-01

Transitioning to tertiary education is a significant life course event that has the potential to influence lifelong eating patterns. This study used a theoretic model developed from a life course perspective to examine factors influencing the change of food choices among 31 young adults in Hong Kong after they moved on to tertiary education. Qualitative analysis of transcripts based on the constant comparative method revealed that present life course experiences, especially increased autonomy, and social-environmental factors strongly influenced young adults' present food choices. A model was developed from life course theory and social-ecological theory to reflect the factors that led to change of food choices among participants. The model provides unique insights on food choices of the future adult population. It could also be used as a reference for the development of nutrition education interventions targeting tertiary students as they experience increased autonomy. In conclusion, food choices of young adults on transitioning to tertiary education are strongly influenced by increased autonomy and change of social and environmental factors. © 2016 APJPH.

Tension-compression-tension tertiary twins in coarse-grained polycrystalline pure magnesium at room temperature

DOE PAGES

Yu, Qin; Jiang, Yanyao; Wang, Jian

2015-04-07

Using electron backscatter diffraction, the microstructural features of tension–compression–tension (T–C–T) tertiary twins are studied in coarse-grained pure polycrystalline magnesium subjected to monotonic compression along the extrusion direction in ambient air. T–C–T tertiary twins are developed due to the formation of a compression–tension double twin inside a primary tension twin. All the observed T–C–T twin variants are of T iC jT j type. T iC i+1T i+1 (or T iC i–1T i–1) variants are observed more frequently than T iC i+2T i+2 (or T iC i–2T i–2) variants. Moreover, the number of tertiary twin lamellae increases with the applied compressive strain.

Cryptosporidium and Giardia removal by secondary and tertiary wastewater treatment.

PubMed

Taran-Benshoshan, Marina; Ofer, Naomi; Dalit, Vaizel-Ohayon; Aharoni, Avi; Revhun, Menahem; Nitzan, Yeshayahu; Nasser, Abidelfatah M

2015-01-01

Wastewater disposal may be a source of environmental contamination by Cryptosporidium and Giardia. This study was conducted to evaluate the prevalence of Cryptosporidium oocysts and Giardia cysts in raw and treated wastewater effluents. A prevalence of 100% was demonstrated for Giardia cysts in raw wastewater, at a concentration range of 10 to 12,225 cysts L(-1), whereas the concentration of Cryptosporidium oocysts in raw wastewater was 4 to 125 oocysts L(-1). The removal of Giardia cysts by secondary and tertiary treatment processes was greater than those observed for Cryptosporidium oocysts and turbidity. Cryptosporidium and Giardia were present in 68.5% and 76% of the tertiary effluent samples, respectively, at an average concentration of 0.93 cysts L(-1) and 9.94 oocysts L(-1). A higher detection limit of Cryptosporidium oocysts in wastewater was observed for nested PCR as compared to immune fluorescent assay (IFA). C. hominis was found to be the dominant genotype in wastewater effluents followed by C. parvum and C. andersoni or C. muris. Giardia was more prevalent than Cryptosporidium in the studied community and treatment processes were more efficient for the removal of Giardia than Cryptosporidium. Zoonotic genotypes of Cryptosporidium were also present in the human community. To assess the public health significance of Cryptosporidium oocysts present in tertiary effluent, viability (infectivity) needs to be assessed.

Tertiary individual prevention improves mental health in patients with severe occupational hand eczema.

PubMed

Breuer, K; John, S M; Finkeldey, F; Boehm, D; Skudlik, C; Wulfhorst, B; Dwinger, C; Werfel, T; Diepgen, T L; Schmid-Ott, G

2015-09-01

Occupational hand eczema (OHE) is associated with impaired health-related quality of life (QoL) and mental distress. Interdisciplinary inpatient rehabilitation measures in the framework of tertiary individual prevention (TIP) offered by the German employers' liability insurance associations include dermatological treatment, education and psychological interventions. To investigate the effects of interdisciplinary inpatient rehabilitation in the framework of TIP on mental health in patients with severe OHE and the relationships between recovery of OHE and improvement of mental health and QoL. A total of 122 patients participated in the study. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale (HADS-D), the Dermatology Life Quality Index (DLQI), the Short Form Health Survey-36 (SF-36) and the Trier Inventory for the Assessment of Chronic Stress (TICS) was applied at the time of admission (T1) and 3 weeks after dismissal (T2). Severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). All parameters improved significantly from T1 to T2. A relationship was established between the improvement of QoL and recovery of OHE, while there was no such relationship between the improvement of mental distress and improvement of OHE. Nonresponders had significantly more cumulative days of sickness at T1. Our data underscore the importance of psychological interventions in addition to dermatological treatment in the framework of prevention measures for OHE. These measures should be applied at an early stage of OHE prior to the occurrence of sick leave. © 2015 European Academy of Dermatology and Venereology.

West Hackberry Tertiary Project. Quarterly technical progress report, July 1--September 30, 1995

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

NONE

The goal of the West Hackberry Tertiary Project is to demonstrate the technical and economic feasibility of combining air injection with the Double Displacement Process for tertiary oil recovery. The Double Displacement Process is the gas displacement of a water invaded oil column for the purpose of recovering oil through gravity drainage. The novel aspect of this project is the use of air as the injection fluid. The target reservoir for the project is the Camerina C-1,2,3 Sand located on the West Flank of West Hackberry Field in Cameron Parish, Louisiana. If successful, this project will demonstrate that the usemore » of air injection in the Double Displacement Process can economically recover oil in reservoirs where tertiary oil recovery is presented uneconomic. During this quarter, the West Hackberry Tertiary Project completed the first ten months of air injection operations. Plots of air injection rates and cumulative air injected are included in this report as attachments. The following events are reviewed in this quarter`s technical progress report: (1) successful workovers on the Gulf Land D Nos. 44, 45 and 51 and the Watkins No. 3; (2) the unsuccessful repair attempt on the Watkins No. 16; (3) gathering of additional bottom hole pressure data; (4) air compressor operations and repairs; and (5) technology transfer activities.« less

Adults Studying Pure Mathematics in Adult Tertiary Preparation.

ERIC Educational Resources Information Center

Bennison, Anne

2002-01-01

Investigated the experiences of a group of adults enrolled in the Pure Mathematics module of the Certificate IV in Adult Tertiary Preparation in 2000 at one of the Institutes of TAFE in Brisbane, Australia. Classroom learning experiences, exposure to technology, and the impact of returning to study on other facets of students' lives were…

Early mortality in multiple myeloma: the time-dependent impact of comorbidity: A population-based study in 621 real-life patients.

PubMed

Ríos-Tamayo, Rafael; Sáinz, Juan; Martínez-López, Joaquín; Puerta, José Manuel; Chang, Daysi-Yoe-Ling; Rodríguez, Teresa; Garrido, Pilar; de Veas, José Luís García; Romero, Antonio; Moratalla, Lucía; López-Fernández, Elisa; González, Pedro Antonio; Sánchez, María José; Jiménez-Moleón, José Juan; Jurado, Manuel; Lahuerta, Juan José

2016-07-01

Multiple myeloma is a heterogeneous disease with variable survival; this variability cannot be fully explained by the current systems of risk stratification. Early mortality remains a serious obstacle to further improve the trend toward increased survival demonstrated in recent years. However, the definition of early mortality is not standardized yet. Importantly, no study has focused on the impact of comorbidity on early mortality in multiple myeloma to date. Therefore, we analyzed the role of baseline comorbidity in a large population-based cohort of 621 real-life myeloma patients over a 31-year period. To evaluate early mortality, a sequential multivariate regression model at 2, 6, and 12 months from diagnosis was performed. It was demonstrated that comorbidity had an independent impact on early mortality, which is differential and time-dependent. Besides renal failure, respiratory disease at 2 months, liver disease at 6 months, and hepatitis virus C infection at 12 months, were, respectively, associated with early mortality, adjusting for other well-established prognostic factors. On the other hand, the long-term monitoring in our study points out a modest downward trend in early mortality over time. This is the first single institution population-based study aiming to assess the impact of comorbidity on early mortality in multiple myeloma. It is suggested that early mortality should be analyzed at three key time points (2, 6, and 12 months), in order to allow comparisons between studies. Comorbidity plays a critical role in the outcome of myeloma patients in terms of early mortality. Am. J. Hematol. 91:700-704, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Viscous cosmology for early- and late-time universe

NASA Astrophysics Data System (ADS)

Brevik, Iver; Grøn, Øyvind; de Haro, Jaume; Odintsov, Sergei D.; Saridakis, Emmanuel N.

From a hydrodynamicist’s point of view the inclusion of viscosity concepts in the macroscopic theory of the cosmic fluid would appear most natural, as an ideal fluid is after all an abstraction (exluding special cases such as superconductivity). Making use of modern observational results for the Hubble parameter plus standard Friedmann formalism, we may extrapolate the description of the universe back in time up to the inflationary era, or we may go to the opposite extreme and analyze the probable ultimate fate of the universe. In this review, we discuss a variety of topics in cosmology when it is enlarged in order to contain a bulk viscosity. Various forms of this viscosity, when expressed in terms of the fluid density or the Hubble parameter, are discussed. Furthermore, we consider homogeneous as well as inhomogeneous equations of state. We investigate viscous cosmology in the early universe, examining the viscosity effects on the various inflationary observables. Additionally, we study viscous cosmology in the late universe, containing current acceleration and the possible future singularities, and we investigate how one may even unify inflationary and late-time acceleration. Finally, we analyze the viscosity-induced crossing through the quintessence-phantom divide, we examine the realization of viscosity-driven cosmological bounces, and we briefly discuss how the Cardy-Verlinde formula is affected by viscosity.

The Pipe Creek Sinkhole biota, a diverse late tertiary continental fossil assemblage from Grant County, Indiana

USGS Publications Warehouse

Farlow, J.O.; Sunderman, J.A.; Havens, J.J.; Swinehart, A.L.; Holman, J.A.; Richards, R.L.; Miller, N.G.; Martin, R.A.; Hunt, R.M.; Storrs, G.W.; Curry, B. Brandon; Fluegeman, R.H.; Dawson, M.; Flint, M.E.T.

2001-01-01

Quarrying in east-central Indiana has uncovered richly fossiliferous unconsolidated sediment buried beneath Pleistocene glacial till. The fossiliferous layer is part of a sedimentary deposit that accumulated in a sinkhole developed in the limestone flank beds of a Paleozoic reef. Plant and animal (mostly vertebrate) remains are abundant in the fossil assemblage. Plants are represented by a diversity of terrestrial and wetland forms, all of extant species. The vertebrate assemblage (here designated the Pipe Creek Sinkhole local fauna) is dominated by frogs and pond turtles, but fishes, birds; snakes and small and large mammals are also present; both extinct and extant taxa are represented. The mammalian assemblage indicates an early Pliocene age (latest Hemphillian or earliest Blancan North American Land Mammal Age). This is the first Tertiary continental biota discovered in the interior of the eastern half of North America.

Global fire at the Cretaceous-Tertiary boundary

NASA Technical Reports Server (NTRS)

Wolbach, Wendy S.; Gilmour, Iain; Anders, Edward; Orth, Charles J.; Brooks, Robert R.

1988-01-01

Cretaceous-Tertiary boundary clays rich in iridium from five sites in Europe and New Zealand were investigated. The clays are found to be 100-10,000-fold-enriched in elemental carbon (mainly soot), which is isotopically uniform and apparently comes from a single global fire. The soot layer coincides with the iridium layer, suggesting that the fire was triggered by meteorite impact and began before the ejecta had settled.

