Factors associated with the decline disease of sugar maple on the Allegheny Plateau

Treesearch

Stephen B. Horsley; Robert P. Long; Scott W. Bailey; Richard A. Hallett; Thomas J. Hall

2000-01-01

Mortality of sugar maple (Acer saccharum Marsh.) has reached unusually high levels across northern Pennsylvania since the early to mid-1980s. We evaluated the influence of glaciation, topographic position, foliage chemistry, defoliation history, and stand characteristics (species composition, structure, density) on the health of sugar maple in 43...

Unusual complication of toxic megacolon in typhoid colitis.

PubMed

Arun Babu, Thirunavukkarasu; Ananthakrishnan, Shanthi; Jayakumar, P; Kullu, Poonam

2014-05-01

Colitis is a rare manifestation of enteric fever in children. Toxic megacolon complicating typhoid colitis is even rarer and requires early recognition and aggressive management due to the high mortality associated with this condition. The authors report a rare case of Toxic megacolon secondary to typhoid colitis in a seven-year-old girl.

Intermittent Ovarian Torsion in Pregnancy

PubMed Central

Young, Randall; Cork, Kelly

2017-01-01

Ovarian torsion during pregnancy is a fairly uncommon complication with a high patient morbidity and fetal mortality if not immediately treated. Ovarian torsion should be considered a clinical diagnosis, and a high level of clinical suspicion is needed by the practitioner to ensure that this diagnosis is not missed. We present an unusual case of intermittent ovarian torsion discussing both the presentation and the operative and post-operative management. PMID:29849404

Tree mortality patterns following prescribed fire for Pinus and Abies across the southwestern United States

USGS Publications Warehouse

van Mantgem, Philip J.; Nesmith, Jonathan C. B.; Keifer, MaryBeth; Brooks, Matthew

2012-01-01

The reintroduction of fire to historically fire-prone forests has been repeatedly shown to reduce understory fuels and promote resistance to high severity fire. However, there is concern that prescribed fire may also have unintended consequences, such as high rates of mortality for large trees and fire-tolerant Pinus species. To test this possibility we evaluated mortality patterns for two common genera in the western US, Pinus and Abies, using observations from a national-scale prescribed fire effects monitoring program. Our results show that mortality rates of trees >50 DBH were similar for Pinus (4.6% yr-1) and Abies (4.0% yr-1) 5 years following prescribed fires across seven sites in the southwestern US. In contrast, mortality rates of trees >50 cm DBH differed between Pinus (5.7% yr-1) and Abies (9.0% yr-1). Models of post-fire mortality probabilities suggested statistically significant differences between the genera (after including differences in bark thickness), but accounting for these differences resulted in only small improvements in model classification. Our results do not suggest unusually high post-fire mortality for large trees or for Pinus relative to the other common co-occurring genus, Abies, following prescribed fire in the southwestern US.

Survival of largemouth bass from populations infected with largemouth bass virus and subjected to simulated tournament conditions

USGS Publications Warehouse

Schramm, H.L.; Davis, J.G.

2006-01-01

Mortality was measured for largemouth bass Micropterus salmoides in simulated tournaments conducted at 26??C to determine whether an easily accomplished live-well management protocol reduced mortality. Treatment fish, which received the live-well management protocol, were held for 8 h in live wells at 23??C with water containing more than 5 mg of dissolved oxygen/L and 0.3% salt (NaCl). Control fish, were confined for 8 h in live wells at 26??C (ambient temperature) with dissolved oxygen fluctuating from 3 to 5 mg/L and no salt, which simulated the live-well management practices used by largemouth bass tournament anglers. Mortality after live-well confinement was 0% for both treatment and control fish, and mortality during the first 24 h after the simulated tournaments was 2.5%. Mortality of fish observed for up to 5 d after the simulated tournaments was high for treatment fish (mean = 75%; SE = 16%) and control fish (mean = 85%; SE = 11%), and we conclude that the treatment conditions did not reduce postrelease mortality. We suggest that the unusually high posttournament mortality was related to largemouth bass virus infections. ?? Copyright by the American Fisheries Society 2006.

Saigas on the brink: Multidisciplinary analysis of the factors influencing mass mortality events

PubMed Central

Kock, Richard A.; Orynbayev, Mukhit; Robinson, Sarah; Zuther, Steffen; Singh, Navinder J.; Beauvais, Wendy; Morgan, Eric R.; Kerimbayev, Aslan; Khomenko, Sergei; Martineau, Henny M.; Rystaeva, Rashida; Omarova, Zamira; Wolfs, Sara; Hawotte, Florent; Radoux, Julien; Milner-Gulland, Eleanor J.

2018-01-01

In 2015, more than 200,000 saiga antelopes died in 3 weeks in central Kazakhstan. The proximate cause of death is confirmed as hemorrhagic septicemia caused by the bacterium Pasteurella multocida type B, based on multiple strands of evidence. Statistical modeling suggests that there was unusually high relative humidity and temperature in the days leading up to the mortality event; temperature and humidity anomalies were also observed in two previous similar events in the same region. The modeled influence of environmental covariates is consistent with known drivers of hemorrhagic septicemia. Given the saiga population’s vulnerability to mass mortality and the likely exacerbation of climate-related and environmental stressors in the future, management of risks to population viability such as poaching and viral livestock disease is urgently needed, as well as robust ongoing veterinary surveillance. A multidisciplinary approach is needed to research mass mortality events under rapid environmental change. PMID:29376120

Genomic signatures predict migration and spawning failure in wild Canadian salmon.

PubMed

Miller, Kristina M; Li, Shaorong; Kaukinen, Karia H; Ginther, Norma; Hammill, Edd; Curtis, Janelle M R; Patterson, David A; Sierocinski, Thomas; Donnison, Louise; Pavlidis, Paul; Hinch, Scott G; Hruska, Kimberly A; Cooke, Steven J; English, Karl K; Farrell, Anthony P

2011-01-14

Long-term population viability of Fraser River sockeye salmon (Oncorhynchus nerka) is threatened by unusually high levels of mortality as they swim to their spawning areas before they spawn. Functional genomic studies on biopsied gill tissue from tagged wild adults that were tracked through ocean and river environments revealed physiological profiles predictive of successful migration and spawning. We identified a common genomic profile that was correlated with survival in each study. In ocean-tagged fish, a mortality-related genomic signature was associated with a 13.5-fold greater chance of dying en route. In river-tagged fish, the same genomic signature was associated with a 50% increase in mortality before reaching the spawning grounds in one of three stocks tested. At the spawning grounds, the same signature was associated with 3.7-fold greater odds of dying without spawning. Functional analysis raises the possibility that the mortality-related signature reflects a viral infection.

Bird mortality during nocturnal migration over Lake Michigan: A case study

USGS Publications Warehouse

Diehl, Robert H.; Bates, John M.; Willard, David E.; Gnoske, Thomas P.

2014-01-01

Millions of birds die each year during migration. Most of this mortality goes unobserved and conditions surrounding the actual events are often not thoroughly documented. We present a case study of substantial migrant casualties along the shores of southwestern Lake Michigan during May 1996 when we found 2,981 dead birds of 114 species, mostly migrant passerines. An unusual sequence of events allowed us to document the circumstances surrounding this migratory bird kill. Bird carcasses appeared on the southwestern shores of Lake Michigan in the days following storm systems that produced high rain and in one case, hail. Encounters between birds and precipitation over open water were recorded by weather radar, and were followed by winds that drifted dead birds toward highly populated shorelines where the kill was observed and documented. Climatologically, May 1996 was exceptional for producing weather conditions that both killed birds en masse and allowed the mortality to be documented. As a result, this is one of the more thoroughly documented instances of a weather-related mass mortality event during migration.

PFOS and PFOSA in Bottlenose Dolphins: An Investigation into Two Unusual Mortality Epizootics (WDA)

EPA Science Inventory

Along the Atlantic coast of the United States during 1987 and 1988, bottlenose dolphins (Tursiops truncatus) suffered one of this country's largest marine mammal mass mortality events. An estimated 50% of all near-shore bottlenose died during this short period. Two years later a ...

Extreme mortality after first introduction of measles virus to the polynesian island of Rotuma, 1911.

PubMed

Shanks, G Dennis; Lee, Seung-Eun; Howard, Alan; Brundage, John F

2011-05-15

Rotuma is an isolated Polynesian island. In January 1911, most residents of Rotuma (population approximately 2,600) were exposed to measles virus for the first time. The official mortality register documented 491 deaths due to all causes among Rotumans during 1911 (cumulative measles-related mortality: 12.8%); most deaths occurred in April-May and were attributed to measles and its sequelae. Measles-related mortality rates were higher among young children (23.4 per 100 person-years) and young adults (17.1 per 100 person-years) than among adolescents (11.0 per 100 person-years) and older adults (5.6 per 100 person-years); females (16.2 per 100 person-years) died at a higher rate than males (13.2 per 100 person-years). Gastrointestinal complications (75%), not respiratory complications, were the predominant clinical manifestations of fatal measles cases; tuberculosis mortality was unusually high during the year of the epidemic. In 1911, measles-related mortality varied by nearly 3-fold across geographic districts (range, 7.4%-21.6%). The extreme mortality due to measles on Rotuma typifies the experiences of isolated populations after first encounters with measles; it suggests that prior exposures to a narrow range of microbes and genetic homogeneity predispose isolated populations to lethal outcomes when they are first exposed to highly contagious and pathogenic viruses (e.g., measles, influenza).

Identifying the determinants of premature mortality in Russia: overcoming a methodological challenge

PubMed Central

Tomkins, Susannah; Shkolnikov, Vladimir; Andreev, Evgueni; Kiryanov, Nikolay; Leon, David A; McKee, Martin; Saburova, Lyudmila

2007-01-01

Background It is thought that excessive alcohol consumption is related to the high mortality among working age men in Russia. Moreover it has been suggested that alcohol is a key proximate driver of the very sharp fluctuations in mortality seen in this group since the mid-1980s. Designing an individual-level study suitable to address the potential acute effects of alcohol consumption on mortality in Russia has posed a challenge to epidemiologists, especially because of the need to identify factors that could underlie the rapid changes up and down in mortality rates that have been such a distinctive feature of the Russian mortality crisis. In order to address this study question which focuses on exposures acting shortly before sudden death, a cohort would be unfeasibly large and would suffer from recruitment bias. Methods Although the situation in Russia is unusual, with a very high death rate characterised by many sudden and apparently unexpected deaths in young men, the methodological problem is common to research on any cause of death where many deaths are sudden. Results We describe the development of an innovative approach that has overcome some of these challenges: a case-control study employing proxy informants and external data sources to collect information about proximate determinants of mortality. Conclusion This offers a set of principles that can be adopted by epidemiologists studying sudden and unexpected deaths in other settings. PMID:18045487

Identifying the determinants of premature mortality in Russia: overcoming a methodological challenge.

PubMed

Tomkins, Susannah; Shkolnikov, Vladimir; Andreev, Evgueni; Kiryanov, Nikolay; Leon, David A; McKee, Martin; Saburova, Lyudmila

2007-11-28

It is thought that excessive alcohol consumption is related to the high mortality among working age men in Russia. Moreover it has been suggested that alcohol is a key proximate driver of the very sharp fluctuations in mortality seen in this group since the mid-1980s. Designing an individual-level study suitable to address the potential acute effects of alcohol consumption on mortality in Russia has posed a challenge to epidemiologists, especially because of the need to identify factors that could underlie the rapid changes up and down in mortality rates that have been such a distinctive feature of the Russian mortality crisis. In order to address this study question which focuses on exposures acting shortly before sudden death, a cohort would be unfeasibly large and would suffer from recruitment bias. Although the situation in Russia is unusual, with a very high death rate characterised by many sudden and apparently unexpected deaths in young men, the methodological problem is common to research on any cause of death where many deaths are sudden. We describe the development of an innovative approach that has overcome some of these challenges: a case-control study employing proxy informants and external data sources to collect information about proximate determinants of mortality. This offers a set of principles that can be adopted by epidemiologists studying sudden and unexpected deaths in other settings.

Ruptured Left Gastric Artery Aneurysm: Unique Presentation with Hemothorax and Hemomediastinum

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

Lee, Michael K.S., E-mail: mkslee@optusnet.com.au; Vrazas, John I.

2006-06-15

Although splanchnic artery aneurysms are uncommon and remain mostly asymptomatic, they are associated with a high mortality rate when they rupture. We discuss the case of a 66-year-old woman who had successful embolization of a left gastric artery aneurysm after presenting with acute chest pain and the unusual computed tomography findings of hemothorax and hemomediastinum. To our knowledge, only one other similar case has been published in the literature.

Unusually High Mortality in Waterfowl Caused by Highly Pathogenic Avian Influenza A(H5N1) in Bangladesh.

PubMed

Haider, N; Sturm-Ramirez, K; Khan, S U; Rahman, M Z; Sarkar, S; Poh, M K; Shivaprasad, H L; Kalam, M A; Paul, S K; Karmakar, P C; Balish, A; Chakraborty, A; Mamun, A A; Mikolon, A B; Davis, C T; Rahman, M; Donis, R O; Heffelfinger, J D; Luby, S P; Zeidner, N

2017-02-01

Mortality in ducks and geese caused by highly pathogenic avian influenza A(H5N1) infection had not been previously identified in Bangladesh. In June-July 2011, we investigated mortality in ducks, geese and chickens with suspected H5N1 infection in a north-eastern district of the country to identify the aetiologic agent and extent of the outbreak and identify possible associated human infections. We surveyed households and farms with affected poultry flocks in six villages in Netrokona district and collected cloacal and oropharyngeal swabs from sick birds and tissue samples from dead poultry. We conducted a survey in three of these villages to identify suspected human influenza-like illness cases and collected nasopharyngeal and throat swabs. We tested all swabs by real-time RT-PCR, sequenced cultured viruses, and examined tissue samples by histopathology and immunohistochemistry to detect and characterize influenza virus infection. In the six villages, among the 240 surveyed households and 11 small-scale farms, 61% (1789/2930) of chickens, 47% (4816/10 184) of ducks and 73% (358/493) of geese died within 14 days preceding the investigation. Of 70 sick poultry swabbed, 80% (56/70) had detectable RNA for influenza A/H5, including 89% (49/55) of ducks, 40% (2/5) of geese and 50% (5/10) of chickens. We isolated virus from six of 25 samples; sequence analysis of the hemagglutinin and neuraminidase gene of these six isolates indicated clade 2.3.2.1a of H5N1 virus. Histopathological changes and immunohistochemistry staining of avian influenza viral antigens were recognized in the brain, pancreas and intestines of ducks and chickens. We identified ten human cases showing signs compatible with influenza-like illness; four were positive for influenza A/H3; however, none were positive for influenza A/H5. The recently introduced H5N1 clade 2.3.2.1a virus caused unusually high mortality in ducks and geese. Heightened surveillance in poultry is warranted to guide appropriate diagnostic testing and detect novel influenza strains. © 2015 Blackwell Verlag GmbH.

Unusually High Mortality in Waterfowl Caused by Highly Pathogenic Avian Influenza A(H5N1) in Bangladesh

PubMed Central

Haider, N.; Sturm-Ramirez, K.; Khan, S. U.; Rahman, M. Z.; Sarkar, S.; Poh, M. K.; Shivaprasad, H. L.; Kalam, M. A.; Paul, S. K.; Karmakar, P. C.; Balish, A.; Chakraborty, A.; Mamun, A. A.; Mikolon, A. B.; Davis, C. T.; Rahman, M.; Donis, R. O.; Heffelfinger, J. D.; Luby, S. P.; Zeidner, N.

2015-01-01

Summary Mortality in ducks and geese caused by highly pathogenic avian influenza A (H5N1) infection had not been previously identified in Bangladesh. In June–July 2011, we investigated mortality in ducks, geese and chickens with suspected H5N1 infection in a north-eastern district of the country to identify the aetiologic agent and extent of the outbreak and identify possible associated human infections. We surveyed households and farms with affected poultry flocks in six villages in Netrokona district and collected cloacal and oropharyngeal swabs from sick birds and tissue samples from dead poultry. We conducted a survey in three of these villages to identify suspected human influenza-like illness cases and collected nasopharyngeal and throat swabs. We tested all swabs by real-time RT-PCR, sequenced cultured viruses, and examined tissue samples by histopathology and immunohistochemistry to detect and characterize influenza virus infection. In the six villages, among the 240 surveyed households and 11 small-scale farms, 61% (1789/2930) of chickens, 47% (4816/10 184) of ducks and 73% (358/493) of geese died within 14 days preceding the investigation. Of 70 sick poultry swabbed, 80% (56/70) had detectable RNA for influenza A/H5, including 89% (49/55) of ducks, 40% (2/5) of geese and 50% (5/10) of chickens. We isolated virus from six of 25 samples; sequence analysis of the hemagglutinin and neuraminidase gene of these six isolates indicated clade 2.3.2.1a of H5N1 virus. Histopathological changes and immunohistochemistry staining of avian influenza viral antigens were recognized in the brain, pancreas and intestines of ducks and chickens. We identified ten human cases showing signs compatible with influenza-like illness; four were positive for influenza A/H3; however, none were positive for influenza A/H5. The recently introduced H5N1 clade 2.3.2.1a virus caused unusually high mortality in ducks and geese. Heightened surveillance in poultry is warranted to guide appropriate diagnostic testing and detect novel influenza strains. PMID:25892457

Hepatobiliary and gallium imaging findings in gallbladder perforation: A case report and review of the literature

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

Yeo, E.; Chen, D.C.; Siegel, M.E.

1989-02-01

Gallbladder perforation is an unusual condition with a high mortality rate. Early detection with prompt surgical intervention can increase the survival rate. Hepatobiliary imaging using Technetium-99m-labeled iminodiacetic acid has been used for the diagnosis of gallbladder perforation. However, the results vary and are somewhat confusing. The authors report a case of gallbladder perforation with hepatobiliary imaging and an unusual gallium image; review the literature; and propose a classification of three different imaging patterns: (1) visualization of the gallbladder with bile leakage, (2) nonvisualization of the gallbladder with a photopenic fluid collection, and (3) nonvisualization of the gallbladder with bile leakage.more » These patterns may provide pathophysiologic information for the surgeon. 27 references.« less

Gauging the influence of increased search effort on reporting rates of bottlenose dolphin (Tursiops truncatus) strandings following the deepwater horizon oil spill.

PubMed

Pitchford, Jonathan L; Garcia, Michael; Pulis, Eric E; Ambert, Ashley Millan; Heaton, Andrew J; Solangi, Moby

2018-01-01

The co-occurrence of the Deepwater Horizon oil spill and the northern Gulf of Mexico cetacean Unusual Mortality Event have raised questions about the stability of inshore bottlenose dolphin (Tursiops truncatus) populations throughout the region. Several factors could have contributed to the ongoing event, but little attention has been paid to the potential effects of increased search effort and reporting of strandings associated with oil spill response activities, which were widespread for an extended period. This study quantified the influence of increased search effort by estimating the number of bottlenose dolphin strandings reported by oil spill responders and comparing monthly stranding rates with and without response-related records. Results showed that response teams reported an estimated 58% of strandings during the Active Response period within the study area. Comparison of Poisson rates tests showed that when responder-influenced stranding records were removed, the monthly stranding rates from the Active Response period (May 2010 -April 2014) were similar to the Post-Removal Actions Deemed Complete period (May 2013 -March 2015) (e.g., p = 0.83 for remote areas in Louisiana). Further, analyses using the Getis-Ord Gi* spatial statistic showed that when response-related stranding reports were removed from the Active Response period, significant spatial clustering of strandings (p < 0.05) was reduced by 48% in coastal Louisiana. Collectively, these results suggest that increased search effort resulting from the Deepwater Horizon oil spill response throughout remote portions of the Unusual Mortality Event geographic region had the capacity to increase reporting and recovery of marine mammal strandings to unusually high levels. To better understand how stranding data relates to actual mortality, more work is needed to quantify dolphin population size, population trends, and carcass detection rates including the role of search effort. This is vital for understanding the status of a protected species within the northern Gulf of Mexico.

Bat rabies surveillance in France: first report of unusual mortality among serotine bats.

PubMed

Picard-Meyer, Evelyne; Servat, Alexandre; Wasniewski, Marine; Gaillard, Matthieu; Borel, Christophe; Cliquet, Florence

2017-12-13

Rabies is a fatal viral encephalitic disease that is caused by lyssaviruses which can affect all mammals, including human and bats. In Europe, bat rabies cases are attributed to five different lyssavirus species, the majority of rabid bats being attributed to European bat 1 lyssavirus (EBLV-1), circulating mainly in serotine bats (Eptesicus serotinus). In France, rabies in bats is under surveillance since 1989, with 77 positive cases reported between 1989 and 2016. In the frame of the bat rabies surveillance, an unusual mortality of serotine bats was reported in 2009 in a village in North-East France. Six juvenile bats from an E. serotinus maternity colony counting ~200 individuals were found to be infected with EBLV-1. The active surveillance of the colony by capture sessions of bats from July to September 2009 showed a high detection rate of neutralising EBLV-1 antibodies (≈ 50%) in the colony. Moreover, one out of 111 animals tested was found to shed viable virus in saliva, while lyssavirus RNA was detected by RT-PCR for five individuals. This study demonstrated that the lyssavirus infection in the serotine maternity colony was followed by a high rate of bat rabies immunity after circulation of the virus in the colony. The ratio of seropositive bats is probably indicative of an efficient virus transmission coupled to a rapid circulation of EBLV-1 in the colony.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation.

PubMed

Bruner, David I; Gustafson, Corey

2011-06-22

Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation

PubMed Central

2011-01-01

Background Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. Method We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. Results We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Conclusions Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality. PMID:21696590

Early Host Responses to Prion Infection: Development of In Vivo and In Vitro Assays

DTIC Science & Technology

2006-05-01

in plasma glycoproteins that are induced by prion infection in mice. The unusual nature of prion disease prompted a systems approach to identify... pheochromocytoma cells (13, 14), spontaneously im- mortalized hamster brain cells (15), the T-antigen immortalized GT1 hypothalamic neuron line (16), and T-antigen...PK- digested (+) or undigested (-) samples are indicated. (MW markers? Nothing unusual here so probably not necessary.)

Experiments with classes of stock suitable for forest planting in the northern Rocky Mountains

Treesearch

W. G. Wahlenberg

1928-01-01

Except in unusually moist years the survival of planted stock in the northern Rocky Mountains, even on favorable slopes, has not been satisfactory. On good and poor sites alike, the principal cause of the unusual degree of mortality has been the combination of dry soil and dry winds during the hot days of July and August. The results have made it clear that the most...

Examining possible causes of mortality in white pine seedlings

Treesearch

Elizabeth Gilles; Ronald Reitz; Greg Hoss; David. Gwaze

2011-01-01

White pine (Pinus strobus L.) is one of the most important timber trees in the northeastern United States and eastern Canada (Demeritt and Garrett 1996). White pine is not native to Missouri; it is commonly planted for wind breaks and erosion control and as an ornamental. Unusual mortality of bare-root seedlings of white pine purchased from the...

Prototheca wickerhamii algaemia presenting as cholestatic hepatitis in a patient with systemic lupus erythematosus: A case report and literature review

PubMed Central

Min, Zaw; Moser, Stephen A.; Pappas, Peter G.

2012-01-01

Human protothecal infection is uncommon and could be localized or systemic disease. Disseminated Prototheca algaemia tends to occur in immunocompromised patients (solid organ transplants, hematological malignancies) with high mortality. Diagnosis could be missed or delayed due to unusual clinical presentation and/or under-recognition of characteristic microscopic features of Prototheca species. Combined approach that includes removal of source of infection and intravenous amphotericin B provides the best chance of cure. PMID:24432207

Omphalocele: experience in the African tropics

PubMed Central

Ihekwaba, F. Nwabueze

1981-01-01

Omphalocele, the congenital anomaly of the anterior abdominal wall in the newborn, is a serious condition with a grave prognosis. Sac rupture, occurring in 25% of cases in Ibadan is associated with a high mortality. Although its embryogenesis is now better understood, its underlying aetiology remains obscure. Prematurity and low birth weight have no causal relationship to the condition, but a preponderance among the lower socio-economic groups in Ibadan is observed. Thirty-three cases seen over a 5-year period at the University College Hospital, Ibadan, Nigeria, constitute an unusually high incidence, suggesting that the condition may be aetiologically related to umbilical hernia which is known to be commoner in African than in Caucasian infants. Overall treatment results remain unsatisfactory for all types and mortality is still high. In those centres, particularly in the developing countries with scarce resources, conservative management should be the primary treatment modality for all intact sacs but staged procedures utilizing prosthetic materials should be reserved for the large ruptured sac. PMID:7335562

An unusual mortality event in Johnstone River snapping turtles Elseya irwini (Johnstone) in Far North Queensland, Australia.

PubMed

Ariel, E; Freeman, A B; Elliott, E; Wirth, W; Mashkour, N; Scott, J

2017-10-01

An unusual mortality event in Johnstone River snapping turtles (Elseya irwini) in Far North Queensland, Australia, occurred during the summer months of December 2014 and January 2015. We report the data collected during the mortality event, including counts of sick and dead animals, clinical appearance and one necropsy. Moribund animals appeared lethargic with variable degrees of necrotising dermatitis. Postmortem investigation of one freshly dead animal revealed bacterial and fungal involvement in the skin lesions as well as multifocal fibrinous hepatitis and splenitis and necrotising enteritis with vascular thrombosis. Aeromonas hydrophila was isolated from liver, spleen and skin lesions. All samples tested negative for ranavirus, and water and soil testing for environmental contaminants were negative. All affected E. irwini either died or were euthanased and no other species of animals in the river were affected. Aeromonas hydrophila is ubiquitous in the freshwater environment and although it caused septicaemia in the one individual that was submitted for laboratory diagnosis, the primary aetiology of the outbreak may not have been identified. © 2017 Australian Veterinary Association.

Why are women so intelligent? The effect of maternal IQ on childhood mortality may be a relevant evolutionary factor.

PubMed

Charlton, Bruce G

2010-03-01

Humans are an unusual species because they exhibit an economic division of labour. Most theories concerning the evolution of specifically human intelligence have focused either on economic problems or sexual selection mechanisms, both of which apply more to men than women. Yet while there is evidence for men having a slightly higher average IQ, the sexual dimorphism of intelligence is not obvious (except at unusually high and low levels). However, a more female-specific selection mechanism concerns the distinctive maternal role in child care during the offspring's early years. It has been reported that increasing maternal intelligence is associated with reducing child mortality. This would lead to a greater level of reproductive success for intelligent women, and since intelligence is substantially heritable, this is a plausible mechanism by which natural selection might tend to increase female intelligence in humans. Any effect of maternal intelligence on improving child survival would likely be amplified by assortative mating for IQ by which people tend to marry others of similar intelligence - combining female maternal and male economic or sexual selection factors. Furthermore, since general intelligence seems to have the functional attribute of general purpose problem-solving and more rapid learning, the advantages of maternal IQ are likely to be greater as the environment for child-rearing is more different from the African hunter-gatherer society and savannah environment in which ancestral humans probably evolved. However, the effect of maternal IQ on child mortality would probably only be of major evolutionary significance in environments where childhood mortality rates were high. The modern situation is that population growth is determined mostly by birth rates; so in modern conditions, maternal intelligence may no longer have a significant effect on reproductive success; the effect of female IQ on reproductive success is often negative. Nonetheless, in the past it is plausible that the link between maternal IQ and child survival constituted a strong selection pressure acting specifically on women. Copyright (c) 2009. Published by Elsevier Ltd.

Mortality and economic instability: detailed analyses for Britain and comparative analyses for selected industrialized countries.

PubMed

Brenner, M H

1983-01-01

This paper discusses a first-stage analysis of the link of unemployment rates, as well as other economic, social and environmental health risk factors, to mortality rates in postwar Britain. The results presented represent part of an international study of the impact of economic change on mortality patterns in industrialized countries. The mortality patterns examined include total and infant mortality and (by cause) cardiovascular (total), cerebrovascular and heart disease, cirrhosis of the liver, and suicide, homicide and motor vehicle accidents. Among the most prominent factors that beneficially influence postwar mortality patterns in England/Wales and Scotland are economic growth and stability and health service availability. A principal detrimental factor to health is a high rate of unemployment. Additional factors that have an adverse influence on mortality rates are cigarette consumption and heavy alcohol use and unusually cold winter temperatures (especially in Scotland). The model of mortality that includes both economic changes and behavioral and environmental risk factors was successfully applied to infant mortality rates in the interwar period. In addition, the "simple" economic change model of mortality (using only economic indicators) was applied to other industrialized countries. In Canada, the United States, the United Kingdom, and Sweden, the simple version of the economic change model could be successfully applied only if the analysis was begun before World War II; for analysis beginning in the postwar era, the more sophisticated economic change model, including behavioral and environmental risk factors, was required. In France, West Germany, Italy, and Spain, by contrast, some success was achieved using the simple economic change model.

Silica-volatile interaction and the geological cause of the Xuan Wei lung cancer epidemic

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

David J. Large; Shona Kelly; Baruch Spiro

2009-12-01

Parts of Xuan Wei County, Yunnan Province, China have the highest known lung cancer mortality in nonsmoking women. This high mortality displays a clear spatial relationship to the mines producing coal from the uppermost Permian. Geochemical, petrographic, and grain size analyses were undertaken on a set of coal samples from Xuan Wei. Results demonstrate that the single geochemical property that makes this coal unusual is its high concentration of quartz (13.5 wt %) of which 35-55% occurs as < 10 {mu}m grains. We propose the potential for silica-volatile interaction (PSVI) as a new method for assessing the combined influence ofmore » silica and volatile organic matter and use this as a basis for re-evaluating existing ecological data. Published lung cancer mortality values are more strongly correlated with PSVI values for Xuan Wei coal than with volatiles or silica alone and the PSVI values measured are distinct from those of other coals. Finally we propose that the localization of this epidemic to Xuan Wei results from enhanced weathering of the local Emeishan basalts as a consequence of geochemical perturbations at the Permo-Triassic Boundary.« less

Killer Whale (Orcinus orca) Deaths in Prince William Sound, Alaska, 1985-1990.

PubMed

Fraker, Mark A

2013-01-01

During 1985-1990, two groups of killer whales in Prince William Sound, Alaska, experienced unusually high rates of mortality, while seven others did not. Those affected were AB pod, part of the southern Alaska population of resident (fish-eating) killer whales, and the AT1 transient (marine mammal-eating) group, a very small, reproductively isolated population that last reproduced in 1984. In 1985-1986, several AB pod members were shot by fishermen defending their catch from depredation, which explains some of the deaths. Understanding the other deaths is complicated by the Exxon Valdez oil spill (March 1989) and uncertainties about the causes and times of the deaths. For AB pod, possible factors involved in the post-spill mortalities are delayed effects of bullet wounds, continued shooting, oil exposure, and consequences of being orphaned. For the AT1 group, possible factors are oil exposure, small population size, old age, and high-contaminant burdens. An analysis of possible effects of inhalation of volatile organic compounds, contact with the oil slick, and ingestion of oil with water or prey did not reveal route(s) of exposure that could explain the mortalities. The cause(s) of the killer whale deaths recorded following the oil spill remain uncertain.

Impact of West Nile virus and other mortality factors on American white pelicans at breeding colonies in the northern plains of North America

USGS Publications Warehouse

Sovada, M.A.; Pietz, P.J.; Converse, K.A.; Tommy, King D.; Hofmeister, Erik K.; Scherr, P.; Ip, Hon S.

2008-01-01

American white pelicans (Pelecanus erythrorhynchos) are colonial-nesting birds and their breeding sites are concentrated in a few small areas, making this species especially vulnerable to factors that can influence productivity, such as disease, disturbance, predation, weather events and loss of nesting habitat. Nearly half of the American white pelican population breeds at four colonies in the northern plains: Chase Lake National Wildlife Refuge (NWR) in North Dakota, Bitter Lake (Waubay NWR) in South Dakota, Medicine Lake NWR in Montana, and Marsh Lake in Minnesota. Thus, sustained productivity at these colonies is crucial to the health of the entire species. During the latter half of the 2002 and 2003 breeding seasons, unusually high mortality of pelican chicks was observed at these colonies. West Nile virus (WNv) was identified as one source of these losses. In 2004-2007 we monitored three major colonies in the northern plains to assess mortality of chicks during the late breeding season. We documented severe weather events, disturbance, and WNv as factors contributing to chick mortality. Before WNv arrived in the region in 2002, chick mortality after mid-July was ???4%, and then jumped to as high as 44% in the years since WNv arrived. WNv kills older chicks that are no longer vulnerable to other common mortality factors (e.g., severe weather, gull predation) and typically would have survived to fledge; thus WNv appears to be an additive mortality factor. Persistence of lower productivity at American white pelican colonies in the northern plains might reduce the adult breeding population of this species in the region.

Unusual mortality pattern among short term workers in the perfumery industry in Geneva.

PubMed Central

Gubéran, E; Usel, M

1987-01-01

A cohort of 537 workers employed for less than one year between 1900 and 1964 in the Geneva perfumery industry was followed up from entry to the end of 1983. During the period of study, 251 workers died and 41 (8%) were lost to follow up. The standardised mortality ratio (SMR) was significantly above 100 for all causes (SMR = 120), all cancers (SMR = 127), lung cancer (SMR = 186), and violent death (SMR = 179). The highest SMR from all causes was associated with the shortest period of employment (less than two months) and it decreased significantly with longer duration. Such mortality excesses had not been recorded among the 1168 workers of the same industry employed one year or more, previously studied in similar fashion. Interviews among a random sample of 52 workers employed for less than two months seem to indicate that the prevalence of smoking, exposures to asbestos, and occupational accidents in other hazardous industries were higher for these workers than for the reference population. Furthermore, unmarried men were overrepresented among the study cohort. These findings support previous observations indicating that short term workers share atypical features related to high mortality from various causes. It is suggested that mortality in this subgroup should be analysed separately in occupational studies. PMID:3663526

Ochre star mortality during the 2014 wasting disease epizootic: role of population size structure and temperature.

PubMed

Eisenlord, Morgan E; Groner, Maya L; Yoshioka, Reyn M; Elliott, Joel; Maynard, Jeffrey; Fradkin, Steven; Turner, Margaret; Pyne, Katie; Rivlin, Natalie; van Hooidonk, Ruben; Harvell, C Drew

2016-03-05

Over 20 species of asteroids were devastated by a sea star wasting disease (SSWD) epizootic, linked to a densovirus, from Mexico to Alaska in 2013 and 2014. For Pisaster ochraceus from the San Juan Islands, South Puget Sound and Washington outer coast, time-series monitoring showed rapid disease spread, high mortality rates in 2014, and continuing levels of wasting in the survivors in 2015. Peak prevalence of disease at 16 sites ranged to 100%, with an overall mean of 61%. Analysis of longitudinal data showed disease risk was correlated with both size and temperature and resulted in shifts in population size structure; adult populations fell to one quarter of pre-outbreak abundances. In laboratory experiments, time between development of disease signs and death was influenced by temperature in adults but not juveniles and adult mortality was 18% higher in the 19 °C treatment compared to the lower temperature treatments. While larger ochre stars developed disease signs sooner than juveniles, diseased juveniles died more quickly than diseased adults. Unusual 2-3 °C warm temperature anomalies were coincident with the summer 2014 mortalities. We suggest these warm waters could have increased the disease progression and mortality rates of SSWD in Washington State. © 2016 The Authors.

Ochre star mortality during the 2014 wasting disease epizootic: role of population size structure and temperature

PubMed Central

Eisenlord, Morgan E.; Yoshioka, Reyn M.; Elliott, Joel; Maynard, Jeffrey; Fradkin, Steven; Turner, Margaret; Pyne, Katie; Rivlin, Natalie; van Hooidonk, Ruben; Harvell, C. Drew

2016-01-01

Over 20 species of asteroids were devastated by a sea star wasting disease (SSWD) epizootic, linked to a densovirus, from Mexico to Alaska in 2013 and 2014. For Pisaster ochraceus from the San Juan Islands, South Puget Sound and Washington outer coast, time-series monitoring showed rapid disease spread, high mortality rates in 2014, and continuing levels of wasting in the survivors in 2015. Peak prevalence of disease at 16 sites ranged to 100%, with an overall mean of 61%. Analysis of longitudinal data showed disease risk was correlated with both size and temperature and resulted in shifts in population size structure; adult populations fell to one quarter of pre-outbreak abundances. In laboratory experiments, time between development of disease signs and death was influenced by temperature in adults but not juveniles and adult mortality was 18% higher in the 19°C treatment compared to the lower temperature treatments. While larger ochre stars developed disease signs sooner than juveniles, diseased juveniles died more quickly than diseased adults. Unusual 2–3°C warm temperature anomalies were coincident with the summer 2014 mortalities. We suggest these warm waters could have increased the disease progression and mortality rates of SSWD in Washington State. PMID:26880844

The geography of mortality from Hurricane Katrina in New Orleans

NASA Astrophysics Data System (ADS)

Mutter, J. C.; Mara, V.; Jayaprakash, S.; None

2011-12-01

Hurricane Katrina was one of the highest mortality disasters in US history. Typical hurricanes of the same strength take very few lives. Katrina's mortality is exceeded only by the so-called Galveston Flood (a hurricane) of 1900 that occurred at a time when forecasting was poor and evacuation was possible only by train or horse. The levee failures in New Orleans were a major contributing factor unique to Katrina. An examination of the characteristics of mortality may give insight into the cause of the great scope of the tragedy and the special vulnerability of those who died. We examine the spatial aspects of mortality. The locations of deceased victims were matched with victim information including age, race and gender for approximately 800 victims (data from Louisiana Department of Health and Hospitals). From this we can analyze for spatial clustering of mortality. We know that Katrina took a particularly heavy toll on the elderly so we can analyze, for instance, whether the elderly were more likely to die in some locations than in others. Similarly, we analyze for gender and race against age (dividing age into five groups this gives 20 categories) as a factory in the geographic distribution of mortality as a way to recover measures of vulnerability. We can also correlate the spatial characteristics of mortality with underlying causes that might contribute to vulnerability. Data is available at a census block level on household income, poverty rates, education, home ownership, car ownership and a variety of other factors that can be correlated with the spatial mortality data. This allows for a multi-parameter estimation of factors that govern mortality in this unusually high mortality event.