Major wildfires at the Cretaceous-Tertiary boundary

NASA Technical Reports Server (NTRS)

Anders, Edward; Wolbach, Wendy S.; Gilmour, Iain

1991-01-01

The current status of the reconstruction of major biomass fire events at the Cretaceous-Tertiary boundary is discussed. Attention is given to the sources of charcoal and soot, the identification of biomass and fossil carbon, and such ignition-related problems as delated fires, high atmospheric O2 content, ignition mechanisms, and the greenhouse-effect consequences of fire on the scale envisioned. Consequences of these factors for species extinction patterns are noted.

National Rules for Drug–Drug Interactions: Are They Appropriate for Tertiary Hospitals?

PubMed Central

2016-01-01

The application of appropriate rules for drug–drug interactions (DDIs) could substantially reduce the number of adverse drug events. However, current implementations of such rules in tertiary hospitals are problematic as physicians are receiving too many alerts, causing high override rates and alert fatigue. We investigated the potential impact of Korean national DDI rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Using lists of high-priority DDIs developed with the support of the U.S. government, we evaluated 706 contraindicated DDI pairs released in May 2015. We evaluated clinical log data from one tertiary hospital and prescription data from two other tertiary hospitals. The measured parameters were national DDI rule coverage for high-priority DDIs, alert override rate, and number of prescription pairs. The coverage rates of national DDI rules were 80% and 3.0% at the class and drug levels, respectively. The analysis of the system log data showed an overall override rate of 79.6%. Only 0.3% of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5%, which was much lower than for the overall DDI rules. We also found 342 and 80 unmatched high-priority DDI pairs which were absent in national rules in inpatient orders from the other two hospitals. The national DDI rules are not complete in terms of their coverage of severe DDIs. They also lack clinical efficiency in tertiary settings, suggesting improved systematic approaches are needed. PMID:27822925

Disaster content in Australian tertiary postgraduate emergency nursing courses: a survey.

PubMed

Ranse, Jamie; Shaban, Ramon Z; Considine, Julie; Hammad, Karen; Arbon, Paul; Mitchell, Belinda; Lenson, Shane

2013-05-01

Emergency nurses play a pivotal role in disaster relief during the response to, and recovery of both in-hospital and out-of-hospital disasters. Postgraduate education is important in preparing and enhancing emergency nurses' preparation for disaster nursing practice. The disaster nursing content of Australian tertiary postgraduate emergency nursing courses has not been compared across courses and the level of agreement about suitable content is not known. To explore and describe the disaster content in Australian tertiary postgraduate emergency nursing courses. A retrospective, exploratory and descriptive study of the disaster content of Australian tertiary postgraduate emergency nursing courses conducted in 2009. Course convenors from 12 universities were invited to participate in a single structured telephone survey. Data was analysed using descriptive statistics. Ten of the twelve course convenors from Australian tertiary postgraduate emergency nursing courses participated in this study. The content related to disasters was varied, both in terms of the topics covered and duration of disaster content. Seven of these courses included some content relating to disaster health, including types of disasters, hospital response, nurses' roles in disasters and triage. The management of the dead and dying, and practical application of disaster response skills featured in only one course. Three courses had learning objectives specific to disasters. The majority of courses had some disaster content but there were considerable differences in the content chosen for inclusion across courses. The incorporation of core competencies such as those from the International Council of Nurses and the World Health Organisation, may enhance content consistency in curriculum. Additionally, this content could be embedded within a proposed national education framework for disaster health. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights

Benthic foraminifera at the Cretaceous-Tertiary boundary around the Gulf of Mexico

NASA Astrophysics Data System (ADS)

Alegret, Laia; Molina, Eustoquio; Thomas, Ellen

2001-10-01

Cretaceous-Tertiary (K-T) boundary sections in northeastern Mexico contain marly formations separated by a controversial clastic unit. Benthic foraminifera in seven sections indicate middle and lower bathyal depths of deposition for the marls, with the exception of the upper bathyal northernmost section. Mixed neritic-bathyal faunas were present in the clastic unit, indicating redeposition in the deep basin by mass-wasting processes resulting from the K-T bolide impact in the Gulf of Mexico. Benthic foraminifera in the Mexican sections, and at other deep-sea locations, were not subject to major extinction at the time of impact, but there were temporary changes in assemblage composition. Benthic faunas indicate well- oxygenated bottom waters and mesotrophic conditions during the late Maastrichtian and increased food supply during the latest Maastrichtian. The food supply decreased drastically just after the K-T boundary, possibly because of the collapse of surface productivity. Cretaceous and early Paleogene benthic foraminifera, however, did not exhibit the benthic-pelagic coupling of present-day faunas, as documented by the lack of significant extinction at the K-T collapse of surface productivity. Much of the food supplied to the benthic faunas along this continental margin might have been refractory material transported from land or shallow coastal regions. The decrease in food supply at the K-T boundary might be associated with the processes of mass wasting, which removed surface, food-rich sediment. Benthic faunas show a staggered pattern of faunal recovery in the lowermost Paleogene, consistent with a staged recovery of the vertical organic flux but also with a gradual buildup of organic matter in the sediment.

Acknowleding attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review.

PubMed

Wyllie, Aileen; DiGiacomo, Michelle; Jackson, Debra; Davidson, Patricia; Phillips, Jane

2016-10-01

To optimise the career development in early career academic nurses by providing an overview of the attributes necessary for success. Evidence of early prospective career planning is necessary to optimise success in the tertiary sector. This is particularly important for nurse academics given the profession's later entry into academia, the ageing nursing workforce and the continuing global shortage of nurses. A qualitative systematic review. Academic Search Complete, CINAHL, Medline, ERIC, Professional Development Collection and Google Scholar databases were searched; resulting in the inclusion of nine qualitative nurse-only focussed studies published between 2004 and 2014. The studies were critically appraised and the data thematically analysed. Three abilities were identified as important to the early career academic nurse: a willingness to adapt to change, an intention to pursue support and embodying resilience. These abilities give rise to attributes that are recommended as key to successful academic career development for those employed on a continuing academic basis. The capacity to rely on one's own capabilities is becoming seen as increasingly important. It is proposed that recognition of these attributes, their skilful application and monitoring outlined in the review are recommended for a successful career in academia. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Thermodynamics and kinetics of RNA tertiary structure formation in the junctionless hairpin ribozyme.

PubMed

White, Neil A; Hoogstraten, Charles G

2017-09-01

The hairpin ribozyme consists of two RNA internal loops that interact to form the catalytically active structure. This docking transition is a rare example of intermolecular formation of RNA tertiary structure without coupling to helix annealing. We have used temperature-dependent surface plasmon resonance (SPR) to characterize the thermodynamics and kinetics of RNA tertiary structure formation for the junctionless form of the ribozyme, in which loops A and B reside on separate molecules. We find docking to be strongly enthalpy-driven and to be accompanied by substantial activation barriers for association and dissociation, consistent with the structural reorganization of both internal loops upon complex formation. Comparisons with the parallel analysis of a ribozyme variant carrying a 2'-O-methyl modification at the self-cleavage site and with published data in other systems reveal a surprising diversity of thermodynamic signatures, emphasizing the delicate balance of contributions to the free energy of formation of RNA tertiary structure. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of Social Media Utilization and Study Habit of Students of Tertiary Institutions in Katsina State

ERIC Educational Resources Information Center

Olutola, Adekunle Thomas; Olatoye, Olufunke Omotoke; Olatoye, Rafiu Ademola

2016-01-01

This study investigated assessment of social media utilization and study habits of students of tertiary institutions in Katsina State. The descriptive survey design was adopted for this study. Three hundred and eighty-one (381) students' of tertiary institutions in Katsina State were randomly selected for the study. Researchers'-designed…

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

PubMed

Viikari-Juntura, Eira; Kausto, Johanna; Shiri, Rahman; Kaila-Kangas, Leena; Takala, Esa-Pekka; Karppinen, Jaro; Miranda, Helena; Luukkonen, Ritva; Martimo, Kari-Pekka

2012-03-01

The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. Time to RTW sustained for ≥4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.

Synchronization of the astronomical time scales in the Early Toarcian: A link between anoxia, carbon-cycle perturbation, mass extinction and volcanism

NASA Astrophysics Data System (ADS)

Ait-Itto, Fatima-Zahra; Martinez, Mathieu; Price, Gregory D.; Ait Addi, Abdellah

2018-07-01

The Late Pliensbachian-Early Toarcian is a pivotal time in the Mesozoic era, marked by pronounced carbon-isotope excursions, biotic crises and major climatic and oceanographic changes. Here we present new high-resolution carbon-isotope and magnetic-susceptibility measurements from an expanded hemipelagic Late Pliensbachian-Early Toarcian section from the Middle Atlas Basin (Morocco). Our new astronomical calibration allows the construction of an orbital time scale based on the 100-kyr eccentricity cycle. The Early Toarcian Polymorphum Zone contains 10 to 10.5 repetitions of the 100-kyr eccentricity both in the carbon-isotope and the magnetic-susceptibility data, leading to an average duration of 1.00 ± 0.08 myr. We also show that the Late Pliensbachian-Early Toarcian global carbon-cycle perturbation has an average duration of 0.24 ± 0.02 myr. These durations are comparable to previous astrochronological time scales provided for this time interval in the most complete sections of the Tethyan area, and longer than what has been provided in condensed sections. Anchoring this framework on published radiometric ages and astrochronological time scales, we estimate that the carbon-cycle perturbation of the Late Pliensbachian-Early Toarcian corresponds with the early phase of the Karoo and Chonke Aike large igneous provinces. Likewise, our new age constraints confirm that the Toarcian oceanic anoxic event is synchronous to the main phase of the Ferrar volcanic activity. Thus, these successive and short phases of the volcanic activity may have been at the origin of the successive phases of the mass extinctions observed in marine biotas in the Pliensbachian and Toarcian times.

Antibiotic use in acute pancreatitis: An audit of current practice in a tertiary centre.

PubMed

Baltatzis, Minas; Mason, J M; Chandrabalan, Vishnu; Stathakis, Panagiotis; McIntyre, Ben; Jegatheeswaran, Santhalingam; Jamdar, Saurabh; O'Reilly, Derek A; Siriwardena, Ajith K

Intravenous antibiotic prophylaxis is not recommended in acute pancreatitis. According to current international guidelines antibiotics together with further intervention should be considered in the setting of infected necrosis. Appropriate antibiotic therapy particularly avoiding over-prescription is important. This study examines antibiotic use in acute pancreatitis in a tertiary centre using the current IAP/APA guidelines for reference. Data were collected on a consecutive series of patients admitted with acute pancreatitis over a 12 month period. Data were dichotomized by patients admitted directly to the centre and tertiary transfers. Information was collected on clinical course with specific reference to antibiotic use, episode severity, intervention and outcome. 111 consecutive episodes of acute pancreatitis constitute the reported population. 31 (28%) were tertiary transfers. Overall 65 (58.5%) patients received antibiotics. Significantly more tertiary transfer patients received antibiotics. Mean person-days of antibiotic use was 23.9 (sd 29.7) days in the overall study group but there was significantly more use in the tertiary transfer group as compared to patients having their index admission to the centre (40.9 sd 37.1 vs 10.2 sd 8.9; P < 0.005). Thirty four (44%) of patients with clinically mild acute pancreatitis received antibiotics. There is substantial use of antibiotics in acute pancreatitis, in particular in patients with severe disease. Over-use is seen in mild acute pancreatitis. Better consideration must be given to identification of prophylaxis or therapy as indication. In relation to repeated courses of antibiotics in severe disease there must be clear indications for use. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Reaction Time is a Marker of Early Cognitive and Behavioral Alterations in Pure Cerebral Small Vessel Disease.