Streptococcus pneumoniae necrotizing fasciitis in systemic lupus erythematosus.

PubMed

Sánchez, A; Robaina, R; Pérez, G; Cairoli, E

2016-04-01

Necrotizing fasciitis is a rapidly progressive destructive soft tissue infection with high mortality. Streptococcus pneumoniae as etiologic agent of necrotizing fasciitis is extremely unusual. The increased susceptibility to Streptococcus pneumoniae infection in patients with systemic lupus erythematosus is probably a multifactorial phenomenon. We report a case of a patient, a 36-year-old Caucasian female with 8-year history of systemic lupus erythematosus who presented a fatal Streptococcus pneumoniae necrotizing fasciitis. The role of computed tomography and the high performance of blood cultures for isolation of the causative microorganism are emphasized. Once diagnosis is suspected, empiric antibiotic treatment must be prescribed and prompt surgical exploration is mandatory. © The Author(s) 2015.

[Fungal peritonitis due to Rhodotorula mucilaginosa in a patient with automated peritoneal dialysis: Literature review].

PubMed

Verdugo, Fernando J; Briones, Eduardo; Porte, Lorena; Amaro, José; Fica, Alberto

2016-04-01

Fungal peritonitis is a major complication of peritoneal dialysis associated with high mortality. Most survivors have a high rate of abandonment of peritoneal dialysis. We report a case of fungal peritonitis due to an unusual agent. An 83 year-old woman, with a history of type 2 diabetes mellitus and multiple episodes of bacterial peritonitis associated to technical flaws in the implementation of automated peritoneal dialysis, was admitted due to abdominal pain and cloudy peritoneal fluid. Rhodotorula mucilaginosa was identified in the peritoneal fluid by MALDI-TOF. She was treated with catheter removal and oral posaconazole for 14 days showing clinical resolution and non-recurrence.

An Unusual Transorbital Penetrating Injury and Principles of Management

PubMed Central

Dekker, Andrew Peter; El-Sawy, Abdel Hamid; Rejali, Darius Stephen

2014-01-01

The objective of this study was to present an unusual low velocity transorbital penetrating injury. The study design was a clinical record (case report). A 38-year-old gentleman tripped and fell face first onto the wing of an ornamental brass eagle. This penetrated the inferomedial aspect of the right orbit, breaching the lamina papyracea to extend into the ethmoid sinuses and reaching the dura of the anterior cranial fossa. The foreign body was removed in theater under a joint ophthalmology and ENT procedure. The patient was left with reduced visual acuity in the right eye but no other long-term sequelae. Transorbital penetrating injury presents unusual challenges to investigation and management requiring a multidisciplinary approach to prevent significant morbidity and mortality. If managed well the prognosis is good. PMID:25383154

An unusual transorbital penetrating injury and principles of management.

PubMed

Dekker, Andrew Peter; El-Sawy, Abdel Hamid; Rejali, Darius Stephen

2014-12-01

The objective of this study was to present an unusual low velocity transorbital penetrating injury. The study design was a clinical record (case report). A 38-year-old gentleman tripped and fell face first onto the wing of an ornamental brass eagle. This penetrated the inferomedial aspect of the right orbit, breaching the lamina papyracea to extend into the ethmoid sinuses and reaching the dura of the anterior cranial fossa. The foreign body was removed in theater under a joint ophthalmology and ENT procedure. The patient was left with reduced visual acuity in the right eye but no other long-term sequelae. Transorbital penetrating injury presents unusual challenges to investigation and management requiring a multidisciplinary approach to prevent significant morbidity and mortality. If managed well the prognosis is good.

An Unusual Cause of GI Bleeding in a Quadriplegic: Report of a Case and Review of the Literature

PubMed Central

Joseph, Raymond E.; Epsten, Robert; Kowlessar, O. Dhodanand

1982-01-01

The authors report a case of upper gastrointestinal hemorrhage in a quadriplegic. The cause was a Mallory-Weiss tear, a previously unrecognized problem in these patients. The incidence of bleeding in patients with spinal cord injury is as high as 25 percent in the few reported series. We feel that with the increased risk of gastrointestinal bleeding in the spinal cord patient and the accompanying significant mortality, early endoscopy is essential for accurate diagnosis since clues to the presence, etiology, and severity of the bleeding are often lacking. PMID:6981707

Salmonella myocarditis in a young adult patient presenting with acute pulmonary edema, rhabdomyolysis, and multi-organ failure.

PubMed

Al-aqeedi, Rafid Fayadh; Kamha, Ahmed; Al-aani, Fuad K; Al-ani, Ahmed A

2009-12-01

The mortality and morbidity of salmonella infections is seriously underestimated. Salmonella myocarditis is an unusual complication of salmonella sepsis in adults. Cases that do occur may be associated with high morbidity and mortality. We present a rare case of salmonella myocarditis with multi-organ failure in a previously healthy young adult man who was brought to the emergency room with fever, diarrhea, shortness of breath, and altered sensorium, discovered to have acute pulmonary edema and respiratory compromise for which he was assisted with mechanical ventilation for 8 days. Blood culture grew Salmonella typhi. Biochemically he exhibited myocardial, hepatic, and muscular enzymatic surge with renal failure, features of rhabdomyolysis, and disseminated intravascular coagulation. The patient showed a progressive improvement on treatment with ceftriaxone for 2 weeks in addition to decongestive therapy. He was discharged in good condition afterward.

A review of episodes of zinc phosphide toxicosis in wild geese (Branta spp.) in Oregon (2004−2011)

USGS Publications Warehouse

Bildfell, Rob J.; Rumbeiha, Wilson K.; Schuler, Krysten L.; Meteyer, Carol U.; Wolff, Peregrine L.; Gillin, Colin M.

2013-01-01

Epizootic mortality in several geese species, including cackling geese (Branta hutchinsii) and Canada geese (Branta canadensis), has been recognized in the Willamette Valley of Oregon for over a decade. Birds are generally found dead on a body of water or are occasionally observed displaying neurologic clinical signs such as an inability to raise or control the head prior to death. Investigation of these epizootic mortality events has revealed the etiology to be accidental poisoning with the rodenticide zinc phosphide (Zn3P2). Gross and histologic changes are restricted to acute pulmonary congestion and edema, sometimes accompanied by distension of the upper alimentary tract by fresh grass. Geese are unusually susceptible to this pesticide; when combined with an epidemiologic confluence of depredation of specific agricultural crops by rodents and seasonal avian migration pathways, epizootic toxicosis may occur. Diagnosis requires a high index of suspicion, appropriate sample collection and handling, plus specific test calibration for this toxicant. Interagency cooperation, education of farmers regarding pesticide use, and enforcement of regulations has been successful in greatly decreasing these mortality events since 2009.

Brief report: How short is too short? An ultra-brief measure of the big-five personality domains implicates "agreeableness" as a risk for all-cause mortality.

PubMed

Chapman, Benjamin P; Elliot, Ari J

2017-08-01

Controversy exists over the use of brief Big Five scales in health studies. We investigated links between an ultra-brief measure, the Big Five Inventory-10, and mortality in the General Social Survey. The Agreeableness scale was associated with elevated mortality risk (hazard ratio = 1.26, p = .017). This effect was attributable to the reversed-scored item "Tends to find fault with others," so that greater fault-finding predicted lower mortality risk. The Conscientiousness scale approached meta-analytic estimates, which were not precise enough for significance. Those seeking Big Five measurement in health studies should be aware that the Big Five Inventory-10 may yield unusual results.

Review of historical unusual mortality events (UMEs) in the Gulf of Mexico (1990-2009): providing context for the multi-year northern Gulf of Mexico cetacean UME declared in 2010.

PubMed

Litz, Jenny A; Baran, Melody A; Bowen-Stevens, Sabrina R; Carmichael, Ruth H; Colegrove, Kathleen M; Garrison, Lance P; Fire, Spencer E; Fougeres, Erin M; Hardy, Ron; Holmes, Secret; Jones, Wanda; Mase-Guthrie, Blair E; Odell, Daniel K; Rosel, Patricia E; Saliki, Jeremiah T; Shannon, Delphine K; Shippee, Steve F; Smith, Suzanne M; Stratton, Elizabeth M; Tumlin, Mandy C; Whitehead, Heidi R; Worthy, Graham A J; Rowles, Teresa K

2014-12-02

An unusual mortality event (UME) was declared for cetaceans in the northern Gulf of Mexico (GoM) for Franklin County, Florida, west through Louisiana, USA, beginning in February 2010 and was ongoing as of September 2014. The 'Deepwater Horizon' (DWH) oil spill began on 20 April 2010 in the GoM, raising questions regarding the potential role of the oil spill in the UME. The present study reviews cetacean mortality events that occurred in the GoM prior to 2010 (n = 11), including causes, durations, and some specific test results, to provide a historical context for the current event. The average duration of GoM cetacean UMEs prior to 2010 was 6 mo, and the longest was 17 mo (2005-2006). The highest number of cetacean mortalities recorded during a previous GoM event was 344 (in 1990). In most previous events, dolphin morbillivirus or brevetoxicosis was confirmed or suspected as a causal factor. In contrast, the current northern GoM UME has lasted more than 48 mo and has had more than 1000 reported mortalities within the currently defined spatial and temporal boundaries of the event. Initial results from the current UME do not support either morbillivirus or brevetoxin as primary causes of this event. This review is the first summary of cetacean UMEs in the GoM and provides evidence that the most common causes of previous UMEs are unlikely to be associated with the current UME.

Unusual disease conditions in pet and aviary birds.

PubMed

Panigrahy, B; Mathewson, J J; Hall, C F; Grumbles, L C

1981-02-15

Ninety percent ot 100% mortality in budgerigar (Melopsittacus undulatus) nestlings from 2 aviaries was attributed to giardiasis. Treatment with dimetridazole in drinking water was effective in controlling mortality. Aeromonas hydrophila infection incriminated in acute deaths of aviary canaries (Serinus canarius) was successfully treated with chlortetracycline. Aeromonas hydrophila also was isolated in pure culture from a toucan (ramphastos toco) with acute nephrosis and a cockatiel (Nymphicus hollandicus) with chlamydiosis (psittacosis). Coccidiosis associated with hemorrhagic enteritis, diarrhea, and mortality was diagnosed in budgerigars originating from 3 aviaries. Sporulated oocysts from 1 group of budgerigars were identified as Eimera sp. Sulfamethazine in drinking water was an effective treatment.

Killer Whale (Orcinus orca) Deaths in Prince William Sound, Alaska, 1985–1990

PubMed Central

Fraker, Mark A.

2013-01-01

During 1985–1990, two groups of killer whales in Prince William Sound, Alaska, experienced unusually high rates of mortality, while seven others did not. Those affected were AB pod, part of the southern Alaska population of resident (fish-eating) killer whales, and the AT1 transient (marine mammal–eating) group, a very small, reproductively isolated population that last reproduced in 1984. In 1985–1986, several AB pod members were shot by fishermen defending their catch from depredation, which explains some of the deaths. Understanding the other deaths is complicated by the Exxon Valdez oil spill (March 1989) and uncertainties about the causes and times of the deaths. For AB pod, possible factors involved in the post-spill mortalities are delayed effects of bullet wounds, continued shooting, oil exposure, and consequences of being orphaned. For the AT1 group, possible factors are oil exposure, small population size, old age, and high-contaminant burdens. An analysis of possible effects of inhalation of volatile organic compounds, contact with the oil slick, and ingestion of oil with water or prey did not reveal route(s) of exposure that could explain the mortalities. The cause(s) of the killer whale deaths recorded following the oil spill remain uncertain. PMID:23335844

Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

PubMed

Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

2016-10-22

The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Reporting an outbreak of Candida pelliculosa fungemia in a neonatal intensive care unit.

PubMed

Lin, Hsiao-Chuan; Lin, Hsiang-Yu; Su, Bai-Hong; Ho, Mao-Wang; Ho, Cheng-Mao; Lee, Ching-Yi; Lin, Ming-Hsia; Hsieh, Hsin-Yang; Lin, Hung-Chih; Li, Tsai-Chung; Hwang, Kao-Pin; Lu, Jang-Jih

2013-12-01

Fungemia in preterm infants is associated with high mortality and morbidity. This study reports an outbreak of unusual fungemia in a tertiary neonatal intensive care unit (NICU). Ten Candida pelliculosa bloodstream isolates were identified from six infants hospitalized in the NICU from February to March 2009. Environmental study was performed, and genetic relatedness among the 10 clinical isolates of C pelliculosa and six control C pelliculosa strains was characterized by randomly amplified polymorphic DNA assay. In vitro susceptibility of isolates to six antifungal agents was analyzed by broth microdilution method. Amphotericin B was given to infected infants and prophylactic fluconazole was prescribed to the other noninfected extremely low birth weight infants during the outbreak. Thrombocytopenia (platelet counts <100×10(9)/L) was the early laboratory finding in four infants. One of six patients died, making overall mortality 17%. Fluconazole, voriconazole, amphotericin B, and micafungin provided good antifungal activity. Cultures from the environment and hands of caregivers were all negative. Molecular studies indicated the outbreak as caused by a single strain. The outbreak was controlled by strict hand washing, cohort infected patients, confined physicians and nurses to take care of patients, prophylactic fluconazole to uninfected neonates, and proper management of human milk. The study demonstrated the clinical importance of emerged non-albicans Candida species in NICU. For unusual pathogen isolated from immunocompromised hosts, more attention should be paid to monitor the possibility of an outbreak. Copyright © 2012. Published by Elsevier B.V.

Morbillivirus-associated unusual mortality event in South Australian bottlenose dolphins is largest reported for the Southern Hemisphere

PubMed Central

Tomo, I.; Bingham, J.; Bastianello, S. S.; Wang, J.; Gibbs, S. E.; Woolford, L.; Dickason, C.; Kelly, D.

2016-01-01

Cases of morbillivirus have been recorded in the Southern Hemisphere but have not been linked to significant marine mammal mortality. Post-mortems were conducted on 58 carcasses (44 Indo-Pacific bottlenose dolphins, two common bottlenose dolphins, 12 short-beaked common dolphins) from South Australia during 2005–2013, including an unusual mortality event (UME) in St Vincent Gulf Bioregion (SVG) during 2013. Diagnostic pathology, circumstance of death, body condition, age and stomach contents were documented for Indo-Pacific bottlenose dolphins. At least 50 dolphins died during the UME, 41 were Indo-Pacific bottlenose dolphins and most were young. The UME lasted about seven months and had two peaks, the first being the largest. Effect on the population is unknown. Diagnostic testing for morbillivirus was conducted on 57 carcasses, with evidence for infection in all species during 2011–2013. All tested UME bottlenose dolphins were positive for cetacean morbillivirus (CeMV), and the pathology included interstitial pneumonia, lymphoid depletion and syncytia. Concurrent pathologies, including lung parasite and fungal infections, and severe cutaneous bruising were observed in many dolphins. The event coincided with elevated water temperatures, a diatom bloom and significant fish die-offs. We conclude that the cause for the UME was multifactorial and that CeMV was a major contributor. PMID:28083115

Geographical variations in seasonal mortality across the United States: A bioclimatological approach

NASA Astrophysics Data System (ADS)

Kalkstein, Adam

2008-10-01

Human mortality exhibits a strong seasonal pattern with deaths in winter far exceeding those in the summer. Surprisingly, this seasonal trend is evident in all major cities across the United States, seemingly independent of climate. While the pattern itself is clear, its magnitude varies considerably across space, and it is not known if there is regional homogeneity among cities. Additionally, the causal mechanisms relating to pattern variability are not clearly understood. The goal of this study is to conduct a comprehensive geographic analysis of seasonal mortality across the United States, to uncover systematic regional differences in such mortality, and to determine what role weather plays in impacting seasonal mortality rates. Unique seasonal mortality curves were created for 28 Metropolitan Statistical Areas across the United States, and the amplitude and timing of mortality peaks were determined. In addition, seasonality was calculated for different demographic groups and causes of death. Meteorological factors were also evaluated as possible causal mechanisms. The findings here indicate that the seasonality of mortality exhibits strong spatial variation with the largest seasonal mortality amplitudes found in the southwestern United States and the smallest in the North, along with South Florida. In addition, there have been changes in the timing of seasonal mortality; the date of maximum mortality is occurring increasingly early in the year. Demographics also play an important role with women, Whites, and the elderly exhibiting the strongest seasonality in mortality. There is a strong connection between respiratory disease and other causes of death, implying a cause-effect relationship. Meteorology also plays an important role in seasonal mortality; variations in the frequency of certain air masses were associated with changes in the timing and amplitude of seasonal mortality. Finally, there were strong intra-regional similarities that exist among the examined cities, implying that environmental factors are more important than social factors in determining seasonal mortality response. This work begins to fill a large gap within the scientific literature concerning the causes, geographic variation, and meteorological influences on seasonal mortality. Additionally, these results will increase the forecasting capabilities of determining when and where winter mortality will reach unusually high levels.

[Recurrent urinary tract infection due to enterovesical fistula secondary to colon diverticular disease: a case report].

PubMed

Cavalcanti, Natália Silva; da Silva, Lorena Luryann Cartaxo; da Silva, Leonardo Sales; da Fonseca, Luiz Antonio Cavalcante; Alexandre, Cristianne da Silva

2013-01-01

Enterovesical fistula are pathological connections between the bladder and pelvic intestinal segments. It consists of a rare complication of neoplastic and inflammatory pelvic disorders, in addition to iatrogenic or traumatic injuries, and correlates with both high morbidity and mortality indexes. Male patient, 61 years old, admitted at the hospital clinics featuring abdominal pain and distension, vomiting and fecal retention. Patient's pathological precedents include high blood pressure, diabetes mellitus, vesical dysfunction and recurrent urinary tract infection on the past three years. Magnetic resonance imaging of abdomen and pelvis revealed enterovesical fistula in association with colon diverticular disease of the sigmoid. Management of choice consisted of partial colectomy with bowel lowering and partial cystectomy with surgical double-J stent insertion. Although consisting of a gastrointestinal primary affection, patients with enterovesical fistula usually search for medical help charging urinary tract features. In this particular case, our patient was admitted with gastrointestinal symptoms, reasoned by diagnostic delay, as the patient had already attended at multiple centers with urinary symptoms. Despite being an unusual affection, recurrent urinary tract infection associated with colon diverticular disease must always be considered at differential diagnosis of recurrent urinary tract infection as it concurs with high morbidity and mortality.

Marine Mammals :: NOAA Fisheries

Science.gov Websites

Education Grants Scholarships and Fellowships Teacher at Sea Climate Stewards Get Involved Dolphin Smart » Sign up for FishNews GO OPR Home Species Marine Mammals Sea Turtles Marine & Anadromous Fish Marine Marine Mammal Database National Tissue Bank Prescott Grants Sea Turtles Unusual Mortality Events Permits

Green Turtle (Chelonia mydas) :: NOAA Fisheries

Science.gov Websites

Education Grants Scholarships and Fellowships Teacher at Sea Climate Stewards Get Involved Dolphin Smart » Sign up for FishNews GO OPR Home Species Marine Mammals Sea Turtles Marine & Anadromous Fish Marine Marine Mammal Database National Tissue Bank Prescott Grants Sea Turtles Unusual Mortality Events Permits

EML4-ALK-positive lung adenocarcinoma presenting an unusual metastatic pattern in a 29-year-old woman who is alive and well in her third year follow up:A case report.

PubMed

Tokat, Fatma; Zeren, Handan; Barut, Pinar; Tansan, Sualp; Ince, Umit

2017-01-01

Non-small cell lung cancer (NSCLC) is a frequent tumor entity with high mortality. Although several newly discovered chromosomal translocations and mutations opened new horizons for targeted therapy, literature still lacks large series of NSCLC with chromosomal abberations and their correlations with histological and clinical features. We present a case of echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation positive adenocarcinoma of the lung with an unusual metastatic pattern in a 29-year-old young woman. Young adult non-smoker female patients with an unexplained pleural effusion and signs of metastatic disease should alert the physicians straight away for all types of malignancies including lung cancer. Any skin lesions should be evaluated carefully, biopsies should be done to exclude metastasis in urgency. On the other hand, an uncommon clinical presentation of a lung cancer requires corresponding molecular testing rapidly in order to offer the best treatment option.

Demographic Clusters Identified within the Northern Gulf of Mexico Common Bottlenose Dolphin (Tursiops truncates) Unusual Mortality Event: January 2010 - June 2013

PubMed Central

Venn-Watson, Stephanie; Garrison, Lance; Litz, Jenny; Fougeres, Erin; Mase, Blair; Rappucci, Gina; Stratton, Elizabeth; Carmichael, Ruth; Odell, Daniel; Shannon, Delphine; Shippee, Steve; Smith, Suzanne; Staggs, Lydia; Tumlin, Mandy; Whitehead, Heidi; Rowles, Teri

2015-01-01

A multi-year unusual mortality event (UME) involving primarily common bottlenose dolphins (Tursiops truncates) was declared in the northern Gulf of Mexico (GoM) with an initial start date of February 2010 and remains ongoing as of August 2014. To examine potential changing characteristics of the UME over time, we compared the number and demographics of dolphin strandings from January 2010 through June 2013 across the entire GoM as well as against baseline (1990-2009) GoM stranding patterns. Years 2010 and 2011 had the highest annual number of stranded dolphins since Louisiana’s record began, and 2011 was one of the years with the highest strandings for both Mississippi and Alabama. Statewide, annual numbers of stranded dolphins were not elevated for GoM coasts of Florida or Texas during the UME period. Demographic, spatial, and temporal clusters identified within this UME included increased strandings in northern coastal Louisiana and Mississippi (March-May 2010); Barataria Bay, Louisiana (August 2010-December 2011); Mississippi and Alabama (2011, including a high prevalence and number of stranded perinates); and multiple GoM states during early 2013. While the causes of the GoM UME have not been determined, the location and magnitude of dolphin strandings during and the year following the 2010 Deepwater Horizon oil spill, including the Barataria Bay cluster from August 2010 to December 2011, overlap in time and space with locations that received heavy and prolonged oiling. There are, however, multiple known causes of previous GoM dolphin UMEs, including brevetoxicosis and dolphin morbillivirus. Additionally, increased dolphin strandings occurred in northern Louisiana and Mississippi before the Deepwater Horizon oil spill. Identification of spatial, temporal, and demographic clusters within the UME suggest that this mortality event may involve different contributing factors varying by location, time, and bottlenose dolphin populations that will be better discerned by incorporating diagnostic information, including histopathology. PMID:25671657

Demographic clusters identified within the northern Gulf of Mexico common bottlenose dolphin (Tursiops truncates) unusual mortality event: January 2010-June 2013.

PubMed

Venn-Watson, Stephanie; Garrison, Lance; Litz, Jenny; Fougeres, Erin; Mase, Blair; Rappucci, Gina; Stratton, Elizabeth; Carmichael, Ruth; Odell, Daniel; Shannon, Delphine; Shippee, Steve; Smith, Suzanne; Staggs, Lydia; Tumlin, Mandy; Whitehead, Heidi; Rowles, Teri

2015-01-01

A multi-year unusual mortality event (UME) involving primarily common bottlenose dolphins (Tursiops truncates) was declared in the northern Gulf of Mexico (GoM) with an initial start date of February 2010 and remains ongoing as of August 2014. To examine potential changing characteristics of the UME over time, we compared the number and demographics of dolphin strandings from January 2010 through June 2013 across the entire GoM as well as against baseline (1990-2009) GoM stranding patterns. Years 2010 and 2011 had the highest annual number of stranded dolphins since Louisiana's record began, and 2011 was one of the years with the highest strandings for both Mississippi and Alabama. Statewide, annual numbers of stranded dolphins were not elevated for GoM coasts of Florida or Texas during the UME period. Demographic, spatial, and temporal clusters identified within this UME included increased strandings in northern coastal Louisiana and Mississippi (March-May 2010); Barataria Bay, Louisiana (August 2010-December 2011); Mississippi and Alabama (2011, including a high prevalence and number of stranded perinates); and multiple GoM states during early 2013. While the causes of the GoM UME have not been determined, the location and magnitude of dolphin strandings during and the year following the 2010 Deepwater Horizon oil spill, including the Barataria Bay cluster from August 2010 to December 2011, overlap in time and space with locations that received heavy and prolonged oiling. There are, however, multiple known causes of previous GoM dolphin UMEs, including brevetoxicosis and dolphin morbillivirus. Additionally, increased dolphin strandings occurred in northern Louisiana and Mississippi before the Deepwater Horizon oil spill. Identification of spatial, temporal, and demographic clusters within the UME suggest that this mortality event may involve different contributing factors varying by location, time, and bottlenose dolphin populations that will be better discerned by incorporating diagnostic information, including histopathology.

Motor neuron disease mortality rates in New Zealand 1992-2013.

PubMed

Cao, Maize C; Chancellor, Andrew; Charleston, Alison; Dragunow, Mike; Scotter, Emma L

2018-05-01

We determined the mortality rates of motor neuron disease (MND) in New Zealand over 22 years from 1992 to 2013. Previous studies have found an unusually high and/or increasing incidence of MND in certain regions of New Zealand; however, no studies have examined MND rates nationwide to corroborate this. Death certificate data coded G12.2 by International Classification of Diseases (ICD)-10 coding, or 335.2 by ICD-9 coding were obtained. These codes specify amyotrophic lateral sclerosis, progressive bulbar palsy, or other motor neuron diseases as the underlying cause of death. Mortality rates for MND deaths in New Zealand were age-standardized to the European Standard Population and compared with rates from international studies that also examined death certificate data and were age-standardized to the same standard population. The age-standardized mortality from MND in New Zealand was 2.3 per 100,000 per year from 1992-2007 and 2.8 per 100,000 per year from 2008-2013. These rates were 3.3 and 4.0 per 100,000 per year, respectively, for the population 20 years and older. The increase in rate between these two time periods was likely due to changes in MND death coding from 2008. Contrary to a previous regional study of MND incidence, nationwide mortality rates did not increase steadily over this time period once aging was accounted for. However, New Zealand MND mortality rate was higher than comparable studies we examined internationally (mean 1.67 per 100,000 per year), suggesting that further analysis of MND burden in New Zealand is warranted.

The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project.

PubMed

D'Ippoliti, Daniela; Michelozzi, Paola; Marino, Claudia; de'Donato, Francesca; Menne, Bettina; Katsouyanni, Klea; Kirchmayer, Ursula; Analitis, Antonis; Medina-Ramón, Mercedes; Paldy, Anna; Atkinson, Richard; Kovats, Sari; Bisanti, Luigi; Schneider, Alexandra; Lefranc, Agnès; Iñiguez, Carmen; Perucci, Carlo A

2010-07-16

The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity. Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated. The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions. Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.

Mortality in England during the 1783 4 Laki Craters eruption

NASA Astrophysics Data System (ADS)

Witham, C. S.; Oppenheimer, C.

2004-12-01

1783/4 has been recognised as a mortality “crisis year” in the population history of England. This demographic incident coincides with the Laki Craters eruption, Iceland, which began in June 1783 and fumigated many parts of Europe with volcanic gases and particles. Many reports and proxy climate records implicate the volcanic cloud in meteorological anomalies, including notably hot 1783 summer conditions in England and a severe subsequent winter. We present here a detailed analysis of the geographical and temporal trends in English mortality data, and interpret them in the light of the climatological records and observations of the pollutant cloud. We show that there were two distinct crisis periods: in August-September 1783, and January-February 1784, which together accounted for ~20,000 extra deaths. In both cases, the East of England was the worst affected region. Possible causes for the two crisis periods are considered and we conclude that the timing and magnitude of the winter mortality peak can be explained by the severe cold of January 1784. The late summer mortality followed 1 2 months after the very hot July of 1783 and may also have been related to the weather, with the time lag reflecting the relatively slow spread of enteric disease or the contraction of malaria. However, it is hard to explain the entire late summer anomaly by these high temperature causes. We therefore consider that fine acid aerosol and/or gases in the volcanic haze may also have contributed to the unusual August-September mortality. Given that complex radiative and dynamical effects of the volcanic cloud are implicated in the climatic anomalies in 1783 4, it is likely that the Laki Craters eruption did play a role in the English mortality crises of the same period.

Emergence of canine distemper virus strains with modified molecular signature and enhanced neuronal tropism leading to high mortality in wild carnivores.

PubMed

Origgi, F C; Plattet, P; Sattler, U; Robert, N; Casaubon, J; Mavrot, F; Pewsner, M; Wu, N; Giovannini, S; Oevermann, A; Stoffel, M H; Gaschen, V; Segner, H; Ryser-Degiorgis, M-P

2012-11-01

An ongoing canine distemper epidemic was first detected in Switzerland in the spring of 2009. Compared to previous local canine distemper outbreaks, it was characterized by unusually high morbidity and mortality, rapid spread over the country, and susceptibility of several wild carnivore species. Here, the authors describe the associated pathologic changes and phylogenetic and biological features of a multiple highly virulent canine distemper virus (CDV) strain detected in and/or isolated from red foxes (Vulpes vulpes), Eurasian badgers (Meles meles), stone (Martes foina) and pine (Martes martes) martens, from a Eurasian lynx (Lynx lynx), and a domestic dog. The main lesions included interstitial to bronchointerstitial pneumonia and meningopolioencephalitis, whereas demyelination--the classic presentation of CDV infection--was observed in few cases only. In the brain lesions, viral inclusions were mainly in the nuclei of the neurons. Some significant differences in brain and lung lesions were observed between foxes and mustelids. Swiss CDV isolates shared together with a Hungarian CDV strain detected in 2004. In vitro analysis of the hemagglutinin protein from one of the Swiss CDV strains revealed functional and structural differences from that of the reference strain A75/17, with the Swiss strain showing increased surface expression and binding efficiency to the signaling lymphocyte activation molecule (SLAM). These features might be part of a novel molecular signature, which might have contributed to an increase in virus pathogenicity, partially explaining the high morbidity and mortality, the rapid spread, and the large host spectrum observed in this outbreak.

An unusual case of fatal pulmonary hemorrhage in pregnancy.

PubMed

Dissanayake, N L A; Madegedara, Dushantha

2011-07-01

Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis.

Proactive Conservation Program: Species of Concern :: NOAA Fisheries

Science.gov Websites

Education Grants Scholarships and Fellowships Teacher at Sea Climate Stewards Get Involved Dolphin Smart » Sign up for FishNews GO OPR Home Species Marine Mammals Sea Turtles Marine & Anadromous Fish Marine Marine Mammal Database National Tissue Bank Prescott Grants Sea Turtles Unusual Mortality Events Permits

Toxicoinfectious botulism in commercial caponized chickens

USGS Publications Warehouse

Trampel, D.W.; Smith, Susan; Rocke, Tonie E.

2005-01-01

During the summer of 2003, two flocks of commercial broiler chickens experienced unusually high death losses following caponizing at 3 wk of age and again between 8 and 14 wk of age. In September, fifteen 11-wk-old live capons were submitted to the Iowa State University Veterinary Diagnostic Laboratory for assistance. In both flocks, the second episode of elevated mortality was associated with incoordination, flaccid paralysis of leg, wing, and neck muscles, a recumbent body posture characterized by neck extension, and diarrhea. No macroscopic or microscopic lesions were detected in affected chickens. Hearts containing clotted blood and ceca were submitted to the National Wildlife Health Center in Madison, WI. Type C botulinum toxin was identified in heart blood and ceca by mouse bioassay tests. Enzyme-linked immunosorbent assay tests on heart blood samples were also positive for type C botulinum toxin. Clostridium botulinum was isolated from the ceca and genes encoding type C botulinum toxin were detected in cecal contents by a polymerase chain reaction test. Chickens are less susceptible to botulism as they age, and this disease has not previously been documented in broilers as old as 14 wk of age. Wound contamination by spores of C. botulinum may have contributed to the unusually high death losses following caponizing.

Idiopathic Pulmonary Fibrosis and Myasthenia Gravis: An Unusual Association

PubMed Central

Chogtu, Bharti; Malik, Daliparty Vasudev

2016-01-01

Idiopathic Pulmonary Fibrosis (IPF) is a chronic fibrosing lung condition with high morbidity and mortality, accounting for about 25% of the cases of interstitial lung diseases. It usually has a progressive course resulting in death due to respiratory failure. Myasthenia Gravis (MG) is an autoimmune neuromuscular disease, caused by antibody mediated activity against acetylcholine receptor at the neuromuscular junction. It is characterized by fluctuating muscle weakness and fatigue. Extensive literature search did not reveal any case report of an association between these two conditions. Here we present a case of a patient with IPF who also developed MG. The diagnosis of IPF was based on High Resolution Computed Tomography (HRCT) of the lung and that of MG was based on clinical criteria and electrophysiological testing. The case was successfully managed. PMID:27190866

Comprehensive bee pathogen screening in Belgium reveals Crithidia mellificae as a new contributory factor to winter mortality.

PubMed

Ravoet, Jorgen; Maharramov, Jafar; Meeus, Ivan; De Smet, Lina; Wenseleers, Tom; Smagghe, Guy; de Graaf, Dirk C

2013-01-01

Since the last decade, unusually high honey bee colony losses have been reported mainly in North-America and Europe. Here, we report on a comprehensive bee pathogen screening in Belgium covering 363 bee colonies that were screened for 18 known disease-causing pathogens and correlate their incidence in summer with subsequent winter mortality. Our analyses demonstrate that, in addition to Varroa destructor, the presence of the trypanosomatid parasite Crithidia mellificae and the microsporidian parasite Nosema ceranae in summer are also predictive markers of winter mortality, with a negative synergy being observed between the two in terms of their effects on colony mortality. Furthermore, we document the first occurrence of a parasitizing phorid fly in Europe, identify a new fourth strain of Lake Sinai Virus (LSV), and confirm the presence of other little reported pathogens such as Apicystis bombi, Aphid Lethal Paralysis Virus (ALPV), Spiroplasma apis, Spiroplasma melliferum and Varroa destructor Macula-like Virus (VdMLV). Finally, we provide evidence that ALPV and VdMLV replicate in honey bees and show that viruses of the LSV complex and Black Queen Cell Virus tend to non-randomly co-occur together. We also noticed a significant correlation between the number of pathogen species and colony losses. Overall, our results contribute significantly to our understanding of honey bee diseases and the likely causes of their current decline in Europe.

Puerperal group A streptococcal infection: beyond Semmelweis.

PubMed

Anderson, Brenna L

2014-04-01

Ignaz Semmelweiss made one of the most important contributions to modern medicine when he instituted handwashing in an obstetric clinic in Austria in 1847, decreasing mortality there from more than 10% to 2%. Unfortunately, puerperal sepsis remains a leading cause of maternal mortality throughout the world. Group A streptococcus (GAS), Streptococcus pyogenes, is an organism associated with high rates of morbidity and mortality from puerperal infections. When associated with sepsis, known as streptococcal toxic shock syndrome, mortality rates approach 30-50%. Group A streptococcus can cause invasive infections in the form of endometritis, necrotizing fasciitis, or streptococcal toxic shock syndrome. The clinical presentation of women with puerperal GAS infections is often atypical with extremes of temperature, unusual and vague pain, and pain in extremities. Toxin production by the organism may allow GAS to spread across tissue planes and cause necrosis while evading containment by the maternal immune system in the form of a discrete abscess. Endometrial aspiration in addition to blood cultures may be a useful rapid diagnostic tool. Imaging may appear normal and should not dissuade the clinician from aggressive management. When suspected, invasive GAS infections should be treated emergently with fluid resuscitation, antibiotic administration, and source control. The optimal antibiotic regimen contains penicillin and clindamycin. Source control may require extensive wound or vulvar debridement, hysterectomy, or a combination of these, which may be life-saving. The benefit of immunoglobulins in management of puerperal GAS infections is unclear.

Were multiple stressors a 'perfect storm' for northern Gulf of Mexico bottlenose dolphins (Tursiops truncatus) in 2011?

PubMed

Carmichael, Ruth H; Graham, William M; Aven, Allen; Worthy, Graham; Howden, Stephan

2012-01-01

An unusual number of near term and neonatal bottlenose dolphin (Tursiops truncatus) mortalities occurred in the northern Gulf of Mexico (nGOM) in 2011, during the first calving season after two well documented environmental perturbations; sustained cold weather in 2010 and the Deepwater Horizon oil spill (DWHOS). Preceding the stranding event, large volumes of cold freshwater entered the nGOM due to unusually large snowmelt on the adjacent watershed, providing a third potential stressor. We consider the possibility that this extreme cold and freshwater event contributed to the pattern of perinatal dolphin strandings along the nGOM coast. During the 4-month period starting January 2011, 186 bottlenose dolphins, including 46% perinatal calves (nearly double the percentage for the same time period from 2003-2010) washed ashore from Louisiana to western Florida. Comparison of the frequency distribution of strandings to flow rates and water temperature at a monitoring buoy outside Mobile Bay, Alabama (the 4(th) largest freshwater drainage in the U.S.) and along the nGOM coast showed that dolphin strandings peaked in Julian weeks 5, 8, and 12 (February and March), following water temperature minima by 2-3 weeks. If dolphin condition was already poor due to depleted food resources, bacterial infection, or other factors, it is plausible that the spring freshet contributed to the timing and location of the unique stranding event in early 2011. These data provide strong observational evidence to assess links between the timing of the DWHOS, other local environmental stressors, and mortality of a top local predator. Targeted analyses of tissues from stranded dolphins will be essential to define a cause of death, and our findings highlight the importance of considering environmental data along with biological samples to interpret stranding patterns during and after an unusual mortality event.

Churg-Strauss syndrome presenting with eosinophilic myocarditis: a diagnostic challenge.

PubMed

Correia, Ana Sofia; Gonçalves, Alexandra; Araújo, Vítor; Almeida e Silva, João; Pereira, José Manuel; Rodrigues Pereira, Pedro; Pizarro, Manuel; Silva, João Carlos; Maciel, Maria Júlia

2013-09-01

Churg-Strauss syndrome (CSS) is an unusual disease that presents as systemic vasculitis and peripheral eosinophilia in patients with an atopic constitution. Cardiac involvement is unusual and often not prominent on initial presentation, but is an important cause of morbidity and mortality in patients with CSS. We report the case of a young woman with severe acute myocarditis. Coronary arteriography demonstrated extensive focal vasculopathy, consistent with coronary vasculitis, and myocardial biopsy showed eosinophilic myocarditis. This presentation led to an initial diagnosis of CSS in this patient and appropriate therapy resulted in a spectacular remission of disease activity. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Reconstruction of the 1918 Influenza Virus: Unexpected Rewards from the Past

PubMed Central

Taubenberger, Jeffery K.; Baltimore, David; Doherty, Peter C.; Markel, Howard; Morens, David M.; Webster, Robert G.; Wilson, Ian A.

2012-01-01

ABSTRACT The influenza pandemic of 1918–1919 killed approximately 50 million people. The unusually severe morbidity and mortality associated with the pandemic spurred physicians and scientists to isolate the etiologic agent, but the virus was not isolated in 1918. In 1996, it became possible to recover and sequence highly degraded fragments of influenza viral RNA retained in preserved tissues from several 1918 victims. These viral RNA sequences eventually permitted reconstruction of the complete 1918 virus, which has yielded, almost a century after the deaths of its victims, novel insights into influenza virus biology and pathogenesis and has provided important information about how to prevent and control future pandemics. PMID:22967978

'Between one and three million': towards the demographic reconstruction of a decade of Cambodian history (1970-79).

PubMed

Heuveline, P

1998-03-01

Estimates of mortality in Camabodia during the Khmer Rouge regime (1975-79) range from 20,000 deaths according to former Khmer Rouge sources, to over three million victims according to Vietnamese government sources. This paper uses an unusual data source - the 1992 electoral lists registered by the United Nations - to estimate the population size after the Khmer Rouge regime and the extent of "excess" mortality in the 1970s. These data also provide the first breakdown of population by single year of age, which allows analysis of the age structure of "excess" mortality and inference of the relative importance of violence as a cause of death in that period. The estimates derived here are more comparable with the higher estimates made in the past. In addition, the analysis of likely causes of death that could have generated the age pattern of "excess" mortality clearly shows a larger contribution of direct or violent mortality than has been previously recognized.

Type C botulism in pelicans and other fish-eating birds at the Salton Sea

USGS Publications Warehouse

Rocke, T.E.; Nol, P.; Pelizza, C.; Sturm, K.K.

2004-01-01

In 1996, type C avian botulism killed over 10,000 pelicans and nearly 10,000 other fish-eating birds at the Salton Sea in southern California. Although botulism had been previously documented in waterbirds at the Sea, this die-off was unusual in that it involved primarily fish-eating birds. The American White Pelican (Pelecanus erythrorynchos) was the species with the greatest mortality in 1996. Since 1996, mortality has recurred every year but losses have declined (<2,000 birds/year), with relatively more Brown Pelicans (P. occidentalis) than White Pelicans afflicted. In 2000, morbidity and mortality of Brown Pelicans with type C botulism (1311) approached the numbers afflicted in 1996 (2034). In recent years, mortality reached a peak earlier in the summer, July and August, in contrast to 1996 when mortality reached a peak in September. An exotic fish species, tilapia (Oreochromis mossambicus), has been implicated as the source of toxin for birds at Salton Sea, but the source of toxin for fish is unknown.

An unusual case of fatal pulmonary hemorrhage in pregnancy

PubMed Central

Dissanayake, N. L. A; Madegedara, Dushantha

2011-01-01

Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis. PMID:21886958

Mortality patterns associated with the 1918 influenza pandemic in Mexico: evidence for a spring herald wave and lack of pre-existing immunity in older populations

PubMed Central

Chowell, Gerardo; Viboud, Cécile; Simonsen, Lone; Miller, Mark A.; Acuna-Soto, Rodolfo

2010-01-01

Background While the mortality burden of the devastating 1918 influenza pandemic has been carefully quantified in the US, Japan, and European countries, little is known about the pandemic experience elsewhere. Here, we compiled extensive archival records to quantify the pandemic mortality patterns in two Mexican cities, Mexico City and Toluca. Methods We applied seasonal excess mortality models to age-specific respiratory mortality rates for 1915–1920 and quantified the reproduction number from daily data. Results We identified 3 pandemic waves in Mexico City in spring 1918, fall 1918, and winter 1920, characterized by unusual excess mortality in 25–44 years old. Toluca experienced 2-fold higher excess mortality rates than Mexico City, but did not have a substantial 3rd wave. All age groups including those over 65 years experienced excess mortality during 1918–20. Reproduction number estimates were below 2.5 assuming a 3-day generation interval. Conclusion Mexico experienced a herald pandemic wave with elevated young adult mortality in spring 1918, similar to the US and Europe. In contrast to the US and Europe, there was no mortality sparing in Mexican seniors, highlighting potential geographical differences in pre-existing immunity to the 1918 virus. We discuss the relevance of our findings to the 2009 pandemic mortality patterns. PMID:20594109

Severe 2010 Cold-Water Event Caused Unprecedented Mortality to Corals of the Florida Reef Tract and Reversed Previous Survivorship Patterns

PubMed Central

Lirman, Diego; Schopmeyer, Stephanie; Manzello, Derek; Gramer, Lewis J.; Precht, William F.; Muller-Karger, Frank; Banks, Kenneth; Barnes, Brian; Bartels, Erich; Bourque, Amanda; Byrne, James; Donahue, Scott; Duquesnel, Janice; Fisher, Louis; Gilliam, David; Hendee, James; Johnson, Meaghan; Maxwell, Kerry; McDevitt, Erin; Monty, Jamie; Rueda, Digna; Ruzicka, Rob; Thanner, Sara

2011-01-01

Background Coral reefs are facing increasing pressure from natural and anthropogenic stressors that have already caused significant worldwide declines. In January 2010, coral reefs of Florida, United States, were impacted by an extreme cold-water anomaly that exposed corals to temperatures well below their reported thresholds (16°C), causing rapid coral mortality unprecedented in spatial extent and severity. Methodology/Principal Findings Reef surveys were conducted from Martin County to the Lower Florida Keys within weeks of the anomaly. The impacts recorded were catastrophic and exceeded those of any previous disturbances in the region. Coral mortality patterns were directly correlated to in-situ and satellite-derived cold-temperature metrics. These impacts rival, in spatial extent and intensity, the impacts of the well-publicized warm-water bleaching events around the globe. The mean percent coral mortality recorded for all species and subregions was 11.5% in the 2010 winter, compared to 0.5% recorded in the previous five summers, including years like 2005 where warm-water bleaching was prevalent. Highest mean mortality (15%–39%) was documented for inshore habitats where temperatures were <11°C for prolonged periods. Increases in mortality from previous years were significant for 21 of 25 coral species, and were 1–2 orders of magnitude higher for most species. Conclusions/Significance The cold-water anomaly of January 2010 caused the worst coral mortality on record for the Florida Reef Tract, highlighting the potential catastrophic impacts that unusual but extreme climatic events can have on the persistence of coral reefs. Moreover, habitats and species most severely affected were those found in high-coral cover, inshore, shallow reef habitats previously considered the “oases” of the region, having escaped declining patterns observed for more offshore habitats. Thus, the 2010 cold-water anomaly not only caused widespread coral mortality but also reversed prior resistance and resilience patterns that will take decades to recover. PMID:21853066

Using subjective expectations to forecast longevity: do survey respondents know something we don't know?

PubMed

Perozek, Maria

2008-02-01

Old-age mortality is notoriously difficult to predict because it requires not only an understanding of the process of senescence-which is influenced by genetic, environmental, and behavioral factors-but also a prediction of how these factors will evolve. In this paper I argue that individuals are uniquely qualified to predict their own mortality based on their own genetic background, as well as environmental and behavioral risk factors that are often known only to the individual. Given this private information, individuals form expectations about survival probabilities that may provide additional information to demographers and policymakers in their challenge to predict mortality. From expectations data from the 1992 Health and Retirement Study (HRS), I construct subjective, cohort life tables that are shown to predict the unusual direction of revisions to U.S. life expectancy by gender between 1992 and 2004: that is, for these cohorts, the Social Security Actuary (SSA) raised male life expectancy in 2004 and at the same lowered female life expectancy, narrowing the gender gap in longevity by 25% over this period. Further, although the subjective life expectancies for men appear to be roughly in line with the 2004 life tables, the subjective expectations of women suggest that female life expectancies estimated by the SSA might still be on the high side.

Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality.

PubMed

Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Kumar, Anjay; Mishra, Kiran; Mohanty, Debajyoti; Agrawal, Vivek

2013-01-01

Invasive colonic amoebiasis presents primarily with dysentery; colonic perforation occurs rarely. Cases of amoebic colonic perforations have been reported sporadically over the past 20 years. A retrospective study was done in the surgical unit of a tertiary care hospital in North India. The case records of those patients were reviewed who underwent exploratory laparotomy from January 2011 to September 2012 and were diagnosed with amoebic colonic perforation on histopathological examination. Details concerning the clinical presentation, investigations, intraoperative findings, operative procedures, and postoperative outcomes were retrieved. Amongst, a total of 186 emergency exploratory laparotomies carried out during the study, 15 patients of amoebic colonic perforation were identified. The median age of the patients was 42 years (IQR 32.0-58.0) and the male to female ratio was 13:2. Previous history of colitis was present in only 1 patient. The preoperative diagnosis was perforation peritonitis in 12 patients; and intussusception, intestinal obstruction and ruptured liver abscess in 1 patient each. Ten patients had single perforation while 5 had multiple colonic perforations. All the patients except one had perforations in the right colon. Bowel resection was performed depending upon the site and extent of the colon involved-right hemicolectomy (8), limited ileocolic resection (6) and sigmoidectomy (1). Bowel continuity could be restored only in 2 of the 15 patients and a stoma was constructed in the remaining 13 patients. The overall mortality rate was found to be 40% (6/15). Amoebic colonic perforation is associated with unusually high mortality.

Effects of subsidized predators, resource variability, and human population density on desert tortoise populations in the Mojave Desert, USA

USGS Publications Warehouse

Esque, Todd C.; Nussear, Kenneth E.; Drake, K. Kristina; Walde, Andrew D.; Berry, Kristin H.; Averill-Murray, Roy C.; Woodman, A. Peter; Boarman, William I.; Medica, Phil A.; Mack, Jeremy S.; Heaton, Jill S.

2010-01-01

Understanding predator–prey relationships can be pivotal in the conservation of species. For 2 decades, desert tortoise Gopherus agassizii populations have declined, yet quantitative evidence regarding the causes of declines is scarce. In 2005, Ft. Irwin National Training Center, California, USA, implemented a translocation project including 2 yr of baseline monitoring of desert tortoises. Unusually high predation on tortoises was observed after translocation occurred. We conducted a retrospective analysis of predation and found that translocation did not affect the probability of predation: translocated, resident, and control tortoises all had similar levels of predation. However, predation rates were higher near human population concentrations, at lower elevation sites, and for smaller tortoises and females. Furthermore, high mortality rates were not limited to the National Training Center. In 2008, elevated mortality (as high as 43%) occurred throughout the listed range of the desert tortoise. Although no temporal prey base data are available for analysis from any of the study sites, we hypothesize that low population levels of typical coyote Canis latrans prey (i.e. jackrabbits Lepus californicus and other small animals) due to drought conditions influenced high predation rates in previous years. Predation may have been exacerbated in areas with high levels of subsidized predators. Many historical reports of increased predation, and our observation of a range-wide pattern, may indicate that high predation rates are more common than generally considered and may impact recovery of the desert tortoise throughout its range.

Comparative Analysis of Three Brevetoxin-Associated Bottlenose Dolphin (Tursiops truncatus) Mortality Events in the Florida Panhandle Region (USA)

PubMed Central

Twiner, Michael J.; Flewelling, Leanne J.; Fire, Spencer E.; Bowen-Stevens, Sabrina R.; Gaydos, Joseph K.; Johnson, Christine K.; Landsberg, Jan H.; Leighfield, Tod A.; Mase-Guthrie, Blair; Schwacke, Lori; Van Dolah, Frances M.; Wang, Zhihong; Rowles, Teresa K.

2012-01-01

In the Florida Panhandle region, bottlenose dolphins (Tursiops truncatus) have been highly susceptible to large-scale unusual mortality events (UMEs) that may have been the result of exposure to blooms of the dinoflagellate Karenia brevis and its neurotoxin, brevetoxin (PbTx). Between 1999 and 2006, three bottlenose dolphin UMEs occurred in the Florida Panhandle region. The primary objective of this study was to determine if these mortality events were due to brevetoxicosis. Analysis of over 850 samples from 105 bottlenose dolphins and associated prey items were analyzed for algal toxins and have provided details on tissue distribution, pathways of trophic transfer, and spatial-temporal trends for each mortality event. In 1999/2000, 152 dolphins died following extensive K. brevis blooms and brevetoxin was detected in 52% of animals tested at concentrations up to 500 ng/g. In 2004, 105 bottlenose dolphins died in the absence of an identifiable K. brevis bloom; however, 100% of the tested animals were positive for brevetoxin at concentrations up to 29,126 ng/mL. Dolphin stomach contents frequently consisted of brevetoxin-contaminated menhaden. In addition, another potentially toxigenic algal species, Pseudo-nitzschia, was present and low levels of the neurotoxin domoic acid (DA) were detected in nearly all tested animals (89%). In 2005/2006, 90 bottlenose dolphins died that were initially coincident with high densities of K. brevis. Most (93%) of the tested animals were positive for brevetoxin at concentrations up to 2,724 ng/mL. No DA was detected in these animals despite the presence of an intense DA-producing Pseudo-nitzschia bloom. In contrast to the absence or very low levels of brevetoxins measured in live dolphins, and those stranding in the absence of a K. brevis bloom, these data, taken together with the absence of any other obvious pathology, provide strong evidence that brevetoxin was the causative agent involved in these bottlenose dolphin mortality events. PMID:22916189

Recurring ventriculitis due to Citrobacter diversus: clinical and bacteriologic analysis.

PubMed

Eppes, S C; Woods, C R; Mayer, A S; Klein, J D

1993-09-01

Neonatal meningitis due to Citrobacter diversus is usually accompanied by the development of brain abscesses and tends to have high rates of morbidity and mortality. We report a case of a newborn with C. diversus meningitis and brain abscesses who relapsed after initial antibiotic therapy and from whom C. diversus was recovered from cerebrospinal fluid 4 years later during a neurosurgical procedure. Genetic differences in the early and late isolates were discovered, and explanations for this phenomenon are suggested. Possible mechanisms for prolonged persistence in the central nervous system are explored. This unusual case and the analysis of the organisms illustrate the unique features of C. diversus as a pathogen and underscore the need for developing optimal therapeutic strategies.

Placento-Cranial Adhesions in Amniotic Band Syndrome and the Role of Surgery in Their Management: An Unusual Case Presentation and Systematic Literature Review.

PubMed

Menekse, Guner; Mert, Mustafa Kurthan; Olmaz, Burak; Celik, Tamer; Celik, Umit Sizmaz; Okten, Ali Ihsan

2015-01-01

Amniotic band syndrome is a group of sporadic congenital anomalies that involve the limbs, craniofacial regions and trunk, ranging from simple digital band constriction to complex craniofacial and central nervous system abnormalities. Placento-cranial adhesions in amniotic band syndrome are extremely rare, and severe conditions are associated with high morbidity and mortality rates. In this study, we pooled placento-cranial adhesion case reports that were published in the medical literature and added an unpublished case from our institution. The purpose of this article was to review and discuss the clinical features and outcomes of placento-cranial adhesions in amniotic band syndrome. © 2015 S. Karger AG, Basel.

Clinical spectrum of Kawasaki disease in infants younger than 6 months of age.

PubMed

Burns, J C; Wiggins, J W; Toews, W H; Newburger, J W; Leung, D Y; Wilson, H; Glodé, M P

1986-11-01

We report an unselected series of eight patients younger than 6 months of age with Kawasaki disease evaluated between January 1982 and May 1984. The incidence of coronary artery aneurysms (six patients) and the mortality (two patients) were unusually high in this small series. Because of the confusing clinical presentation in three patients, diagnosis was delayed until pathologic or echocardiographic evidence of coronary vasculitis or aneurysm was discovered. The currently accepted clinical criteria for Kawasaki disease may not always identify patients with the pathologic findings of the syndrome who are younger than 6 months of age. The diagnosis of Kawasaki disease and echocardiographic evaluation of the coronary arteries should be considered in young infants with prolonged fever of unknown origin.

Reconnaissance study of the geology of U.S. vermiculite deposits: Are asbestos minerals common constituents?

USGS Publications Warehouse

Van Gosen, Bradley S.; Lowers, Heather; Bush, Alfred L.; Meeker, Gregory P.; Plumlee, Geoffrey S.; Brownfield, Isabelle K.; Sutley, Stephen J.

2002-01-01

Unusually high incidences of asbestos-related mortality and respiratory disease in the small town of Libby, Montana, have been linked to amphibole mineral fibers intergrown with the vermiculite deposits mined and milled near the town from 1923 to 1990. A study conducted by the U.S. Agency for Toxic Substances and Disease Registry concluded that mortality due to asbestosis in Libby mine and mill workers and residents during 1979 to 1998 was much higher than expected for a similar Montana or United States population group. Recent medical testing of past and present mineworkers and residents of Libby showed lung abnormalities in nearly one-fifth of the adult study participants. The U.S. Environmental Protection Agency, under Superfund authority, is completing sampling and cleanup of asbestos-bearing materials in the mine, mill, and town sites. The U.S. Geological Survey is conducting a study, reviewed herein, to investigate the mineral content of other U.S. vermiculite deposits and to determine if the amphibole asbestos minerals like those found in the Libby deposits are common in other vermiculite deposits.

Multiple splenic abscesses in a rather healthy woman: a case report.

PubMed

Saber, Aly

2009-07-23

Abscess of the spleen is a rather clinical rarity with reported mortality rate up to 47%. The timely and widespread use of imaging methods facilitates early diagnosis and guides treatment, thus improving the prognosis. Most of patients were with recognized risk factors including conditions that compromise the immune system, trauma and intravenous drug abuse in addicts. The surgical treatment by splenectomy is usually the first choice of treatment. A healthy 45-year-old woman presented to the outpatient clinic with fever, 39 degrees C together with persistent upper-left-quadrant abdominal pain. Her past medical history was free from any chronic debilitating diseases or other predisposing factors. Imaging included chest and abdominal X-ray, followed by a CT scan of the upper abdomen. Splenic abscess is an unusual and potentially life-threatening disease with a diagnostic challenge due to the nonspecific clinical picture and diagnosis confirmed based mostly on imaging studies. Multiple splenic abscesses are very rarely encountered in surgical practice with a reported high mortality rate in neglected and untreated cases. Splenectomy is a safe procedure for patients with splenic abscess.

Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013

PubMed Central

Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting. PMID:29538437

Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013.

PubMed

Gignoux, Etienne; Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting.

Pseudomonas fluorescens strain CL145A - a biopesticide for the control of zebra and quagga mussels (Bivalvia: Dreissenidae).

PubMed

Molloy, Daniel P; Mayer, Denise A; Gaylo, Michael J; Morse, John T; Presti, Kathleen T; Sawyko, Paul M; Karatayev, Alexander Y; Burlakova, Lyubov E; Laruelle, Franck; Nishikawa, Kimi C; Griffin, Barbara H

2013-05-01

Zebra mussels (Dreissena polymorpha) and quagga mussels (Dreissena rostriformis bugensis) are the "poster children" of high-impact aquatic invasive species. In an effort to develop an effective and environmentally acceptable method to control their fouling of raw-water conduits, we have investigated the potential use of bacteria and their natural metabolic products as selective biological control agents. An outcome of this effort was the discovery of Pseudomonas fluorescens strain CL145A - an environmental isolate that kills these dreissenid mussels by intoxication (i.e., not infection). In the present paper, we use molecular methods to reconfirm that CL145A is a strain of the species P. fluorescens, and provide a phylogenetic analysis of the strain in relation to other Pseudomonas spp. We also provide evidence that the natural product lethal to dreissenids is associated with the cell wall of P. fluorescens CL145A, is a heat-labile secondary metabolite, and has degradable toxicity within 24 h when applied to water. CL145A appears to be an unusual strain of P. fluorescens since it was the only one among the ten strains tested to cause high mussel mortality. Pipe trials conducted under once-through conditions indicated: (1) P. fluorescens CL145A cells were efficacious against both zebra and quagga mussels, with high mortalities achieved against both species, and (2) as long as the total quantity of bacterial cells applied during the entire treatment period was the same, similar mussel mortality could be achieved in treatments lasting 1.5-12.0 h, with longer treatment durations achieving lower mortalities. The efficacy data presented herein, in combination with prior demonstration of its low risk of non-target impact, indicate that P. fluorescens CL145A cells have significant promise as an effective and environmentally safe control agent against these invasive mussels. Copyright © 2012 Elsevier Inc. All rights reserved.

Anemia and neutropenic fever with high dose diazoxide treatment in a case with hyperinsulinism due to Munchausen by proxy.

PubMed

Ozon, A; Demirbilek, H; Ertugrul, A; Unal, S; Gumruk, F; Kandemir, N

2010-07-01

The etiology of hyperinsulinemic hypoglycemia in adolescents is similar to that of adults. Patients resistant to medical treatment may undergo pancreatectomy. Diazoxide is the mainstay of medical treatment. Rarely bone marrow suppression is reported due to diazoxide. An adolescent with severe hyperinsulinemic hypoglycemia was referred for pancreatectomy after she was treated with high doses of diazoxide, octreotide and glucose. She developed anemia and febrile neutropenia in the course of diazoxide treatment that resolved with cessation of medication. The cause of the hyperinsulinemia proved to be classical Munchausen by proxy. This is the first report of bone marrow suppression involving erythroid series by diazoxide. Follow-up of blood count may be considered in patients on high dosages since anemia may be dose dependent. Munchausen by proxy poses a serious threat to children with significant morbidity and mortality. Awareness and a high index of suspicion in clinical settings with unusual causes are the mainstay for the diagnosis.

Elevated fat skatole levels in immunocastrated, surgically castrated and entire male pigs with acute dysentery.

PubMed

Skrlep, Martin; Batorek, Nina; Bonneau, Michel; Fazarinc, Gregor; Segula, Blaž; Candek-Potokar, Marjeta

2012-12-01

Boar taint is due to androstenone and skatole (3-methyl-indole) accumulation in fat tissues. During a study to investigate the effect of immunocastration on fattening pigs, an outbreak of acute dysentery occurred caused by Lawsonia intracellularis and Brachyspira hyodysenteriae and resulted in cachexia and high mortality. Low androstenone levels in the immunocastrates (0.25 ± 0.04 μg/g liquid fat) suggested that the immunocastration had been effective, but unusually high skatole concentrations in fat tissues were found not only in entire males, but also in surgical castrates and immunocastrates (0.22 ± 0.15, 0.14 ± 0.08 and 0.18 ± 0.14 μg/g liquid fat, respectively). The findings suggest that boar taint can arise in cases of intestinal infections, even in castrated pigs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Severe metabolic alkalosis due to pyloric obstruction: case presentation, evaluation, and management.

PubMed

McCauley, Meredith; Gunawardane, Manjula; Cowan, Mark J

2006-12-01

A 46-year-old man presented to the emergency room with severe metabolic alkalosis, hypokalemia, and respiratory failure requiring intubation and mechanical ventilation. The cause of his acid-base disorder was initially unclear. Although alkalosis is common in the intensive care unit, metabolic alkalosis of this severity is unusual, carries a very high mortality rate, and requires careful attention to the pathophysiology and differential diagnosis to effectively evaluate and treat the patient. A central concept in the diagnosis of metabolic alkalosis is distinguishing chloride responsive and chloride nonresponsive states. Further studies are then guided by the history and physical examination in most cases. By using a systematic approach to the differential diagnosis, we were able to determine that a high-grade gastric outlet obstruction was the cause of the patients' alkalosis and to offer effective therapy for his condition. A literature review and algorithm for the diagnosis and management of metabolic alkalosis are also presented.

Pulmonary aspergillosis in patients with AIDS. Clinical and radiographic correlations.

PubMed

Miller, W T; Sais, G J; Frank, I; Gefter, W B; Aronchick, J M; Miller, W T

1994-01-01

To evaluate the clinical and radiographic features of pulmonary aspergillosis as they present in AIDS patients; in particular, to determine similarities and differences between Aspergillus infection in patients with AIDS vs those without AIDS. Six new cases of confirmed or probable pulmonary aspergillosis were discovered during a search of hospital records. These are reviewed with 30 previously reported cases with special attention to radiographic appearance of disease and how radiographic appearance influences clinical outcome. Symptoms of pulmonary aspergillosis in AIDS were nonspecific, most often including fever, cough, and dyspnea, and less commonly, chest pain or hemoptysis. Major risk factors for the development of pulmonary aspergillosis in patients with AIDS were steroid administration and neutropenia. Neutropenia was often a complication of therapies for AIDS, in particular, ganciclovir and zidovudine. Radiographic appearance of disease could be divided into three general categories. One third of the patients (13/36) presented with cavitary upper lobe disease resembling noninvasive or chronic necrotizing aspergillosis. Fatal hemoptysis occurred in 42 percent of patients with this form of disease. Twenty-two percent (8/36) of the cases presented as a nondescript focal alveolar opacity similar to invasive aspergillosis. In several patients, the focal infiltrate remained stable for several months, a feature that is unusual for aspergillosis in non-AIDS patients. The air crescent sign was present in none of the 36 reported cases. Patients with only focal disease had the best prognosis of patients with pulmonary aspergillosis. Bilateral alveolar or interstitial disease similar to invasive aspergillosis was present in 23 percent (9/36) of the patients. Bilateral disease appears to be a marker for disseminated infection and was associated with a high mortality due to aspergillosis. Two new forms of bronchial aspergillosis (5/36 cases) have been described previously. These patients presented with either obstructing fungal casts or bronchial pseudomembranes demonstrated bronchoscopically. In some patients with the bronchial forms of aspergillosis, transient alveolar opacities were seen on chest radiographs. These opacities may represent regions of atelectasis due to airway obstruction. One patient who had bilateral pneumothoraces without parenchymal opacities did not correspond to any of the three previously mentioned categories. Mortality due to aspergillosis was greater than 50 percent among AIDS patients. Death was subsequent to fatal hemoptysis or widespread pulmonary or systemic infection. Unlike other risk groups that tend to contract only one form of pulmonary aspergillosis, AIDS patients can develop the whole spectrum of aspergillosis-related pulmonary disorders, including chronic cavitary, invasive, and bronchial forms of aspergillosis. Clinical symptoms are nonspecific and major risk factors include neutropenia, which is often a side effect of various therapies for AIDS, and steroid administration. Patients with the chronic cavitary form of disease have an unusually high mortality due to fatal hemoptysis. Patients with bilateral pulmonary infiltrates and aspergillosis have a high mortality due to disseminated infection.

Regional patterns of mortality during the 1918 influenza pandemic in Newfoundland.

PubMed

Sattenspiel, Lisa

2011-07-22

The Spanish Influenza pandemic reached the island of Newfoundland in the summer of 1918 and by the time it disappeared, nearly 2000 of its 250,000 residents died. The pandemic spread in several waves, including a mild outbreak during the summer of 1918 (Wave I), a major, deadly outbreak in the succeeding fall and spring (Wave II), and a small echo wave in 1920. All parts of the island experienced the epidemic, but the effects varied across districts, both in timing and in severity. Overall P&I mortality rates across districts during the entire epidemic (1918-1920) ranged from 28.6 to 109.3 deaths per 10,000 population, with the island as a whole experiencing a mortality rate of 74.5 per 10,000. This island-wide mortality rate was 4.5 times higher than the P&I mortality rate for the 3 years immediately preceding the epidemic. Estimates of the reproduction number, R, range from 1.2 to 2.4 for Wave I and from 2.4 to 9.3 for Wave II. The pandemic experience on Newfoundland illustrates the high degree of regional variability in incidence and severity that epidemics can exhibit. In addition, compared to other world regions, the island's pandemic peaked relatively late and exhibited an unusual bimodal peak during Wave II, emphasizing that local and regional conditions can have major influences on timing, location, and rate of spread. This suggests the need to for greater understanding of how local factors influence epidemic spread so that more effective control strategies can be developed for populations experiencing future influenza pandemics. Copyright © 2011 Elsevier Ltd. All rights reserved.

Salticid predation as one potential driving force of ant mimicry in jumping spiders

PubMed Central

Huang, Jin-Nan; Cheng, Ren-Chung; Li, Daiqin; Tso, I-Min

2011-01-01

Many spiders possess myrmecomorphy, and species of the jumping spider genus Myrmarachne exhibit nearly perfect ant mimicry. Most salticids are diurnal predators with unusually high visual acuity that prey on various arthropods, including conspecifics. In this study, we tested whether predation pressure from large jumping spiders is one possible driving force of perfect ant mimicry in jumping spiders. The results showed that small non-ant-mimicking jumping spiders were readily treated as prey by large ones (no matter whether heterospecific or conspecific) and suffered high attack and mortality rates. The size difference between small and large jumping spiders significantly affected the outcomes of predatory interactions between them: the smaller the juvenile jumping spiders, the higher the predation risk from large ones. The attack and mortality rates of ant-mimicking jumping spiders were significantly lower than those of non-ant-mimicking jumping spiders, indicating that a resemblance to ants could provide protection against salticid predation. However, results of multivariate behavioural analyses showed that the responses of large jumping spiders to ants and ant-mimicking salticids differed significantly. Results of this study indicate that predation pressure from large jumping spiders might be one selection force driving the evolution of nearly perfect myrmecomorphy in spiders and other arthropods. PMID:20961898

Enhanced biological processes associated with alopecia in polar bears (Ursus maritimus).

PubMed

Bowen, Lizabeth; Miles, A Keith; Stott, Jeffrey; Waters, Shannon; Atwood, Todd

2015-10-01

Populations of wildlife species worldwide experience incidents of mass morbidity and mortality. Primary or secondary drivers of these events may escape classical detection methods for identifying microbial insults, toxin exposure, or additional stressors. In 2012, 28% of polar bears sampled in a study in the southern Beaufort Sea region of Alaska had varying degrees of alopecia that was concomitant with reduced body condition. Concurrently, elevated numbers of sick or dead ringed seals were detected in the southern Beaufort, Chukchi, and Bering seas in 2012, resulting in the declaration of an unusual mortality event (UME) by the National Oceanic and Atmospheric Administration (NOAA). The primary and possible ancillary causative stressors of these events are unknown, and related physiological changes within individual animals have been undetectable using classical diagnostic methods. Here we present an emerging technology as a potentially guiding investigative approach aimed at elucidating the circumstances responsible for the susceptibility of certain polar bears to observed conditions. Using transcriptomic analysis we identified enhanced biological processes including immune response, viral defense, and response to stress in polar bears with alopecia. Our results support an alternative mechanism of investigation into the causative agents that, when used proactively, could serve as an early indicator for populations and species at risk. We suggest that current or classical methods for investigation into events of unusual morbidity and mortality can be costly, sometimes unfocused, and often inconclusive. Advances in technology allow for implementation of a holistic system of surveillance and investigation that could provide early warning of health concerns in wildlife species important to humans. Published by Elsevier B.V.

Enhanced biological processes associated with alopecia in polar bears (Ursus maritimus)

USGS Publications Warehouse

Bowen, Lizabeth; Miles, A. Keith; Stott, Jeffrey L.; Waters, Shannon C.; Atwood, Todd C.

2015-01-01

Populations of wildlife species worldwide experience incidents of mass morbidity and mortality. Primary or secondary drivers of these events may escape classical detection methods for identifying microbial insults, toxin exposure, or additional stressors. In 2012, 28% of polar bears sampled in a study in the southern Beaufort Sea region of Alaska had varying degrees of alopecia that was concomitant with reduced body condition. Concurrently, elevated numbers of sick or dead ringed seals were detected in the southern Beaufort, Chukchi, and Bering seas in 2012, resulting in the declaration of an unusual mortality event (UME) by the National Oceanic and Atmospheric Administration (NOAA). The primary and possible ancillary causative stressors of these events are unknown, and related physiological changes within individual animals have been undetectable using classical diagnostic methods. Here we present an emerging technology as a potentially guiding investigative approach aimed at elucidating the circumstances responsible for the susceptibility of certain polar bears to observed conditions. Using transcriptomic analysis we identified enhanced biological processes including immune response, viral defense, and response to stress in polar bears with alopecia. Our results support an alternative mechanism of investigation into the causative agents that, when used proactively, could serve as an early indicator for populations and species at risk. We suggest that current or classical methods for investigation into events of unusual morbidity and mortality can be costly, sometimes unfocused, and often inconclusive. Advances in technology allow for implementation of a holistic system of surveillance and investigation that could provide early warning of health concerns in wildlife species important to humans.

A comparative climate analysis of heat-related emergency 911 dispatches: Chicago, Illinois and Phoenix, Arizona USA 2003 to 2006.

PubMed

Hartz, Donna A; Brazel, Anthony J; Golden, Jay S

2013-09-01

Research into the health impacts of heat has proliferated since 2000. Temperature increases could exacerbate the increased heat already experienced by urban populations due to urbanization. Heat-related mortality studies have found that hot southern cities in North America have not experienced the summer increases in mortality found in their more northern counterparts. Heat-related morbidity studies have not assessed this possible regional difference. This comparison study uses data from emergency 911 dispatches [referred to as heat-related dispatches (HRD)] identified by responders as heat-related for two United States cities located in different regions with very different climates: Chicago, Illinois in the upper midwest and Phoenix, Arizona in the southwest. Phoenix's climate is hot and arid. Chicago's climate is more temperate, but can also experience days with unusually high temperatures combined with high humidity. This study examines the relationships between rising HRD and daily temperatures: maximum (Tmax); apparent (ATmax): minimum (Tmin) and two energy balance indices (PET and UTCI). Phoenix had more HRD cumulatively, over a longer warm weather season, but did not experience the large spikes in HRD that occurred in Chicago, even though it was routinely subjected to much hotter weather conditions. Statistical analyses showed the strongest relationships to daily ATmax for both cities. Phoenix's lack of HRD spikes, similar to the summer mortality patterns for southern cities, suggests an avenue for future research to better understand the dynamics of possible physiological or behavioral adaption that seems to reduce residents' vulnerability to heat.

A comparative climate analysis of heat-related emergency 911 dispatches: Chicago, Illinois and Phoenix, Arizona USA 2003 to 2006

NASA Astrophysics Data System (ADS)

Hartz, Donna A.; Brazel, Anthony J.; Golden, Jay S.

2013-09-01

Research into the health impacts of heat has proliferated since 2000. Temperature increases could exacerbate the increased heat already experienced by urban populations due to urbanization. Heat-related mortality studies have found that hot southern cities in North America have not experienced the summer increases in mortality found in their more northern counterparts. Heat-related morbidity studies have not assessed this possible regional difference. This comparison study uses data from emergency 911 dispatches [referred to as heat-related dispatches (HRD)] identified by responders as heat-related for two United States cities located in different regions with very different climates: Chicago, Illinois in the upper midwest and Phoenix, Arizona in the southwest. Phoenix's climate is hot and arid. Chicago's climate is more temperate, but can also experience days with unusually high temperatures combined with high humidity. This study examines the relationships between rising HRD and daily temperatures: maximum (Tmax); apparent (ATmax): minimum (Tmin) and two energy balance indices (PET and UTCI). Phoenix had more HRD cumulatively, over a longer warm weather season, but did not experience the large spikes in HRD that occurred in Chicago, even though it was routinely subjected to much hotter weather conditions. Statistical analyses showed the strongest relationships to daily ATmax for both cities. Phoenix's lack of HRD spikes, similar to the summer mortality patterns for southern cities, suggests an avenue for future research to better understand the dynamics of possible physiological or behavioral adaption that seems to reduce residents' vulnerability to heat.

Species-specific crab predation on the hydrozoan clinging jellyfish Gonionemus sp. (Cnidaria, Hydrozoa), subsequent crab mortality, and possible ecological consequences.

PubMed

Carman, Mary R; Grunden, David W; Govindarajan, Annette F

2017-01-01

Here we report a unique trophic interaction between the cryptogenic and sometimes highly toxic hydrozoan clinging jellyfish Gonionemus sp. and the spider crab Libinia dubia . We assessed species-specific predation on the Gonionemus medusae by crabs found in eelgrass meadows in Massachusetts, USA. The native spider crab species L. dubia consumed Gonionemus medusae, often enthusiastically, but the invasive green crab Carcinus maenus avoided consumption in all trials. One out of two blue crabs ( Callinectes sapidus ) also consumed Gonionemus , but this species was too rare in our study system to evaluate further. Libinia crabs could consume up to 30 jellyfish, which was the maximum jellyfish density treatment in our experiments, over a 24-hour period. Gonionemus consumption was associated with Libinia mortality. Spider crab mortality increased with Gonionemus consumption, and 100% of spider crabs tested died within 24 h of consuming jellyfish in our maximum jellyfish density containers. As the numbers of Gonionemus medusae used in our experiments likely underestimate the number of medusae that could be encountered by spider crabs over a 24-hour period in the field, we expect that Gonionemus may be having a negative effect on natural Libinia populations. Furthermore, given that Libinia overlaps in habitat and resource use with Carcinus , which avoids Gonionemus consumption, Carcinus populations could be indirectly benefiting from this unusual crab-jellyfish trophic relationship.