PubMed

Jouvent, Eric; Reyes, Sonia; De Guio, François; Chabriat, Hugues

2015-01-01

The assessment of early and subtle cognitive and behavioral effects of cerebral small vessel disease (SVD) requires specific and long-lasting evaluations performed by experienced neuropsychologists. Simpler tools would be helpful for daily clinical practice. To determine whether a simple reaction time task that lasts 5 minutes and can be performed without external supervision on any tablet or laptop can be used as a proxy of early cognitive and behavioral alterations in CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), a monogenic form of pure SVD related to NOTCH3 mutations. Twenty-two genetically confirmed patients with CADASIL having preserved global cognitive abilities and without disability (MMSE >24 and modified Rankin's scale ≤1) were compared to 29 age-and-gender matched controls to determine group differences according to: 1) conventional neuropsychological and behavioral testing; 2) a computerized battery evaluating reaction time, processing speed, and executive functions. In a second step, correlations between reaction time and cognitive and behavioral alterations detected using both conventional and computerized testing were tested in patients. Reaction time was significantly higher in patients than in controls (mean in patients: 283 ms - in controls: 254 ms, p = 0.03). In patients, reaction time was significantly associated with conventional and chronometric tests of executive functions, working memory, and apathy. Reaction time obtained using a very simple task may serve as a proxy of early cognitive and behavioral alterations in SVD and could be easily used in daily clinical practice.

Early clinical outcomes of primary percutaneous coronary intervention in bharatpur, Nepal.

PubMed

Dubey, Laxman; Bhattacharya, Rabindra; Guruprasad, Sogunuu; Subramanyam, Gangapatnam

2013-06-01

Primary percutaneous coronary intervention represents one of the cornerstone management modalities for patients with acute ST-elevation myocardial infarction and has undergone tremendous growth over the past two decades. This study was aimed to determine the early clinical outcomes of primary percutaneous coronary interventions in a tertiary-level teaching hospital without onsite cardiac surgery backup. This was a prospective descriptive study which included all consecutive patients who were admitted for primary percutaneous coronary interventions between March 2011 and January 2013 at the College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal. Total 68 patients underwent primary percutaneous coronary interventions as a mode of revascularization. The primary end point of the study was to identify in-hospital as well as 30-day clinical outcomes of primary percutaneous coronary interventions. The mean age was 56.31 ± 11.47 years, with age range of 32 years to 91 years. Of the 68 primary percutaneous coronary interventions performed, 15 (22.05%) were carried out in women and 10 (14.70%) in patients over 75 years of age. Primary percutaneous coronary intervention for anterior wall myocardial infarction was more common than for non-anterior wall myocardial infarction (55.88% vs. 44.12%). Proximal artery stenting was performed in 38.50% and the non proximal artery stenting in 61.50%. The outcomes were mortality (5.88%), cardiogenic shock (5.88%), contrast-induced nephropathy requiring dialysis (2.94%), arrhythmias requiring treatment (4.41%), early stent thrombosis (2.94%) and minor complications (14.70%). Primary percutaneous coronary intervention improves the early clinical outcomes in patient with acute ST-elevation myocardial infarction. Despite having no onsite cardiac surgery backup, primary percutaneous coronary intervention was feasible with acceptable complications in a tertiary-care teaching hospital.

Late Mesozoic and possible early Tertiary accretion in western Washington State: the Helena-Haystack melange and the Darrington- Devils Mountain fault zone

USGS Publications Warehouse

Tabor, R.W.

1994-01-01

The Helena-Haystack melange (HH melange) and coincident Darrington-Devils Mountain fault zone (DDMFZ) in northwestern Washington separate two terranes, the northwest Cascade System (NWCS) and the western and eastern melange belts (WEMB). The two terranes of Paleozoic and Mesozoic rocks superficially resemble each other but record considerable differences in structural and metamorphic history. The HH melange is a serpentinite-matrix melange containing blocks of adjacent terranes but also exotic blocks. The HH melange must have formed between early Cretaceous and late middle Eocene time, because it contains tectonic clasts of early Cretaceous Shuksan Greenschist and is overlain by late middle Eocene sedimentary and volcanic rocks. The possible continuation of the DDMFZ to the northwest as the San Juan and the West Coast faults on Vancouver Island suggests that the structure has had a major role in the emplacement of all the westernmost terranes in the Pacific Northwest. -from Author

Stepwise radical endoscopic resection for eradication of Barrett's oesophagus with early neoplasia in a cohort of 169 patients.

PubMed

Pouw, Roos E; Seewald, Stefan; Gondrie, Joep J; Deprez, Pierre H; Piessevaux, Hubert; Pohl, Heiko; Rösch, Thomas; Soehendra, Nib; Bergman, Jacques J

2010-09-01

Endoscopic resection is safe and effective to remove early neoplasia (ie,high-grade intra-epithelial neoplasia/early cancer) in Barrett's oesophagus. To prevent metachronous lesions during follow-up, the remaining Barrett's oesophagus can be removed by stepwise radical endoscopic resection (SRER). The aim was to evaluate the combined experience in four tertiary referral centres with SRER to eradicate Barrett's oesophagus with early neoplasia. Retrospective cohort study. Four tertiary referral centres. 169 patients (151 males, age 64 years (IQR 57-71), Barrett's oesophagus 3 cm (IQR 2-5)) with early neoplasia in Barrett's oesophagus < or = 5 cm, without deep submucosal infiltration or lymph node metastases, treated by SRER between January 2000 and September 2006. Endoscopic resection every 4-8 weeks, until complete endoscopic and histological eradication of Barrett's oesophagus and neoplasia. According to intention-to-treat analysis complete eradication of all neoplasia and all intestinal metaplasia by the end of the treatment phase was reached in 97.6% (165/169) and 85.2% (144/169) of patients, respectively. One patient had progression of neoplasia during treatment and died of metastasised adenocarcinoma (0.6%). After median follow-up of 32 months (IQR 19-49), complete eradication of neoplasia and intestinal metaplasia was sustained in 95.3% (161/169) and 80.5% (136/169) of patients, respectively. Acute, severe complications occurred in 1.2% of patients, and 49.7% of patients developed symptomatic stenosis. SRER of Barrett's oesophagus < or = 5 cm containing early neoplasia appears to be an effective treatment modality with a low rate of recurrent lesions during follow-up. The procedure, however, is technically demanding and is associated with oesophageal stenosis in half of the patients.

Methods for Detecting Early Warnings of Critical Transitions in Time Series Illustrated Using Simulated Ecological Data

PubMed Central

Dakos, Vasilis; Carpenter, Stephen R.; Brock, William A.; Ellison, Aaron M.; Guttal, Vishwesha; Ives, Anthony R.; Kéfi, Sonia; Livina, Valerie; Seekell, David A.; van Nes, Egbert H.; Scheffer, Marten

2012-01-01

Many dynamical systems, including lakes, organisms, ocean circulation patterns, or financial markets, are now thought to have tipping points where critical transitions to a contrasting state can happen. Because critical transitions can occur unexpectedly and are difficult to manage, there is a need for methods that can be used to identify when a critical transition is approaching. Recent theory shows that we can identify the proximity of a system to a critical transition using a variety of so-called ‘early warning signals’, and successful empirical examples suggest a potential for practical applicability. However, while the range of proposed methods for predicting critical transitions is rapidly expanding, opinions on their practical use differ widely, and there is no comparative study that tests the limitations of the different methods to identify approaching critical transitions using time-series data. Here, we summarize a range of currently available early warning methods and apply them to two simulated time series that are typical of systems undergoing a critical transition. In addition to a methodological guide, our work offers a practical toolbox that may be used in a wide range of fields to help detect early warning signals of critical transitions in time series data. PMID:22815897

Lithospheric mantle structure beneath Northern Scotland: Pre-plume remnant or syn-plume signature?

NASA Astrophysics Data System (ADS)

Knapp, J.

2003-04-01

Upper mantle reflectors (Flannan and W) beneath the northwestern British Isles are some of the best-known and most-studied examples of preserved structure within the continental mantle lithosphere, and are spatially coincident with the surface location of early Iceland plume volcanism in the British Tertiary Province. First observed on BIRPS (British Institutions Reflection Profiling Syndicate) marine deep seismic reflection profiles in the early 1980's, these reflectors have subsequently been imaged and correlated on additional reflection and refraction profiles in the offshore area of northern and western Scotland. The age and tectonic significance of these reflectors remains a subject of wide debate, due in part to the absence of robust characterization of the upper mantle velocity structure in this tectonically complex area. Interpretations advanced over the past two decades for the dipping Flannan reflector range from fossilized subduction complex to large-scale extensional shear zone, and span ages from Proterozoic to early Mesozoic. Crustal geology of the region records early Paleozoic continental collision and late Paleozoic to Mesozoic extension. Significant modification of the British lithosphere in early Tertiary time, including dramatic thinning and extensive basaltic intrusion associated with initiation and development of the Iceland plume, suggests either (1) an early Tertiary age for the Flannan reflector or (2) preservation of ancient features within the mantle lithosphere despite such pervasive modification. Exisitng constraints are consistent with a model for early Tertiary origin of the Flannan reflector as the downdip continuation of the Rockall Trough extensional system of latest Cretaceous to earliest Tertiary age during opening of the northern Atlantic Ocean and initiation of the Iceland plume. Lithopsheric thinning beneath present-day northern Scotland could have served to focus the early expression of plume volcanism (British Tertiary

Bullying Behavior, Parents' Work Hours and Early Adolescents' Perceptions of Time Spent with Parents

ERIC Educational Resources Information Center

Christie-Mizell, C. Andre; Keil, Jacqueline M.; Laske, Mary Therese; Stewart, Jennifer

2011-01-01

This research investigates the relationships among bullying behavior, mother's and father's work hours, and early adolescents' perceptions of whether they spend sufficient time with their parents. In cross-sectional models, we find maternal work hours are modestly associated with increases in bullying behavior. However, in more rigorous change…

The relationship between educational attainment and waiting time among the elderly in Norway.

PubMed

Carlsen, Fredrik; Kaarboe, Oddvar Martin

2015-11-01

We investigate whether educational attainment affects waiting time of elderly patients in somatic hospitals. We consider three distinct pathways; that patients with different educational attainment have different disease patterns, that patients with different levels of education receive treatments at different hospitals, and that patient choice and supply of local health services within hospital catchment areas explain unequal waiting time of different educational groups. We find evidence of an educational gradient in waiting time for male patients, but not for female patients. Conditional on age, male patients with tertiary education wait 45% shorter than male patients with secondary or primary education. The first pathway is not quantitatively important as controlling for disease patters has little effect on relative waiting times. The second pathway is important. Relative to patients with primary education, variation in waiting time and education level across local hospitals contributes to higher waiting time for male patients with secondary education and female patients with secondary or tertiary education and lower waiting time for male patients with tertiary education. These effects are in the order of 15-20%. The third pathway is also quantitatively important. The educational gradients within catchment areas disappear when we control for travel distance and supply of private specialists. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prediction of protein tertiary structure from sequences using a very large back-propagation neural network

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

Liu, X.; Wilcox, G.L.