Species–specific crab predation on the hydrozoan clinging jellyfish Gonionemus sp. (Cnidaria, Hydrozoa), subsequent crab mortality, and possible ecological consequences

PubMed Central

Carman, Mary R.; Grunden, David W.

2017-01-01

Here we report a unique trophic interaction between the cryptogenic and sometimes highly toxic hydrozoan clinging jellyfish Gonionemus sp. and the spider crab Libinia dubia. We assessed species–specific predation on the Gonionemus medusae by crabs found in eelgrass meadows in Massachusetts, USA. The native spider crab species L. dubia consumed Gonionemus medusae, often enthusiastically, but the invasive green crab Carcinus maenus avoided consumption in all trials. One out of two blue crabs (Callinectes sapidus) also consumed Gonionemus, but this species was too rare in our study system to evaluate further. Libinia crabs could consume up to 30 jellyfish, which was the maximum jellyfish density treatment in our experiments, over a 24-hour period. Gonionemus consumption was associated with Libinia mortality. Spider crab mortality increased with Gonionemus consumption, and 100% of spider crabs tested died within 24 h of consuming jellyfish in our maximum jellyfish density containers. As the numbers of Gonionemus medusae used in our experiments likely underestimate the number of medusae that could be encountered by spider crabs over a 24-hour period in the field, we expect that Gonionemus may be having a negative effect on natural Libinia populations. Furthermore, given that Libinia overlaps in habitat and resource use with Carcinus, which avoids Gonionemus consumption, Carcinus populations could be indirectly benefiting from this unusual crab–jellyfish trophic relationship. PMID:29085761

Assessing the Adaptability to Irregular Rest-Work Rhythms in Military Personnel

DTIC Science & Technology

2000-03-01

Aeronautica Militare Italiana, CSV Reparto Medicina Aerospaziale Pratica di Mare, 00040 Pomezia (Roma) Italy 2 Dipartimento di Psicologia - Universitd...characteristics to adapt to increased work errors and impaired social work at unusual hours. and family relationship. In addition, there is an increased mortality...DUTY: a brief questionnaire on critical evaluation. Journal of Personality the sleep-wake cycle and vigilance filled in and Social Psychology. 58: 844

Severe red spruce winter injury in 2003 creates unusual ecological event in the northeastern United States

Treesearch

Brynne E. Lazarus; Paul G. Schaberg; Donald H. DeHayes; Gary J. Hawley

2004-01-01

Abundant winter injury to the current-year (2002) foliage of red spruce (Picea rubens Sarg.) became apparent in the northeastern United States in late winter of 2003. To assess the severity and extent of this damage, we measured foliar winter injury at 28 locations in Vermont and surrounding states and bud mortality at a subset of these sites. Ninety percent of all...

Pathologic Findings and Trends in Mortality in the Beluga (Delphinapterus leucas) Population of the St Lawrence Estuary, Quebec, Canada, From 1983 to 2012.

PubMed

Lair, S; Measures, L N; Martineau, D

2016-01-01

An isolated population of beluga (Delphinapterus leucas) inhabits the St Lawrence Estuary, Quebec, Canada. This population has failed to recover despite the prohibition of hunting >30 years ago, suggesting the presence of other limiting factors. The authors summarize the reported causes of death and propose risk factors to explain the lack of recovery of this population. From 1983 to 2012, a total of 472 beluga were found stranded. Complete necropsies were carried out on 222 beluga, including 178 adults, 25 juveniles, and 19 newborn calves. Infectious diseases, the most prevalent cause of mortality in this population, accounted for the death of one-third of all beluga (32%). Verminous pneumonia was the cause of mortality of 13 juvenile beluga (52% of juvenile beluga). A total of 39 malignant neoplasms, diagnosed in 35 beluga, caused the death of 31 beluga (20% of beluga >19 years old). Median age at diagnosis of cancer was 48 years (range, 30-61 years). Dystocia and postpartum complications were the cause of death in 18 beluga, accounting for 19% of the females >19 years old examined. The occurrence of parturition-associated complications, as well as mortality of calves <1 year old, have increased recently in this population and may be the probable cause of the recent decrease in the size of this population. One of the hypotheses proposed to explain the unusually high occurrence of some of the pathologic conditions observed in this population is chronic exposure to environmental contaminants. © The Author(s) 2015.

49 CFR 236.1021 - Discontinuances, material modifications, and amendments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... such as landslide, burned bridge, high water, high and wide load, or tunnel protection when the unusual... to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 236.1021 - Discontinuances, material modifications, and amendments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... such as landslide, burned bridge, high water, high and wide load, or tunnel protection when the unusual... to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 235.7 - Changes not requiring filing of application.

Code of Federal Regulations, 2013 CFR

2013-10-01

... unusual contingencies such as landslide, burned bridge, high water, high and wide load, or tunnel... used to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 235.7 - Changes not requiring filing of application.

Code of Federal Regulations, 2014 CFR

2014-10-01

... unusual contingencies such as landslide, burned bridge, high water, high and wide load, or tunnel... used to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 236.1021 - Discontinuances, material modifications, and amendments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... such as landslide, burned bridge, high water, high and wide load, or tunnel protection when the unusual... to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 236.1021 - Discontinuances, material modifications, and amendments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... such as landslide, burned bridge, high water, high and wide load, or tunnel protection when the unusual... to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 235.7 - Changes not requiring filing of application.

Code of Federal Regulations, 2012 CFR

2012-10-01

... unusual contingencies such as landslide, burned bridge, high water, high and wide load, or tunnel... used to provide protection against unusual contingencies such as landslide, burned bridges, high water...

49 CFR 236.1021 - Discontinuances, material modifications, and amendments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... such as landslide, burned bridge, high water, high and wide load, or tunnel protection when the unusual... to provide protection against unusual contingencies such as landslide, burned bridges, high water...

Venous outflow obstruction and portopulmonary hypertension after orthotopic liver transplantation

PubMed Central

Aguirre-Avalos, Guadalupe; Covarrubias-Velasco, Marco Antonio; Rojas-Sánchez, Antonio Gerardo

2013-01-01

Patient: Female, 54 Final Diagnosis: Suprahepatic inferior vena cava anastomosis stricture Symptoms: Ascites • fatigue • lower limb edema • hepatomegaly Medication: — Clinical Procedure: — Specialty: Transplantology • Critical Care Medicine Objective: Unusual clinical course Background: Suprahepatic inferior vena cava anastomosis stricture is an unusual vascular complication after orthotopic liver transplantation with the “piggyback” technique. Clinical manifestations are dependent upon the severity of the stenosis. Portopulmonary hypertension after orthotopic liver transplantation is a complication that carries high mortality due to cardiopulmonary dysfunction. The pathogenesis of pulmonary vascular disorders after orthotopic liver transplantation remains uncertain. Case Report: We report a case of acute right heart pressure overload after surgical correction of the suprahepatic inferior vena cava anastomotic stricture in a 54-year-old woman who had preexisting pulmonary arterial hypertension associated with portal hypertension after orthotopic liver transplantation. Twenty months posttransplantation, she developed fatigue and progressive ascites. On admission, the patient had hepatomegaly, ascites, and lower limb edema. Symptoms in the patient developed gradually over time. Conclusions: Recurrent portal hypertension by vascular complications is a cause of pulmonary arterial hypertension after orthotopic liver transplantation. Clinical manifestations of suprahepatic inferior vena cava anastomotic stenosis are dependent upon their severity. Sildenafil is an effective drug for treatment of pulmonary arterial hyper-tension after portal hypertension by vascular complications. PMID:24046802

MR imaging of ectopic pregnancy with an emphasis on unusual implantation sites.

PubMed

Köroğlu, Mert; Kayhan, Arda; Soylu, Fatma Nur; Erol, Bekir; Schmid-Tannwald, Christine; Gürses, Cemil; Karademir, İbrahim; Ernst, Randy; Yousuf, Ambereen; Oto, Aytekin

2013-02-01

Ectopic pregnancy (EP) is a life-threatening condition and remains the leading cause of death in the first trimester of pregnancy, although the mortality rate has significantly decreased over the past few decades because of earlier diagnoses and great improvements in treatment. EP is most commonly located in the ampullary portion of the fallopian tube and rarely in unusual sites such as the interstitium, cervix, cesarean scar, anomalous rudimentary horn of the uterus and peritoneal abdominal cavity. MRI may confirm or give additional information to ultrasonography, which is the most user-dependent imaging modality. Magnetic resonance imaging can accurately localize the site of abnormal implantation. It could be helpful for EP patient treatment by distinguishing the ruptured and unruptured cases before methotrexate treatment. MRI is quite sensitive to blood and can identify the hemorrhage phase.

Saturday night blue--a case of near fatal poisoning from the abuse of amyl nitrite.

PubMed Central

Stambach, T; Haire, K; Soni, N; Booth, J

1997-01-01

A case of severe methaemoglobinaemia caused by the abuse of volatile nitrites is reported. The agents are commonly abused, but this complication is rare. The clinical presentation can make diagnosis difficult; however, the subsequent treatment needs to be rapid to avoid serious morbidity or mortality. This report presents the clinical picture and the background information leading to the detection and treatment of this unusual problem. PMID:9315944

[Spontaneous splenic rupture due to infectious acute mononucleosis: case report].

PubMed

Greco, L; De Gennaro, E; Degara, A; Papa, U

2003-01-01

Infectious mononucleosis is an acute, viral, illness associated with a high incidence of splenomegaly. Spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. The authors report the case of a 19-year-old patient with an infectious mononucleosis causing a spontaneous splenic rupture. When rupture occurs the mortality has been significant. The spleen may be vulnerable for the histopathologic changes that occur as a result of this illness. Two thirds of patients with infectious mononucleosis develop an enlarged spleen, but in only 0.5% of all patients will it rupture. Abdominal pain and tachycardia are unusual in uncomplicated infectious mononucleosis and should alert a doctor to the possibility of spontaneous splenic rupture. The diagnosis of splenic rupture may be confirmed in a variety of ways. In this patient ultrasound and Rutkow's criteria may aid in establishing the diagnosis. In patients with infectious mononucleosis suspected of having rupture of the spleen, a rapid but thorough assessment and prompt implementation of appropriate management should minimize the associated morbidity and mortality. On the basis of review of the medical literature and of our own experience, we advocate emergent splenectomy for spontaneous splenic rupture in patients with infectious mononucleosis.

Death rates reflect accumulating brain damage in arthropods.

PubMed

Fonseca, Duane B; Brancato, Carolina L; Prior, Andrew E; Shelton, Peter M J; Sheehy, Matt R J

2005-09-22

We present the results of the first quantitative, whole-lifespan study of the relationship between age-specific neurolipofuscin concentration and natural mortality rate in any organism. In a convenient laboratory animal, the African migratory locust, Locusta migratoria, we find an unusual delayed-onset neurolipofuscin accumulation pattern that is highly correlated with exponentially accelerating age-specific Gompertz-Makeham death rates in both males (r=0.93, p=0.0064) and females (r=0.97, p=0.0052). We then test the conservation of this association by aggregating the locust results with available population-specific data for a range of other terrestrial, freshwater, marine, tropical and temperate arthropods whose longevities span three orders of magnitude. This synthesis shows that the strong association between neurolipofuscin deposition and natural mortality is a phylogenetically and environmentally widespread phenomenon (r=0.96, p < 0.0001). These results highlight neurolipofuscin as a unique and outstanding integral biomarker of ageing. They also offer compelling evidence for the proposal that, in vital organs like the brain, either the accumulation of toxic garbage in the form of lipofuscin itself, or the particular molecular reactions underlying lipofuscinogenesis, including free-radical damage, are the primary events in senescence.

Thinness at birth in a northern industrial town.

PubMed

Law, C M; Barker, D J; Richardson, W W; Shiell, A W; Grime, L P; Armand-Smith, N G; Cruddas, A M

1993-08-01

To determine whether babies in an area of Britain with unusually high perinatal mortality have different patterns of fetal growth to those born elsewhere in the country. Measurement of body size in newborn babies. Burnley (perinatal mortality in 1988 15.9/1000 total births) and Salisbury (perinatal mortality 10.8/1000 total births), England. Subjects comprised 1544 babies born in Burnley, Pendle, and Rossendale Health District, and 1025 babies born in Salisbury Health District. Birthweight, length, head, arm and abdominal circumferences, and placental weight were determined. Compared with babies born in Salisbury, Burnley babies had lower mean birthweight (difference 116 g, 95% confidence interval (CI) 77,154), smaller head circumferences (difference 0.3 cm, 95% CI 0.2, 0.4), and were thinner as measured by arm circumference (difference 0.3 cm, 95% CI 0.3, 0.4), abdominal circumference (difference 0.5 cm, 95% CI 0.4, 0.6) and ponderal index (difference 0.8 kg/m3, 95% CI 0.6, 1.0). The ratio of placental weight to birthweight was higher in Burnley (difference 0.6%, 95% CI 0.4, 0.9). These differences were found in boys and girls and did not depend on differences in duration of gestation or on the different ethnic mix of the two districts. Mothers in Burnley were younger, shorter in stature, had had more children, were of lower social class, and more of them smoked during pregnancy than mothers in Salisbury. These differences did not explain the greater thinness of their babies. Babies born in Burnley, an area with high perinatal mortality, are thin. The reason is unknown. Poor maternal nutrition is suspected because Burnley babies have a higher ratio of placental weight to birthweight. The greater thinness at birth of Burnley babies could have long term consequences, including higher rates of cardiovascular disease.

United States black:white infant mortality disparities are not inevitable: identification of community resilience independent of socioeconomic status.

PubMed

Fry-Johnson, Yvonne W; Levine, Robert; Rowley, Diane; Agboto, Vincent; Rust, George

2010-01-01

U.S. disparities in Black:White infant mortality are persistent. National trends, however, may obscure local successes. Zero-corrected, negative binomial multivariable modeling was used to predict Black infant mortality (1999-2003) in all U.S. counties with reliable rates. Independent variables included county population size, racial composition, educational attainment, poverty, income and geographic origin. Resilient counties were defined as those whose Black infant mortality rate residual score was < 2.0. Mortality data was accessed from the Compressed Mortality File compiled by the National Center for Health Statistics and found on the CDC WONDER website. Demographic information was obtained from the US Census. The final model included the percentage of Blacks, age 18 to 64 years, speaking little or no English (P < .008), a socioeconomic index comprising educational attainment, poverty, and per capita income (P < .001), and household income in 1990 (P < .001). After accounting for these factors, a stratum comprising Essex and Plymouth Counties, Mass.; Bronx, N.Y.; and Multnomah, Ore. was identified as unusually resilient. Percentage of Black poverty and educational attainment in Black women in the resilient stratum approximated the average for all 330 counties. In 1979, Black infant mortality in the resilient stratum (23.6 per 1000 live births) exceeded Black US infant mortality (22.6). By 2001, Black infant mortality in the resilient stratum (5.6) was below the corresponding value for Whites (5.7). Resilient county neonatal mortality declined both early and late in the observation period, while post-neonatal declines were most marked after 1996. Models for reduction/elimination of racial disparities in US infant mortality, independent from county-level contextual measures of socioeconomic status, may already exist.

Measles trends and vaccine effectiveness in Nairobi, Kenya.

PubMed

Borus, P K; Cumberland, P; Sonoiya, S; Kombich, J; Tukei, P M; Cutts, F T

2003-07-01

To determine morbidity and mortality from measles and to estimate measles vaccine effectiveness among children hospitalised with measles in two hospitals in Nairobi. A review of hospital records (index cards). Kenyatta National Hospital and Mbagathi District Hospitals covering the years 1996-2000. A review of index cards for measles morbility and mortality was undertaken in the two hospitals. Measles data at the Kenya Expanded Programme on Immunisation covering both hospitals was analysed for vaccine effectiveness. The incidence of measles was unusually high in 1998 between July and November (monthly range 130-305), reflecting on the occurrence of an outbreak at that time. There was no definite monthly incidence trend of measles in 1996,1997, 1999 and 2000. The median age of cases was 13 months (range 0-420 months) for Kenyatta hospital and 18 months (range 1-336 months) for Mbagathi Hospital. Significantly, 29.8% of all cases were aged below nine months when routine immunisation for measles had not begun. The median number of days spent in hospital were five days (range 0-87 days) for Kenyatta and four days (range 1-13 days) for Mbagathi. The overall case fatality rate was 5.6% and was similar for both males and females. The overall measles vaccine effectiveness among measles cases admitted to Kenyatta and Mbagathi Hospitals was 84.1%. The case admissions in Kenyatta and Mbagathi Hospitals suggest measles was prevalent in Nairobi over the latter half decade of the 1990's. Apart from 1998 when there was an outbreak, the seasonality of measles was dampened. The 1998 outbreak suggests a build up of susceptible children the majority of whom were born in the last quarter of 1996. The high mortality may have had to do with the majority of cases presenting late when symptoms were already complicated and severe.

Repeated CMV Infection in a Heart Transplantation Patient

PubMed Central

Melero-Ferrer, Josep; Sanchez-Lazaro, Ignacio J.; Navea-Tejerina, Amparo; Almenar-Bonet, Luis; Blanes-Julia, Marino; Martinez-Dolz, Luis; Salvador-Sanz, Antonio

2012-01-01

Infections are one of the leading causes of morbidity and mortality in heart transplantation (HTx). Cytomegalovirus (CMV) is the most common viral infection during the first year after HTx, but it is more unusual after this time. We present the case of a patient who underwent an HTx due to a severe ischemic heart disease. Although the patient did not have a high risk for CMV, infection, he suffered a reactivation during the first year and then up to six more episodes, especially in his eyes. The patient received different treatments against CMV and the immunosuppression was changed several times. Finally, everolimus was introduced instead of cyclosporine, and mycophenolate mofetil was withdrawn. The presented case provides an example of how the immunosupresion plays a key role in some infections in spite of being a suitable antiviral treatment. PMID:23213610

Elemental Levels Analyzed by PIXE in Florida Alligators

NASA Astrophysics Data System (ADS)

Kuharik, J. C.; Kravchenko, I. I.; Dunnam, F. E.; Van Rinsvelt, H. A.; Ross, J. P.

2003-08-01

Unusual and alarming mortality of alligators (Alligator mississippiensis) has been reported from Lake Griffin, Florida, where almost 400 dead alligators have been observed since 1997. In addition, the hatch rate for alligator eggs around Lake Griffin fell below 10% and remains low (30-45%) while the normal hatch rate is typically 80%. Standard diagnostic methods have been ineffective in determining the cause of the phenomenon. Many possibilities have been considered including pollutants, nutrition, and toxic algae. Particle Induced X-ray Emission (PIXE) analysis is highly suitable for investigating concentrations of a wide range of elements in animal tissue. Liver, kidney and spinal cord tissues from healthy and sick alligators have been analyzed by PIXE for elemental content. Initial results showed positive correlation between certain elements and neural impairment and morbidity of alligators in Lake Griffin, but have failed to prove significant.

Spontaneous C. septicum gas gangrene: A literature review.

PubMed

Srivastava, Ira; Aldape, Michael J; Bryant, Amy E; Stevens, Dennis L

2017-12-01

As the infectious disease paradigm undergoes a subtle shift, unusual infections associated with malignancy and immunosuppression are being increasingly reported. Spontaneous or non-traumatic Clostridium septicum infection is one such unusual infection which has gained prominence. This article aims to understand the pathophysiology, clinical manifestations and current trends in diagnosing and treating this rare but deadly infection. To understand the multifactorial causation of this infection a review of published cases of spontaneous C. septicum gas gangrene was performed and a total of 94 such cases were identified. Several factors were analyzed for each case: age, infection location and underlying illness, presenting signs and symptoms, neutropenia, gross pathology of the colon, antibiotic use, surgical intervention, and survival. A known or occult malignancy was present in 71% patients and an overall mortality of 67% was observed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Concurrent outbreaks of cholera and peripheral neuropathy associated with high mortality among persons internally displaced by a volcanic eruption.

PubMed

Rosewell, Alexander; Clark, Geoff; Mabong, Paul; Ropa, Berry; Posanai, Enoch; Man, Nicola W Y; Dutta, Samir R; Wickramasinghe, Wasa; Qi, Lixia; Ng, Jack C; Mola, Glen; Zwi, Anthony B; MacIntyre, C Raina

2013-01-01

In October 2004, Manam Island volcano in Papua New Guinea erupted, causing over 10 000 villagers to flee to internally displaced person (IDP) camps, including 550 from Dugulaba village. Following violence over land access in March 2010, the IDPs fled the camps, and four months later concurrent outbreaks of acute watery diarrhea and unusual neurological complaints were reported in this population. A retrospective case-control study was conducted to identify the risk factors for peripheral neuropathy. Rectal swabs were collected from cases of acute watery diarrhea. Hair and serum metals and metalloids were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). There were 17 deaths among the 550 village inhabitants during the outbreak period at a crude mortality rate 21-fold that of a humanitarian crisis. Vibrio cholerae O1 El Tor Ogawa was confirmed among the population. Access to community-level rehydration was crucial to mortality. Peripheral neuropathy was diagnosed among cases with neurological symptoms. A balanced diet was significantly protective against neuropathy. A dose-response relationship was seen between peripheral neuropathy and a decreasing number of micronutrient- rich foods in the diet. Deficiencies in copper, iron, selenium and zinc were identified among the cases of peripheral neuropathy. Cholera likely caused the mostly preventable excess mortality. Peripheral neuropathy was not caused by cholera, but cholera may worsen existing nutritional deficiencies. The peripheral neuropathy was likely caused by complex micronutrient deficiencies linked to non-diversified diets that potentially increased the vulnerability of this population, however a new zinc-associated neuropathy could not be ruled out. Reoccurrence can be prevented by addressing the root cause of displacement and ensuring access to arable land and timely resettlement.

Concurrent Outbreaks of Cholera and Peripheral Neuropathy Associated with High Mortality among Persons Internally Displaced by a Volcanic Eruption

PubMed Central

Rosewell, Alexander; Clark, Geoff; Mabong, Paul; Ropa, Berry; Posanai, Enoch; Man, Nicola W. Y.; Dutta, Samir R.; Wickramasinghe, Wasa; Qi, Lixia; Ng, Jack C.; Mola, Glen; Zwi, Anthony B.; MacIntyre, C. Raina

2013-01-01

Background In October 2004, Manam Island volcano in Papua New Guinea erupted, causing over 10 000 villagers to flee to internally displaced person (IDP) camps, including 550 from Dugulaba village. Following violence over land access in March 2010, the IDPs fled the camps, and four months later concurrent outbreaks of acute watery diarrhea and unusual neurological complaints were reported in this population. Materials and Methods A retrospective case-control study was conducted to identify the risk factors for peripheral neuropathy. Rectal swabs were collected from cases of acute watery diarrhea. Hair and serum metals and metalloids were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Results There were 17 deaths among the 550 village inhabitants during the outbreak period at a crude mortality rate 21-fold that of a humanitarian crisis. Vibrio cholerae O1 El Tor Ogawa was confirmed among the population. Access to community-level rehydration was crucial to mortality. Peripheral neuropathy was diagnosed among cases with neurological symptoms. A balanced diet was significantly protective against neuropathy. A dose-response relationship was seen between peripheral neuropathy and a decreasing number of micronutrient- rich foods in the diet. Deficiencies in copper, iron, selenium and zinc were identified among the cases of peripheral neuropathy. Conclusions Cholera likely caused the mostly preventable excess mortality. Peripheral neuropathy was not caused by cholera, but cholera may worsen existing nutritional deficiencies. The peripheral neuropathy was likely caused by complex micronutrient deficiencies linked to non-diversified diets that potentially increased the vulnerability of this population, however a new zinc-associated neuropathy could not be ruled out. Reoccurrence can be prevented by addressing the root cause of displacement and ensuring access to arable land and timely resettlement. PMID:24023752

Hydraulic responses to extreme drought conditions in three co-dominant tree species in shallow soil over bedrock.

PubMed

Kukowski, Kelly R; Schwinning, Susanne; Schwartz, Benjamin F

2013-04-01

An important component of the hydrological niche involves the partitioning of water sources, but in landscapes characterized by shallow soils over fractured bedrock, root growth is highly constrained. We conducted a study to determine how physical constraints in the root zone affected the water use of three tree species that commonly coexist on the Edwards Plateau of central Texas; cedar elm (Ulmus crassifolia), live oak (Quercus fusiformis), and Ashe juniper (Juniperus ashei). The year of the study was unusually dry; minimum predawn water potentials measured in August were -8 MPa in juniper, less than -8 MPa in elm, and -5 MPa in oak. All year long, species used nearly identical water sources, based on stable isotope analysis of stem water. Sap flow velocities began to decline simultaneously in May, but the rate of decline was fastest for oak and slowest for juniper. Thus, species partitioned water by time when they could not partition water by source. Juniper lost 15-30 % of its stem hydraulic conductivity, while percent loss for oak was 70-75 %, and 90 % for elm. There was no tree mortality in the year of the study, but 2 years later, after an even more severe drought in 2011, we recorded 34, 14, 6, and 1 % mortality among oak, elm, juniper, and Texas persimmon (Diospyros texana), respectively. Among the study species, mortality rates ranked in the same order as the rate of sap flow decline in 2009. Among the angiosperms, mortality rates correlated with wood density, lending further support to the hypothesis that species with more cavitation-resistant xylem are more susceptible to catastrophic hydraulic failure under acute drought.

"Can Breast Feeding Help You in Later Life? Evidence from German Military Heights in the Early 20th Century"*

PubMed Central

Haines, Michael R.; Kintner, Hallie J.

2008-01-01

Considerable literature exists on the benefits of breast feeding on the health and survival of infants and young children, but there is less on the effects on later life outcomes. One such measure of health and well-being that has received attention in the historical literature is terminal adult stature. Information on height is rather widely available; however, it is much more difficult to obtain data on breast feeding. One country that does have such information is Imperial Germany (1871–1919). A number of physicians and local health officials collected information on the incidence and duration of breast feeding early in the 20th century, particularly because of concern about the unusually high infant mortality rates in parts of Germany. Hallie Kintner has surveyed the published results of these studies. The information on the prevalence of breast feeding for the period 1903/10 has been inputed into a database of demographic and economic variables for the counties (Regierungsbezirke) of Germany (1850–1939) There are also published data on heights of military recruits from the Imperial German military forces in 1906. These can be linked to areas in the database and related to breast feeding practices and infant mortality both contemporaneously and approximately 20 years previous to 1906. Results indicate a significant effect of infant feeding practices on later life outcomes operating through infant health conditions, proxied by the infant mortality rate. PMID:18715833

Cold-induced mortality of invasive Burmese pythons in south Florida

USGS Publications Warehouse

Mazzotti, Frank J.; Cherkiss, Michael S.; Hart, Kristen M.; Snow, Ray W.; Rochford, Michael R.; Dorcas, Michael E.; Reed, Robert N.

2011-01-01

A recent record cold spell in southern Florida (2–11 January 2010) provided an opportunity to evaluate responses of an established population of Burmese pythons (Python molurus bivittatus) to a prolonged period of unusually cold weather. We observed behavior, characterized thermal biology, determined fate of radio-telemetered (n = 10) and non-telemetered (n = 104) Burmese pythons, and analyzed habitat and environmental conditions experienced by pythons during and after a historic cold spell. Telemetered pythons had been implanted with radio-transmitters and temperature-recording data loggers prior to the cold snap. Only one of 10 telemetered pythons survived the cold snap, whereas 59 of 99 (60%) non-telemetered pythons for which we determined fate survived. Body temperatures of eight dead telemetered pythons fluctuated regularly prior to 9 January 2010, then declined substantially during the cold period (9–11 January) and exhibited no further evidence of active thermoregulation indicating they were likely dead. Unusually cold temperatures in January 2010 were clearly associated with mortality of Burmese pythons in the Everglades. Some radio-telemetered pythons appeared to exhibit maladaptive behavior during the cold spell, including attempting to bask instead of retreating to sheltered refugia. We discuss implications of our findings for persistence and spread of introduced Burmese pythons in the United States and for maximizing their rate of removal.

Genome sequence of a serotype M3 strain of group A Streptococcus: phage-encoded toxins, the high-virulence phenotype, and clone emergence.

PubMed

Beres, Stephen B; Sylva, Gail L; Barbian, Kent D; Lei, Benfang; Hoff, Jessica S; Mammarella, Nicole D; Liu, Meng-Yao; Smoot, James C; Porcella, Stephen F; Parkins, Larye D; Campbell, David S; Smith, Todd M; McCormick, John K; Leung, Donald Y M; Schlievert, Patrick M; Musser, James M

2002-07-23

Genome sequences are available for many bacterial strains, but there has been little progress in using these data to understand the molecular basis of pathogen emergence and differences in strain virulence. Serotype M3 strains of group A Streptococcus (GAS) are a common cause of severe invasive infections with unusually high rates of morbidity and mortality. To gain insight into the molecular basis of this high-virulence phenotype, we sequenced the genome of strain MGAS315, an organism isolated from a patient with streptococcal toxic shock syndrome. The genome is composed of 1,900,521 bp, and it shares approximately 1.7 Mb of related genetic material with genomes of serotype M1 and M18 strains. Phage-like elements account for the great majority of variation in gene content relative to the sequenced M1 and M18 strains. Recombination produces chimeric phages and strains with previously uncharacterized arrays of virulence factor genes. Strain MGAS315 has phage genes that encode proteins likely to contribute to pathogenesis, such as streptococcal pyrogenic exotoxin A (SpeA) and SpeK, streptococcal superantigen (SSA), and a previously uncharacterized phospholipase A(2) (designated Sla). Infected humans had anti-SpeK, -SSA, and -Sla antibodies, indicating that these GAS proteins are made in vivo. SpeK and SSA were pyrogenic and toxic for rabbits. Serotype M3 strains with the phage-encoded speK and sla genes increased dramatically in frequency late in the 20th century, commensurate with the rise in invasive disease caused by M3 organisms. Taken together, the results show that phage-mediated recombination has played a critical role in the emergence of a new, unusually virulent clone of serotype M3 GAS.

Observed effects of an exceptional drought on tree mortality in a tropical dry forest

NASA Astrophysics Data System (ADS)

Medvigy, D.; Vargas, G.; Xu, X.; Smith, C. M.; Becknell, J.; Brodribb, T.; Powers, J. S.

2016-12-01

Climate models predict that the coming century will bring reduced rainfall to Neotropical dry forests. It is unknown how tropical dry forest trees will respond to such rainfall reductions. Will there be increased mortality? If so, what will be the dominant mechanism of mortality? Will certain functional groups or size classes be more susceptible to unusually dry conditions and do functional traits underlie these patterns? With these questions in mind, we analyzed the response of trees from 18 Costa Rican tropical dry forest inventory plots and from additional transects to the exceptional 2015 drought that coincided with a strong ENSO event. We compared stand-level mortality rates observed during pre-drought years (2008-2014) and during the drought year of 2015 in the inventory plots. For both inventory plots and transects, we analyzed whether particular functional groups or size classes experienced exceptional mortality after the drought. We found that mortality rates were two to three times higher during the drought than before the drought. In contrast to observations at moist tropical forests, tree size had little influence on mortality. In terms of functional groups, mortality rates of evergreen oaks growing on nutrient-poor soils particularly increased during drought. Legumes seemed less affected by the drought than non-legumes. However, elevated mortality rates were not clearly correlated with commonly-measured traits like wood density or specific leaf area. Instead, hydraulic traits like P50 or turgor loss point may be better predictors of drought-driven mortality. In addition, trees that died during the drought tended to have smaller relative growth rate prior to the drought than trees that survived the drought.

Climate-induced forest dieback as an emergent global phenomenon: Organized oral session at the Ecological Society of America/Society of Ecological Restoration Joint Meeting; San Jose, California, 5-10 August 2007

USGS Publications Warehouse

Allen, Craig D.; Breshears, David D.

2007-01-01

An organized oral session at the annual meeting of the Ecological Society of America in San Jose, Calif., posed this question: Is climate-induced drought stress triggering increasing rates and unusual patterns of forest die-off at a global scale? Twenty-nine researchers representing five continents reported on patterns, mechanisms, and projections of forest mortality.Observations include widespread forest dieback or reductions in tree cover and biodiversity in response to drought and warmer temperatures in the African Sahel (Patrick Gonzalez, The Nature Conservancy), Mediterranean and alpine Europe (Jorge Castro, Universidad de Granada), and Argentinean Patagonia (Thomas Kitzberger, Universidad Nacional del Comahue). In contrast, although much Eucalyptus mortality has resulted from recent droughts in Australia, warming trends have been less pronounced in the Southern Hemisphere and it is unclear if contemporary climate-induced tree mortality differs from previous historical drought impacts (Rod Fensham, Queensland Herbarium).

[Face presentation: retrospective study of 32 cases at term].

PubMed

Ducarme, G; Ceccaldi, P-F; Chesnoy, V; Robinet, G; Gabriel, R

2006-05-01

To determine the etiologic factors, circumstances of diagnosis, obstetrical management and complications of face presentation and to value the maternal and foetal prognosis of this presentation. Thirty-two cases of face presentation have been observed in the maternity wards of Reims and Troyes over the last 12 years. The incidence of face presentation was 0.7 per 1000 deliveries. Spontaneous vaginal delivery occurred with mento-anterior presentation 73% of the time and caesarean section was performed in 100% of mento-posterior presentation. There was no increasing rate of foetal or maternal mortality and morbidity with vaginal delivery. Face presentation is an unusual complication of pregnancy with obstetric factors that predispose the foetus to face presentation. The low foetal and maternal mortality and morbidity substantiate the effectiveness of conservative management in face presentation.

Combined uterine and urinary bladder rupture: an unusual complication of obstructed labor in a primigravida

PubMed Central

Takai, Idris Usman; Abubakar, Abdulkadir

2016-01-01

Background Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. Objective To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting. Case A 17-year-old married unbooked primigravida who presented with a 3-day history of spontaneous onset of labor at term that was initially managed at home and later in a primary health care center where she had fundal pressure and oxytocin augmentation, respectively. The labor was complicated by combined uterine and urinary bladder rupture with sepsis. She was resuscitated and had exploratory laparotomy with uterine and urinary bladder repair. The postoperative period was uneventful and she was followed-up at the gynecology and family planning clinics. Conclusion There is a need for community reawakening on the inherent risks of teenage pregnancy, bad obstetric practices, and unsupervised pregnancy, labor, and delivery, particularly in the rural settings as in the index patient. A high index of suspicion and prompt appropriate intervention will reduce the sequel of morbidity and occasional mortality from this predicament. PMID:27499647

Laparoscopic splenectomy: a single center experience. Unusual cases and expanded inclusion criteria for laparoscopic approach.

PubMed

Marte, Gianpaolo; Scuderi, Vincenzo; Rocca, Aldo; Surfaro, Giuseppe; Migliaccio, Carla; Ceriello, Antonio

2013-06-01

Laparoscopic splenectomy (LS) is nowadays considered as the gold standard for most hematological diseases where splenectomy is necessary, but many questions still remain. The aim of this study was to analyze our 5-years experiences consisting of 48 consecutive LS cases in order to assess the optimal approach and the feasibility of the procedure also in malignant diseases and unusual cases such as a primary spleen lymphoma, a big splenic artery aneurism, or a spleen infarct due to a huge pancreatic pseudo-cyst. Forty-eight consecutive patients underwent LS from January 2006 to January 2011 with at least 1-year follow-up. Clinical data and immediate outcome were retrospectively recorded; age, diagnosis, operation time, perioperative transfusion requirement, conversion rate, accessory incision, hospital stay, and complications were analyzed. We had 14 cases of malignant splenic disease, the most frequent malignant diagnosis was non-Hodgkin's lymphoma (12/14, 85.7 %). Splenomegaly (interpole diameter (ID) >20 cm) was observed in 12 cases (25 %) and massive splenomegaly (ID >25 cm) in 3 cases (6.25 %). Conversion to laparotomy occurred in two patients (4.16 %), both associated to uncontrollable bleeding in patients with splenomegaly. Mean operative time was 138 ± 22 min. Mean hospital stay was 4.5 days. Postoperative morbidity rate was 8.8 % for the benign group and 35.7 % in the malignant group. Mortality occurred in 1/48 patients (2.08 %), as a result of overwhelming post-splenectomy infection (OPSI). LS can be performed safely for malignant splenic disease and splenomegaly without any statistically significant increase of morbidity and mortality rate. Conversion rate is increased for massive splenomegaly. LS should be considered as the preferential approach even in patients with malignant disease, splenomegaly, or unusual cases. Massive splenomegaly should be considered as relative contraindication to LS even at experienced centers.

Wildfire air pollution and daily mortality in a large urban area.

PubMed

Vedal, Sverre; Dutton, Steven J

2006-09-01

Unusual air pollution episodes, such as when smoke from wildfires covers a large urban area, can be used to attempt to detect associations between short-term increases in particulate matter (PM) concentrations and subsequent mortality without relying on the sophisticated statistical models that are typically required in the absence of such episodes. The objective of this study was to explore whether acute increases in PM concentrations from wildfire smoke cause acute increases in daily mortality. The temporal patterns of daily nonaccidental deaths and daily cardiorespiratory deaths for June of 2002 in the Denver metropolitan area were examined and compared to those in two nearby counties in Colorado that were not affected by the wildfire smoke and to daily deaths in Denver in June of 2001. Abrupt increases in PM concentrations in Denver occurred on 2 days in June of 2002 as a result of wildfire smoke drifting over the Denver area. Small peaks in mortality corresponded to both of the PM peaks, but the first mortality peak also corresponded to a peak of mortality in the control counties, and cardiorespiratory deaths began to increase on the day before the second peak. Further, there was no detectable increase in cardiorespiratory deaths in the hours immediately following the PM peaks. Although the findings from this study do not rule out the possibility of small increases in mortality due to abrupt and dramatic increases in PM concentrations from wildfire smoke, in a population of over 2 million people no perceptible increases in daily mortality could be attributed to such events.

An ERP study of passive creative conceptual expansion using a modified alternate uses task.