1993-12-31

We have implemented large scale back-propagation neural networks on a 544 node Connection Machine, CM-5, using the C language in MIMD mode. The program running on 512 processors performs backpropagation learning at 0.53 Gflops, which provides 76 million connection updates per second. We have applied the network to the prediction of protein tertiary structure from sequence information alone. A neural network with one hidden layer and 40 million connections is trained to learn the relationship between sequence and tertiary structure. The trained network yields predicted structures of some proteins on which it has not been trained given only their sequences.more » Presentation of the Fourier transform of the sequences accentuates periodicity in the sequence and yields good generalization with greatly increased training efficiency. Training simulations with a large, heterologous set of protein structures (111 proteins from CM-5 time) to solutions with under 2% RMS residual error within the training set (random responses give an RMS error of about 20%). Presentation of 15 sequences of related proteins in a testing set of 24 proteins yields predicted structures with less than 8% RMS residual error, indicating good apparent generalization.« less

Complex Cure Kinetics of the Tertiary Amine activated Reaction in DGEBA Epoxy Hardened with Diethanolamine

NASA Astrophysics Data System (ADS)

Ancipink, Windy; McCoy, John; Clarkson, Caitlyn; Kropka, Jamie; Celina, Mathias; Giron, Nicholas; Hailesilassie, Lebelo; Fredj, Narjes

The curing of a diglycidyl ether of bisphenol-A (DGEBA) epoxy with diethanolamine (DEA) involves a well understood fast amine-epoxide reaction followed by a more complicated slower hydroxyl-epoxide reaction. The time scale of these two reactions are well separated and can be studied independently from one another. The initial amine-epoxide reaction results in a tertiary amine adduct which is a product of the direct reaction of a secondary amine from the DEA reacting with a single DGEBA epoxide. The second hydroxyl-epoxide reaction results in a highly crosslinked glassy epoxy resin. The deviation in the mechanisms between high and low temperatures are discerned through the use of differential scanning calorimetry (DSC), infrared spectroscopy (IR), and isothermal microcalorimetry (IMC) data. Observations of reaction rates at temperatures ranging from 30° C to 110° C have led to the determination that the hydroxyl-epoxide reaction is temperature sensitive. The hydroxyl-epoxide reaction occurs through two different mechanisms: at low temperatures, the reaction is catalyzed by the tertiary amine adduct; at higher temperatures, the reaction does not appear to be catalyzed. Sandia National Laboratories, Albuquerque, NM.

Why Do Tertiary Education Graduates Regret Their Study Program? A Comparison between Spain and the Netherlands

ERIC Educational Resources Information Center

Kucel, Aleksander; Vilalta-Bufi, Montserrat

2013-01-01

In this paper we investigate the determinants of regret of study program for tertiary education graduates in Spain and the Netherlands. These two countries differ in their educational system in terms of the tracking structure in their secondary education and the strength of their education-labor market linkages in tertiary education. Therefore, by…

The Managerial Approach to Tertiary Education: A Critical Analysis.

ERIC Educational Resources Information Center

Baron, Bernard

The various elements of the management approach to tertiary education (broadly, all institutions of further and higher education maintained by local authorities) are identified, with the principal focus on the general approach known as "Management by Objectives" (MBO). The arguments for and against its use and possible hazards following…

Deterministic Demographic Characteristics in Tertiary Education: An Exploratory Study

ERIC Educational Resources Information Center

Morton, Lisa; Lamb, Charles

2006-01-01

This paper reports the responses of 235 tertiary commerce students to a questionnaire in relation to their learning and assessment experiences. Significant correlations between measures were used to identify underlying constructs within the overall set of variable measures. Logistic regression incorporating the factors was then used to further…

Mudflow utilization for construction materials of tertiary irrigation canal lining

NASA Astrophysics Data System (ADS)

Azis, Subandiyah; Kustamar

2017-11-01

Mudflow in Siring Village, Sidoarjo Regency, Indonesia, has been in eruption since May 29, 2006. It still shows irregular large bursts which loaded in a sludge reservoir with capacity of 59 million m3. From 2007 until 2015, there were more than 20 studies which concluded that the mudflow could be used as a mixture of building materials. However, the studies were not detailed and needed further research. This research aims to investigate the use of mudflow as tertiary irrigation canal lining material. This research comes with several laboratory tests to obtain a mixture that is solid and water-resistant. The methods that were used are descriptive methods as follows: 1). Sampling of mudflow, to be analyzed in Material Testing Laboratory. 2). Sampling of soil at research site, to be analyzed in Soil Mechanics Laboratory 3). Mixing of materials which are consist of mudflow and other materials and doing strength test in the laboratory. 4). Installation of tertiary irrigation canal lining using materials that have been tested. 5). Observation of lining's strength inactive soil pressure-bearing and its impermeability. It is expected that the results of this research will be applied extensively throughout the tertiary irrigation canals, so mudflow can be utilized as raw materials that are environmentally friendly, which are able to help preserving the environment, also to reduce the removal of sand / rock in the river, which has been used for lining materials, that benefits in preventing damage to the river ecosystem.

Facility Benchmarking Trends in Tertiary Education - An Australian Case Study.

ERIC Educational Resources Information Center

Fisher, Kenn

2001-01-01

Presents how Australia's facility managers are responding to the growing impact of tertiary education participation and the increase in educational facility usage. Topics cover strategic asset management and the benchmarking of education physical assets and postsecondary institutions. (GR)

Parental Monitoring during Early Adolescence Deters Adolescent Sexual Initiation: Discrete-Time Survival Mixture Analysis

ERIC Educational Resources Information Center

Huang, David Y. C.; Murphy, Debra A.; Hser, Yih-Ing

2011-01-01

We used discrete-time survival mixture modeling to examine 5,305 adolescents from the 1997 National Longitudinal Survey of Youth regarding the impact of parental monitoring during early adolescence (ages 14-16) on initiation of sexual intercourse and problem behavior engagement (ages 14-23). Four distinctive parental-monitoring groups were…

Delivering tertiary centre specialty care to ALS patients via telemedicine: a retrospective cohort analysis.

PubMed

Selkirk, Stephen M; Washington, Monique O; McClellan, Frances; Flynn, Broderick; Seton, Jacinta M; Strozewski, Richard

2017-08-01

This study was undertaken to determine if ALS patients evaluated via telemedicine received the same quality of care as patients evaluated by traditional face-to-face encounters. A retrospective cohort study design was used. Participants were patients diagnosed with ALS that received multidisciplinary care at the tertiary Cleveland VA ALS Centre between 1 March 2008- and 31 anuary 2015. Participants were not randomised, but chose telemedicine based on preference, disability level or distance from the clinic. Telemedicine in this study consisted of a video conferencing platform enabling remote rather than face-to-face encounters with participants. There was no significant association between receiving quality ALS care and the mode of care. There was a trend for telemedicine patients to utilise home health care less often than those that received clinic care (AOR 0.50; 95% CI 0.16-1.59). There was no significant difference in survival time between the two groups (log-rank test χ 2  = 3.62, df = 1, p = 0.05). Patients receiving telemedicine had a higher probability of remaining stable or having <30% decrease in ALSFRS-R over time (log-rank test χ 2  = 4.46, df = 1, p = 0.03). There was a significantly lower risk of disease progression for patients receiving telemedicine (HR = 0.39, 95% CI = 0.16-0.93). Patients managed by telemedicine received the same quality of care and had similar outcomes to those patients seen via traditional face-to-face encounters. Telemedicine is an effective platform for delivering high quality tertiary ALS care.

The roles of tertiary amine structure, background organic matter and chloramine species on NDMA formation.

PubMed

Selbes, Meric; Kim, Daekyun; Ates, Nuray; Karanfil, Tanju

2013-02-01

N-nitrosodimethylamine (NDMA), a probable human carcinogen, is a disinfection by-product that has been detected in chloraminated and chlorinated drinking waters and wastewaters. Formation mechanisms and precursors of NDMA are still not well understood. The main objectives of this study were to systematically investigate (i) the effect of tertiary amine structure, (ii) the effect of background natural organic matter (NOM), and (iii) the roles of mono vs. dichloramine species on the NDMA formation. Dimethylamine (DMA) and 20 different tertiary aliphatic and aromatic amines were carefully examined based on their functional groups attached to the basic DMA structure. The wide range (0.02-83.9%) of observed NDMA yields indicated the importance of the structure of tertiary amines, and both stability and electron distribution of the leaving group of tertiary amines on NDMA formation. DMA associated with branched alkyl groups or benzyl like structures having only one carbon between the ring and DMA structure consistently gave higher NDMA yields. Compounds with electron withdrawing groups (EWG) reacted preferentially with monochloramine, whereas compounds with electron donating group (EDG) showed tendency to react with dichloramine to form NDMA. When the selected amines were present in NOM solutions, NDMA formation increased for compounds with EWG while decreased for compounds with EDG. This impact was attributed to the competitions between NOM and amines for chloramine species. The results provided additional information to the commonly accepted mechanism for NDMA formation including chloramine species reacting with tertiary amines and the role of the leaving group on overall NDMA conversion. Copyright © 2012 Elsevier Ltd. All rights reserved.

Six-month outcome in patients with myocardial infarction initially admitted to tertiary and nontertiary hospitals. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempos de Espera.

PubMed

Marrugat, J; Sanz, G; Masiá, R; Valle, V; Molina, L; Cardona, M; Sala, J; Serés, L; Szescielinski, L; Albert, X; Lupón, J; Alonso, J

1997-11-01

The aim of the present study was to ascertain whether the degree of accessibility to coronary angiography and revascularization results in differing usages or outcomes, or both, in the setting of a high coverage national health system. The selective use of coronary angiography and revascularization procedures in the management of acute myocardial infarction (MI) remains controversial. A cohort of 1,460 consecutive patients with a first MI admitted to four referral teaching hospitals (one with tertiary facilities) were followed up for 6 months after admission. Only patients initially admitted to each of the study hospitals were retained for analysis in the original hospital's cohort. End points were 6-month mortality and readmission for reinfarction, unstable angina, heart failure or severe ventricular arrhythmia. Patients admitted to the tertiary hospital were more likely to undergo coronary angiography (adjusted relative risk 4.22, 95% confidence interval [CI] 3.37 to 5.45) than those admitted to the nontertiary sites (use rate: 22.1% for nontertiary care, 55.5% for tertiary care). Revascularization procedures were performed in 21.2% of patients in the tertiary hospital and in 8.3% in the nontertiary hospitals (p < 0.0001). Median delay for emergency coronary angiography was shorter in the tertiary hospital (within 1 vs. 2 days, p < 0.0001). Six-month mortality or readmission rates were similar (23.7% and 24.7% for tertiary and nontertiary care, respectively). After adjustment for comorbidity and disease severity, the relative risk of death or readmission for the tertiary hospital was 1.03 (95% CI 0.69 to 1.53) times that of the nontertiary hospitals. Selective use of coronary angiography and revascularization procedures may be as effective as less restricted use in the management of acute MI.

Is It Ever Too Late to Study? The Economic Returns on Late Tertiary Degrees in Sweden

ERIC Educational Resources Information Center

Hallsten, Martin

2012-01-01

This paper addresses the economic returns on tertiary degrees obtained in ages above 30 for individuals with upper-secondary schooling in light of current ideas on lifelong learning. Sweden is a case in point: Swedish tertiary education is open to older students, and labor market legislation supports employees who take a leave to study. The…

A Comparison of Teacher and Lecturer Perspectives on the Transition from Secondary to Tertiary Mathematics Education

ERIC Educational Resources Information Center

Hong, Ye Yoon; Kerr, Suzanne; Klymchuk, Sergiy; McHardy, Johanna; Murphy, Priscilla; Spencer, Sue; Thomas, Michael O. J.; Watson, Peter

2009-01-01

The transition from school to tertiary study of mathematics comes under increasing scrutiny in research. This article reports on some findings from a project analysing the transition from secondary to tertiary education in mathematics. One key variable in this transition is the teacher or lecturer. This article deals with a small part of the data…

Entrepreneurship Education in Delta State Tertiary Institution as a Means of Achieving National Growth and Development

ERIC Educational Resources Information Center

Osakwe, Regina N.

2015-01-01

This study examined entrepreneurship education in Delta Sate tertiary institutions as a means of national growth and development. Two research questions were asked to guide the study. The population comprised all the 1,898 academic staff in eight tertiary institutions in the state. A sample of 800 lecturers was drawn through the multi stage and…

Transportability of tertiary qualifications and CPD: a continuing challenge for the global health workforce.

PubMed

Saltman, Deborah C; Kidd, Michael R; Jackson, Debra; Cleary, Michelle

2012-07-09

In workforces that are traditionally mobile and have long lead times for new supply, such as health, effective global indicators of tertiary education are increasingly essential. Difficulties with transportability of qualifications and cross-accreditation are now recognised as key barriers to meeting the rapidly shifting international demands for health care providers. The plethora of mixed education and service arrangements poses challenges for employers and regulators, let alone patients; in determining equivalence of training and competency between individuals, institutions and geographical locations. This paper outlines the shortfall of the current indicators in assisting the process of global certification and competency recognition in the health care workforce. Using Organisation for Economic Cooperation and Development (OECD) data we highlight how International standardisation in the tertiary education sector is problematic for the global health workforce. Through a series of case studies, we then describe a model which enables institutions to compare themselves internally and with others internationally using bespoke or prioritised parameters rather than standards. The mobility of the global health workforce means that transportability of qualifications is an increasing area of concern. Valid qualifications based on workplace learning and assessment requires at least some variables to be benchmarked in order to judge performance.

Manufacture of a combined primary and tertiary mirror for the Large Synoptic Survey Telescope

NASA Astrophysics Data System (ADS)

Martin, H. M.; Burge, J. H.; Cuerden, B.; Davison, W. B.; Kingsley, J. S.; Lutz, R. D.; Miller, S. M.; Tuell, M.

2008-07-01

The Large Synoptic Survey Telescope uses a unique optomechanical design that places the primary and tertiary mirrors on a single glass substrate. The honeycomb sandwich mirror blank was formed in March 2008 by spin-casting. The surface is currently a paraboloid with a 9.9 m focal length matching the primary. The deeper curve of the tertiary mirror will be produced when the surfaces are generated. Both mirrors will be lapped and polished using stressed laps and other tools on an 8.4 m polishing machine. The highly aspheric primary mirror will be measured through a refractive null lens, and a computer-generated hologram will be used to validate the null lens. The tertiary mirror will be measured through a diffractive null corrector, also validated with a separate hologram. The holograms for the two tests provide alignment references that will be used to make the axes of the two surfaces coincide.

Investigation of the working behavior of part-time occupational physicians using practical recording sheets.

PubMed

Ikegami, Kazunori; Nozawa, Hiroki; Michii, Satoshi; Sugano, Ryosuke; Ando, Hajime; Hasegawa, Masayuki; Kitamura, Hiroko; Ogami, Akira

2016-12-03

We investigated the working behavior of part-time occupational physicians using practical recording sheets to clarify issues of occupational physicians' activities according to industrial groups or size of business. We collected 561 recording sheets in 96 industries from 11 part-time occupational physicians as collaborators, who volunteered to be a part of this research. We collected a variety of information from the practical recording sheets, including the industry in which each occupational physician was employed, the annual number of times of work attendance, occupational physician-conducted workplace patrol, and employee health management. We investigated their annual practices regarding work environment management, work management, health management, and general occupational health management. In addition, we analyzed the differences between the secondary and tertiary industry groups and between the group of offices employing 100 people or fewer (≤100 group) and 101 people and above (≥101 group) in each industry group. The median work attendance by all occupational physicians was four times a year; the tertiary industry group had a significantly lower rate of work attendance than the secondary industry group. The occupational physicians' participation in risk assessment, mental health measures or overwork prevention, and the formulation of the occupational health management system and the annual plan were significantly lower in the tertiary industry group than in the secondary industry group. We observed that for the annual number of times of work attendance, occupational physician-conducted workplace patrol was significantly lower in the ≤100 group than in the ≥101 group in each industry group. These findings show that occupational physicians' activities have not been conducted enough in tertiary industries and small-sized offices employing ≤100 people. It would be necessary to evaluate how to provide occupational health service or appropriate

Leaf evolution in early-diverging ferns: insights from a new fern-like plant from the Late Devonian of China.

PubMed

Wang, De-Ming; Xu, Hong-He; Xue, Jin-Zhuang; Wang, Qi; Liu, Le

2015-06-01

With the exception of angiosperms, the main euphyllophyte lineages (i.e. ferns sensu lato, progymnosperms and gymnosperms) had evolved laminate leaves by the Late Devonian. The evolution of laminate leaves, however, remains unclear for early-diverging ferns, largely represented by fern-like plants. This study presents a novel fern-like taxon with pinnules, which provides new insights into the early evolution of laminate leaves in early-diverging ferns. Macrofossil specimens were collected from the Upper Devonian (Famennian) Wutong Formation of Anhui and Jiangsu Provinces, South China. A standard degagement technique was employed to uncover compressed plant portions within the rock matrix. A new fern-like taxon, SHOUGANGIA BELLA GEN ET SP NOV: , is described and represents an early-diverging fern with highly derived features. It has a partially creeping stem with adventitious roots only on one side, upright primary and secondary branches arranged in helices, tertiary branches borne alternately or (sub)oppositely, laminate and usually lobed leaves with divergent veins, and complex fertile organs terminating tertiary branches and possessing multiple divisions and numerous terminal sporangia. Shougangia bella provides unequivocal fossil evidence for laminate leaves in early-diverging ferns. It suggests that fern-like plants, along with other euphyllophyte lineages, had independently evolved megaphylls by the Late Devonian, possibly in response to a significant decline in atmospheric CO2 concentration. Among fern-like plants, planate ultimate appendages are homologous with laminate pinnules, and in the evolution of megaphylls, fertile organs tend to become complex. © The Author 2015. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effectiveness of Using Games in Tertiary-Level Mathematics Classrooms

ERIC Educational Resources Information Center

Afari, Ernest; Aldridge, Jill M.; Fraser, Barry J.

2012-01-01

The primary focus of this study was to investigate the effectiveness of games when used in tertiary-level mathematics classes in the United Arab Emirates. Our study incorporated a mixed-method approach that involved surveys (to assess students' perceptions of the learning environment and attitudes towards mathematics), interviews, observations of…

Child and family characteristics associated with age of diagnosis of an autism spectrum disorder in a tertiary care setting.

PubMed

Bickel, Julie; Bridgemohan, Carolyn; Sideridis, Georgios; Huntington, Noelle

2015-01-01

To identify child and family characteristics associated with age of diagnosis of autism spectrum disorder (ASD) in a tertiary care setting using objective, standardized assessments ensuring diagnostic validity and timing. The authors conducted a chart review of children who received their initial ASD diagnosis from 2007 to 2011. Child variables included gender, birth order, cognitive functioning, and for children ≤36 months, language and adaptive assessments. Family variables included insurance, maternal age, maternal education, sibling or family member with ASD, and number of children in the house. Primary outcome was age of ASD diagnosis. The authors ran multiple regression models evaluating the impact of child and family variables on the total sample and on the subsample of children ≤36 months. Median age of diagnosis was 2.9 years (range, 15 mo-13.8 yr; n = 591). In the total sample, significant predictors of earlier age of diagnosis were later birth order, higher maternal education, fewer children in the house, and a sibling with ASD. In a separate analysis of children ≤36 months of age (n = 315) with additional data for language and adaptive assessments, significant predictors of younger age of diagnosis were higher cognitive and adaptive functioning, lower receptive and expressive language, and having a sibling with ASD. This study suggests that both family and child characteristics play an important role in the early identification of ASD and that predictive variables may vary based on a child's age. Future research should help to elucidate this finding so that screening measures and policies aimed at early identification can target the most predictive factors.

Paleomagnetic constraints on the interpretation of early Cenozoic Pacific Northwest paleogeography

USGS Publications Warehouse

Wells, Ray E.

1984-01-01

Widespread Cenozoic clockwise tectonic rotation in the Pacific Northwest is an established fact; however, the geologic reconstructions based on these rotations are the subject of continuing debate. Three basic mechanisms have been proposed to explain the rotations: (1) simple shear rotation of marginal terranes caught in the dextral shear couple between oceanic plates and North America; (2) rotation during oblique microplate collision and accretion to the continental margin; and (3) rotation of continental margin areas during episodes of intracontinental extension. In areas where detailed structure and stratigraphy are available, distributed shear rotations are amplv demonstrated paleomagnetically. However, rotation due to asymmetric interarc extension must be significant, especially for the Oregon Coast Range, in light of recent estimates of large Tertiary extension across the northern Basin and Range. The relative importance of shear versus extension is difficult to determine, but shear could account for nearly onehalf of the observed rotations. Oblique microplate collision has not contributed significantly to the observed Cenozoic rotations because most of the rotation post-dates collision-related deformation in the Oregon and Washington. Coast Range. The resultant continental reconstructions suggest that about 300 km of extension has occurred at 42°N. latitude (southern Oregon border) since early Eocene time. This reconstruction suggests that Cretaceous sedimentary basins east of the Klamath Mountains have undergone significant Tertiary extension (about f<0%) , but little rotation. Upper Cretaceous sedimentary rocks in the Blue Mountains of Oregon near Mitchell are probably rotated at least 15° and perhaps as much as 60°, which allows considerable latitude in the restoration of that part of the basin.

Closure of the Mongol-Okhotsk Ocean as Constrained by Late Permian to Early Cretaceous Paleomagnetic Data from the Suture Zone

NASA Astrophysics Data System (ADS)

Cogne, J.; Kravchinsky, V.; Gilder, S.; Hankard, F.

2005-12-01

The Paleozoic Mongol-Okhotsk Ocean separated the Siberian craton to the north from a landmass composed of Amuria, Tarim, Qaidam, Tibet and the North and South China blocks to the south. Based on a comparison of paleomagnetic data from the NCB with the Eurasian apparent polar wander path, this ocean closed by the beginning of the Cretaceous. We present here a review of recent paleomagnetic studies of Late Permian to Early Cretaceous formations from the Transbaikal area of south Siberia, coming from localities situated on both sides of the Mongol-Okhotsk suture zone. The main conclusions that we draw from these studies are as follows. (1) A Late Permian ~4500 km latitude difference indeed existed between Amuria and the Siberia blocks at 110°E longitude. (2) In Middle-Late Jurassic times, a 1700 to 2700 km paleolatitudinal gap still existed between the two blocks. This contradicts geological interpretations of a Middle Jurassic closure of the ocean at this longitude. (3) Consistency of Early Cretaceous paleolatitudes from both sides of the suture demonstrates the closure of the ocean at that time. Altogether, these suggest a quite fast closure between the Middle Jurassic and the Early Cretaceous, at about 15±11 cm/yr. Finally, all pre-Late Cretaceous paleomagnetic poles appear to be distributed along small-circles centered on site localities. We think this is due to continued deformation acting in the Mongol-Okhotsk suture region related to suturing. Conversely, the post-Early Cretaceous rotations may be related to Tertiary deformation under the effect of the India-Asia collision.