PubMed

Kröger, Sören; Rutter, Barbara; Hill, Holger; Windmann, Sabine; Hermann, Christiane; Abraham, Anna

2013-08-21

A novel ERP paradigm was employed to investigate conceptual expansion, a central component of creative thinking. Participants were presented with word pairs, consisting of everyday objects and uses for these objects, which had to be judged based on the two defining criteria of creative products: unusualness and appropriateness. Three subject-determined trial types resulted from this judgement: high unusual and low appropriate (nonsensical uses), low unusual and high appropriate (common uses), and high unusual and high appropriate (creative uses). Word pairs of the creative uses type are held to passively induce conceptual expansion. The N400 component was not specifically modulated by conceptual expansion but was, instead, generally responsive as a function of unusualness or novelty of the stimuli (nonsense=creative>common). Explorative analyses in a later time window (500-900 ms) revealed that ERP activity in this phase indexes appropriateness (nonsense>creative=common). In the discussion of these findings with reference to the literature on semantic cognition, both components are proposed as indexing processes relevant to conceptual expansion as they are selectively involved in the encoding and integration of a newly established semantic connection between two previously unrelated concepts. Copyright © 2013 Elsevier B.V. All rights reserved.

An Unusual Cause of Dysphagia: Live Leech in the Tongue Base

PubMed Central

Erdoğan, Osman; İsmi, Onur; Vayısoğlu, Yusuf; Azizoğlu, Mustafa; Görür, Kemal; Özcan, Cengiz

2015-01-01

Inhaled or ingested foreign bodies are relatively common causes of airway obstructions. They can be associated with significant morbidity and even mortality. Although various foreign bodies are aspirated or ingested, live leeches are rarely encountered. We reported a case of a live leech at the base of the tongue in an 18-year-old female patient with a history of unfiltered spring water drinking. We discussed the surgical technique and importance of anesthesia with this brief study. PMID:29392006

Patterns of Human Plague in Uganda, 2008–2016

PubMed Central

Forrester, Joseph D.; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J.; Schriefer, Martin; Sexton, Christopher; Ben Beard, C.; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph

2017-01-01

Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008–2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient’s village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague. PMID:28820134

Patterns of Human Plague in Uganda, 2008-2016.

PubMed

Forrester, Joseph D; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J; Schriefer, Martin; Sexton, Christopher; Ben Beard, C; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph; Mead, Paul S

2017-09-01

Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008-2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient's village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague.

Egg-laying butterflies distinguish predaceous ants by sight.

PubMed

Sendoya, Sebastián F; Freitas, André V L; Oliveira, Paulo S

2009-07-01

Information about predation risks is critical for herbivorous insects, and natural selection favors their ability to detect predators before oviposition and to select enemy-free foliage when offspring mortality risk is high. Food plants are selected by ovipositing butterflies, and offspring survival frequently varies among plants because of variation in the presence of predators. Eunica bechina butterflies oviposit on Caryocar brasiliense, an ant-defended plant. Experiments with dried Camponotus and Cephalotes ants pinned to leaves revealed that butterflies use ant size and form as visual cues to avoid ovipositing on plant parts occupied by ants more likely to kill larval offspring. Presence of sap-sucking bugs did not affect butterfly oviposition. This is the first demonstration that visual recognition of predators can mediate egg-laying decisions by an insect herbivore and that an insect will discriminate among different species of potential predators. This unusual behavioral capability permits specialization on a risky, ant-defended food plant.

Duodenal perforation: an unusual complication of sickle cell anemia.

PubMed

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.

Duodenal perforation: an unusual complication of sickle cell anemia

PubMed Central

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia. PMID:25422692

Extensive variation at MHC DRB in the New Zealand sea lion (Phocarctos hookeri) provides evidence for balancing selection

PubMed Central

Osborne, A J; Zavodna, M; Chilvers, B L; Robertson, B C; Negro, S S; Kennedy, M A; Gemmell, N J

2013-01-01

Marine mammals are often reported to possess reduced variation of major histocompatibility complex (MHC) genes compared with their terrestrial counterparts. We evaluated diversity at two MHC class II B genes, DQB and DRB, in the New Zealand sea lion (Phocarctos hookeri, NZSL) a species that has suffered high mortality owing to bacterial epizootics, using Sanger sequencing and haplotype reconstruction, together with next-generation sequencing. Despite this species' prolonged history of small population size and highly restricted distribution, we demonstrate extensive diversity at MHC DRB with 26 alleles, whereas MHC DQB is dimorphic. We identify four DRB codons, predicted to be involved in antigen binding, that are evolving under adaptive evolution. Our data suggest diversity at DRB may be maintained by balancing selection, consistent with the role of this locus as an antigen-binding region and the species' recent history of mass mortality during a series of bacterial epizootics. Phylogenetic analyses of DQB and DRB sequences from pinnipeds and other carnivores revealed significant allelic diversity, but little phylogenetic depth or structure among pinniped alleles; thus, we could neither confirm nor refute the possibility of trans-species polymorphism in this group. The phylogenetic pattern observed however, suggests some significant evolutionary constraint on these loci in the recent past, with the pattern consistent with that expected following an epizootic event. These data may help further elucidate some of the genetic factors underlying the unusually high susceptibility to bacterial infection of the threatened NZSL, and help us to better understand the extent and pattern of MHC diversity in pinnipeds. PMID:23572124

2. GORGE HIGH DAM. UNUSUALLY HIGH WATER IN GORGE LAKE ...

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

2. GORGE HIGH DAM. UNUSUALLY HIGH WATER IN GORGE LAKE DUE TO THE COMBINATION OF UNIT 24 BEING DOWN FOR REWINDING AND TWO UNITS COMING ON LINE UNEXPECTEDLY AT ROSS POWERHOUSE LED TO WATER FLOWING OVER THE SPILLGATES. EACH GATE IF 47 FEET WIDE AND 50 FEET HIGH, 1989. - Skagit Power Development, Gorge High Dam, On Skagit River, 2.9 miles upstream from Newhalem, Newhalem, Whatcom County, WA

Mortality rates and cause-of-death patterns in a vaccinated population.

PubMed

McCarthy, Natalie L; Weintraub, Eric; Vellozzi, Claudia; Duffy, Jonathan; Gee, Julianne; Donahue, James G; Jackson, Michael L; Lee, Grace M; Glanz, Jason; Baxter, Roger; Lugg, Marlene M; Naleway, Allison; Omer, Saad B; Nakasato, Cynthia; Vazquez-Benitez, Gabriela; DeStefano, Frank

2013-07-01

Determining the baseline mortality rate in a vaccinated population is necessary to be able to identify any unusual increases in deaths following vaccine administration. Background rates are particularly useful during mass immunization campaigns and in the evaluation of new vaccines. Provide background mortality rates and describe causes of death following vaccination in the Vaccine Safety Datalink (VSD). Analyses were conducted in 2012. Mortality rates were calculated at 0-1 day, 0-7 days, 0-30 days, and 0-60 days following vaccination for deaths occurring between January 1, 2005, and December 31, 2008. Analyses were stratified by age and gender. Causes of death were examined, and findings were compared to National Center for Health Statistics (NCHS) data. Among 13,033,274 vaccinated people, 15,455 deaths occurred between 0 and 60 days following vaccination. The mortality rate within 60 days of a vaccination visit was 442.5 deaths per 100,000 person-years. Rates were highest in the group aged ≥85 years, and increased from the 0-1-day to the 0-60-day interval following vaccination. Eleven of the 15 leading causes of death in the VSD and NCHS overlap in both systems, and the top four causes of death were the same in both systems. VSD mortality rates demonstrate a healthy vaccinee effect, with rates lowest in the days immediately following vaccination, most apparent in the older age groups. The VSD mortality rate is lower than that in the general U.S. population, and the causes of death are similar. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

Human mortality impacts of the 2015 summer heat spells in Slovakia

NASA Astrophysics Data System (ADS)

Výberči, Dalibor; Labudová, Lívia; Eštóková, Milada; Faško, Pavol; Trizna, Milan

2017-07-01

In 2015, Central Europe experienced an unusually warm summer season. For a great majority of climatic stations around Slovakia, it had been the warmest summer ever recorded over their entire instrumental observation period. In this study, we investigate the mortality effects of hot days' sequences during that particular summer on the Slovak population. In consideration of the range of available mortality data, the position of 2015 is analysed within the years 1996-2015. Over the given 20-year period, the summer heat spells of 2015 were by far the most severe from a meteorological point of view, and clearly the deadliest with the total of almost 540 excess deaths. In terms of impacts, an extraordinary 10-day August heat spell was especially remarkable. The massive lethal effects of heat would have likely been even more serious under normal circumstances, since the number of premature deaths appeared to be partially reduced due to a non-standard mortality pattern in the first quarter of the year. The heat spells of the extremely warm summer of 2015 in Slovakia are notable not just for their short-term response in mortality. It appears that in a combination with the preceding strong influenza season, they subsequently affected mortality conditions in the country in the following months up until the end of the year. The impacts described above were rather different for selected population subgroups (men and women, the elderly). Both separately and as a part of the annual mortality cycle, the 2015 summer heat spells may represent a particularly valuable source of information for public health.

Emerging and Mechanism-Based Therapies for Recurrent or Metastatic Merkel Cell Carcinoma

PubMed Central

Miller, Natalie J.; Bhatia, Shailender; Parvathaneni, Upendra; Iyer, Jayasri G.; Nghiem, Paul

2013-01-01

Opinion statement Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine skin cancer with a disease-specific mortality of approximately 40 %. The association of MCC with a recently discovered polyomavirus, combined with the increased incidence and mortality of MCC among immunocompromised patients, highlight the importance of the immune system in controlling this cancer. Initial management of MCC is summarized within the NCCN guidelines and in recently published reviews. The high rate of recurrent and metastatic disease progression in MCC, however, presents a major challenge in a cancer that lacks mechanism-based, disease-specific therapies. Traditional treatment approaches have focused on cytotoxic chemotherapy that, despite frequent initial efficacy, rarely provides durable responses and has high morbidity among the elderly. In addition, the immunosuppressive nature of chemotherapy is of concern when treating a virus-associated cancer for which survival is unusually tightly linked to immune function. With a median survival of 9.6 months after development of an initial metastasis (n=179, described herein), and no FDA-approved agents for this cancer, there is an urgent need for more effective treatments. We review diverse management options for patients with advanced MCC, with a focus on emerging and mechanism-based therapies, some of which specifically target persistently expressed viral antigens. These treatments include single-dose radiation and novel immunotherapies, some of which are in clinical trials. Due to their encouraging efficacy, low toxicity, and lack of immune suppression, these therapies may offer viable alternatives to traditional cytotoxic chemotherapy. PMID:23436166

Coral mortality induced by the 2015-2016 El-Niño in Indonesia: the effect of rapid sea level fall

NASA Astrophysics Data System (ADS)

Elvan Ampou, Eghbert; Johan, Ofri; Menkes, Christophe E.; Niño, Fernando; Birol, Florence; Ouillon, Sylvain; Andréfouët, Serge

2017-02-01

The 2015-2016 El-Niño and related ocean warming has generated significant coral bleaching and mortality worldwide. In Indonesia, the first signs of bleaching were reported in April 2016. However, this El Niño has impacted Indonesian coral reefs since 2015 through a different process than temperature-induced bleaching. In September 2015, altimetry data show that sea level was at its lowest in the past 12 years, affecting corals living in the bathymetric range exposed to unusual emersion. In March 2016, Bunaken Island (North Sulawesi) displayed up to 85 % mortality on reef flats dominated by Porites, Heliopora and Goniastrea corals with differential mortality rates by coral genus. Almost all reef flats showed evidence of mortality, representing 30 % of Bunaken reefs. For reef flat communities which were living at a depth close to the pre-El Niño mean low sea level, the fall induced substantial mortality likely by higher daily aerial exposure, at least during low tide periods. Altimetry data were used to map sea level fall throughout Indonesia, suggesting that similar mortality could be widespread for shallow reef flat communities, which accounts for a vast percent of the total extent of coral reefs in Indonesia. The altimetry historical records also suggest that such an event was not unique in the past two decades, therefore rapid sea level fall could be more important in the dynamics and resilience of Indonesian reef flat communities than previously thought. The clear link between mortality and sea level fall also calls for a refinement of the hierarchy of El Niño impacts and their consequences on coral reefs.

Fetal distress and in utero pneumonia in perinatal dolphins during the Northern Gulf of Mexico unusual mortality event.

PubMed

Colegrove, Kathleen M; Venn-Watson, Stephanie; Litz, Jenny; Kinsel, Michael J; Terio, Karen A; Fougeres, Erin; Ewing, Ruth; Pabst, D Ann; McLellan, William A; Raverty, Stephen; Saliki, Jeremiah; Fire, Spencer; Rappucci, Gina; Bowen-Stevens, Sabrina; Noble, Lauren; Costidis, Alex; Barbieri, Michelle; Field, Cara; Smith, Suzanne; Carmichael, Ruth H; Chevis, Connie; Hatchett, Wendy; Shannon, Delphine; Tumlin, Mandy; Lovewell, Gretchen; McFee, Wayne; Rowles, Teresa K

2016-04-12

An unusual mortality event (UME) involving primarily common bottlenose dolphins Tursiops truncatus of all size classes stranding along coastal Louisiana, Mississippi, and Alabama, USA, started in early 2010 and continued into 2014. During this northern Gulf of Mexico UME, a distinct cluster of perinatal dolphins (total body length <115 cm) stranded in Mississippi and Alabama during 2011. The proportion of annual dolphin strandings that were perinates between 2009 and 2013 were compared to baseline strandings (2000-2005). A case-reference study was conducted to compare demographics, histologic lesions, and Brucella sp. infection prevalence in 69 UME perinatal dolphins to findings from 26 reference perinates stranded in South Carolina and Florida outside of the UME area. Compared to reference perinates, UME perinates were more likely to have died in utero or very soon after birth (presence of atelectasis in 88 vs. 15%, p < 0.0001), have fetal distress (87 vs. 27%, p < 0.0001), and have pneumonia not associated with lungworm infection (65 vs. 19%, p = 0.0001). The percentage of perinates with Brucella sp. infections identified via lung PCR was higher among UME perinates stranding in Mississippi and Alabama compared to reference perinates (61 vs. 24%, p = 0.01), and multiple different Brucella omp genetic sequences were identified in UME perinates. These results support that from 2011 to 2013, during the northern Gulf of Mexico UME, bottlenose dolphins were particularly susceptible to late-term pregnancy failures and development of in utero infections including brucellosis.

[Surgical treatment of iatrogenic bile duct injuries following laparoscopic cholecystectomy: analysis of long-term results. Retrospective clinical study in 51 patients operated in the Campania region from 1991 to 2003].

PubMed

Conzo, Giovanni; Amato, Giuseppe; Angrisani, Luigi; Bardi, Ugo; Barone, Giovanni; Belli, Giulio; Brancaccio, Umberto; Calise, Fulvio; Caliendo, Angelo; Celsi, Salvatore; Corcione, Francesco; Cuccurullo, Diego; De Falco, Giuseppe; Delrio, Paolo; De Werra, Carlo; De Sena, Guido; Docimo, Giovanni; Esposito, Maria Grazia; Fantini, Corrado; Giardiello, Cristiano; Musella, Mario; Molino, Carlo; Muto, Crescenzo; Pennetti, Lucio; Puziello, Alessandro; Porcelli, Alberto; Rea, Roberto; Rendano, Franco; Palazzo, Antonietta; Santangelo, Michele; Santaniello, Walter; Santini, Luigi; Sperlongano, Pasquale; Stanzione, Francesco; Tartaglia, Alberto; Tricarico, Annunziato; Vincenti, Rodolfo; Lorenzo, Michele

2005-01-01

An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a complex biliary and vascular injury. The postoperative mortality rate of revision surgery was 5/50 (10%). T-tube positioning (n = 20) and Roux-en-Y hepato-jejunostomy (n = 20) were the procedures most frequently performed. The complication rate in patients treated with the T-tube was significantly higher than in those treated with hepatico-jejunostomy. Surgical treatment of biliary injuries following laparoscopic cholecystectomy was characterized by unusually high mortality and morbidity for a non-neoplastic disease. Roux-en-Y hepato-jejunostomy remains the procedure of choice for these injuries.

Estimating mortality rates of adult fish from entrainment through the propellers of river towboats

USGS Publications Warehouse

Gutreuter, S.; Dettmers, J.M.; Wahl, David H.

2003-01-01

We developed a method to estimate mortality rates of adult fish caused by entrainment through the propellers of commercial towboats operating in river channels. The method combines trawling while following towboats (to recover a fraction of the kills) and application of a hydrodynamic model of diffusion (to estimate the fraction of the total kills collected in the trawls). The sampling problem is unusual and required quantifying relatively rare events. We first examined key statistical properties of the entrainment mortality rate estimators using Monte Carlo simulation, which demonstrated that a design-based estimator and a new ad hoc estimator are both unbiased and converge to the true value as the sample size becomes large. Next, we estimated the entrainment mortality rates of adult fishes in Pool 26 of the Mississippi River and the Alton Pool of the Illinois River, where we observed kills that we attributed to entrainment. Our estimates of entrainment mortality rates were 2.52 fish/km of towboat travel (80% confidence interval, 1.00-6.09 fish/km) for gizzard shad Dorosoma cepedianum, 0.13 fish/km (0.00-0.41) for skipjack herring Alosa chrysochloris, and 0.53 fish/km (0.00-1.33) for both shovelnose sturgeon Scaphirhynchus platorynchus and smallmouth buffalo Ictiobus bubalus. Our approach applies more broadly to commercial vessels operating in confined channels, including other large rivers and intracoastal waterways.

Evaluation of Drugs for Prevention of Hyperthermia in Rats Exposed to Microwave Irradiation.

DTIC Science & Technology

1987-03-04

is deficient in antidiuretic hormone (ADH) and has diabetes insipidus (DI). The latter condition causes unusually high water intake and urine...ADH) and consequently has diabetes ihsipidus (DI). A DI-rat, also known as Brattleboro rat, has both unusually high water intake and rate of

Hypercalcemic crisis: a clinical review.

PubMed

Ahmad, Shazia; Kuraganti, Gayatri; Steenkamp, Devin

2015-03-01

Hypercalcemia is a common metabolic perturbation. However, hypercalcemic crisis is an unusual endocrine emergency, with little clinical scientific data to support therapeutic strategy. We review the relevant scientific English literature on the topic and review current management strategies after conducting a PubMed, MEDLINE, and Google Scholar search for articles published between 1930 and June 2014 using specific keywords: "hypercalcemic crisis," "hyperparathyroid crisis," "parathyroid storm," "severe primary hyperparathyroidism," "acute hyperparathyroidism," and "severe hypercalcemia" for articles pertaining to the diagnosis, epidemiology, clinical presentation, and treatment strategies. Despite extensive clinical experience, large and well-designed clinical studies to direct appropriate clinical care are lacking. Nonetheless, morbidity and mortality rates have substantially decreased since early series reported almost universal fatality. Improved outcomes can be attributed to modern diagnostic capabilities, leading to earlier diagnosis, along with the recognition that primary hyperparathyroidism is the most common etiology for hypercalcemic crisis. Hypercalcemic crisis is an unusual endocrine emergency that portends excellent outcomes if rapid diagnosis, medical treatment, and definitive surgical treatment are expedited. Copyright © 2015 Elsevier Inc. All rights reserved.

Cephalic Tetanus in an Immunized Teenager: An Unusual Case Report.

PubMed

Felter, Robert A; Zinns, Lauren E

2015-07-01

Tetanus is a rare disease in developed countries but is prevalent worldwide. It has significant morbidity and mortality. The causative agent Clostridium tetani is ubiquitous in nature. In the United States, approximately 50 to 100 cases are reported per year but rarely in immunocompetent, fully immunized patients. Of the four types of tetanus (generalized, neonatal, cephalic, and localized), cephalic is the least common. We present a case of cephalic tetanus in a 14-year-old boy who completed his primary immunizations with a video of his physical examination findings.

Thyroid storm complicated by bicytopenia and disseminated intravascular coagulation.

PubMed

Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

2014-07-24

Male, 23. Thyroid storm. Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss. -. -. Endocrinology and Metabolic. Unusual clinical course. The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems.

Necrotizing Fasciitis of Thoracic and Abdominal Wall with Emphysematous Pyelonephritis and Retroperitoneal Abscess

PubMed Central

Khaladkar, Sanjay Mhalasakant; Jain, Kunaal Mahesh; Kuber, Rajesh; Gandage, Sidappa

2018-01-01

Emphysematous pyelonephritis is a life-threatening severe form of pyelonephritis usually occurring in patients with diabetes mellitus with or without obstructive uropathies in whom there is necrotizing infection leading to the gas production of an unclear mechanism involving the renal parenchyma and the collecting system. Necrotizing fasciitis is characterized by progressive necrosis of fat and fascia due to deep-seated infection of subcutaneous tissue. It has a fulminant course with considerable mortality. Diabetes Mellitus is a common predisposing factor. The combined occurrence of emphysematous pyelonephritis and necrotizing fasciitis is extremely unusual. Early recognition and management is mandatory to avoid mortality. We report a case of a 53-year-old female, a known case of Type II diabetes mellitus, who presented with necrotizing fasciitis of thoracic and abdominal wall with emphysematous pyelonephritis in the left kidney with a retroperitoneal abscess. PMID:29541493

Occurrence of enteric redmouth disease in rainbow trout (Oncorhynchus mykiss) on farms in Croatia.

PubMed

Oraić, D; Zrncić, Snjezana; Sostarić, B; Bazulić, D; Lipej, Z

2002-01-01

During the spring of 1996 and autumn of 1997 unusual mortality outbreaks among rainbow trout fry and yearlings occurred at two different trout farms, resulting in mortality of 20 and 10 per cent, respectively. Generally, the affected fish, swimming at the water surface, were reluctant to eat and were dark pigmented with visible haemorrhages around and within the oral cavity. Bacterial isolates from moribund fish from both cases were identified as Yersinia ruckeri by standard biochemical tests and API 20E. The isolated strains were found to be sensitive to tetracycline, chloramphenicol, co-trimoxazole, nalidixic acid, flumequine, enrofloxacin, carbenicillin and gentamicin. Microplate agglutination assay confirmed that both isolates belonged to serotype O1. The pathogenicity of the isolated bacteria was confirmed by challenge experiment. Titres of specific antibodies were determined in the sera of survivors. The titre was highest on the 21st day postchallenge and was detectable until the 81st day.

Spontaneous ruptured pheochromocytoma: an unusual case report and literature review.

PubMed

Jee, Ye Seob

2017-09-01

Ruptured pheochromocytoma is a rare disease. Its mortality rate is up to 31%-50%. Proper management of ruptured pheochromocytoma remains unclear. A 44-year-old male patient visited our Emergency Department and presented with abrupt onset of left flank pain. His blood pressure was 190/140 mmHg with purse rate of 130 beats/min. CT scan showed 8.1 × 5.6-cm-sized heterogeneously mass with rupture on the left retroperitoneal space and active bleeding. His symptom of abdominal pain was aggravated. Follow-up laboratory analysis revealed elevated WBC count and decreased hemoglobin 2 hours after admission. Emergency laparotomy was performed. We resected the ruptured left retroperitoneal mass and hemostasis. Pathologic exams revealed adrenal pheochromocytoma with rupture. Although our patient was alive, according to literature review, mortality rate of emergency operation without medical management is higher than elective operation after blood pressure control with either medical or interventional methods such as transcatheter arterial embolization.

Bleaching and recovery of a phototrophic bioeroding sponge

NASA Astrophysics Data System (ADS)

Marlow, Joseph; Davy, Simon K.; Shaffer, Megan; Haris, Abdul; Bell, James J.

2018-06-01

In the Wakatobi region of Indonesia, a prolonged period of elevated water temperature in 2016 caused extensive coral bleaching and mortality. Unusually, bleaching was also observed in the bioeroding sponge Cliona aff. viridis, with affected sponges expelling 99% of their Symbiodinium. Bleaching surveys of C. aff. viridis were conducted 6 weeks apart, coinciding with a 0.8 °C drop in water temperature. Over this period, bleaching prevalence dropped from 73.9% (± 9.9 SE) to 25.7% (± 5.8 SE), and bleaching severity dropped from 25.95% (± 4.5 SE) to 11.54% (± 1.9 SE) of sponge tissue. Over the same period, monitored bleached sponges showed an 81% drop in bleaching severity, but also a 13% reduction in overall sponge size. Our results show that while the clionaid- Symbiodinium relationship is susceptible to break down under thermal stress, rapid recovery can occur, although incurring some partial host mortality.

Chemical residues in Dolphins from the US Atlantic coast including atlantic bottlenose obtained during the 1987/88 mass mortality

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

Kuehl, D.W.; Haebler, R.; Potter, C.

1991-01-01

Bottlenose dolphins (Tursiops truncatus) collected during the 1987/88 mass mortality event along the Atlantic coast of the United States have been analyzed for anthropogenic chemical contaminants. Average contaminant concentrations in adult males were higher than the average concentrations measured in adult females. Females could be divided into two groups by contaminant concentrations, one with low concentrations, and another with concentrations 4.4 times (PCBs) to 8.9 times (p,p'-DDE) greater. Contaminant concentrations in bottlenose were generally greater than the concentrations measured in either common (Delphinus delphis) or white-sided (Lagernorhynchus acutus) dolphins from the western North Atlantic Ocean. A subset of animals screenedmore » for unusual chemical contaminants showed that numerous polybrominated chemicals were present, including polybrominated biphenyls and diphenyl ethers not previously found in marine mammals from U.S. coastal waters.« less

Marine mammal strandings and environmental changes: a 15-year study in the St. Lawrence ecosystem.

PubMed

Truchon, Marie-Hélène; Measures, Lena; L'Hérault, Vincent; Brêthes, Jean-Claude; Galbraith, Peter S; Harvey, Michel; Lessard, Sylvie; Starr, Michel; Lecomte, Nicolas

2013-01-01

Understanding the effects of climatic variability on marine mammals is challenging due to the complexity of ecological interactions. We used general linear models to analyze a 15-year database documenting marine mammal strandings (1994-2008; n = 1,193) and nine environmental parameters known to affect marine mammal survival, from regional (sea ice) to continental scales (North Atlantic Oscillation, NAO). Stranding events were more frequent during summer and fall than other seasons, and have increased since 1994. Poor ice conditions observed during the same period may have affected marine mammals either directly, by modulating the availability of habitat for feeding and breeding activities, or indirectly, through changes in water conditions and marine productivity (krill abundance). For most species (75%, n = 6 species), a low volume of ice was correlated with increasing frequency of stranding events (e.g. R(2)adj = 0.59, hooded seal, Cystophora cristata). This likely led to an increase in seal mortality during the breeding period, but also to increase habitat availability for seasonal migratory cetaceans using ice-free areas during winter. We also detected a high frequency of stranding events for mysticete species (minke whale, Balaenoptera acutorostrata) and resident species (beluga, Delphinapterus leucas), correlated with low krill abundance since 1994. Positive NAO indices were positively correlated with high frequencies of stranding events for resident and seasonal migratory cetaceans, as well as rare species (R(2)adj = 0.53, 0.81 and 0.34, respectively). This contrasts with seal mass stranding numbers, which were negatively correlated with a positive NAO index. In addition, an unusual multiple species mortality event (n = 114, 62% of total annual mortality) in 2008 was caused by a harmful algal bloom. Our findings provide an empirical baseline in understanding marine mammal survival when faced with climatic variability. This is a promising step in integrating stranding records to monitor the consequences of environmental changes in marine ecosystems over long time scales.

Marine Mammal Strandings and Environmental Changes: A 15-Year Study in the St. Lawrence Ecosystem

PubMed Central

Truchon, Marie-Hélène; Measures, Lena; L’Hérault, Vincent; Brêthes, Jean-Claude; Galbraith, Peter S.; Harvey, Michel; Lessard, Sylvie; Starr, Michel; Lecomte, Nicolas

2013-01-01

Understanding the effects of climatic variability on marine mammals is challenging due to the complexity of ecological interactions. We used general linear models to analyze a 15-year database documenting marine mammal strandings (1994–2008; n = 1,193) and nine environmental parameters known to affect marine mammal survival, from regional (sea ice) to continental scales (North Atlantic Oscillation, NAO). Stranding events were more frequent during summer and fall than other seasons, and have increased since 1994. Poor ice conditions observed during the same period may have affected marine mammals either directly, by modulating the availability of habitat for feeding and breeding activities, or indirectly, through changes in water conditions and marine productivity (krill abundance). For most species (75%, n = 6 species), a low volume of ice was correlated with increasing frequency of stranding events (e.g. R2 adj = 0.59, hooded seal, Cystophora cristata). This likely led to an increase in seal mortality during the breeding period, but also to increase habitat availability for seasonal migratory cetaceans using ice-free areas during winter. We also detected a high frequency of stranding events for mysticete species (minke whale, Balaenoptera acutorostrata) and resident species (beluga, Delphinapterus leucas), correlated with low krill abundance since 1994. Positive NAO indices were positively correlated with high frequencies of stranding events for resident and seasonal migratory cetaceans, as well as rare species (R2 adj = 0.53, 0.81 and 0.34, respectively). This contrasts with seal mass stranding numbers, which were negatively correlated with a positive NAO index. In addition, an unusual multiple species mortality event (n = 114, 62% of total annual mortality) in 2008 was caused by a harmful algal bloom. Our findings provide an empirical baseline in understanding marine mammal survival when faced with climatic variability. This is a promising step in integrating stranding records to monitor the consequences of environmental changes in marine ecosystems over long time scales. PMID:23544059

Cardiovascular Effects of Nickel in Ambient Air

PubMed Central

Lippmann, Morton; Ito, Kazuhiko; Hwang, Jing-Shiang; Maciejczyk, Polina; Chen, Lung-Chi

2006-01-01

Background Fine particulate matter (FPM) in ambient air causes premature mortality due to cardiac disease in susceptible populations. Objective Our objective in this study was to determine the most influential FPM components. Methods A mouse model of atherosclerosis (ApoE−/−) was exposed to either filtered air or concentrated FPM (CAPs) in Tuxedo, New York (85 μg/m3 average, 6 hr/day, 5 days/week, for 6 months), and the FPM elemental composition was determined for each day. We also examined associations between PM components and mortality for two population studies: National Mortality and Morbidity Air Pollution Study (NMMAPS) and Hong Kong. Results For the CAPs-exposed mice, the average of nickel was 43 ng/m3, but on 14 days, there were Ni peaks at ~ 175 ng/m3 and unusually low FPM and vanadium. For those days, back-trajectory analyses identified a remote Ni point source. Electrocardiographic measurements on CAPs-exposed and sham-exposed mice showed Ni to be significantly associated with acute changes in heart rate and its variability. In NMMAPS, daily mortality rates in the 60 cities with recent speciation data were significantly associated with average Ni and V, but not with other measured species. Also, the Hong Kong sulfur intervention produced sharp drops in sulfur dioxide, Ni, and V, but not other components, corresponding to the intervention-related reduction in cardiovascular and pulmonary mortality. Conclusions Known biological mechanisms cannot account for the significant associations between Ni with the acute cardiac function changes in the mice or with cardiovascular mortality in people at low ambient air concentrations; therefore, further research is needed. PMID:17107850

Emergence of Atypical Mycoplasma agalactiae Strains Harboring a New Prophage and Associated with an Alpine Wild Ungulate Mortality Episode

PubMed Central

Tardy, Florence; Baranowski, Eric; Nouvel, Laurent-Xavier; Mick, Virginie; Manso-Silvàn, Lucía; Thiaucourt, François; Thébault, Patricia; Breton, Marc; Sirand-Pugnet, Pascal; Blanchard, Alain; Garnier, Alexandre; Gibert, Philippe; Game, Yvette; Poumarat, François

2012-01-01

The bacterium Mycoplasma agalactiae is responsible for contagious agalactia (CA) in small domestic ruminants, a syndrome listed by the World Organization for Animal Health and responsible for severe damage to the dairy industry. Recently, we frequently isolated this pathogen from lung lesions of ibexes during a mortality episode in the French Alps. This situation was unusual in terms of host specificity and tissue tropism, raising the question of M. agalactiae emergence in wildlife. To address this issue, the ibex isolates were characterized using a combination of approaches that included antigenic profiles, molecular typing, optical mapping, and whole-genome sequencing. Genome analyses showed the presence of a new, large prophage containing 35 coding sequences (CDS) that was detected in most but not all ibex strains and has a homolog in Mycoplasma conjunctivae, a species causing keratoconjunctivitis in wild ungulates. This and the presence in all strains of large integrated conjugative elements suggested highly dynamic genomes. Nevertheless, M. agalactiae strains circulating in the ibex population were shown to be highly related, most likely originating from a single parental clone that has also spread to another wild ungulate species of the same geographical area, the chamois. These strains clearly differ from strains described in Europe so far, including those found nearby, before CA eradication a few years ago. While M. agalactiae pathogenicity in ibexes remains unclear, our data showed the emergence of atypical strains in Alpine wild ungulates, raising the question of a role for the wild fauna as a potential reservoir of pathogenic mycoplasmas. PMID:22522685

Snag characteristics and dynamics following natural and artificially induced mortality in a managed loblolly pine forest

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

Zarnoch, Stanley J.; Vukovich, Mark A.; Kilgo, John C.

A 14-year study of snag characteristics was established in 41- to 44-year old loblolly pine (Pinus taeda L.) stands in southeastern USA. During the initial 5.5 years, no stand manipulation or unusually high-mortality events occurred. Afterwards, three treatments were applied consisting of trees thinned and removed, trees felled and not removed, and artificial creation of snags produced by girdling and herbicide injection. The thinned treatments were designed to maintain the same live canopy density as the snag-created treatment, disregarding snags that remained standing.We monitored snag height, diameter, density, volume, and bark percentage; the number of cavities was monitored in naturalmore » snags only. During the first 5.5 years, recruitment and loss rates were stable, resulting in a stable snag population. Large snags (≥25 cm diameter) were common, but subcanopy small snags (10 to <25 cm diameter) dominated numerically. Large natural snags survived (90% quantile) significantly longer (6.0–9.4 years) than smaller snags (4.4–6.9 years). Large artificial snags persisted the longest (11.8 years). Cavities in natural snags developed within 3 years following tree death. The mean number of cavities per snag was five times greater in large versus small snags and large snags were more likely to have multiple cavities, emphasizing the importance of mature pine stands for cavity-dependent wildlife species.« less

Infection Profile in Chronic Granulomatous Disease: a 23-Year Experience from a Tertiary Care Center in North India.

PubMed

Rawat, Amit; Vignesh, Pandiarajan; Sharma, Avinash; Shandilya, Jitendra K; Sharma, Madhubala; Suri, Deepti; Gupta, Anju; Gautam, Vikas; Ray, Pallab; Rudramurthy, Shivaprakash M; Chakrabarti, Arunaloke; Imai, Kohsuke; Nonoyama, Shigeaki; Ohara, Osamu; Lau, Yu L; Singh, Surjit

2017-04-01

Chronic granulomatous disease (CGD) is an inherited phagocytic disorder characterized by recurrent infections with usually catalase-positive organisms. Infections in CGD from developing countries are expected to be different from those in the Western countries. We report the profile of infections in children diagnosed with CGD from a tertiary care center in North India. Case records of children diagnosed with CGD at Pediatric Immunodeficiency Clinic, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India, from August 1993 to April 2016 (23 years) were analyzed. Thirty-eight children were diagnosed to have CGD. Median follow-up of patients was 2 years (interquartile range 0.75, 6.0). Staphylococcus aureus and Pseudomonas spp. were the two most common causative bacteria isolated. Aspergillus was the most common fungus isolated. The most common organ involved was the lung (94.7%). Liver abscesses were identified in 5 patients (13.2%), and 20 (52.6%) patients had lymphadenitis. Infections with Pseudomonas spp. were high in our cohort (15.7%) compared to the other studies. Infections with some unusual organisms (e.g., Fusarium dimerium and Chryseobacterium gleum) were also seen in our cohort. Children with X-linked CGD presented earlier and also had a greater number of infections as compared to autosomal recessive CGD. Various socioeconomic factors coupled with the lack of awareness and paucity of readily available diagnostic facilities for primary immunodeficiencies accounted for a late clinical presentation with severe infections and increased mortality (28.9%) in our cohort. However, mortality was similar in X-linked and autosomal recessive CGD as was the number of fungal infections. The incidence of infections and mortality was significantly lower after initiation of antibacterial and antifungal prophylaxis.

Intercostal muscle twitching: An unusual manifestation of extracardiac stimulation related to right ventricular outflow tract pacing

PubMed Central

Erdogan, Okan

2007-01-01

The present case report describes a patient who underwent successful dual-chamber pacemaker implantation with active ventricular lead fixation at a high septal region in the right ventricular outflow tract. Unexpectedly, stimulation at a high output in the right ventricular outflow tract caused an unusual extracardiac stimulation, specifically, intercostal muscle twitching. PMID:17703261

Notes on the geology and meteorology of sites infected with white-nose syndrome before July 2010 in Southeastern United States

USGS Publications Warehouse

Swezey, Christopher S.; Garrity, Christopher P.

2011-01-01

Since 2006, numerous bat colonies in North America have experienced unusually high incidences of mortality. In these colonies, bats are infected by a white fungus named Geomyces destructans, which has been observed on bat muzzles, noses, ears, and (or) wings. Although it is not exactly certain how and why these bats are dying, this condition has been named white-nose syndrome (WNS). WNS appears to have spread from an initial infection site at a cave in New York, and was first identified south of Pennsylvania during January 2009. By the end of June 2010, 41 infected sites had identified in the states of West Virginia, Maryland, Delaware, Virginia, and Tennessee. Most of these sites are natural caves in limestone of either Cambrian-Ordovician age or Silurian-Devonian age. Published air temperature values in these WNS-infected caves range from -3.3 to 15.6 °C, and humidity measurements range from 68 to 100 %.

Bilateral pheochromocytoma during the postpartum period.

PubMed

Wattanachanya, Lalita; Bunworasate, Udomsak; Plengpanich, Wanee; Houngngam, Natnicha; Buranasupkajorn, Patinut; Sunthornyothin, Sarat; Shotelersuk, Vorasuk; Snabboon, Thiti

2009-12-01

Pheochromocytoma manifesting during pregnancy is uncommon but it is responsible for a high maternal and fetal mortality rate, especially when unrecognized. Most cases of pheochromocytoma are sporadic but they can be part of hereditary autosomal dominant syndromes. We describe a case of bilateral pheochromocytoma in a term-pregnant patient with a previous history of medullary thyroid carcinoma (MTC). Her genetic study revealed a heterozygous mutation, c.1900T>C, in the RET proto-oncogene which confirmed the diagnosis of multiple endocrine neoplasia type 2A (MEN2A). Unrecognized, the tumors caused a crisis with fatal outcome in the mother during the postpartum period. This event might have been prevented if the tumor had been detected previously. MEN2A affected pregnancy is an unusual condition. This syndrome should be suspected when a pregnant patient has a history of MTC. Early detection and appropriate management can prevent serious maternal and fetal complications. We also reviewed the literature of MEN2A-affected pregnancies.

Massive thymic hemorrhage and hemothorax occurring in utero.

PubMed

Gargano, Giancarlo; Paltrinieri, Anna Lucia; Gallo, Claudio; Di Pancrazio, Luciana; Roversi, Maria Federica; Ferrari, Fabrizio

2015-11-14

Thymic enlargement is a common and physiological finding in children and neonates' X-rays, but it is usually asymptomatic. Occasionally it can cause respiratory distress. In most cases the aetiology of this expansion remains unclear and it is diagnosed as a thymic hyperplasia. True thymic hyperplasia is defined as a gland expansion, both in size and weight, while maintaining normal microscopic architecture. Often it is a diagnosis of exclusion and prognosis is good. Thymic haemorrhage is an unusual condition related to high foetal and neonatal mortality. We report a case of spontaneous massive thymic haemorrhage in a newborn developing at birth acute respiratory distress associated with severe bilateral haemothorax. Thymic enlargement was evident after pleural evacuation and confirmed by radiographic, Computed Tomography (CT) images and Magnetic Resonance Imaging (MRI) sequences. The spontaneous resolution of this enlargement seen with CT scan and MRI sequences suggested a thymic haemorrhage; surgery was not necessary. Thymic haemorrhage should be considered in newborn infants with pleural effusion, mediastinal space enlargement and Respiratory Distress.

Exploring molecular genetics of bladder cancer: lessons learned from mouse models

PubMed Central

Ahmad, Imran; Sansom, Owen J.; Leung, Hing Y.

2012-01-01

Urothelial cell carcinoma (UCC) of the bladder is one of the most common malignancies worldwide, causing considerable morbidity and mortality. It is unusual among the epithelial carcinomas because tumorigenesis can occur by two distinct pathways: low-grade, recurring papillary tumours usually contain oncogenic mutations in FGFR3 or HRAS, whereas high-grade, muscle-invasive tumours with metastatic potential generally have defects in the pathways controlled by the tumour suppressors p53 and retinoblastoma (RB). Over the past 20 years, a plethora of genetically engineered mouse (GEM) models of UCC have been developed, containing deletions or mutations of key tumour suppressor genes or oncogenes. In this review, we provide an up-to-date summary of these GEM models, analyse their flaws and weaknesses, discuss how they have advanced our understanding of UCC at the molecular level, and comment on their translational potential. We also highlight recent studies supporting a role for dysregulated Wnt signalling in UCC and the development of mouse models that recapitulate this dysregulation. PMID:22422829

Avian mortality associated with a volcanic gas seep at Kiska Island, Aleutian Islands, Alaska

USGS Publications Warehouse

Bond, Alexander L.; Evans, William C.; Jones, Ian L.

2012-01-01

We identified natural pits associated with avian mortality at the base of Kiska Volcano in the western Aleutian Islands, Alaska in 2007. Living, moribund, and dead birds were regularly found at low spots in a canyon between two lava flows during 2001–2006, but the phenomenon was attributed to natural trapping and starvation of fledgling seabirds (mostly Least Auklets, Aethia pusilla) at a colony site with >1 million birds present. However, 302 birds of eight species, including passerines, were found dead at the site during 2007–2010, suggesting additional factors were involved. Most carcasses showed no signs of injury and concentrations of dead birds had accumulated in a few distinctive low pits in the canyon. Gas samples from these locations showed elevated CO2 concentrations in late 2010. Analysis of carcasses indicated no evidence of blunt trauma or internal bleeding. Volcanic gases accumulating at these poorly ventilated sites may have caused the observed mortality, but are temporally variable. Most auklets breeding in the Aleutian Islands do so in recent lava flows that provide breeding habitat; our study documents a cost of this unusual habitat selection.

Umbilical cord rupture: a case report and review of literature.

PubMed

Naidu, Madhusudhan; Nama, Vivek; Karoshi, Mahantesh; Kakumani, Vijayasri; Worth, Richard

2007-01-01

The umbilical cord acts as a mechanical conduit between the fetus and placenta, allowing movement of water and nutrient substances between the fetal circulation and the amniotic fluid. Complications can occur antenatally or intranatally and are usually acute events that require immediate delivery to prevent intrauterine death. Even though the majority of the cord complications are unpreventable, significant improvement in perinatal mortality and morbidity can be achieved if such an event can be predicted. Umbilical cord rupture is not uncommon, but significantly underreported. We present an unusual cause of umbilical cord rupture and a review of literature.

Protothecosis after liver transplantation.

PubMed

Narita, Masashi; Muder, Robert R; Cacciarelli, Thomas V; Singh, Nina

2008-08-01

Prototheca species are unicellular algae of low virulence that are rarely associated with human infections. We report a liver transplant recipient with disseminated protothecosis and review the literature on this unusual opportunistic infection in transplant recipients. Of 9 cases, including ours, 5 had a localized infection, and 4 had disseminated protothecosis. Seven cases were due to Prototheca wickerhamii, and 2 were due to Prototheca zopfii. Overall mortality in transplant recipients with Prototheca infections was 88% (7/8). All 4 cases of disseminated protothecosis died despite therapy with amphotericin B. Posttransplant protothecosis is a rare but significant infection that is associated with a grave prognosis.

Differential female mortality and health care in South Asia.

PubMed

Harriss, B

1989-04-01

This report examines differential female mortality in South Asia--India, Sri Lanka, Bangladesh, and Pakistan. Under conditions of mortality decline and an aggregate trend toward convergence of life expectancy, disequilibria which are comparatively unusual, persist. The converging life expectancies are a product of changes unique to each sex. Female mortality gains after the reproductive period conceal excess female mortality from the post-neonatal period to 5 years and in most regions of South Asia during the reproductive years as well. These imbalances appear to be most exaggerated on the upper Gangetic plain and among communities such as the Jats and Rajputs. The most marked imbalances do not bear a consistent relationship to economic conditions. They may, however, be declining over time. In certain regions of India, most notably in the peripheral south, discrimination against women is not seen in demographic data and has not been for several decades. Male life expectancy is being affected by only slow improvement in male mortality from age 35. Major social changes are accompanying these changes in gender differences in vital statistics, including changes in the technology of agricultural production, falling female participation rates, the education of girls, the increasing practice of dowry, and fertility decision making changes. It is not clear whether child mortality or maternal mortality is the key to the political economy of Indian demography, whether maldistribution of food or health care is the prime determinant of excess female child mortality, whether excess female mortality is the result of being neglect or conscious selection, whether regional contrasts result from differences in the religious roles of sons between north and south India, whether the female sex is culturally inferior and the male sex superior, whether food scarcity is more important than food availability in the determination of sex bias, whether poverty results in greater discrimination, whether class position determines reproductive strategy, whether major contrasts in demographic regime exist between north and south India, or whether material conditions or cultural practices determine demographic regimes. The workshop papers contributed data for the decision process, advocacy for the agenda, and details on the results of implementation, and the realities of access.

A rare presentation of pheochromocytoma in pregnancy: a case report.

PubMed

Ghalandarpoor-Attar, Seyedeh Noushin; Ghalandarpoor-Attar, Seyedeh Mojgan; Borna, Sedigheh; Ghotbizadeh, Fahimeh

2018-02-09

Early diagnosis of pheochromocytoma and its proper management can lessen its mortality and morbidity. This case report describes a 24-year-old pregnant woman with an unusual presentation of pheochromocytoma. An Iranian 24-year-old primigravid woman from Kordistan province was referred to our center with left flank pain at 37 weeks of gestation. She had a history of gestational diabetes mellitus since the 12th week of gestation which was managed by insulin administration. She also had a history of pulsatile bi-temporal headache for 2 years prior to her referral to us. She underwent complete abdominal and pelvic ultrasound imaging for her flank pain. This examination revealed a heterogeneous mass of 119 × 87 × 79 mm above her left kidney, highly suspicious of being an adrenal-originating tumor. Subsequently, we consulted an endocrinologist. She underwent abdominopelvic magnetic resonance imaging and her 24-hour urine metanephrine, normetanephrine, and vanillylmandelic acid were assessed. Finally, the diagnosis of pheochromocytoma was confirmed. She underwent a cesarean section and adrenal mass excision at the 40th week of gestation. This timely diagnosis resulted in her proper management and good maternal and neonatal treatment outcomes. Our patient had pheochromocytoma during pregnancy. She had no complaints about hypertension before or during pregnancy until giving birth to her child; her only symptoms were a vague left flank pain, gestational diabetes, and headaches for the past 2 years. The unusual symptom of flank pain led to timely diagnosis and a good treatment outcome.

The impacts of a massive harmful algal bloom along the US west coast in 2015

NASA Astrophysics Data System (ADS)

Kudela, R. M.; Trainer, V. L.; McCabe, R. M.; Hickey, B. M.; Negrey, K.

2016-02-01

In 2015, a massive bloom of the marine diatom Pseudo-nitzschia, stretching from southern California to southern Alaska, resulted in significant impacts to coastal resources and marine life. This bloom was first detected in early May 2015, when Washington closed its scheduled razor clam digs on coastal beaches. It is the largest and longest-lasting bloom in at least the past 15 years, and concentrations of domoic acid in seawater, some forage fish, and crab samples have been among the highest ever reported for this region. By mid-May, domoic acid concentrations in Monterey Bay, California were 10 to 30 times the level that would be considered high for a normal Pseudo-nitzschia bloom. Impacts to coastal communities and marine life include shellfish and Dungeness crab closures in multiple states, impacting commercial, recreational and subsistence harvesters, anchovy and sardine fishery health advisories in some areas of California, and sea lion strandings in California and Washington. Other marine mammal and bird mortalities have been reported in multiple states, and domoic acid poisoning is a suspected cause. In addition to the spatial extent and toxicity, the bloom has also lasted for many months (ongoing as of September 2015). While the exact causes of the bloom's severity and early onset are not yet known, unusually warm surface water in the Pacific Ocean may be a contributing factor. Here we present an overview of the bloom dynamics and impacts, and preliminary analysis about the bloom initiation and relationship to unusual ocean conditions in 2014-2015.

Primary forest dynamics in lowland dipterocarp forest at Danum Valley, Sabah, Malaysia, and the role of the understorey.

PubMed

Newbery, D M; Kennedy, D N; Petol, G H; Madani, L; Ridsdale, C E

1999-11-29

Changes in species composition in two 4-ha plots of lowland dipterocarp rainforest at Danum, Sabah, were measured over ten years (1986-1996) for trees > or = 10 cm girth at breast height (gbh). Each included a lower-slope to ridge gradient. The period lay between two drought events of moderate intensity but the forest showed no large lasting responses, suggesting that its species were well adapted to this regime. Mortality and recruitment rates were not unusual in global or regional comparisons. The forest continued to aggrade from its relatively (for Sabah) low basal area in 1986 and, together with the very open upper canopy structure and an abundance of lianas, this suggests a forest in a late stage of recovery from a major disturbance, yet one continually affected by smaller recent setbacks. Mortality and recruitment rates were not related to population size in 1986, but across subplots recruitment was positively correlated with the density and basal area of small trees (10-< 50cm gbh) forming the dense understorey. Neither rate was related to topography. While species with larger mean gbh had greater relative growth rates (rgr) than smaller ones, subplot mean recruitment rates were correlated with rgr among small trees. Separating understorey species (typically the Euphorbiaceae) from the overstorey (Dipterocarpaceae) showed marked differences in change in mortality with increasing gbh: in the former it increased, in the latter it decreased. Forest processes are centred on this understorey quasi-stratum. The two replicate plots showed a high correspondence in the mortality, recruitment, population changes and growth rates of small trees for the 49 most abundant species in common to both. Overstorey species had higher rgrs than understorey ones, but both showed considerable ranges in mortality and recruitment rates. The supposed trade-off in traits, viz slower rgr, shade tolerance and lower population turnover in the understorey group versus faster potential growth rate, high light responsiveness and high turnover in the overstorey group, was only partly met, as some understorey species were also very dynamic. The forest at Danum, under such a disturbance-recovery regime, can be viewed as having a dynamic equilibrium in functional and structural terms. A second trade-off in shade-tolerance versus drought-tolerance is suggested for among the understorey species. A two-storey (or vertical component) model is proposed where the understorcy-overstorey species' ratio of small stems (currently 2:1) is maintained by a major feedback process. The understorey appears to be an important part of this forest, giving resilience against drought and protecting the overstorey saplings in the long term. This view could be valuable for understanding forest responses to climate change where drought frequency in Borneo is predicted to intensify in the coming decades.

Fatal fat embolism in isolated vertebral compression fracture

PubMed Central

Saldanha, Vilas; Balasubramanian, Manjula; Handal, John

2010-01-01

Fat embolism after long bone and pelvic fractures as well as orthopedic interventions is a well-documented phenomenon, but it is highly unusual after isolated vertebral fractures. We report a case of fatal fat embolism in a 78-year-old man after an isolated vertebral compression fracture with no related orthopedic intervention. A high index of suspicion is necessary for early diagnosis and successfully treating this unusual complication. PMID:20229119

Fatal fat embolism in isolated vertebral compression fracture.

PubMed

Lastra, Ricardo R; Saldanha, Vilas; Balasubramanian, Manjula; Handal, John

2010-07-01

Fat embolism after long bone and pelvic fractures as well as orthopedic interventions is a well-documented phenomenon, but it is highly unusual after isolated vertebral fractures. We report a case of fatal fat embolism in a 78-year-old man after an isolated vertebral compression fracture with no related orthopedic intervention. A high index of suspicion is necessary for early diagnosis and successfully treating this unusual complication.

An unusual percutaneous transmitral commissurotomy: A collection of four rare occurrences!

PubMed

Shankarappa, Ravindranath K; Agrawal, Navin; Patra, Soumya; Karur, Satish; Nanjappa, Manjunath C

2013-09-01

We are presenting an interesting case of a 30-year-old patient taken for percutaneous transvenous mitral commissurotomy (PTMC) for severe rheumatic mitral stenosis in which there was a collection of four unusual occurrences during the course of a procedure. She had recurrent generalized tonic-clonic seizures immediately after femoral sheath insertion requiring the patient to be mechanically ventilated. Subsequently, the pressure tracings recorded with catheters in the aorta and the pulmonary artery showed transient unusually high supra-systemic pulmonary artery pressure. During inflation the Accura PTMC balloon which was used to dilate the mitral valve ruptured and the procedure subsequently had to be completed using another balloon catheter. During the procedure the presence of a distended stomach due to insufflations of air during positive pressure ventilation which subsided subsequently was another unusual documentation on fluoroscopy. The final outcome of the procedure was successful. This case presents an interesting collection of unusual occurrences during a PTMC procedure which started on an unusual note but ended on a successful one. Careful assessment and appropriate management of complications can lead to successful outcome of procedures as in our case.

Magnetic vortex excitation as spin torque oscillator and its unusual trajectories

NASA Astrophysics Data System (ADS)

Natarajan, Kanimozhi; Muthuraj, Ponsudana; Rajamani, Amuda; Arumugam, Brinda

2018-05-01

We report an interesting observation of unusual trajectories of vortex core oscillations in a spin valve pillar. Micromagnetic simulation in the composite free layer spin valve nano-pillar shows magnetic vortex excitation under critical current density. When current density is slightly increased and wave vector is properly tuned, for the first time we observe a star like and square gyration. Surprisingly this star like and square gyration also leads to steady, coherent and sustained oscillations. Moreover, the frequency of gyration is also very high for this unusual trajectories. The power spectral analysis reveals that there is a marked increase in output power and frequency with less distortions. Our investigation explores the possibility of these unusual trajectories to exhibit spin torque oscillations.

Spectrum of perforation peritonitis in India--review of 504 consecutive cases.

PubMed

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-09-05

Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high. In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

[Surgical management of ankylosing spondylitis (Bechterew's disease)].

PubMed

Allouch, H; Shousha, M; Böhm, H

2017-12-01

Ankylosing spondylitis is an inflammatory rheumatic disease that is often associated with back pain and restricted spinal movement. In the later stages of the disease, complete ossification of the entire spine and severe deformity can occur, often resulting in a marked reduction in quality of life and an increased risk of loss of independence due to diminished visual field. Patients with ankylosing spondylitis are at greater risk of spinal fractures. These are generally complex fractures associated with high morbidity and mortality; in addition, neurological deficits are not unusual. Conventional radiological diagnosis is often insufficient to establish a diagnosis. Conservative treatment of fractures of the spine in this patient group is unsatisfactory. Surgical procedures, if necessary combined with decompression, are often the preferred treatment of choice in the fractured or malaligned ankylosed spine. Rebalancing of the sagittal profile with normalization of the visual axis and an improvement of quality of life is achieved through corrective osteotomies. Despite the high rate of complications, long-term results following spinal surgery in patients with ankylosing spondylitis are good. Minimally invasive surgery is appropriate for a further reduction in the complication rate. Meticulous preoperative planning is essential in the treatment of patients with ankylosing spondylitis.

Unusual CoS2 ellipsoids with anisotropic tube-like cavities and their application in supercapacitors.

PubMed

Zhang, Lei; Wu, Hao Bin; Lou, Xiong Wen

2012-07-14

Unusual CoS(2) ellipsoids with anisotropic tube-like cavities have been synthesized from the simultaneous thermal decomposition and sulfidation of a preformed cobalt carbonate precursor. The as-prepared CoS(2) ellipsoids show interesting supercapacitive properties with high capacitance and good cycling performance.

Engineering the production of conjugated fatty acids in Arabidopsis thaliana leaves

USDA-ARS?s Scientific Manuscript database

The seeds of many non-domesticated plant species synthesize oils containing high amounts of a single unusual fatty acid, many of which have potential usage in industry. Despite the identification of enzymes for unusual oxidized fatty acid synthesis, the production of these fatty acids in engineered ...

Serosurvey for selected viral diseases and demography of African wild dogs in Tanzania.

PubMed

Creel, S; Creel, N M; Munson, L; Sanderlin, D; Appel, M J

1997-10-01

African wild dogs (Lycaon pictus) are endangered, with only 3,000-5,000 remaining in the wild. It is believed that wild dogs are unusually vulnerable to viral diseases, particularly rabies and canine distemper (CDV). However, canine distemper has been confirmed by laboratory diagnosis in only one free-living wild dog. The 43,000 km2 Selous Game Reserve (SGR; Tanzania) holds approximately 900 adult wild dogs. In a study area of 2,600 km2, the population maintained high density (> or = 1 dog/20.5 km2) from 1991 to 1996. The population was stable, varying 18% below and 9% above the mean density over the 6-yr period. Serum samples (n = 22) collected over 3 yr showed that most individuals were exposed to CDV (59%:95% confidence interval = 43-76% seropositive) and canine parvovirus (68%:95% CI = 54-81% seropositive), although none were seropositive for rabies (0%:95% CI = 0-17%). CDV titers were positively related to age, with no seropositive dogs younger than 1.9 yr. At least five of 13 dogs positive for CDV seroconverted during the study. Dogs with high CDV titers did not survive better in the years after sampling (mean survival +/- SE for those that died = 638 +/- 92 days,). Variation in mean litter size was inversely related to CPV exposure in the SGR and elsewhere. Annual mortality rates were low in comparison to other populations for all age classes (pups: 31 +/- 8%, n = 127, yearlings: 22 +/- 10%, n = 93, adults: 20 +/- 6%, n = 235). Annual mortality rates fluctuated little between 1992 and 1996. These data show that wild dog populations, like those of other canids, can remain stable and demographically healthy despite exposure to CDV and CPV.

Convalescent pulmonary dysfunction following hantavirus pulmonary syndrome in Panama and the United States.

PubMed

Gracia, Fernando; Armien, Blas; Simpson, Steven Q; Munoz, Carlos; Broce, Candida; Pascale, Juan Miguel; Koster, Frederick

2010-10-01

The objective of this study was to document persistent pulmonary symptoms and pulmonary function abnormalities in adults surviving hantavirus pulmonary syndrome (HPS). Acute infection by most hantaviruses result in mortality rates of 25-35%, while in Panama the mortality rate of 10% is contrasted by an unusually high incidence. In all types of HPS, the viral prodrome, cardiopulmonary phase due to massive pulmonary capillary leak syndrome, and spontaneous diuresis are followed by a convalescent phase with exertional dyspnea for 3-4 weeks, but the frequency of persistent symptoms is not known. In this observational study of a convenience sample, 14 survivors of HPS caused by Choclo virus infection in Panama and 9 survivors of HPS caused by Sin Nombre virus infection in New Mexico completed a questionnaire and pulmonary function tests up to 8 years after infection. In both groups, exertional dyspnea persisted for 1-2 years after acute infection in 43% (Panama) and 77% (New Mexico) of survivors surveyed. Reduction in midexpiratory flows (FEF(25-75%)), increased residual volume (RV), and reduced diffusion capacity (D(L)CO/VA) also were common in both populations; but the severity of reduced expiratory flow did not correlate with exertional dyspnea. Symptoms referable to previous hantavirus infection had resolved within 3 years of acute infection in most but not all patients in the Panama group. Temporary exertional dyspnea and reduced expiratory flow are common in early convalescence after HPS but resolves in almost all patients.

Survey for antibodies to infectious bursal disease virus serotype 2 in wild turkeys and Sandhill Cranes of Florida, USA.

PubMed

Candelora, Kristen L; Spalding, Marilyn G; Sellers, Holly S

2010-07-01

Captive-reared Whooping Cranes (Grus americana) released into Florida for the resident reintroduction project experienced unusually high mortality and morbidity during the 1997-98 and 2001-02 release seasons. Exposure to infectious bursal disease virus (IBDV) serotype 2 as evidenced by seroconversion was suspected to be the factor that precipitated these mortality events. Very little is known about the incidence of IBD in wild bird populations. Before this study, natural exposure had not been documented in wild birds of North America having no contact with captive-reared cranes, and the prevalence and transmission mechanisms of the virus in wild birds were unknown. Sentinel chickens (Gallus gallus) monitored on two Whooping Crane release sites in central Florida, USA, during the 2003-04 and 2004-05 release seasons seroconverted, demonstrating natural exposure to IBDV serotype 2. Blood samples collected from Wild Turkeys (Meleagris gallopavo) and Sandhill Cranes (Grus canadensis) in eight of 21 counties in Florida, USA, and one of two counties in southern Georgia, USA, were antibody-positive for IBDV serotype 2, indicating that exposure from wild birds sharing habitat with Whooping Cranes is possible. The presence of this virus in wild birds in these areas is a concern for the resident flock of Whooping Cranes because they nest and raise their chicks in Florida, USA. However, passively transferred antibodies may protect them at this otherwise vulnerable period in their lives.

BLACK-BACKED JACKAL EXPOSURE TO RABIES VIRUS, CANINE DISTEMPER VIRUS, AND BACILLUS ANTHRACIS IN ETOSHA NATIONAL PARK, NAMIBIA

PubMed Central

Bellan, Steve E.; Cizauskas, Carrie A.; Miyen, Jacobeth; Ebersohn, Karen; Küsters, Martina; Prager, Katie; Van Vuuren, Moritz; Sabeta, Claude; Getz, Wayne M.

2017-01-01

Canine distemper virus (CDV) and rabies virus (RABV) occur worldwide in wild carnivore and domestic dog populations and pose threats to wildlife conservation and public health. In Etosha National Park (ENP), Namibia, anthrax is endemic and generates carcasses frequently fed on by an unusually dense population of black-backed jackals (Canis mesomelas). Using serology and phylogenetic analyses (on samples obtained from February, 2009 to July, 2010), and historical mortality records (1975–2011), we assessed jackal exposure to Bacillus anthracis (BA; the causal bacterial agent of anthrax), CDV, and RABV. Seroprevalence to all three pathogens was relatively high with 95% (n = 86), 73% (n = 86), and 9% (n = 81) of jackals exhibiting antibodies to BA, CDV, and RABV, respectively. Exposure to BA, as assessed with an anti-Protective Antigen ELISA test, increased significantly with age and all animals >1 yr old tested positive. Seroprevalence of exposure to CDV also increased significantly with age, with similar age-specific trends during both years of the study. No significant effect of age was found on RABV seroprevalence. Three of the seven animals exhibiting immunity to RABV were monitored for more than one year after sampling and did not succumb to the disease. Mortality records revealed that rabid animals are destroyed nearly every year inside the ENP tourist camps. Phylogenetic analyses demonstrated that jackal RABV in ENP is part of the same transmission cycle as other dog-jackal RABV cycles in Namibia. PMID:22493112

A Sickle Cell Disease Patient with Severe Tricuspid Regurgitation and Early Developed Pulmonary Hypertension.

PubMed

Vaidya, Gaurang; Sarwar, Muhammad; Sun, Zongxia; Wei, Tiemin; Liu, Kan

2015-01-01

Pulmonary hypertension (PH) worsens the mortality of the patients with sickle cell disease (SCD). The exact mechanism of PH development/progression in SCD, including the role of tricuspid regurgitation (TR), remains unclear. We herein report an unusual SCD case, complicated by chronic thromboembolic disorder, who developed severe TR and an accelerated progression of PH. Tricuspid valve surgery significantly ameliorated the patient's symptoms and reduced hospital readmission. The early detection and management of the reversible disorder accelerating the PH development in SCD patients may alter the clinical course, improve the quality of life, and potentially affect the long-term outcome.

Incidence of Secondary Cancer Development After High-Dose Intensity-Modulated Radiotherapy and Image-Guided Brachytherapy for the Treatment of Localized Prostate Cancer

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

Zelefsky, Michael J., E-mail: Zelefskm@mskcc.org; Housman, Douglas M.; Pei Xin

2012-07-01

Purpose: To report the incidence and excess risk of second malignancy (SM) development compared with the general population after external beam radiotherapy (EBRT) and brachytherapy to treat prostate cancer. Methods and Materials: Between 1998 and 2001, 1,310 patients with localized prostate cancer were treated with EBRT (n = 897) or brachytherapy (n = 413). We compared the incidence of SMs in our patients with that of the general population extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results data set combined with the 2000 census data. Results: The 10-year likelihood of SM development was 25% after EBRT andmore » 15% after brachytherapy (p = .02). The corresponding 10-year likelihood for in-field SM development in these groups was 4.9% and 1.6% (p = .24). Multivariate analysis showed that EBRT vs. brachytherapy and older age were the only significant predictors for the development of all SMs (p = .037 and p = .030), with a trend for older patients to develop a SM. The increased incidence of SM for EBRT patients was explained by the greater incidence of skin cancer outside the radiation field compared with that after brachytherapy (10.6% and 3.3%, respectively, p = .004). For the EBRT group, the 5- and 10-year mortality rate was 1.96% and 5.1% from out-of field cancer, respectively; for in-field SM, the corresponding mortality rates were 0.1% and 0.7%. Among the brachytherapy group, the 5- and 10-year mortality rate related to out-of field SM was 0.8% and 2.7%, respectively. Our observed SM rates after prostate RT were not significantly different from the cancer incidence rates in the general population. Conclusions: Using modern sophisticated treatment techniques, we report low rates of in-field bladder and rectal SM risks after prostate cancer RT. Furthermore, the likelihood of mortality secondary to a SM was unusual. The greater rate of SM observed with EBRT vs. brachytherapy was related to a small, but significantly increased, number of skin cancers in the EBRT patients compared with that of the general population.« less

An unusual case of diffuse Merkel cell carcinoma successfully treated with low dose radiotherapy.

PubMed

Chatzinasiou, Foteini; Papadavid, Euaggelia; Korkolopoulou, Penelope; Levidou, Georgia; Panayiotides, Ioannis; Theodoropoulos, Konstadinos; Pogka, Vasiliki; Asimakopoulos, Charalampos; Rigopoulos, Dimitrios

2015-01-01

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine carcinoma of the skin. MCC should be included in the diagnosis of a rapidly growing infiltrating mass and histology as well as laboratory investigations such as Merkel cell polyoma virus (MCPyV) detection are valuable in its diagnosis. We present an unusual case of giant MCC-positive MCPyV in a Greek woman located on the lower leg. Our patient is very unusual in terms of her extensive MCC and her rapid and complete response to radiotherapy. © 2015 Wiley Periodicals, Inc.

Complex reassortment events of unusual G9P[4] rotavirus strains in India between 2011 and 2013.

PubMed

Doan, Yen Hai; Suzuki, Yoshiyuki; Fujii, Yoshiki; Haga, Kei; Fujimoto, Akira; Takai-Todaka, Reiko; Someya, Yuichi; Nayak, Mukti K; Mukherjee, Anupam; Imamura, Daisuke; Shinoda, Sumio; Chawla-Sarkar, Mamta; Katayama, Kazuhiko

2017-10-01

Rotavirus A (RVA) is the predominant etiological agent of acute gastroenteritis in young children worldwide. Recently, unusual G9P[4] rotavirus strains emerged with high prevalence in many countries. Such intergenogroup reassortant strains highlight the ongoing spread of unusual rotavirus strains throughout Asia. This study was undertaken to determine the whole genome of eleven unusual G9P[4] strains detected in India during 2011-2013, and to compare them with other human and animal global RVAs to understand the exact origin of unusual G9P[4] circulating in India and other countries worldwide. Of these 11 RVAs, four G9P[4] strains were double-reassortants with the G9-VP7 and E6-NSP4 genes on a DS-1-like genetic backbone (G9-P[4]-I2-R2-C2-M2-A2-N2-T2-E6-H2). The other strains showed a complex genetic constellation, likely derived from triple reassortment event with the G9-VP7, N1-NSP2 and E6-NSP4 on a DS-1-like genetic backbone (G9-P[4]-I2-R2-C2-M2-A2-N1-T2-E6-H2). Presumably, these unusual G9P[4] strains were generated after several reassortment events between the contemporary co-circulating human rotavirus strains. Moreover, the point mutation S291L at the interaction site between inner and outer capsid proteins of VP6 gene may be important in the rapid spread of this unusual strain. The complex reassortment events within the G9[4] strains may be related to the high prevalence of mixed infections in India as reported in this study and other previous studies. Copyright © 2017. Published by Elsevier B.V.

The Intrinsically X-Ray-weak Quasar PHL 1811. II. Optical and UV Spectra and Analysis

NASA Astrophysics Data System (ADS)

Leighly, Karen M.; Halpern, Jules P.; Jenkins, Edward B.; Casebeer, Darrin

2007-11-01

This is the second of two papers reporting observations and analysis of the unusually bright (mb=14.4), luminous (MB=-25.5), nearby (z=0.192) narrow-line quasar PHL 1811. The first paper reported that PHL 1811 is intrinsically X-ray-weak and presented a spectral energy distribution (SED). Here we present HST STIS optical and UV spectra, and ground-based optical spectra. The optical and UV line emission is very unusual. There is no evidence for forbidden or semiforbidden lines. The near-UV spectrum is dominated by very strong Fe II and Fe III, and unusual low-ionization lines such as Na I D and Ca II H and K are observed. High-ionization lines are very weak; C IV has an equivalent width of 6.6 Å, a factor of ~5 smaller than measured from quasar composite spectra. An unusual feature near 1200 Å can be deblended in terms of Lyα, N V, Si II, and C III* using the blueshifted C IV profile as a template. Photoionization modeling shows that the unusual line emission can be explained qualitatively by the unusually soft SED. Principally, a low gas temperature results in inefficient emission of collisionally excited lines, including the semiforbidden lines generally used as density diagnostics. The emission resembles that of high-density gas; in both cases this is a consequence of inefficient cooling. PHL 1811 is very unusual, but we note that quasar surveys may be biased against finding similar objects. Based on observations made with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555. These observations are associated with proposal 9181. Based on observations obtained at Kitt Peak National Observatory, a division of the National Optical Astronomy Observatories, which is operated by the Association of Universities for Research in Astronomy, Inc., under cooperative agreement with the National Science Foundation.

Population ecology and harvest of the American black duck: a review

USGS Publications Warehouse

Rusch, D.H.; Ankney, C.D.; Boyd, H.; Longcore, J.R.; Montalbano, F.; Ringelman, J.K.; Stotts, V.D.

1989-01-01

1. The purpose of our review was to examine available data on population trends and current status of black ducks and trends in natality and survival and to relate these, where possible, to changes in habitat, predation, disease, contaminants, harvest, and hybridization with mallards. 2. The number of black ducks tallied in the winter survey has declined steadily over the past 30 years at an average rate of about 3%/ year. Reliability and precision of the survey are uncertain; it may not provide an adequate index to the continental population of black ducks. Breeding surveys are incomplete and sporadic, but black ducks have decreased in Ontario and increased in the Maritime Provinces and Quebec. 3. Recent declines in numbers of black ducks tallied in the winter survey are not unusual in magnitude or much different from those that have occurred among several other species of waterfowl. 4. At present, black ducks are not especially scarce relative to numbers of several other ducks in eastern North America. 5. There is no solid evidence of major decreases in quality or quantity of breeding habitat for black ducks in recent years; in some areas, habitat has improved. 6. Natural mortality of black ducks has not been well studied, but does not seem unusually high compared to other dabbling ducks. 7. Harvest rates of black ducks are similar to those of sympatric mallards as determined by banding analyses. 8. There is no strong evidence for direct effects of contaminants on black ducks, but some indirect effects through invertebrate food resources have been detected. 9. Age ratios in black ducks show no trend in the past 18 years. 10. The quality and quantity of wintering habitat for black ducks have decreased substantially in some areas. 11. Disease and other natural mortality that affect black ducks do .not occur in unusually high frequency. 12. A decline in harvest of black ducks has occurred; most of the decline has been in the United States, especially since restrictive regulations were implemented in 1983. 13. Recovery rates of black ducks have declined recently in the U.S., but not in Canada. 14. Survival rates of black ducks are 56-63% for adults and 43% for young. These rates of survival are similar to comparable estimates in sympatric mallards. 15. Long hunting seasons may depress survival in some sex-age classes of black ducks, buteffects of small reductions in survival on population trends are unknown. 16. Available evidence does not support the contention that hunting is either the sole or most important cause of the decline in the winter tally of black duck numbers. 17. Surveys and banding of black ducks should be thoroughly reviewed and maintained or improved as warranted. Obtaining or maintaining a reasonable index to numbers of black ducks is the top priority among survey needs. 18. Experimental manipulation of hunting seasons should be considered to elucidate relationships among regulations, harvest, survival, and population trends. 19. Black ducks and mallards are genetically similar; there is as much genetic differentiation within the 2 species as there is between them. 20. Black duck x mallard hybrids are fertile. Hybrids are difficult to detect by plumage and thus published frequencies (0-13%) of hybrids may be low. 21. Hybridization could be a result of concomitant mallard increases and black duck decreases, or changes in black duck-to-mallard ratios could be from hybridization and genetic swamping of black ducks.

Understanding the Inflammatory Cytokine Response in Pneumonia and Sepsis

PubMed Central

Kellum, John A.; Kong, Lan; Fink, Mitchell P.; Weissfeld, Lisa A.; Yealy, Donald M.; Pinsky, Michael R.; Fine, Jonathan; Krichevsky, Alexander; Delude, Russell L.; Angus, Derek C.

2015-01-01

Background Severe sepsis is common and frequently fatal, and community-acquired pneumonia (CAP) is the leading cause. Although severe sepsis is often attributed to uncontrolled and unbalanced inflammation, evidence from humans with infection syndromes across the breadth of disease is lacking. In this study we describe the systemic cytokine response to pneumonia and determine if specific patterns, including the balance of pro-inflammatory and anti-inflammatory markers, are associated with severe sepsis and death. Methods This is a cohort study of 1886 subjects hospitalized with CAP through the emergency departments in 28 US academic and community hospitals. We defined severe sepsis as CAP complicated by new-onset organ dysfunction, following international consensus conference criteria. We measured plasma tumor necrosis factor, IL-6 (interleukin 6), and IL-10 levels daily for the first week and weekly thereafter. Our main outcome measures were severe sepsis and 90-day mortality. Results A total of 583 patients developed severe sepsis (31%), of whom 149 died (26%). Systemic cytokine level elevation occurred in 82% of all subjects with CAP. Mean cytokine concentrations were highest at presentation, declined rapidly over the first few days, but remained elevated throughout the first week, beyond resolution of clinical signs of infection. Cytokine levels were highest in fatal severe sepsis and lowest in CAP with no severe sepsis. Unbalanced (high/low) cytokine patterns were unusual (4.6%) and not associated with decreased survival. Highest risk of death was with combined high levels of the proinflammatory IL-6 and anti-inflammatory IL-10 cytokine activity (hazard ratio, 20.5; 95% confidence interval, 10.8–39.0) (P<.001). Conclusions The circulating cytokine response to pneumonia is heterogeneous and continues for more than a week after presentation, with considerable overlap between those who do and do not develop severe sepsis. Unbalanced activation is uncommon, and mortality is highest when both proinflammatory and anti-inflammatory cytokine levels are high. PMID:17698689

Reflecting on My Progressive Education

ERIC Educational Resources Information Center

Friend, Nina

2012-01-01

At the end of the 2011-12 version of the project course Schools Across Borders, Schools Across Time (SABSAT), a high school senior wrote a series of letters reflecting on the experience of participating in an unusual course with an unusual outcome. In the letters, the student wanted to evoke what was personal and what was critical--to herself, her…

An unusual reaction of α-alkoxyphosphonium salts with Grignard reagents under an O2 atmosphere.