How one might miss early warning signals of critical transitions in time series data: A systematic study of two major currency pairs

PubMed Central

Ciamarra, Massimo Pica; Cheong, Siew Ann

2018-01-01

There is growing interest in the use of critical slowing down and critical fluctuations as early warning signals for critical transitions in different complex systems. However, while some studies found them effective, others found the opposite. In this paper, we investigated why this might be so, by testing three commonly used indicators: lag-1 autocorrelation, variance, and low-frequency power spectrum at anticipating critical transitions in the very-high-frequency time series data of the Australian Dollar-Japanese Yen and Swiss Franc-Japanese Yen exchange rates. Besides testing rising trends in these indicators at a strict level of confidence using the Kendall-tau test, we also required statistically significant early warning signals to be concurrent in the three indicators, which must rise to appreciable values. We then found for our data set the optimum parameters for discovering critical transitions, and showed that the set of critical transitions found is generally insensitive to variations in the parameters. Suspecting that negative results in the literature are the results of low data frequencies, we created time series with time intervals over three orders of magnitude from the raw data, and tested them for early warning signals. Early warning signals can be reliably found only if the time interval of the data is shorter than the time scale of critical transitions in our complex system of interest. Finally, we compared the set of time windows with statistically significant early warning signals with the set of time windows followed by large movements, to conclude that the early warning signals indeed provide reliable information on impending critical transitions. This reliability becomes more compelling statistically the more events we test. PMID:29538373

How one might miss early warning signals of critical transitions in time series data: A systematic study of two major currency pairs.

PubMed

Wen, Haoyu; Ciamarra, Massimo Pica; Cheong, Siew Ann

2018-01-01

There is growing interest in the use of critical slowing down and critical fluctuations as early warning signals for critical transitions in different complex systems. However, while some studies found them effective, others found the opposite. In this paper, we investigated why this might be so, by testing three commonly used indicators: lag-1 autocorrelation, variance, and low-frequency power spectrum at anticipating critical transitions in the very-high-frequency time series data of the Australian Dollar-Japanese Yen and Swiss Franc-Japanese Yen exchange rates. Besides testing rising trends in these indicators at a strict level of confidence using the Kendall-tau test, we also required statistically significant early warning signals to be concurrent in the three indicators, which must rise to appreciable values. We then found for our data set the optimum parameters for discovering critical transitions, and showed that the set of critical transitions found is generally insensitive to variations in the parameters. Suspecting that negative results in the literature are the results of low data frequencies, we created time series with time intervals over three orders of magnitude from the raw data, and tested them for early warning signals. Early warning signals can be reliably found only if the time interval of the data is shorter than the time scale of critical transitions in our complex system of interest. Finally, we compared the set of time windows with statistically significant early warning signals with the set of time windows followed by large movements, to conclude that the early warning signals indeed provide reliable information on impending critical transitions. This reliability becomes more compelling statistically the more events we test.

Exploring the Relationship between Goal Orientations for Teaching of Tertiary Teachers and Their Teaching Approaches in China

ERIC Educational Resources Information Center

Han, Jiying; Yin, Hongbiao; Wang, Wenlan

2015-01-01

This study addresses a paucity of research into teacher motivation in higher education by exploring the relationship between tertiary teachers' goal orientations for teaching and their approaches to teaching in China. A questionnaire gathered responses from 262 Chinese tertiary teachers, and the results showed these teachers reporting higher…

Assessing Readiness for Integration of Electronic Learning into Business Education Programmes in Tertiary Institutions in Ebonyi State

ERIC Educational Resources Information Center

Nwagwu, Lazarus; Azih, Nonye

2015-01-01

The study was conducted to assess readiness for integration of electronic learning into business education programmes in tertiary institutions in Ebonyi State. Two research questions and two hypotheses guided the study. The population was 37 business education lecturers and 748 Business Education Students in tertiary institutions that offer…

Identifying Facilitating Factors and Barriers to Improving Student Retention Rates in Tertiary Teaching Courses: A Systematic Review

ERIC Educational Resources Information Center

Bowles, Terence V.; Brindle, Kimberley A.

2017-01-01

Factors which impact student retention in tertiary level teaching courses are complex. This study examined facilitating factors and barriers to student retention for students studying education. Due to a limited number of studies, the search was extended to factors impacting students undertaking tertiary education. A systematic review was…

[Current status of job burnout in clinical nurses in a grade A tertiary hospital and related influencing factors].

PubMed

Ye, L Y; Fan, C L; Wang, L G; Tao, T; Gao, W B; Li, Y H

2017-10-20

Objective: To investigate the current status of job burnout in clinical nurses in a grade A tertiary hospitalin Shaoxing,China and related influencing factors. Methods: In October 2016, the Nursing Burnout Scale (NBS)was used for the investigation of 304 clinical nurses in a grade A tertiary hospital.The contents of the investigation included general data(including age,education background,working years,marital status, frequency of night shifts,professional title, and way of employment), characteristics of working environment,burnout, personality characteristics,coping strategy,and psychosomatic symptoms.SPSS 18.0 was used to conduct Pearson correlation analysis of the scores of each dimension of NBS. A multivariate regression analysis was performed with the demographic features of clinical nurses as the independent variable and the scores of each dimension of NBS as the dependent variable. Results: Among the clinical nurses in this grade A tertiary hospital, the incidence rate of severe burnout was 74%.The Pearson correlation analysis showed that burnout,pessimistic personality,negative coping,and psychosomatic symptoms were positively correlated with working environment( r =0.530,0.316,0.116,and 0.502); pessimistic personality and psychosomatic symptoms were positively correlated with burnout( r =0.618 and 0.675); psychosomatic symptoms were positively correlated withpessimistic personality( r =0.540); negative coping was negatively correlated with pessimistic personality( r =-0.145).The multivariate linear regression analysis showed that department(Department of Internal Medicine or Department of Surgery, B =-0.364 and -0.428)and frequency of night shifts(<6 times/month and 6 - 10 times/month, B =0.199 and 0.256)were influencing factors for the score of working environment; department(Department of Internal Medicine or Department of Surgery, B =-0.350 and -0.360)was an influencing factor for the score of burnout; 1 - 3 working years( B =-0.238)was an influencing

A novel assay to measure tertiary and quaternary amines in wastewater: An indicator for NDMA wastewater precursors.

PubMed

Woods-Chabane, Gwen C; Glover, Caitlin M; Marti, Erica J; Dickenson, Eric R V

2017-07-01

This study examined the potential of using a novel bulk amine assay as an approximation for the tertiary and quaternary amine load in wastewaters and surface water samples, and this approximation was compared to N-nitrosodimethylamine (NDMA) formation potential using chloramines. An existing colorimetric method was examined and optimized for the detection of amines in environmental water samples. The method consists of liquid-liquid extraction followed by a catalyzed reaction to form a yet-undefined product that is known to be both a strong chromophore and fluorophore. Previous work verified that this reaction was effectively catalyzed by a number of compounds containing tertiary and quaternary amine moieties. Many tertiary and quaternary compounds are also efficient producers of NDMA under chloramination conditions, and a linear correlation was consequently derived from the bulk amine signals vs. NDMA formation potential in various wastewater samples (R 2  = 0.74; n = 24; p-value < 0.05). The results provide evidence that approximately 2% of the tertiary and quaternary amines measured can form NDMA and an estimated 0.01-1.3% of nitrogen in dissolved organic nitrogen originates from these bulk amines. The normalization of NDMA concentration by the amine measurement revealed that ozone effectively destroyed those tertiary and quaternary amine structures more likely to form NDMA in treated wastewater samples. This bulk amine assay illustrates that proxy measurements of tertiary and quaternary amines can be linked to the NDMA formation potential of a given sample, and this approach may prove useful as a characterizing tool for NDMA precursors in wastewater. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reform and Development of Tertiary Education in Europe. Recommendations.

ERIC Educational Resources Information Center

de Moor, R. A.; Vedel, Doyer Georges

Tertiary education policies in seven Western European and seven Southern European countries are evaluated in two reports. In the first report by R. A. de Moor, attention is focused on France, the Federal Republic of Germany, the Netherlands, Norway, Sweden, Switzerland, and the United Kingdom. The evaluation and policy recommendations for the…

Food Insecurity: Is It an Issue among Tertiary Students?

ERIC Educational Resources Information Center

Gallegos, Danielle; Ramsey, Rebecca; Ong, Kai Wen

2014-01-01

Insufficient access to food is known to compromise tertiary studies. Students often belong to groups known to have poor food security such as those renting or relying on government payments. The present study administered a cross-sectional survey incorporating the USDA food security survey module (FSSM) to 810 students at a metropolitan university…

Learning Assessment in Tertiary Business Education with Revised Taxonomy

ERIC Educational Resources Information Center

Hossain, Md. Shajjad

2017-01-01

The goal of this study was to evaluate the assessment criteria of learning in tertiary education of Bangladesh. The study was aimed at identifying percentage of questions during learning assessment of business graduates following cognitive levels of Bloom's in revised Taxonomy and to test whether there was any significant difference in the…

Childhood adversities and socioeconomic position as predictors of leisure-time physical inactivity in early adulthood.

PubMed

Kestilä, Laura; Mäki-Opas, Tomi; Kunst, Anton E; Borodulin, Katja; Rahkonen, Ossi; Prättälä, Ritva

2015-02-01

Limited knowledge exists on how childhood social, health-related and economic circumstances predict adult physical inactivity. Our aim was a) to examine how various childhood adversities and living conditions predict leisure-time physical inactivity in early adulthood and b) to find out whether these associations are mediated through the respondent's own education. Young adults aged 18-29 were used from the Health 2000 Study of the Finnish. The cross-sectional data were based on interviews and questionnaires including retrospective information on childhood circumstances. The analyses were carried out on 68% of the original sample (N = 1894). The outcome measure was leisure-time physical inactivity. Only a few of the 11 childhood adversities were related with physical activity in early adulthood. Having been bullied at school was associated with physical inactivity independently of the other childhood circumstances and the respondent's own education. Low parental education predicted leisure-time physical inactivity in men and the association was mediated by the respondent's own education. Respondents with only primary or vocational education were more likely to be physically inactive during leisure-time compared with those with secondary or higher education. There is some evidence that few specific childhood adversities, especially bullying at school, have long-lasting effects on physical activity levels.

Optimal timing of early versus delayed adjuvant radiotherapy following radical prostatectomy for locally advanced prostate cancer.

PubMed

Kowalczyk, Keith J; Gu, Xiangmei; Nguyen, Paul L; Lipsitz, Stuart R; Trinh, Quoc-Dien; Lynch, John H; Collins, Sean P; Hu, Jim C

2014-04-01

Although post-radical prostatectomy (RP) adjuvant radiation therapy (ART) benefits disease that is staged as pT3 or higher, the optimal ART timing remains unknown. Our objective is to characterize the outcomes and optimal timing of early vs. delayed ART. From the Surveillance, Epidemiology and End Results-Medicare data from 1995 to 2007, we identified 963 men with pT3N0 disease receiving early (<4 mo after RP, n = 419) vs. delayed (4-12 mo after RP, n = 544) ART after RP. Utilizing propensity score methods, we compared overall mortality, prostate cancer-specific mortality (PCSM), bone-related events (BRE), salvage hormonal therapy utilization, and intervention for urethral stricture. We then used the maximal statistic approach to determine at what time post-RP ART had the most significant effect on outcomes of interest in men with pT3N0 disease. When compared with delayed ART in men with pT3 disease, early ART was associated with improved PCSM (0.47 vs. 1.02 events per 100 person-years; P = 0.038) and less salvage hormonal therapy (2.88 vs. 4.59 events per 100 person-years; P = 0.001). Delaying ART beyond 5 months is associated with worse PCSM (hazard ratio [HR] 2.3; P = 0.020), beyond 3 months is associated with more BRE (HR 1.6; P = 0.025), and beyond 4 months is associated higher rates of salvage hormonal therapy (HR 1.6; P = 0.002). ART performed after 9 months was associated with fewer urethral strictures (HR 0.6; P = 0.042). Initiating ART less than 5 months after RP for pT3 is associated with improved PCSM. Early ART is also associated with fewer BRE and less use of salvage hormonal therapy if administered earlier than 3 and 4 months after RP, respectively. However, ART administered later than 9 months after RP is associated with fewer urethral strictures. Our population-based findings complement randomized trials designed with fixed ART timing. © 2013 Published by Elsevier Inc.