PubMed

Fujioka, Hiromichi; Goto, Akihiro; Otake, Kazuki; Kubo, Ozora; Sawama, Yoshinari; Maegawa, Tomohiro

2011-09-21

An unusual and novel reaction of α-alkoxyphosphonium salts, generated from O,O-acetals and Ph(3)P, with Grignard reagents under an O(2) atmosphere afforded alcohols in moderate to high yields. It was clarified by isotopic labelling experiments that the reaction proceeded via a novel radical pathway.

Copper-Catalyzed Heteroarylboration of 1,3-Dienes with 3-Bromopyridines: A cine Substitution.

PubMed

Smith, Kevin B; Huang, Yuan; Brown, M Kevin

2018-04-26

A method for the heteroarylboration of 1,3-dienes is presented. The process involves an unusual cine substitution of 3-bromopyridine derivatives to deliver highly functionalized heterocyclic products. Mechanistic studies are included that clarify the details of this unusual process. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Child Mortality Estimation: A Global Overview of Infant and Child Mortality Age Patterns in Light of New Empirical Data

PubMed Central

Guillot, Michel; Gerland, Patrick; Pelletier, François; Saabneh, Ameed

2012-01-01

Background The under-five mortality rate (the probability of dying between birth and age 5 y, also denoted in the literature as U5MR and 5 q 0) is a key indicator of child health, but it conceals important information about how this mortality is distributed by age. One important distinction is what amount of the under-five mortality occurs below age 1 y (1 q 0) versus at age 1 y and above (4 q 1). However, in many country settings, this distinction is often difficult to establish because of various types of data errors. As a result, it is common practice to resort to model age patterns to estimate 1 q 0 and 4 q 1 on the basis of an observed value of 5 q 0. The most commonly used model age patterns for this purpose are the Coale and Demeny and the United Nations systems. Since the development of these models, many additional sources of data for under-five mortality have become available, making possible a general evaluation of age patterns of infant and child mortality. In this paper, we do a systematic comparison of empirical values of 1 q 0 and 4 q 1 against model age patterns, and discuss whether observed deviations are due to data errors, or whether they reflect true epidemiological patterns not addressed in existing model life tables. Methods and Findings We used vital registration data from the Human Mortality Database, sample survey data from the World Fertility Survey and Demographic and Health Surveys programs, and data from Demographic Surveillance Systems. For each of these data sources, we compared empirical combinations of 1 q 0 and 4 q 1 against combinations provided by Coale and Demeny and United Nations model age patterns. We found that, on the whole, empirical values fall relatively well within the range provided by these models, but we also found important exceptions. Sub-Saharan African countries have a tendency to exhibit high values of 4 q 1 relative to 1 q 0, a pattern that appears to arise for the most part from true epidemiological causes. While this pattern is well known in the case of western Africa, we observed that it is more widespread than commonly thought. We also found that the emergence of HIV/AIDS, while perhaps contributing to high relative values of 4 q 1, does not appear to have substantially modified preexisting patterns. We also identified a small number of countries scattered in different parts of the world that exhibit unusually low values of 4 q 1 relative to 1 q 0, a pattern that is not likely to arise merely from data errors. Finally, we illustrate that it is relatively common for populations to experience changes in age patterns of infant and child mortality as they experience a decline in mortality. Conclusions Existing models do not appear to cover the entire range of epidemiological situations and trajectories. Therefore, model life tables should be used with caution for estimating 1 q 0 and 4 q 1 on the basis of 5 q 0. Moreover, this model-based estimation procedure assumes that the input value of 5 q 0 is correct, which may not always be warranted, especially in the case of survey data. A systematic evaluation of data errors in sample surveys and their impact on age patterns of 1 q 0 and 4 q 1 is urgently needed, along with the development of model age patterns of under-five mortality that would cover a wider range of epidemiological situations and trajectories. Please see later in the article for the Editors' Summary. PMID:22952438

Unusual MR spectroscopic imaging pattern of an astrocytoma: lack of elevated choline and high myo-inositol and glycine levels.

PubMed

Londoño, Ana; Castillo, Mauricio; Armao, Diane; Kwock, Lester; Suzuki, Kinuko

2003-05-01

We present the case of a patient with an MR imaging study showing an ill-defined intra-axial mass in the right insula and frontal lobe. The mass showed high signal intensity on T2-weighted and fluid-attenuated inversion recovery images and an unusual proton MR spectroscopic imaging pattern characterized by the presence of high levels of myo-inositol/glycine, no significant elevation of choline, and mildly reduced N-acetylaspartate. The histopathologic diagnosis was of diffuse astrocytoma with oligodendroglial components (World Health Organization grade II).

Diagnosis and treatment of viral encephalitis

PubMed Central

Chaudhuri, A; Kennedy, P

2002-01-01

Acute encephalitis constitutes a medical emergency. In most cases, the presence of focal neurological signs and focal seizures will distinguish encephalitis from encephalopathy. Acute disseminated encephalomyelitis is a non-infective inflammatory encephalitis that may require to be treated with steroids. Acute infective encephalitis is usually viral. Herpes simplex encephalitis (HSE) is the commonest sporadic acute viral encephalitis in the Western world. Magnetic resonance imaging of brain is the investigation of choice in HSE and the diagnosis may be confirmed by the polymerase chain reaction test for the virus in the cerebrospinal fluid. In this article, we review the diagnosis, investigations, and management of acute encephalitis. With few exceptions (for example, aciclovir for HSE), no specific therapy is available for most forms of viral encephalitis. Mortality and morbidity may be high and long term sequelae are known among survivors. The emergence of unusual forms of zoonotic encephalitis has posed an important public health problem. Vaccination and vector control measures are useful preventive strategies in certain arboviral and zoonotic encephalitis. However, we need better antiviral therapy to meet the challenge of acute viral encephalitis more effectively. PMID:12415078

Correlates of virulence in a frog-killing fungal pathogen: evidence from a California amphibian decline.

PubMed

Piovia-Scott, Jonah; Pope, Karen; Worth, S Joy; Rosenblum, Erica Bree; Poorten, Thomas; Refsnider, Jeanine; Rollins-Smith, Louise A; Reinert, Laura K; Wells, Heather L; Rejmanek, Dan; Lawler, Sharon; Foley, Janet

2015-07-01

The fungal pathogen Batrachochytrium dendrobatidis (Bd) has caused declines and extinctions in amphibians worldwide, and there is increasing evidence that some strains of this pathogen are more virulent than others. While a number of putative virulence factors have been identified, few studies link these factors to specific epizootic events. We documented a dramatic decline in juvenile frogs in a Bd-infected population of Cascades frogs (Rana cascadae) in the mountains of northern California and used a laboratory experiment to show that Bd isolated in the midst of this decline induced higher mortality than Bd isolated from a more stable population of the same species of frog. This highly virulent Bd isolate was more toxic to immune cells and attained higher density in liquid culture than comparable isolates. Genomic analyses revealed that this isolate is nested within the global panzootic lineage and exhibited unusual genomic patterns, including increased copy numbers of many chromosomal segments. This study integrates data from multiple sources to suggest specific phenotypic and genomic characteristics of the pathogen that may be linked to disease-related declines.

Substantial changes in hemocyte parameters of Manila clam Ruditapes philippinarum two years after the Hebei Spirit oil spill off the west coast of Korea.

PubMed

Hong, Hyun-Ki; Donaghy, Ludovic; Kang, Chang-Keun; Kang, Hyun-Sil; Lee, Hee-Jung; Park, Heung-Sik; Choi, Kwang-Sik

2016-07-15

Two years after the Hebei Spirit oil spill occurred off the west coast of Korea, we determined sub-lethal effects of the spilled oil on hemocyte parameters of Ruditapes philippinarum in the damaged areas. Clams in the spilled sites displayed unusually high proportion of granulocytes, which may result in higher phagocytosis capacity and reactive oxygen species production. Hemocytes in clams from the polluted sites also displayed less DNA damage and mortality than in the control site, possibly due to a faster phagocytosis of the impaired cells. Glycogen, the major energetic reserve, was depleted in clams from the spilled sites, potentially due to energetic consumption for maintenance of a large pool of granulocytes, detoxification processes and oxidative stress. Modified hemocyte parameters in clams in the spilled area, may reflect sub-lethal physiological stresses caused by the residual oils in the sediment, in conjunction with environmental modifications such as food availability and pathogens pattern. Copyright © 2016 Elsevier Ltd. All rights reserved.

Protothecal peritonitis in child after bone marrow transplantation: case report and literature review of paediatric cases.

PubMed

Sykora, T; Horakova, J; Buzzasyova, D; Sladekova, M; Poczova, M; Sufliarska, S

2014-11-01

The case presented here illustrates a protothecal infection caused by Prototheca wickerhamii in a paediatric haematopoietic stem cell recipient followed by a review of the literature of all 13 paediatric cases published since 1980. Protothecosis is a rare disease caused by algae, not described in this setting before. Infection was proven additionally post-mortem from peritoneal dialysis fluid. Even though no death of a paediatric patient due to this infection has been reported and the mortality rate associated with protothecosis is low, our patient died from multiorgan failure as a result of numerous post-transplant complications and a strain of cultivated alga that was highly resistant to antifungal agents. Prototheca spp. show various susceptibility profiles, and there is no direct correlation between in vitro activity and clinical response. There are different treatment regimens described but there are no clear published guidelines of specific therapy of protothecosis. Paediatric cases were successfully treated mostly with amphotericin B and azoles. As the number of immunocompromised patients increases, it is necessary to think more about unusual pathogens such as Prototheca.

Analyzing fat embolism syndrome in trauma patients at AIIMS Apex Trauma Center, New Delhi, India

PubMed Central

Gupta, Babita; D’souza, Nita; Sawhney, Chhavi; Farooque, Kamran; Kumar, Ajeet; Agrawal, Pramendra; Misra, M C

2011-01-01

Background: Fat embolism syndrome (FES) is a constellation of symptoms and signs subsequent to orthopedic trauma. Materials and Methods: The clinical profile of FES in the trauma population was studied over 2 years and 8 months. Results: The incidence of FES among all patients with long bone and pelvic fractures was 0.7% (12). The mean injury severity score was 10.37 (SD 1.69) (range 9-14). The diagnosis of FES was made by clinical and laboratory criteria. Hypoxia was the commonest presentation (92%). The average days of onset of symptoms were 3.5 (SD1.29) days. Management included ventilator support in 75%, average ventilator days being 7.8 (SD 4.08) days. The average ICU stay and hospital stay were 9.1 days and 29.7 days, respectively. A mortality of 8.3% (1) was observed. Conclusion: Fat embolism remains a diagnosis of exclusion and is a clinical dilemma. Clinically apparent FES is unusual and needs high index of suspicion, especially in long bone and pelvic fractures. PMID:21887021

Disseminated Cryptococcosis presenting as cellulitis in a renal transplant recipient.

PubMed

Chaya, Ramachandraiah; Padmanabhan, Srinivasan; Anandaswamy, Venugopal; Moin, Aumir

2013-01-15

Cellulitis is an unusual presentation of cryptococcal infection in renal allograft recipients. In such patients, disseminated cryptococcal infection can result in significant morbidity and mortality. Patients are often treated with antibiotics before a definitive diagnosis is made, delaying appropriate therapy. We describe the case of a 43-year-old post renal transplant recipient presenting with fever and swelling in the right thigh. On physical examination, the patient was found to have features suggestive of cellulitis with minimal slurring of speech. Material obtained from incision and drainage of the wound showed yeast cells resembling Cryptococcus spp. Blood culture and cerebrospinal fluid culture were also found to have growth of Cryptococcus neoformans. He received treatment with amphotericin B 6 mg/kg daily intravenously for two weeks, then continued with fluconazole 400 mg daily for three months. The patient showed a remarkable improvement. There was no recurrence of cryptococcosis after four months of follow-up. The diagnosis of disseminated cryptococcosis should be considered in differential diagnosis of cellulitis among non HIV immunocompromised hosts. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.

The use of old donors in liver transplantation.

PubMed

Dasari, Bobby V M; Schlegel, Andrea; Mergental, Hynek; Perera, M Thamara P R

2017-04-01

The process of ageing has an impact on the entire human body including the organ systems. In transplantation, professionals are daily faced with risk assessment of suitable donor offers , whether to accept a liver graft for a specific recipient. In this context, livers from elderly donors are more frequently accepted for transplantation, to increase the donor pool and compensate the high waiting list mortality. In the current practice it is not unusual to accept 60-year old donor livers for transplantation, as the donor demographics have significantly changed over the years. However, controversy exists regarding the use of livers from donors above 70 or 80 years, particular in combination with other risk factors, e.g. liver steatosis, warm ischaemia or long cold storage. This review focuses first on the impact of ageing on liver morphology and function. Second, we will highlight outcome after transplantation from elderly donors. Finally, we describe further risk factors and donor-recipient selection under the scope of old donor organs and include our institutional experience and policy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recall of false memories in individuals scoring high in schizotypy: memory distortions are scale specific.

PubMed

Saunders, Jo; Randell, Jordan; Reed, Phil

2012-06-01

Previous research has indicated abnormal semantic activation in individuals scoring higher in schizotypy. In the current experiment, semantic activation was examined by using the Deese-Roediger-McDermott paradigm of false memories. Participants were assessed for schizotypy using the Oxford-Liverpool Inventory of Feelings (OLIFE). Participants studied lists of semantically related words in which a critical and highly associated word was absent. Participants then recalled the list. Participants high in Unusual Experiences and Cognitive Disorganization recalled more critical non-presented words, weakly related studied words, and fewer studied words than participants who scored low on these measures. Previous research using the cognitive-perceptual factor of the Schizotypy Personality Questionnaire found reduced false memories, while the Unusual Experiences subscale of the OLIFE was associated with more false memories. Both scales cover similar unusual perceptual experiences and it is unclear why they led to divergent results. The findings suggest that subtypes of schizotypy are associated with abnormal semantic activation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Low-intensity red and infrared laser effects at high fluences on Escherichia coli cultures

PubMed Central

Barboza, L.L.; Campos, V.M.A.; Magalhães, L.A.G.; Paoli, F.; Fonseca, A.S.

2015-01-01

Semiconductor laser devices are readily available and practical radiation sources providing wavelength tenability and high monochromaticity. Low-intensity red and near-infrared lasers are considered safe for use in clinical applications. However, adverse effects can occur via free radical generation, and the biological effects of these lasers from unusually high fluences or high doses have not yet been evaluated. Here, we evaluated the survival, filamentation induction and morphology of Escherichia coli cells deficient in repair of oxidative DNA lesions when exposed to low-intensity red and infrared lasers at unusually high fluences. Cultures of wild-type (AB1157), endonuclease III-deficient (JW1625-1), and endonuclease IV-deficient (JW2146-1) E. coli, in exponential and stationary growth phases, were exposed to red and infrared lasers (0, 250, 500, and 1000 J/cm2) to evaluate their survival rates, filamentation phenotype induction and cell morphologies. The results showed that low-intensity red and infrared lasers at high fluences are lethal, induce a filamentation phenotype, and alter the morphology of the E. coli cells. Low-intensity red and infrared lasers have potential to induce adverse effects on cells, whether used at unusually high fluences, or at high doses. Hence, there is a need to reinforce the importance of accurate dosimetry in therapeutic protocols. PMID:26445339

With an Unusually Hands-On Role, State Feels Its Way in New Orleans

ERIC Educational Resources Information Center

Robelen, Erik W.

2006-01-01

This article reports how Louisiana officials take hits amid strain to start schools. A year after Hurricane Katrina wreaked havoc on New Orleans, the state of Louisiana finds itself in the highly unusual position of essentially starting from scratch--and directly operating--a batch of public schools in the city. While much attention has focused on…

Immunocompetent, Immunized Male With Mumps, Complicated by Orchitis and Meningitis.

PubMed

Tomich, Allison; Grubish, Lindsay; Young, Scott; Franklin, Jillian

2015-10-01

Mumps is a rare pathology often not encountered in the emergency department setting. It is an especially unusual finding in a fully immunized individual. We present a case of a 26-year-old Army active duty male who was evaluated in the emergency department for mumps over the course of two visits. The military population is presumed fully immunized and immunocompetent, travels widely and often lives in close quarters. This case highlights the importance for providers to consider such a disease that carries a risk of significant morbidity, and rarely, mortality. A literature review was performed evaluating mumps in the vaccinated population. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Mortality in Laysan ducks (Anas laysanensis) by emaciation complicated by Echinuria uncinata on Laysan Island, Hawaii, 1993

USGS Publications Warehouse

Work, Thierry M.; Meteyer, Carol U.; Cole, Rebecca A.

2004-01-01

In November 1993, unusual mortality occurred among endangered Laysan ducks on Laysan Island, one of the remote refugia of the Northwestern Hawaiian Islands National Wildlife Refuge (USA). Ten live ducks were emaciated, and blood samples documented anemia, heterophilia, and eosinophilia. Pathology in 13 duck carcasses revealed emaciation, marked thickening of the proventricular wall, abundant mucus, and nodules in the gastrointestinal tract. Histology revealed granulomata associated with nematodes in the proventriculus, small intestines, and body walls of nine of 10 ducks examined on histology. We suspect that low rainfall and low food abundance that year contributed to enhanced pathogenicity of parasite infection, either through increased exposure or decreased host resistance. Because the Laysan duck is found only on Laysan island and is critically endangered, translocation of this species to other islands is being considered. Given that we have not seen pathology associated with Echinuria spp. in native waterfowl on other Hawaiian Islands and given the parasite's potential to cause significant lesions in Laysan ducks, it will be important to prevent the translocation of Echinuria spp.

Unusually high rotational temperature of the CN radical

NASA Astrophysics Data System (ADS)

Krełowski, J.; Galazutdinov, G.; Beletsky, Y.

2011-07-01

We analyse a high-resolution, high signal-to-noise spectrogram of the hot reddened star Trumpler 16 112 to find relationships between the physical parameters of the intervening interstellar medium (e.g., the rotational temperature of the CN radical) and the intensities of interstellar lines/bands. We report on the discovery of an interstellar cloud that shows an exceptionally high rotational temperature of CN (4.5 K) and unusually strong Ca I and Fe I interstellar lines. This rare CaFe-type cloud seemingly contains no diffuse band carriers. Based on observations collected at the European Organisation for Astronomical Research in the Southern Hemisphere, Chile. Programs 073.D-0609(A) and 082.C-0566(A).

Cancer incidence following long-term consumption of drinking water with high inorganic selenium content.

PubMed

Vinceti, Marco; Vicentini, Massimo; Wise, Lauren A; Sacchettini, Claudio; Malagoli, Carlotta; Ballotari, Paola; Filippini, Tommaso; Malavolti, Marcella; Rossi, Paolo Giorgi

2018-04-16

Selenium, a trace element to which humans are exposed mainly through diet, has been involved in the etiology of human cancer. We investigated the long-term effects of selenium exposure on cancer incidence using data from a natural experiment in Northern Italy. During the 1970s-1980s, in a part of the Italian municipality of Reggio Emilia, residents were inadvertently exposed to unusually high levels of inorganic hexavalent selenium (selenate) through drinking water. We followed the exposed residents for 28years, generating data on incidence (when available) and mortality rates for selected cancer sites; the remaining municipal residents comprised the unexposed (reference) group. We observed no substantial difference in overall cancer incidence comparing exposed and unexposed cohorts. We detected, however, a higher incidence of cancer at some sites, and for a few of them, namely cancers of the buccal cavity and pharynx, melanoma, urinary tract and lymphoid tissue, the excess incidence was particularly evident in the first period of follow-up but decreased over time. Overall, these results suggest that consumption of water with levels of selenium in its inorganic hexavalent form close to the European standard, 10μg/L, may have unfavourable effects on cancer incidence. Copyright © 2018 Elsevier B.V. All rights reserved.

Identification of a high-virulence clone of type III Streptococcus agalactiae (group B Streptococcus) causing invasive neonatal disease.

PubMed

Musser, J M; Mattingly, S J; Quentin, R; Goudeau, A; Selander, R K

1989-06-01

Chromosomal genotypes of 128 isolates of six serotypes (Ia, Ib, Ic, II, Ic/II, and III) of Streptococcus agalactiae (group B Streptococcus) recovered predominantly from human infants in the United States were characterized by an analysis of electrophoretically demonstrable allelic profiles at 11 metabolic enzyme loci. Nineteen distinctive electrophoretic types (ETs), representing multilocus clonal genotypes, were identified. Mean genetic diversity per locus among ETs of isolates of the same serotype was, on average, nearly equal to that in all 19 ETs. Cluster analysis of the ETs revealed two primary phylogenetic divisions at a genetic distance of 0.65. A single clone (ET 1) represented by 40 isolates expressing type III antigen formed division I. Division II was composed of 18 ETs in three major lineages diverging from one another at distances greater than 0.35 and included strains of all six antigenic classes. The type III organisms in division I produce more extracellular neuraminidase and apparently are more virulent than the type III strains in division II, which are related to strains of other serotypes that cause disease much less frequently. The existence of this unusually virulent clone accounts, in major part, for the high morbidity and mortality associated with infection by type III organisms.

Pathogenesis of chronic active Epstein-Barr virus infection: is this an infectious disease, lymphoproliferative disorder, or immunodeficiency?

PubMed

Kimura, Hiroshi

2006-01-01

Chronic active Epstein-Barr virus infection (CAEBV) is characterised by chronic or recurrent infectious mononucleosis-like symptoms, such as fever, hepatosplenomegaly, persistent hepatitis and extensive lymphadenopathy. Patients with CAEBV have high viral loads in their peripheral blood and/or an unusual pattern of EBV-related antibodies. This disease is rare but severe with high morbidity and mortality. Nearly three decades have passed since this disease was first identified, and recent advances in technology have increased our understanding of CAEBV pathophysiology. There is accumulating evidence that the clonal expansion of EBV-infected T or natural killer (NK) cells plays a central role in the pathogenesis of CAEBV. However, it remains unclear whether CAEBV is truly a monoclonal lymphoproliferative disorder. EBV-infected T or NK cells are able to evade the host cellular immune system due to the limited expression of viral proteins of reduced antigenicity. Recent studies suggest that infection of T or NK cells is a common event during primary EBV infection. A defect or single nucleotide polymorphism in host immune-modulating genes may allow for the expansion of virus infected cells giving rise to CAEBV. In this review, I summarise our current understanding of the pathogenesis of CAEBV and propose a model of CAEBV pathogenicity.

UNUSUAL BACTEROIDES-LIKE ORGANISM

PubMed Central

Goldberg, Herbert S.; Barnes, Ella M.; Charles, Anthony B.

1964-01-01

Goldberg, Herbert S. (University of Missouri, Columbia), Ella M. Barnes, and Anthony B. Charles. Unusual Bacteroides-like organism. J. Bacteriol. 87:737–742. 1964.—An organism is described which appears to be a new species of gram-negative, anaerobic, nonsporulating rod. It was isolated from poultry caeca at levels of 107 to 108 per g. It is primarily distinguished from related organisms by its unusual size (2.0 by 10.0 μ). It is biochemically differentiated from known species of Bacteroides, Fusobacterium, Sphaerophorous, and other accepted related genera. Its presence in large numbers in the gut of poultry, and its high metabolic activity would seem to indicate an important intestinal organism. Images PMID:14127590

An unusual case of posttrabeculectomy conjunctival granuloma.

PubMed

Choudhary, Samiksha; Sen, Swarnali; Gupta, Omprakash

2018-01-01

We report an unusual case of granulomatous inflammation that presented adjacent to bleb 3 weeks postoperatively after combined phacoemulsification and trabeculectomy surgery with mitomycin-C due to retained microfragments of methyl cellulose sponge. The commonly used antimetabolite delivery devices are made of cellulose. Methyl cellulose sponges are friable, and they are likely to leave behind microfragments in subconjunctival space. In our case, bleb integrity was maintained, unlike the earlier reported cases which presented with bleb leak. Hence, one should have high index of suspicion in unusual cases of postoperative inflammation not resolving conservatively. Although rare, retained sponge particles can be a cause of early bleb-related inflammation which can lead to bleb failure.

An unusual case of posttrabeculectomy conjunctival granuloma

PubMed Central

Choudhary, Samiksha; Sen, Swarnali; Gupta, Omprakash

2018-01-01

We report an unusual case of granulomatous inflammation that presented adjacent to bleb 3 weeks postoperatively after combined phacoemulsification and trabeculectomy surgery with mitomycin-C due to retained microfragments of methyl cellulose sponge. The commonly used antimetabolite delivery devices are made of cellulose. Methyl cellulose sponges are friable, and they are likely to leave behind microfragments in subconjunctival space. In our case, bleb integrity was maintained, unlike the earlier reported cases which presented with bleb leak. Hence, one should have high index of suspicion in unusual cases of postoperative inflammation not resolving conservatively. Although rare, retained sponge particles can be a cause of early bleb-related inflammation which can lead to bleb failure. PMID:29563697

Chapter 5 - Tree Mortality

Treesearch

Mark J. Ambrose

2018-01-01

Tree mortality is a natural process in all forest ecosystems. High mortality can be an indicator of forest health problems. On aregional scale, high mortality levels may indicate widespread insect or disease impacts. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands. The approach...

Tree Mortality

Treesearch

Mark J. Ambrose

2012-01-01

Tree mortality is a natural process in all forest ecosystems. However, extremely high mortality also can be an indicator of forest health issues. On a regional scale, high mortality levels may indicate widespread insect or disease problems. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands....

Intramuscular Dirofilariasis Mimicking an Orbital Metastasis in a Patient with Breast Cancer

PubMed Central

Henderson, Brett M.; Hunt, Christopher H.; Eckel, Laurence J.; Schwartz, Kara M.; Diehn, Felix E.; Pritt, Bobbi S.; Schembri Wismayer, David J.; Garrity, James A.

2012-01-01

We present the unusual case of a 74 year-old female with a history of breast cancer who presented with acute painless orbital swelling and vertical diplopia. MRI revealed a focal enhancing mass within the superior rectus muscle. As the concern for metastatic disease was high, surgical biopsy was performed and revealed an unusual mimicker of metastatic disease, the parasitic infection dirofilariasis. PMID:23008795

Increased Prevalence of Unusual Sensory Behaviors in Infants at Risk For, and Teens With, Autism Spectrum Disorder

ERIC Educational Resources Information Center

Van Etten, Hannah M.; Kaur, Maninderjit; Srinivasan, Sudha M.; Cohen, Shereen J.; Bhat, Anjana; Dobkins, Karen R.

2017-01-01

The current study investigated the prevalence and pattern of unusual sensory behaviors (USBs) in teens with Autism Spectrum Disorder (ASD) and infants (3-36 months) at risk for ASD. From two different sites (UCSD and UConn), caregivers of infants at high (n = 32) and low risk (n = 33) for ASD, and teenagers with (n = 12) and without ASD (n = 11),…

A fluorophosphate-based inverse Keggin structure

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

Fielden, John; Quasdorf, Kyle; Cronin, Leroy

An unusual PFO(3)(2-)-templated "inverse Keggin" polyanion, [Mo(12)O(46)(PF)(4)](4-), has been isolated from the degradation reaction of an {Mo(132)}-type Keplerate to [PMo(12)O(40)](3-) by [Cu(MeCN)(4)](PF(6)) in acetonitrile. (31)P-NMR studies suggest a structure-directing role for [Cu(MeCN)(4)](+) in the formation of the highly unusual all-inorganic inverse Keggin structure.

A fluorophosphate-based inverse Keggin structure.

PubMed

Fielden, John; Quasdorf, Kyle; Cronin, Leroy; Kögerler, Paul

2012-09-07

An unusual PFO(3)(2-)-templated "inverse Keggin" polyanion, [Mo(12)O(46)(PF)(4)](4-), has been isolated from the degradation reaction of an {Mo(132)}-type Keplerate to [PMo(12)O(40)](3-) by [Cu(MeCN)(4)](PF(6)) in acetonitrile. (31)P-NMR studies suggest a structure-directing role for [Cu(MeCN)(4)](+) in the formation of the highly unusual all-inorganic inverse Keggin structure.

Transient 5-oxoprolinuria: unusually high anion gap acidosis in an infant.

PubMed

Hulley, Sarah L; Perring, Jeff; Manning, Nigel; Olpin, Simon; Yap, Sufin

2015-12-01

Transient 5-oxoprolinuria is a phenomenon that is well recognised in adults. We illustrate an unusual paediatric case of transient 5-oxoprolinuria presenting during an episode of severe sepsis with concomitant paracetamol use. The 15-month-old patient had an extremely high anion gap metabolic acidosis. Adequate resuscitation failed to correct the biochemical disturbance, and high levels of 5-oxoproline were identified. A combination of haemofiltration, replenishment of glutathione stores with N-acetylcysteine and cessation of paracetamol administration resulted in the resolution of the acidosis. Subsequent testing following treatment of the sepsis revealed no ongoing 5-oxoprolinuria. Transient 5-oxoprolinuria has been previously reported in the adult population during episodes of severe sepsis and various pharmaceutical interventions. This case illustrates that it is a phenomenon that should be considered in paediatric patients where a very high anion gap metabolic acidosis exists that cannot be explained by the biochemical indices. • 5-oxoprolinuria in the paediatric population is usually secondary to an inborn error of metabolism. • Transient 5-oxoprolinuria is well recognised in adults during episodes of severe glutathione depletion. • Transient 5-oxoprolinuria is a phenomenon rarely reported in the paediatric population. • It highlights the importance of investigating a high anion gap such that unusual diagnoses are not missed.

Projected trends in high-mortality heatwaves under different scenarios of climate, population, and adaptation in 82 US communities.

PubMed

Anderson, G Brooke; Oleson, Keith W; Jones, Bryan; Peng, Roger D

2018-02-01

Some rare heatwaves have extreme daily mortality impacts; moderate heatwaves have lower daily impacts but occur much more frequently at present and so account for large aggregated impacts. We applied health-based models to project trends in high-mortality heatwaves, including proportion of all heatwaves expected to be high-mortality, using the definition that a high-mortality heatwave increases mortality risk by ≥20 %. We projected these trends in 82 US communities in 2061-2080 under two scenarios of climate change (RCP4.5, RCP8.5), two scenarios of population change (SSP3, SSP5), and three scenarios of community adaptation to heat (none, lagged, on-pace) for large- and medium-ensemble versions of the National Center for Atmospheric Research's Community Earth System Model. More high-mortality heatwaves were expected compared to present under all scenarios except on-pace adaptation, and population exposure was expected to increase under all scenarios. At least seven more high-mortality heatwaves were expected in a twenty-year period in the 82 study communities under RCP8.5 than RCP4.5 when assuming no adaptation. However, high-mortality heatwaves were expected to remain <1 % of all heatwaves and heatwave exposure under all scenarios. Projections were most strongly influenced by the adaptation scenario- going from a scenario of on-pace to lagged adaptation or from lagged to no adaptation more than doubled the projected number of and exposure to high-mortality heatwaves. Based on our results, fewer high-mortality heatwaves are expected when following RCP4.5 versus RCP8.5 and under higher levels of adaptation, but high-mortality heatwaves are expected to remain a very small proportion of total heatwave exposure.

Structure and properties during aging of an ultra-high strength Al-Cu-Li-Ag-Mg alloy

NASA Technical Reports Server (NTRS)

Gayle, Frank W.; Heubaum, Frank H.; Pickens, Joseph R.

1990-01-01

The structure and properties of the strengthening phases formed during aging in an Al-Cu-Li-Ag-Mg alloy (Weldalite 049) were elulcidated, by following the development of the microstructure by means of TEM. The results of observations showed that the Weldalite 049 alloy has a series of unusual and technologically useful combinations of mechanical properties in different aging conditions, such as natural aging without prior cold work to produce high strengths, a reversion temper of lower yield strength and unusually high ductility, a room temperature reaging of the reversion temper eventually leading to the original T4 hardness, and ultrahigh-strength T6 properties.

Texture related unusual phenomena in electrodeposition and vapor deposition

NASA Astrophysics Data System (ADS)

Lee, D. N.; Han, H. N.

2015-04-01

The tensile strength of electrodeposits generally decreases with increasing bath temperature because the grain size increases and the dislocation density decreases with increasing bath temperature. Therefore, discontinuities observed in the tensile strength vs. bath temperature curves in electrodeposition of copper are unusual. The tensile strength of electrodeposits generally increases with increasing cathode current density because the rate of nucleation in electrodeposits increases with increasing current density, which in turn gives rise to a decrease in the grain size and in turn an increase in the strength. Therefore, a decrease in the tensile strength of copper electrodeposits at a high current density is unusual. The grain size of vapor deposits is expected to decrease with decreasing substrate temperature. However, rf sputtered Co-Cr deposits showed that deposits formed on water-cooled polyimide substrates had a larger grain size than deposits formed on polyimide substrates at 200 °C. These unusual phenomena can be explained by the preferred growth model for deposition texture evolution.

Myocardial involvement in rocky mountain spotted fever: a case report and review.

PubMed

Doyle, Amy; Bhalla, Karan S; Jones, James M; Ennis, David M

2006-10-01

Rocky Mountain Spotted Fever (RMSF), caused by Rickettia rickettsii, is a serious tickborne illness that is endemic in the southeastern United States. Although it is most commonly known as a cause of fever and rash, it can have systemic manifestations. The myocardium may rarely be involved, with symptoms that can mimic those of acute coronary syndromes. This report describes a case of serologically proven RMSF causing symptomatic myocarditis, manifested by chest pain, elevated cardiac enzyme levels, and decrease myocardial function. After treatment with antibiotics, the myocarditis resolved. Thus, although unusual, the clinician should be aware of myocardial disease in patients with appropriate exposure histories or other clinical signs of RMSF. Close monitoring and an aggressive approach are essential to reduce mortality rates.

Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis.

PubMed

Tan, Florence; Thai, Ah Chuan; Cheah, Wei Keat; Mukherjee, J J

2009-10-01

A 45-year-old woman with poorly controlled hypertension and diabetes mellitus presented with left iliac fossa pain, constipation alternating with diarrhea, and weight loss. She had been diagnosed with idiopathic cardiomyopathy five years previously. Echocardiogram had shown a left ventricular ejection fraction (LVEF) of 35%; coronary angiogram was normal. Colonoscopy revealed sigmoid colitis with stenosis. Abdominal computed tomography revealed a 5 cm right adrenal tumor. Twenty-four hour urinary free catecholamines and fractionated metanephrine excretion values were elevated, confirming pheochromocytoma. Her colitis resolved after one month of adrenergic blockade. Repeat echocardiogram showed improvement of LVEF to 65%. After laparoscopic right adrenalectomy, the patient's hypertension resolved, and diabetic control improved. Timely management avoided further morbidity and potential mortality in our patient.

Lingual Haematoma due to Tenecteplase in a Patient with Acute Myocardial Infarction

PubMed Central

Bal, Muhlis; Salturk, Ziya; Ateş, Ahmet Hakan; Yağcı, Serkan; Coşkun Bal, Gökçen

2013-01-01

The use of intravenous thrombolytic agents has revolutionised the treatment of acute myocardial infarction. However, the improvement in mortality rate achieved with these drugs is tempered by the risk of serious bleeding complications, including intracranial haemorrhage. Tenecteplase is a genetically engineered mutant tissue plasminogen activator. Haemorrhagic complications of tissue plasminogen activator (tPA) are well known. Compared to other tPAs, tenecteplase use leads to lower rates of bleeding complications. Here, we report a case of unusual site of spontaneous bleeding, intralingual haematoma during tenecteplase therapy following acute myocardial infarction, which caused significant upper airway obstruction and required tracheotomy to maintain the patient's airway. Clinical dilemmas related to securing the airway or reversing the effects of tissue plasminogen activator are discussed. PMID:23862086

Enantioseparation of angiotensin II receptor type 1 blockers: evaluation of 6-substituted carbamoyl benzimidazoles on immobilized polysaccharide-based chiral stationary phases. Unusual temperature behavior.

PubMed

Su, Ran; Hou, Zhun; Sang, Lihong; Zhou, Zhi-Ming; Fang, Hao; Yang, Xinying

2017-09-15

Enantioseparation of thirteen 6-substituted carbamoyl benzimidazoles by high-performance liquid chromatography (HPLC) was investigated using two immobilized polysaccharide-based chiral stationary phases (CSPs), Chiralpak IC and Chiralpak IA, in normal-phase mode. Most of the examined compounds were completely resolved. The effects of a polar alcohol modifier, analyte structure, and column temperature on the chiral recognition were investigated. Furthermore, the structure-retention relationship was evaluated, and thermodynamic parameters were calculated from plots of ln k' or ln α versus 1/T. The thermodynamic parameters indicated that the separations were enthalpy-driven. Moreover, nonlinear van't Hoff plots were obtained on Chiralpak IA. However, two unusual phenomena were observed: (1) an unusual increase in retention with increasing temperature with linear van't Hoff plots on Chiralpak IC and (2) an extremely high T iso value (i.e., several thousand degrees centigrade). Copyright © 2017 Elsevier B.V. All rights reserved.

Unusual Entropy of Adsorbed Methane on Zeolite-Templated Carbon

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

Stadie, Nicholas P.; Murialdo, Maxwell; Ahn, Channing C.