Accountability of Tertiary Education at the National Level: A Chimera?

ERIC Educational Resources Information Center

Lindsay, Alan; O'Byrne, Garry

1979-01-01

The concept of accountability and its application to Australian higher education are discussed. It is suggested that due to political, financial, and educational characteristics of tertiary education at the national system level there are fundamental and insoluble problems associated with achieving accountability. (SF)

Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients.

PubMed

Syed, Shahbaz; Wang, Dongmei; Goulard, Debbie; Rich, Tom; Innes, Grant; Lang, Eddy

2013-07-05

Computerized physician order entry (CPOE) systems are designed to increase safety and improve quality of care; however, their impact on efficiency in the ED has not yet been validated. This study examined the impact of CPOE on process times for medication delivery, laboratory utilization and diagnostic imaging in the early, late and control phases of a regional ED-CPOE implementation. Three tertiary care hospitals serving a population in excess of 1 million inhabitants that initiated the same CPOE system during the same 3-week time window. Patients were stratified into three groupings: Control, Early CPOE and Late CPOE (n = 200 patients per group/hospital site). Eligible patients consisted of a stratified (40% CTAS 2 and 60% CTAS 3) random sample of all patients seen 30 days preceding CPOE implementation (Control), 30 days immediately after CPOE implementation (Early CPOE) and 5-6 months after CPOE implementation (Late CPOE). Primary outcomes were time to (TT) from physician assignment (MD-sign) up to MD-order completion. An ANOVA and t-test were employed for statistical analysis. In comparison with control, TT 1st MD-Ordered Medication decreased in both the Early and Late CPOE groups (102.6 min control, 62.8 Early and 65.7 late, p < 0.001). TT 1st MD-ordered laboratory results increased in both the Early and Late CPOE groups compared to Control (76.4, 85.3 and 73.8 min, respectively, p < 0.001). TT 1st X-Ray also significantly increased in both the Early and Late CPOE groups (80.4, 84.8 min, respectively, compared to 68.1, p < 0.001). Given that CT and ultrasound imaging inherently takes increased time, these imaging studies were not included, and only X-ray was examined. There was no statistical difference found between TT discharge and consult request. Regional implementation of CPOE afforded important efficiencies in time to medication delivery for high acuity ED patients. Increased times observed for laboratory and radiology results may reflect system issues

Early relapse after autologous hematopoietic cell transplantation remains a poor prognostic factor in multiple myeloma but outcomes have improved over time.

PubMed

Kumar, S K; Dispenzieri, A; Fraser, R; Mingwei, F; Akpek, G; Cornell, R; Kharfan-Dabaja, M; Freytes, C; Hashmi, S; Hildebrandt, G; Holmberg, L; Kyle, R; Lazarus, H; Lee, C; Mikhael, J; Nishihori, T; Tay, J; Usmani, S; Vesole, D; Vij, R; Wirk, B; Krishnan, A; Gasparetto, C; Mark, T; Nieto, Y; Hari, P; D'Souza, A

2018-04-01

Duration of initial disease response remains a strong prognostic factor in multiple myeloma (MM) particularly for upfront autologous hematopoietic cell transplant (AHCT) recipients. We hypothesized that new drug classes and combinations employed prior to AHCT as well as after post-AHCT relapse may have changed the natural history of MM in this population. We analyzed the Center for International Blood and Marrow Transplant Research database to track overall survival (OS) of MM patients receiving single AHCT within 12 months after diagnosis (N=3256) and relapsing early post-AHCT (<24 months), and to identify factors predicting for early vs late relapses (24-48 months post-AHCT). Over three periods (2001-2004, 2005-2008, 2009-2013), patient characteristics were balanced except for lower proportion of Stage III, higher likelihood of one induction therapy with novel triplets and higher rates of planned post-AHCT maintenance over time. The proportion of patients relapsing early was stable over time at 35-38%. Factors reducing risk of early relapse included lower stage, chemosensitivity, transplant after 2008 and post-AHCT maintenance. Shorter post-relapse OS was associated with early relapse, IgA MM, Karnofsky <90, stage III, >1 line of induction and lack of maintenance. Post-AHCT early relapse remains a poor prognostic factor, even though outcomes have improved over time.

A New Age Dawning? Australia's New Tertiary Education Quality and Standards Agency Moves towards "Third Stage" Internationalisation

ERIC Educational Resources Information Center

Observatory on Borderless Higher Education, 2010

2010-01-01

Australia's Minister for Education, Employment and Workplace Relations recently launched a new agency whose primary focus is the protection of the country's tertiary education system. The government is developing the new AUD$57 million (approximately US$51 million) agency, the Tertiary Education Quality and Standards Agency (TEQSA), in response to…

Peer substance use as a mediator between early pubertal timing and adolescent substance use: longitudinal associations and moderating effect of maltreatment.

PubMed

Negriff, Sonya; Trickett, Penelope K

2012-11-01

Early pubertal timing has received considerable empirical support as a risk for adolescent substance use. However, few studies have examined the mediators linking these variables. Therefore, the aims of this study were (1) to examine peer substance use as a mediator between pubertal timing and adolescent substance use longitudinally and (2) to test gender and maltreatment experience as moderators of the mediational model. Data were obtained from time 1, 2, and 3 of a longitudinal study of maltreatment and development. At time 1 the sample was comprised of 303 maltreated and 151 comparison children aged 9-13 years (213 females and 241 males). Longitudinal mediation was tested using structural equation modeling and moderating effects were tested using multiple group analysis. Peer substance use mediated the relationship between early pubertal timing and later adolescent substance use for the total sample. Moderation analyses indicated this significant indirect effect did not differ for males and females. However, it did differ for maltreated versus comparison adolescents with the mediational effect only remaining significant for the comparison group. This is one of the first studies to examine peer substance use as a mediator of pubertal timing and adolescent substance use using a longitudinal design. Early maturing males are at equal risk to early maturing females for interacting with peers that may draw them into substance use. Additionally, the findings indicate that while peers are mediators for comparison adolescents a different mechanism may link early puberty to substance use for maltreated adolescents. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Treatment of Early Stage Endometrial Cancer by Transumbilical Laparoendoscopic Single-Site Surgery Versus Traditional Laparoscopic Surgery

PubMed Central

Cai, Hui-hua; Liu, Mu-biao; He, Yuan-li

2016-01-01

Abstract To compare the outcomes of transumbilical laparoendoscopic single-site surgery (TU-LESS) versus traditional laparoscopic surgery (TLS) for early stage endometrial cancer (EC). We retrospectively reviewed the medical records of patients with early stage EC who were surgically treated by TU-LESS or TLS between 2011 and 2014 in a tertiary care teaching hospital. We identified 18 EC patients who underwent TU-LESS. Propensity score matching was used to match this group with 18 EC patients who underwent TLS. All patients underwent laparoscopic-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy by TU-LESS or TLS without conversion to laparoscopy or laparotomy. Number of pelvic lymph nodes retrieved, operative time and estimated blood loss were comparable between 2 groups. Satisfaction values of the cosmetic outcome evaluated by the patient at day 30 after surgery were significantly higher in TU-LESS group than that in TLS group (9.6 ± 0.8 vs 7.5 ± 0.7, P < 0.001), while there was no statistical difference in postoperative complications within 30 days after surgery, postoperative hospital stay, and hospital cost. For the surgical management of early stage EC, TU-LESS may be a feasible alternative approach to TLS, with comparable short-term surgical outcomes and superior cosmetic outcome. Future large-scale prospective studies are needed to identify these benefits. PMID:27057851

Tertiary plate tectonics and high-pressure metamorphism in New Caledonia

USGS Publications Warehouse

Brothers, R.N.; Blake, M.C.

1973-01-01

The sialic basement of New Caledonia is a Permian-Jurassic greywacke sequence which was folded and metamorphosed to prehnite-pumpellyite or low-grade greenschist facies by the Late Jurassic. Succeeding Cretaceous-Eocene sediments unconformably overlie this basement and extend outwards onto oceanic crust. Tertiary tectonism occurred in three distinct phases. 1. (1) During the Late Eocene a nappe of peridotite was obducted onto southern New Caledonia from northeast to southwest, but without causing significant metamorphism in the underlying sialic rocks. 2. (2) Oligocene compressive thrust tectonics in the northern part of the island accompanied a major east-west subduction zone, at least 30 km wide, which is identified by an imbricate system of tectonically intruded melanges and by development of lawsonite-bearing assemblages in adjacent country rocks; this high-pressure mineralogy constituted a primary metamorphism for the Cretaceous-Eocene sedimentary pile, but was overprinted on the Mesozoic prehnite-pumpellyite metagreywackes. 3. (3) Post-Oligocene transcurrent faulting along a northwest-southeast line (the sillon) parallel to the west coast caused at least 150 km of dextral offset of the southwest frontal margin of the Eocene ultramafic nappe. At the present time, the tectonics of the southwest Pacific are related to a series of opposite facing subduction (Benioff) zones connected by transform faults extending from New Britain-Solomon Islands south through the New Hebrides to New Zealand and marking the boundary between the Australian and Pacific plates. Available geologic data from this region suggest that a similar geometry existed during the Tertiary and that the microcontinents of New Guinea, New Caledonia and New Zealand all lay along the former plate boundary which has since migrated north and east by a complex process of sea-floor spreading behind the active island arcs. ?? 1973.

Coeliac disease screening is suboptimal in a tertiary gastroenterology setting.

PubMed

Iskandar, Heba; Gray, Darrell M; Vu, Hongha; Mirza, Faiz; Rude, Mary Katherine; Regan, Kara; Abdalla, Adil; Gaddam, Srinivas; Almaskeen, Sami; Mello, Michael; Marquez, Evelyn; Meyer, Claire; Bolkhir, Ahmed; Kanuri, Navya; Sayuk, Gregory; Gyawali, C Prakash

2017-08-01

Coeliac disease (CD) is widely prevalent in North America, but case-finding techniques currently used may not be adequate for patient identification. We aimed to determine the adequacy of CD screening in an academic gastroenterology (GI) practice. Consecutive initial visits to a tertiary academic GI practice were surveyed over a 3-month period as a fellow-initiated quality improvement project. All electronic records were reviewed to look for indications for CD screening according to published guidelines. The timing of screening was noted (before or after referral), as well as the screening method (serology or biopsy). Data were analysed to compare CD screening practices across subspecialty clinics. 616 consecutive patients (49±0.6 years, range 16-87 years, 58.5% females, 94% Caucasian) fulfilled inclusion criteria. CD testing was indicated in 336 (54.5%), but performed in only 145 (43.2%). The need for CD screening was highest in luminal GI and inflammatory bowel disease clinics, followed by biliary and hepatology clinics (p<0.0001); CD screening rate was highest in the luminal GI clinic (p=0.002). Of 145 patients screened, 4 patients (2.4%) had serology consistent with CD, of which 2 were proven by duodenal biopsy. Using this proportion, an additional 5 patients might have been diagnosed in 191 untested patients with indications for CD screening. More than 50% of patients in a tertiary GI clinic have indications for CD screening, but <50% of indicated cases are screened. Case-finding techniques therefore are suboptimal, constituting a gap in patient care and an important target for future quality improvement initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Introductory Statistics Course Tertiary Students' Understanding of P-Values

ERIC Educational Resources Information Center

Reaburn, Robyn

2014-01-01

This study aimed to gain knowledge of students' beliefs and difficulties in understanding p-values, and to use this knowledge to develop improved teaching programs. This study took place over four consecutive teaching semesters of a one-semester tertiary statistics unit. The study was cyclical, in that the results of each semester were used to…

Tertiary Institutions, Entrepreneurship Education and Youth Empowerment in Nigeria

ERIC Educational Resources Information Center

Olasunkanmi, Abari Ayodeji; Olufunke, Oyetola Idowu; Adetayo, Okunuga Adedapo

2013-01-01

Entrepreneurship Education has recently become a global phenomenon in the development of world youths for self employment and self-reliance. The Nigerian nation cannot afford to be left out and left behind in this new trend in education both at the secondary and tertiary levels. However, while the Universal Basic Education (UBE) curriculum has…

[Streptococcal toxic shock syndrome: ten years' experience at a tertiary hospital].

PubMed

Vallalta-Morales, Manuel; Salavert-Lletí, Miguel; Artero-Mora, Arturo; Mahiques-Santos, Laura; Solaz-Moreno, Elena; Pérez-Bellés, Carmen

2005-11-01

In the last two decades there has been a reported increase in the incidence of streptococcal toxic shock syndrome (STSS). The objective of this study was to determine the clinical and epidemiological characteristics of this infection. Retrospective study of all cases of STSS diagnosed at a single tertiary hospital over the last ten years. We report 13 cases of STSS (8 men, mean age 62 years). The mean annual incidence was 0.19 episodes/100,000 population from 1994 to 1998 and 0.53 episodes/100,000 population from 1999 to 2003 (p = 0.059). All patients had at least one underlying disease and there were no intravenous drug users. The most common portals of entry were the skin and soft tissues (85%) and all but one patient had a positive blood culture. Two cases were nosocomial and five patients required surgery (amputation and/or debridement). There was a high mortality rate (85%) and a rapid course from onset to death; nine patients died within four days after establishing the diagnosis. The incidence of SSTS has increased over the last five years at our hospital. Elderly patients with underlying medical conditions were more susceptible to acquiring this infection. Early mortality was very high.

Clinico-radiographic study of odontogenic cysts at a tertiary care centre.

PubMed

Ali, Kamran; Munir, Faisal; Rehman, Abdur; Abbas, Iram; Ahmad, Nofil; Akhtar, Muhammad Usman

2014-01-01

Cysts of the jaws constitute an important pathology in the oral and maxillofacial region and are broadly classified as odontogenic and non-odontogenic. Objective of this study was to document the clinical and radiographic presentation of odontogenic cysts at a tertiary care centre. In this descriptive case-series, patients presenting with features of suspected cystic lesions of the jaws were investigated using radiographs and incisional biopsy. Subjects showing clinico- radiographic features of odontogenic cyst(s) with subsequent confirmation on histopathological examination were included. A total of 112 subjects were investigated for suspected jaw cysts and cystic diagnosis of odontogenic cysts was confirmed in 100 patients with 53 males (53%) and 47 females (47%). The age range of patients was from 12-55 years. Radicular cyst was the most commonly diagnosed odontogenic cyst (63%) followed by dentigerous cyst (22%) and odontogenickeratocyst (14%). Anterior maxilla was the most affected site (44%) followed by posterior mandible (30%). Odontogenic cysts constitute an established pathology affecting the jaws with varying frequency. This study augments the data cited from Western countries and re-emphasizes the need for early diagnosis and prompt management. It also highlights the differences in the presentation of odontogenic cysts as observed in the current series.

Occipital MEG Activity in the Early Time Range (<300 ms) Predicts Graded Changes in Perceptual Consciousness.

PubMed

Andersen, Lau M; Pedersen, Michael N; Sandberg, Kristian; Overgaard, Morten

2016-06-01

Two electrophysiological components have been extensively investigated as candidate neural correlates of perceptual consciousness: An early, occipitally realized component occurring 130-320 ms after stimulus onset and a late, frontally realized component occurring 320-510 ms after stimulus onset. Recent studies have suggested that the late component may not be uniquely related to perceptual consciousness, but also to sensory expectations, task associations, and selective attention. We conducted a magnetoencephalographic study; using multivariate analysis, we compared classification accuracies when decoding perceptual consciousness from the 2 components using sources from occipital and frontal lobes. We found that occipital sources during the early time range were significantly more accurate in decoding perceptual consciousness than frontal sources during both the early and late time ranges. These results are the first of its kind where the predictive values of the 2 components are quantitatively compared, and they provide further evidence for the primary importance of occipital sources in realizing perceptual consciousness. The results have important consequences for current theories of perceptual consciousness, especially theories emphasizing the role of frontal sources. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Wormholes versus black holes: quasinormal ringing at early and late times

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

Konoplya, R.A.; Zhidenko, A., E-mail: roman.konoplya@uni-tuebingen.de, E-mail: olexandr.zhydenko@ufabc.edu.br

Recently it has been argued that the phantom thin-shell wormholes matched with the Schwarzschild space-time near the Schwarzschild radius ring like Schwarzschild black holes at early times, but differently at late times [1]. Here we consider perturbations of the wormhole which was constructed without thin-shells: the Bronnikov-Ellis wormhole supported by the phantom matter and electromagnetic field. This wormhole solution is known to be stable under specific equation of state of the phantom matter. We show that if one does not use the above thin-shell matching, the wormhole, depending on the values of its parameters, either rings as the black holemore » at all times or rings differently also at all times . The wormhole's spectrum, investigated here, posses a number of distinctive features. In the final part we have considered general properties of scattering around arbitrary rotating traversable wormholes. We have found that symmetric and non-symmetric (with respect to the throat) wormholes are qualitatively different in this respect: first, superradiance is allowed only if for those non-symmetric wormholes for which the asymptotic values of the rotation parameters are different on both sides from the throat. Second, the symmetric wormholes cannot mimic effectively the ringing of a black hole at a few various dominant multipoles at the same time, so that the future observations of various events should easily tell the symmetric wormhole from a black hole.« less

Improving Tertiary Student Outcomes in the First Year of Study: What Your Students May Not Tell You

ERIC Educational Resources Information Center

Dewart, Bonnie; Rowan, Linda

2008-01-01

There has been increased interest in retention and completion with regard to tertiary student outcomes in relation to students' successful completion of their study and what influences this. In New Zealand, the government through the Tertiary Education Commission (TEC) has made it clear that it expects institutions to meet retention and completion…

Nickel-Catalyzed Coupling Reactions of Alkyl Electrophiles, Including Unactivated Tertiary Halides, to Generate Carbon–Boron Bonds

PubMed Central

Dudnik, Alexander S.

2012-01-01

Through the use of a catalyst formed in situ from NiBr2•diglyme and a pybox ligand (both of which are commercially available), we have achieved our first examples of coupling reactions of unactivated tertiary alkyl electrophiles, as well as our first success with nickel-catalyzed couplings that generate bonds other than C–C bonds. Specifically, we have determined that this catalyst accomplishes Miyaura-type borylations of unactivated tertiary, secondary, and primary alkyl halides with diboron reagents to furnish alkylboronates, a family of compounds with substantial (and expanding) utility, under mild conditions; indeed, the umpolung borylation of a tertiary alkyl bromide can be achieved at a temperature as low as −10 °C. The method exhibits good functional-group compatibility and is regiospecific, both of which can be issues with traditional approaches to the synthesis of alkylboronates. In contrast to seemingly related nickel-catalyzed C–C bond-forming processes, tertiary halides are more reactive than secondary or primary halides in this nickel-catalyzed C–B bond-forming reaction; this divergence is particularly noteworthy in view of the likelihood that both transformations follow an inner-sphere electron-transfer pathway for oxidative addition. PMID:22668072

Satisfaction among early and mid-career dentists in a metropolitan dental hospital in China

PubMed Central

Cui, Xiaoxi; Dunning, David G; An, Na

2017-01-01

A growing body of research has examined career satisfaction among dentists using a standardized instrument, dentist satisfaction survey (DSS). This project examined career satisfaction of early to mid-career dentists in China, a population whose career satisfaction, heretofore, has not been studied. This is an especially critical time to examine career satisfaction because of health care reform measures being implemented in China. A culturally sensitive Chinese-language version of the DSS (CDSS) was developed and electronically administered to 367 early and mid-career dentists in a tertiary dental hospital in Beijing, China. One hundred and seventy respondents completed the survey. The average total career score was 123, with a range of 82–157. Data analysis showed some significant differences in total career score and several subscales based on gender, working hours per week, and years in practice. A stepwise regression model revealed that two variables predicted total career score: working hours per week and gender. Stepwise regression also demonstrated that four subscales significantly predicted the overall professional satisfaction subscale score: respect, delivery of care, income and patient relations. Implications of these results are discussed in light of the health care delivery system and dentist career paths in China. PMID:29355243

Activities of an ethics consultation service in a Tertiary Military Medical Center.

PubMed

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

Integrating real-time subsurface hydrologic monitoring with empirical rainfall thresholds to improve landslide early warning

USGS Publications Warehouse

Mirus, Benjamin B.; Becker, Rachel E.; Baum, Rex L.; Smith, Joel B.

2018-01-01

Early warning for rainfall-induced shallow landsliding can help reduce fatalities and economic losses. Although these commonly occurring landslides are typically triggered by subsurface hydrological processes, most early warning criteria rely exclusively on empirical rainfall thresholds and other indirect proxies for subsurface wetness. We explore the utility of explicitly accounting for antecedent wetness by integrating real-time subsurface hydrologic measurements into landslide early warning criteria. Our efforts build on previous progress with rainfall thresholds, monitoring, and numerical modeling along the landslide-prone railway corridor between Everett and Seattle, Washington, USA. We propose a modification to a previously established recent versus antecedent (RA) cumulative rainfall thresholds by replacing the antecedent 15-day rainfall component with an average saturation observed over the same timeframe. We calculate this antecedent saturation with real-time telemetered measurements from five volumetric water content probes installed in the shallow subsurface within a steep vegetated hillslope. Our hybrid rainfall versus saturation (RS) threshold still relies on the same recent 3-day rainfall component as the existing RA thresholds, to facilitate ready integration with quantitative precipitation forecasts. During the 2015–2017 monitoring period, this RS hybrid approach has an increase of true positives and a decrease of false positives and false negatives relative to the previous RA rainfall-only thresholds. We also demonstrate that alternative hybrid threshold formats could be even more accurate, which suggests that further development and testing during future landslide seasons is needed. The positive results confirm that accounting for antecedent wetness conditions with direct subsurface hydrologic measurements can improve thresholds for alert systems and early warning of rainfall-induced shallow landsliding.

Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

PubMed

Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin

2016-12-01

This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

Chapter 4: The Cretaceous-Lower Tertiary Composite Total Petroleum System, Wind River Basin, Wyoming