2015-11-25

Methane adsorption at high pressures and across a wide range of temperatures was investigated on the surface of three porous carbon adsorbents with complementary structural properties. The measured adsorption equilibria were analyzed using a method that can accurately account for nonideal fluid properties and distinguish between absolute and excess quantities of adsorption, and that also allows the direct calculation of the thermodynamic potentials relevant to adsorption. On zeolite-templated carbon (ZTC), a material that exhibits extremely high surface area with optimal pore size and homogeneous structure, methane adsorption occurs with unusual thermodynamic properties that are greatly beneficial for deliverable gas storage:more » an enthalpy of adsorption that increases with site occupancy, and an unusually low entropy of the adsorbed phase. The origin of these properties is elucidated by comparison of the experimental results with a statistical mechanical model. The results indicate that temperature-dependent clustering (i.e., reduced configurations) of the adsorbed phase due to enhanced lateral interactions can account for the peculiarities of methane adsorbed on ZTC.« less

Childhood nodal marginal zone lymphoma with unusual clinicopathologic and cytogenetic features for the pediatric variant: a case report.

PubMed

Aqil, Barina; Merritt, Brian Y; Elghetany, M Tarek; Kamdar, Kala Y; Lu, Xinyan Y; Curry, Choladda V

2015-01-01

Nodal marginal zone lymphoma (NMZL) is a B-cell lymphoma that shares morphologic and immunophenotypic features with extranodal and splenic marginal zone lymphomas but lacks extranodal or splenic involvement at presentation. NMZL occurs mostly in adults with no sex predilection, at advanced stage (III or IV), with frequent relapses and a high incidence of tumoral genetic abnormalities including trisomies 3 and 18 and gain of 7q. Pediatric NMZL, however, is a rare but distinct variant of NMZL with characteristic features including male predominance, asymptomatic and localized (stage I) disease, low relapse rates with excellent outcomes, and a lower incidence of essentially similar genetic aberrations compared to adult NMZL. Here we describe a unique case of childhood NMZL with unusual clinicopathologic features for the pediatric variant including generalized lymphadenopathy, high-stage disease with persistence after therapy, unusual immunophenotype (CD5, CD23, and BCL6 positive), and unique chromosomal abnormalities including monosomy 20 and add(10)(p11.2).

Coral-macroalgal phase shifts or reef resilience: links with diversity and functional roles of herbivorous fishes on the Great Barrier Reef

NASA Astrophysics Data System (ADS)

Cheal, A. J.; MacNeil, M. Aaron; Cripps, E.; Emslie, M. J.; Jonker, M.; Schaffelke, B.; Sweatman, H.

2010-12-01

Changes from coral to macroalgal dominance following disturbances to corals symbolize the global degradation of coral reefs. The development of effective conservation measures depends on understanding the causes of such phase shifts. The prevailing view that coral-macroalgal phase shifts commonly occur due to insufficient grazing by fishes is based on correlation with overfishing and inferences from models and small-scale experiments rather than on long-term quantitative field studies of fish communities at affected and resilient sites. Consequently, the specific characteristics of herbivorous fish communities that most promote reef resilience under natural conditions are not known, though this information is critical for identifying vulnerable ecosystems. In this study, 11 years of field surveys recorded the development of the most persistent coral-macroalgal phase shift (>7 years) yet observed on Australia’s Great Barrier Reef (GBR). This shift followed extensive coral mortality caused by thermal stress (coral bleaching) and damaging storms. Comparisons with two similar reefs that suffered similar disturbances but recovered relatively rapidly demonstrated that the phase shift occurred despite high abundances of one herbivore functional group (scraping/excavating parrotfishes: Labridae). However, the shift was strongly associated with low fish herbivore diversity and low abundances of algal browsers (predominantly Siganidae) and grazers/detritivores (Acanthuridae), suggesting that one or more of these factors underpin reef resilience and so deserve particular protection. Herbivorous fishes are not harvested on the GBR, and the phase shift was not enhanced by unusually high nutrient levels. This shows that unexploited populations of herbivorous fishes cannot ensure reef resilience even under benign conditions and suggests that reefs could lose resilience under relatively low fishing pressure. Predictions of more severe and widespread coral mortality due to global climate change emphasize the need for more effective identification and protection of ecosystem components that are critical for the prevention of coral reef phase shifts.

Reversion to virulence and efficacy of an attenuated Canarypox vaccine in Hawai'i 'Amakihi (Hemignathus virens).

PubMed

Atkinson, Carter T; Wiegand, Kimberly C; Triglia, Dennis; Jarvi, Susan I

2012-12-01

Vaccines may be effective tools for protecting small populations of highly susceptible endangered, captive-reared, or translocated Hawaiian honeycreepers from introduced Avipoxvirus, but their efficacy has not been evaluated. An attenuated Canarypox vaccine that is genetically similar to one of two passerine Avipoxvirus isolates from Hawai'i and distinct from Fowlpox was tested to evaluate whether Hawai'i 'Amakihi (Hemignathus virens) can be protected from wild isolates of Avipoxvirus from the Hawaiian Islands. Thirty-one (31) Hawai'i 'Amakihi were collected from high-elevation habitats on Mauna Kea Volcano, where pox transmission is rare, and randomly divided into two groups. One group was vaccinated with Poximune C, whereas the other group received a sham vaccination with sterile water. Four of 15 (27%) vaccinated birds developed life-threatening disseminated lesions or lesions of unusually long duration, whereas one bird never developed a vaccine-associated lesion or "take." After vaccine lesions healed, vaccinated birds were randomly divided into three groups of five and challenged with either a wild isolate of Fowlpox (FP) from Hawai'i, a Hawai'i 'Amakihi isolate of a Canarypox-like virus (PV1), or a Hawai'i 'Amakihi isolate of a related, but distinct, passerine Avipoxvirus (PV2). Similarly, three random groups of five unvaccinated 'Amakihi were challenged with the same virus isolates. Vaccinated and unvaccinated 'Amakihi challenged with FP had transient infections with no clinical signs of infection. Mortality in vaccinated 'Amakihi challenged with PV1 and PV2 ranged from 0% (0/5) for PV1 to 60% (3/5) for PV2. Mortality in unvaccinated 'Amakihi ranged from 40% (2/5) for PV1 to 100% (5/5) for PV2. Although the vaccine provided some protection against PV1, both potential for vaccine reversion and low efficacy against PV2 preclude its use in captive or wild honeycreepers.

Reversion to virulence and efficacy of an attenuated canarypox vaccine in Hawai'i 'Amakihi (Hemignathus Virens)

USGS Publications Warehouse

Atkinson, Carter T.; Wiegand, Kimberly C.; Triglia, Dennis; Jarvi, Susan I.

2012-01-01

Vaccines may be effective tools for protecting small populations of highly susceptible endangered, captive-reared, or translocated Hawaiian honeycreepers from introduced Avipoxvirus, but their efficacy has not been evaluated. An attenuated Canarypox vaccine that is genetically similar to one of two passerine Avipoxvirus isolates from Hawai‘i and distinct from Fowlpox was tested to evaluate whether Hawai‘i ‘Amakihi (Hemignathus virens) can be protected from wild isolates of Avipoxvirus from the Hawaiian Islands. Thirty-one (31) Hawai‘i ‘Amakihi were collected from high-elevation habitats on Mauna Kea Volcano, where pox transmission is rare, and randomly divided into two groups. One group was vaccinated with Poximune C®, whereas the other group received a sham vaccination with sterile water. Four of 15 (27%) vaccinated birds developed life-threatening disseminated lesions or lesions of unusually long duration, whereas one bird never developed a vaccine-associated lesion or “take.” After vaccine lesions healed, vaccinated birds were randomly divided into three groups of five and challenged with either a wild isolate of Fowlpox (FP) from Hawai‘i, a Hawai‘i ‘Amakihi isolate of a Canarypox-like virus (PV1), or a Hawai‘i ‘Amakihi isolate of a related, but distinct, passerine Avipoxvirus (PV2). Similarly, three random groups of five unvaccinated ‘Amakihi were challenged with the same virus isolates. Vaccinated and unvaccinated ‘Amakihi challenged with FP had transient infections with no clinical signs of infection. Mortality in vaccinated ‘Amakihi challenged with PV1 and PV2 ranged from 0% (0/5) for PV1 to 60% (3/5) for PV2. Mortality in unvaccinated ‘Amakihi ranged from 40% (2/5) for PV1 to 100% (5/5) for PV2. Although the vaccine provided some protection against PV1, both potential for vaccine reversion and low efficacy against PV2 preclude its use in captive or wild honeycreepers.

[Prevalence and prognostic value of non-thyroidal illness syndrome among critically ill children].

PubMed

El-Ella, Sohair Sayed Abu; El-Mekkawy, Muhammad Said; El-Dihemey, Mohamed Abdelrahman

2018-04-05

Alterations in thyroid hormones during critical illness, known as non-thyroidal illness syndrome (NTIS), were suggested to have a prognostic value. However, pediatric data is limited. The aim of this study was to assess prevalence and prognostic value of NTIS among critically ill children. A prospective observational study conducted on 70 critically ill children admitted into pediatric intensive care unit (PICU). Free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were measured within 24hours of PICU admission. Primary outcome was 30-day mortality. NTIS occurred in 62.9% of patients but it took several forms. The most common pattern was low FT3 with normal FT4 and TSH (25.7% of patients). Combined decrease in FT3, FT4, and TSH levels occurred in 7.1% of patients. An unusual finding of elevated TSH was noted in three patients, which might be related to disease severity. Low FT4 was significantly more prevalent among non-survivors compared with survivors (50% versus 19.2%, P=.028). NTIS independently predicted mortality (OR=3.91; 95% CI=1.006-15.19; P=.0491). Concomitant decrease in FT3, FT4, and TSH was the best independent predictor of mortality (OR=16.9; 95% CI=1.40-203.04; P=.026). TSH was negatively correlated with length of PICU stay (r s =-0.35, P=.011). FT3 level was significantly lower among patients who received dopamine infusion compared with those who did not receive it (2.1±0.66 versus 2.76±0.91pg/mL, P=.011). NTIS is common among critically ill children and appears to be associated with mortality and illness severity. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Impact of Intravenous Immunoglobulin on Survival in Necrotizing Fasciitis With Vasopressor-Dependent Shock: A Propensity Score–Matched Analysis From 130 US Hospitals

PubMed Central

Swihart, Bruce J.; Bonne, Stephanie L.; Hohmann, Samuel F.; Hennessy, Laura V.; Louras, Peter; Evans, Heather L.; Rhee, Chanu; Suffredini, Anthony F.; Hooper, David C.; Follmann, Dean A.; Bulger, Eileen M.; Danner, Robert L.

2017-01-01

Abstract Background. Shock frequently complicates necrotizing fasciitis (NF) caused by group A Streptococcus (GAS) or Staphylococcus aureus. Intravenous immunoglobulin (IVIG) is sometimes administered for presumptive toxic shock syndrome (TSS), but its frequency of use and efficacy are unclear. Methods. Adult patients with NF and vasopressor-dependent shock undergoing surgical debridement from 2010 to 2014 were identified at 130 US hospitals. IVIG cases were propensity-matched and risk-adjusted. The primary outcome was in-hospital mortality and the secondary outcome was median length of stay (LOS). Results. Of 4127 cases of debrided NF with shock at 121 centers, only 164 patients (4%) at 61 centers received IVIG. IVIG subjects were younger with lower comorbidity indices, but higher illness severity. Clindamycin and vasopressor intensity were higher among IVIG cases, as was coding for TSS and GAS. In-hospital mortality did not differ between matched IVIG and non-IVIG groups (crude mortality, 27.3% vs 23.6%; adjusted odds ratio, 1.00 [95% confidence interval, .55–1.83]; P = .99). Early IVIG (≤2 days) did not alter this effect (P = .99). Among patients coded for TSS, GAS, and/or S. aureus, IVIG use was still unusual (59/868 [6.8%]) and lacked benefit (P = .63). Median LOS was similar between IVIG and non-IVIG groups (26 [13–49] vs 26 [11–43]; P = .84). Positive predictive values for identifying true NF and debridement among IVIG cases using our algorithms were 97% and 89%, respectively, based on records review at 4 hospitals. Conclusions. Adjunctive IVIG was administered infrequently in NF with shock and had no apparent impact on mortality or hospital LOS beyond that achieved with debridement and antibiotics. PMID:28034881

THE PHOENIX POPULATION: DEMOGRAPHIC CRISIS AND REBOUND IN CAMBODIA*

PubMed Central

HEUVELINE, PATRICK; POCH, BUNNAK

2014-01-01

The study of mortality crises provides an unusual and valuable perspective on the relationship between mortality and fertility changes, a relationship that has puzzled demographers for decades. In this article, we combine nationally representative survey and demographic-surveillance system data to study fertility trends around the time of the Khmer Rouge (KR) regime, under which 25% of the Cambodian population died. We present the first quantitative evidence to date that attests to a one-third decline of fertility during this regime, followed by a substantial “baby boom” after the fall of the KR. Further analyses reveal that the fertility rebound was produced not only by a two-year marriage bubble but also by a surge in marital fertility that remained for nearly a decade above its precrisis level. Our results illustrate the potential influence of mortality on fertility, which may be more difficult to identify for more gradual mortality declines. To the extent that until recently, Cambodian fertility appears to fit natural fertility patterns, our findings also reinforce meaning of this core paradigm of demographic analysis. In July 1978, a youth named Korb, bound hand and foot, arrived at a Pol Pot regime extermination camp. The local security chief, “Comrade Uncle An,” was handed the following note: Formerly this person was normal in character. Then, over about ten days, he went crazy. […] If many people come in, first he begins to whistle, and then he sings the following rhyme out loud: O! Khmers with black blood Now the eight-year Buddhist prophecy is being fulfilled. Vietnam is the elder brother Kampuchea is the younger. If we do not follow the Vietnamese as our elder brothers There will be nothing left of the Khmer this time but ashes.(Kiernan and Boua 1982:363) PMID:17583312

Simulation-Based Evaluation of the Performances of an Algorithm for Detecting Abnormal Disease-Related Features in Cattle Mortality Records.

PubMed

Perrin, Jean-Baptiste; Durand, Benoît; Gay, Emilie; Ducrot, Christian; Hendrikx, Pascal; Calavas, Didier; Hénaux, Viviane

2015-01-01

We performed a simulation study to evaluate the performances of an anomaly detection algorithm considered in the frame of an automated surveillance system of cattle mortality. The method consisted in a combination of temporal regression and spatial cluster detection which allows identifying, for a given week, clusters of spatial units showing an excess of deaths in comparison with their own historical fluctuations. First, we simulated 1,000 outbreaks of a disease causing extra deaths in the French cattle population (about 200,000 herds and 20 million cattle) according to a model mimicking the spreading patterns of an infectious disease and injected these disease-related extra deaths in an authentic mortality dataset, spanning from January 2005 to January 2010. Second, we applied our algorithm on each of the 1,000 semi-synthetic datasets to identify clusters of spatial units showing an excess of deaths considering their own historical fluctuations. Third, we verified if the clusters identified by the algorithm did contain simulated extra deaths in order to evaluate the ability of the algorithm to identify unusual mortality clusters caused by an outbreak. Among the 1,000 simulations, the median duration of simulated outbreaks was 8 weeks, with a median number of 5,627 simulated deaths and 441 infected herds. Within the 12-week trial period, 73% of the simulated outbreaks were detected, with a median timeliness of 1 week, and a mean of 1.4 weeks. The proportion of outbreak weeks flagged by an alarm was 61% (i.e. sensitivity) whereas one in three alarms was a true alarm (i.e. positive predictive value). The performances of the detection algorithm were evaluated for alternative combination of epidemiologic parameters. The results of our study confirmed that in certain conditions automated algorithms could help identifying abnormal cattle mortality increases possibly related to unidentified health events.

Simulation-Based Evaluation of the Performances of an Algorithm for Detecting Abnormal Disease-Related Features in Cattle Mortality Records

PubMed Central

Perrin, Jean-Baptiste; Durand, Benoît; Gay, Emilie; Ducrot, Christian; Hendrikx, Pascal; Calavas, Didier; Hénaux, Viviane

2015-01-01

We performed a simulation study to evaluate the performances of an anomaly detection algorithm considered in the frame of an automated surveillance system of cattle mortality. The method consisted in a combination of temporal regression and spatial cluster detection which allows identifying, for a given week, clusters of spatial units showing an excess of deaths in comparison with their own historical fluctuations. First, we simulated 1,000 outbreaks of a disease causing extra deaths in the French cattle population (about 200,000 herds and 20 million cattle) according to a model mimicking the spreading patterns of an infectious disease and injected these disease-related extra deaths in an authentic mortality dataset, spanning from January 2005 to January 2010. Second, we applied our algorithm on each of the 1,000 semi-synthetic datasets to identify clusters of spatial units showing an excess of deaths considering their own historical fluctuations. Third, we verified if the clusters identified by the algorithm did contain simulated extra deaths in order to evaluate the ability of the algorithm to identify unusual mortality clusters caused by an outbreak. Among the 1,000 simulations, the median duration of simulated outbreaks was 8 weeks, with a median number of 5,627 simulated deaths and 441 infected herds. Within the 12-week trial period, 73% of the simulated outbreaks were detected, with a median timeliness of 1 week, and a mean of 1.4 weeks. The proportion of outbreak weeks flagged by an alarm was 61% (i.e. sensitivity) whereas one in three alarms was a true alarm (i.e. positive predictive value). The performances of the detection algorithm were evaluated for alternative combination of epidemiologic parameters. The results of our study confirmed that in certain conditions automated algorithms could help identifying abnormal cattle mortality increases possibly related to unidentified health events. PMID:26536596

West Nile Virus transmission in winter: the 2013 Great Salt Lake Bald Eagle and Eared Grebes Mortality event

USGS Publications Warehouse

Ip, Hon S.; Van Wettere, Arnaud J.; McFarlan, Leslie; Shearn-Bochsler, Valerie I.; Dickson, Sammie L.; Baker, JoDee; Hatch, Gary; Cavender, Kimberly; Long, Renee Romaine; Bodenstein, Barbara L.

2014-01-01

West Nile Virus (WNV) infection has been reported in over 300 species of birds and mammals. Raptors such as eagles, hawks and falcons are remarkably susceptible, but reports of WNV infection in Bald Eagles (Haliaeetus leucocephalus) are rare and reports of WNV infection in grebes (Podicipediformes) even rarer. We report an unusually large wild bird mortality event involving between 15,000-20,000 Eared Grebes (Podiceps nigricollis) and over 40 Bald Eagles around the Great Salt Lake, Utah, in November-December 2013. Mortality in grebes was first reported in early November during a period when the area was unseasonably warm and the grebes were beginning to gather and stage prior to migration. Ten out of ten Eared Grebes collected during this period were WNV RT-PCR and/or isolation positive. This is the first report of WNV infection in Eared Grebes and the associated mortality event is matched in scale only by the combined outbreaks in American White Pelican (Pelecanus erythrorhynchos) colonies in the north central states in 2002-2003. We cannot be sure that all of the grebes were infected by mosquito transmission; some may have become infected through contact with WNV shed orally or cloacally from other infected grebes. Beginning in early December, Bald Eagles in the Great Salt Lake area were observed to display neurological signs such as body tremors, limb paralysis and lethargy. At least 43 Bald Eagles had died by the end of the month. Nine of nine Bald Eagles examined were infected with WNV. To the best of our knowledge, this is the largest single raptor mortality event since WNV became endemic in the USA. Because the majority of the eagles affected were found after onset of below-freezing temperatures, we suggest at least some of the Bald Eagles were infected with WNV via consumption of infected Eared Grebes or horizontal transmission at roost sites.

West Nile Virus Transmission in Winter: The 2013 Great Salt Lake Bald Eagle and Eared Grebes Mortality Event

PubMed Central

Ip, Hon S.; Van Wettere, Arnaud J.; McFarlane, Leslie; Shearn-Bochsler, Valerie; Dickson, Sammie Lee; Baker, JoDee; Hatch, Gary; Cavender, Kimberly; Long, Renee; Bodenstein, Barbara

2014-01-01

West Nile Virus (WNV) infection has been reported in over 300 species of birds and mammals. Raptors such as eagles, hawks and falcons are remarkably susceptible, but reports of WNV infection in Bald Eagles (Haliaeetus leucocephalus) are rare and reports of WNV infection in grebes (Podicipediformes) even rarer. We report an unusually large wild bird mortality event involving between 15,000-20,000 Eared Grebes (Podiceps nigricollis) and over 40 Bald Eagles around the Great Salt Lake, Utah, in November-December 2013. Mortality in grebes was first reported in early November during a period when the area was unseasonably warm and the grebes were beginning to gather and stage prior to migration. Ten out of ten Eared Grebes collected during this period were WNV RT-PCR and/or isolation positive. This is the first report of WNV infection in Eared Grebes and the associated mortality event is matched in scale only by the combined outbreaks in American White Pelican (Pelecanus erythrorhynchos) colonies in the north central states in 2002-2003. We cannot be sure that all of the grebes were infected by mosquito transmission; some may have become infected through contact with WNV shed orally or cloacally from other infected grebes. Beginning in early December, Bald Eagles in the Great Salt Lake area were observed to display neurological signs such as body tremors, limb paralysis and lethargy. At least 43 Bald Eagles had died by the end of the month. Nine of nine Bald Eagles examined were infected with WNV. To the best of our knowledge, this is the largest single raptor mortality event since WNV became endemic in the USA. Because the majority of the eagles affected were found after onset of below-freezing temperatures, we suggest at least some of the Bald Eagles were infected with WNV via consumption of infected Eared Grebes or horizontal transmission at roost sites. PMID:24761310

Unusual forest growth decline in boreal North America covaries with the retreat of Arctic sea ice.

PubMed

Girardin, Martin P; Guo, Xiao Jing; De Jong, Rogier; Kinnard, Christophe; Bernier, Pierre; Raulier, Frédéric

2014-03-01

The 20th century was a pivotal period at high northern latitudes as it marked the onset of rapid climatic warming brought on by major anthropogenic changes in global atmospheric composition. In parallel, Arctic sea ice extent has been decreasing over the period of available satellite data records. Here, we document how these changes influenced vegetation productivity in adjacent eastern boreal North America. To do this, we used normalized difference vegetation index (NDVI) data, model simulations of net primary productivity (NPP) and tree-ring width measurements covering the last 300 years. Climatic and proxy-climatic data sets were used to explore the relationships between vegetation productivity and Arctic sea ice concentration and extent, and temperatures. Results indicate that an unusually large number of black spruce (Picea mariana) trees entered into a period of growth decline during the late-20th century (62% of sampled trees; n = 724 cross sections of age >70 years). This finding is coherent with evidence encoded in NDVI and simulated NPP data. Analyses of climatic and vegetation productivity relationships indicate that the influence of recent climatic changes in the studied forests has been via the enhanced moisture stress (i.e. greater water demands) and autotrophic respiration amplified by the declining sea ice concentration in Hudson Bay and Hudson Strait. The recent decline strongly contrasts with other growth reduction events that occurred during the 19th century, which were associated with cooling and high sea ice severity. The recent decline of vegetation productivity is the first one to occur under circumstances related to excess heat in a 300-year period, and further culminates with an intensifying wildfire regime in the region. Our results concur with observations from other forest ecosystems about intensifying temperature-driven drought stress and tree mortality with ongoing climatic changes. © 2013 Her Majesty the Queen in Right of Canada Global Change Biology © 2013 John Wiley & Sons Ltd Reproduced with the permission of the Minister of Natural Resources Canada.

Exotic s-wave superconductivity in alkali-doped fullerides.

PubMed

Nomura, Yusuke; Sakai, Shiro; Capone, Massimo; Arita, Ryotaro

2016-04-20

Alkali-doped fullerides (A3C60 with A = K, Rb, Cs) show a surprising phase diagram, in which a high transition-temperature (Tc) s-wave superconducting state emerges next to a Mott insulating phase as a function of the lattice spacing. This is in contrast with the common belief that Mott physics and phonon-driven s-wave superconductivity are incompatible, raising a fundamental question on the mechanism of the high-Tc superconductivity. This article reviews recent ab initio calculations, which have succeeded in reproducing comprehensively the experimental phase diagram with high accuracy and elucidated an unusual cooperation between the electron-phonon coupling and the electron-electron interactions leading to Mott localization to realize an unconventional s-wave superconductivity in the alkali-doped fullerides. A driving force behind the exotic physics is unusual intramolecular interactions, characterized by the coexistence of a strongly repulsive Coulomb interaction and a small effectively negative exchange interaction. This is realized by a subtle energy balance between the coupling with the Jahn-Teller phonons and Hund's coupling within the C60 molecule. The unusual form of the interaction leads to a formation of pairs of up- and down-spin electrons on the molecules, which enables the s-wave pairing. The emergent superconductivity crucially relies on the presence of the Jahn-Teller phonons, but surprisingly benefits from the strong correlations because the correlations suppress the kinetic energy of the electrons and help the formation of the electron pairs, in agreement with previous model calculations. This confirms that the alkali-doped fullerides are a new type of unconventional superconductors, where the unusual synergy between the phonons and Coulomb interactions drives the high-Tc superconductivity.

Untethering an unusual cause of kidney injury in a teenager with Down syndrome.

PubMed

Yen, Elizabeth; Miele, Niel F; Barone, Joseph G; Tyagi, Rachana; Weiss, Lynne S

2014-11-01

Acute kidney injury (AKI) is characterized by the acute nature and the inability of kidneys to maintain fluid homeostasis as well as adequate electrolyte and acid-base balance, resulting in an accumulation of nitrogenous waste and elevation of serum blood urea nitrogen and creatinine values. Acute kidney injury may be a single isolated event, yet oftentimes, it results from an acute chronic kidney disease. It is critical to seek out the etiology of AKI and to promptly manage the underlying chronic kidney disease to prevent comorbidities and mortality that may ensue. We described a case of a 16-year-old adolescent girl with Down syndrome who presented with AKI and electrolyte aberrance.Abdominal and renal ultrasounds demonstrated a significantly dilated bladder as well as frank hydronephrosis and hydroureter bilaterally. Foley catheter was successful in relieving the obstruction and improving her renal function. However, a magnetic resonance imaging was pursued in light of her chronic constipation and back pain, and it revealed a structural defect (tethered cord) that underlies a chronic process that was highly likely contributory to her AKI. She was managed accordingly with a guarded result and required long-term and close monitoring.

Revisiting doxycycline in pregnancy and early childhood--time to rebuild its reputation?

PubMed

Cross, Ruby; Ling, Clare; Day, Nicholas P J; McGready, Rose; Paris, Daniel H

2016-01-01

Doxycycline is highly effective, inexpensive with a broad therapeutic spectrum and exceptional bioavailability. However these benefits have been overshadowed by its classification alongside the tetracyclines - class D drugs, contraindicated in pregnancy and in children under 8 years of age. Doxycycline-treatable diseases are emerging as leading causes of undifferentiated febrile illness in Southeast Asia. For example scrub typhus and murine typhus have an unusually severe impact on pregnancy outcomes, and current mortality rates for scrub typhus reach 12-13% in India and Thailand. The emerging evidence for these important doxycycline-treatable diseases prompted us to revisit doxycycline usage in pregnancy and childhood. A systematic review of the available literature on doxycycline use in pregnant women and children revealed a safety profile of doxycycline that differed significantly from that of tetracycline; no correlation between the use of doxycycline and teratogenic effects during pregnancy or dental staining in children was found. The change of the US FDA pregnancy classification scheme to an evidence-based approach will enable adequate evaluation of doxycycline in common tropical illnesses and in vulnerable populations in clinical treatment trials, dosage-optimization pharmacokinetic studies and for the empirical treatment of undifferentiated febrile illnesses, especially in pregnant women and children.

Hurricanes, submarine groundwater discharge, and Florida's red tides

NASA Astrophysics Data System (ADS)

Hu, Chuanmin; Muller-Karger, Frank E.; Swarzenski, Peter W.

2006-06-01

A Karenia brevis Harmful Algal Bloom affected coastal waters shallower than 50 m off west-central Florida from January 2005 through January 2006, showing a sustained anomaly of ~1 mg chlorophyll m-3 over an area of up to 67,500 km2. Red tides occur in the same area (approximately 26-29°N, 82-83°W) almost every year, but the intense 2005 bloom led to a widespread hypoxic zone (dissolved oxygen <2 mg L-1) that caused mortalities of benthic communities, fish, turtles, birds, and marine mammals. Runoff alone provided insufficient nitrogen to support this bloom. We pose the hypothesis that submarine groundwater discharge (SGD) provides the missing nutrients, and indeed can trigger and support the recurrent red tides off west-central Florida. SGD inputs of dissolved inorganic nitrogen (DIN) in Tampa Bay alone are ~35% of that discharged by all central Florida rivers draining west combined. We propose that the unusual number of hurricanes in 2004 resulted in high runoff, and in higher than normal SGD emerging along the west Florida coast throughout 2005, initiating and fueling the persistent HAB. This mechanism may also explain recurrent red tides in other coastal regions of the Gulf of Mexico.

An epizootic of Florida manatees associated with a dinoflagellate bloom

USGS Publications Warehouse

O'Shea, T.J.; Rathbun, G.B.; Bonde, R.K.; Buergelt, C.D.; Odell, D.K.

1991-01-01

Over a 10-wk period in early 1982, 39 Florida manatees (Trichechus manatus latirostris) were found dead in the lower Caloosahatchee River and nearby waters of southwestern Florida. Two were killed by boats. The remainder showed no evidence of trauma. Lesions indicative of infectious agents were not identified, and bacteriological and contaminant residue findings were unremarkable. Nonspecific lesions of congestion and hemorrhage were identified in brain tissue. Numerous reports were also received of manatee morbidity. Some distressed manatees showed no biochemical lesions in clinical analyses of blood samples and recovered quickly. Timing of manatee illnesses coincided with fish and double-crested cormorant (Phalacrocorax auritus) mortality and morbidity. A widespread bloom of the dinoflagellate red tide organism (Gymnodinium breve) also coincided with these incidents. G. breve produces potent neurotoxins (brevetoxins). Circumstantial evidence links these events, and possible routes of exposure may include ingestion of filter-feeding ascidians. Ecological conditions that magnified the extent of the epizootic included an early dispersal of manatees into the area from a nearby winter aggregation site and unusually high salinities that facilitated the inshore spread of the red tide bloom. Management responses to future episodes of red tide in manatee areas are suggested.

The medically important aerobic actinomycetes: epidemiology and microbiology.

PubMed Central

McNeil, M M; Brown, J M

1994-01-01

The aerobic actinomycetes are soil-inhabiting microorganisms that occur worldwide. In 1888, Nocard first recognized the pathogenic potential of this group of microorganisms. Since then, several aerobic actinomycetes have been a major source of interest for the commercial drug industry and have proved to be extremely useful microorganisms for producing novel antimicrobial agents. They have also been well known as potential veterinary pathogens affecting many different animal species. The medically important aerobic actinomycetes may cause significant morbidity and mortality, in particular in highly susceptible severely immunocompromised patients, including transplant recipients and patients infected with human immunodeficiency virus. However, the diagnosis of these infections may be difficult, and effective antimicrobial therapy may be complicated by antimicrobial resistance. The taxonomy of these microorganisms has been problematic. In recent revisions of their classification, new pathogenic species have been recognized. The development of additional and more reliable diagnostic tests and of a standardized method for antimicrobial susceptibility testing and the application of molecular techniques for the diagnosis and subtyping of these microorganisms are needed to better diagnose and treat infected patients and to identify effective control measures for these unusual pathogens. We review the epidemiology and microbiology of the major medically important aerobic actinomycetes. Images PMID:7923055

Hurricanes, submarine groundwater discharge, and Florida's red tides

USGS Publications Warehouse

Hu, C.; Muller-Karger, F. E.; Swarzenski, P.W.

2006-01-01

A Karenia brevis Harmful Algal Bloom affected coastal waters shallower than 50 m off west-central Florida from January 2005 through January 2006, showing a sustained anomaly of ???1 mg chlorophyll m-3 over an area of up to 67,500 km2. Red tides occur in the same area (approximately 26-29??N, 82-83??W) almost every year, but the intense 2005 bloom led to a widespread hypoxic zone (dissolved oxygen <2 mg L-1) that caused mortalities of benthic communities, fish, turtles, birds, and marine mammals. Runoff alone provided insufficient nitrogen to support this bloom. We pose the hypothesis that submarine groundwater discharge (SGD) provides the missing nutrients, and indeed can trigger and support the recurrent red tides off west-central Florida. SGD inputs of dissolved inorganic nitrogen (DIN) in Tampa Bay alone are ???35% of that discharged by all central Florida rivers draining west combined. We propose that the unusual number of hurricanes in 2004 resulted in high runoff, and in higher than normal SGD emerging along the west Florida coast throughout 2005, initiating and fueling the persistent HAB. This mechanism may also explain recurrent red tides in other coastal regions of the Gulf of Mexico. Copyright 2006 by the American Geophysical Union.

Cervical lymph node metastasis in adenoid cystic carcinoma of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal: a collective international review.

PubMed

2016-12-01

To review reports of adenoid cystic carcinomas arising in the head and neck area outside of the major salivary glands, in order to enhance the care of patients with these unusual neoplasms. An international team of head and neck surgeons, pathologists, oncologists and radiation oncologists was assembled to explore the published experience and their own working experience of the diagnosis and treatment of adenoid cystic carcinomas arising in the vicinity of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal. The behaviour of adenoid cystic carcinoma arising in head and neck sites exclusive of the major salivary glands parallels that of tumours with a similar histology arising in the major salivary glands - these are relentless, progressive tumours, associated with high rates of mortality. Of 774 patients reviewed, at least 41 (5.3 per cent) developed documented regional node metastases. The relatively low overall incidence of nodal metastases in adenoid cystic carcinomas arising in the head and neck region outside of the major salivary glands suggests that routine elective regional lymph node dissection might not be indicated in most patients with these tumours.

Cervical lymph node metastasis in adenoid cystic carcinoma of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal: a collective international review

PubMed Central

2017-01-01

Objective To review reports of adenoid cystic carcinomas arising in the head and neck area outside of the major salivary glands, in order to enhance the care of patients with these unusual neoplasms. Methods An international team of head and neck surgeons, pathologists, oncologists and radiation oncologists was assembled to explore the published experience and their own working experience of the diagnosis and treatment of adenoid cystic carcinomas arising in the vicinity of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal. Results The behaviour of adenoid cystic carcinoma arising in head and neck sites exclusive of the major salivary glands parallels that of tumours with a similar histology arising in the major salivary glands – these are relentless, progressive tumours, associated with high rates of mortality. Of 774 patients reviewed, at least 41 (5.3 per cent) developed documented regional node metastases. Conclusion The relatively low overall incidence of nodal metastases in adenoid cystic carcinomas arising in the head and neck region outside of the major salivary glands suggests that routine elective regional lymph node dissection might not be indicated in most patients with these tumours. PMID:27839526

Necrotizing cellulitis with multiple abscesses on the leg caused by Serratia marcescens.

PubMed

Hau, Estelle; Bouaziz, Jean-David; Lafaurie, Matthieu; Saussine, Anne; Masson, Vincent; Rausky, Jonathan; Bagot, Martine; Guibal, Fabien

2016-03-01

Serratia marcescens is an unusual cause of severe skin infection initially described in immunocompromised patients. We report a case of necrotizing cellulitis of the leg caused by S marcescens in a 68-year-old woman with diabetes mellitus and a history of chronic lymphoedema of the leg. We reviewed the literature and found 49 cases of severe skin infections from S marcescens that included 20 cases of necrotizing fasciitis (NF) as well as 29 cases of severe skin infections without NF (non-NF cases). Patients were immunocompromised in 59% to 70% of cases. The mortality rate was high in NF cases (60%) versus non-NF cases (3%). Surgery was required in 95% of NF cases and in 24% of non-NF cases. The other clinical manifestations of S marcescens skin infection reported in the literature included disseminated papular eruptions in patients infected with human immunodeficiency virus with folliculitis on the trunk. Serratia marcescens is naturally resistant to amoxicillin alone and amoxicillin associated with clavulanic acid. Broad-spectrum antibiotics are indicated to treat S marcescens skin infections, and surgery should be promptly considered in cases of severe skin infections if appropriate antibiotic therapy does not lead to rapid improvement.

PCR/oligonucleotide probe typing of HLA class II alleles in a Filipino population reveals an unusual distribution of HLA haplotypes

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

Bugawan, T.L.; Chang, J.D.; Erlich, H.A.

1994-02-01

The authors have analyzed the distribution of HLA class II alleles and haplotypes in a Filipino population by PCR amplification of the DRB1, DQB1, and DPB1 second-exon sequences from buccal swabs obtained from 124 family members and 53 unrelated individuals. The amplified DNA was typed by using nonradioactive sequence-specific oligonucleotide probes. Twenty-two different DRB1 alleles, including the novel Filipino *1105, and 46 different DRB1/DQB1 haplotypes, including the unusual DRB1*0405-DQB1*0503, were identified. An unusually high frequency (f = .383) of DPB1*0101, a rare allele in other Asian populations, was also observed. In addition, an unusual distribution of DRB1 alleles and haplotypesmore » was seen in this population, with DR2 (f = .415) and DRB1*1502-DQB1*0502 (f = .233) present at high frequencies. This distribution of DRB1 alleles differs from the typical HLA population distribution, in which the allele frequencies are more evenly balanced. The distribution of HLA class II alleles and haplotypes in this Filipino population is different from that of other Asian and Pacific groups: of those populations studied to date, the Indonesian population is the most similar. DRB1*1502-DQB1*0502 was in strong linkage disequilibrium (D[prime] = .41) with DPB 1*0101 (f = .126, for the extended haplotype), which is consistent with selection for this DR, DQ, DP haplotype being responsible for the high frequency of these three class II alleles in this populations. 30 refs., 2 figs., 6 tabs.« less

Rhodium(I)-catalyzed cyclization of allenynes with a carbonyl group through unusual insertion of a C-O bond into a rhodacycle intermediate.

PubMed

Oonishi, Yoshihiro; Yokoe, Takayuki; Hosotani, Akihito; Sato, Yoshihiro

2014-01-20

Rhodium(I)-catalyzed cyclization of allenynes with a tethered carbonyl group was investigated. An unusual insertion of a CO bond into the C(sp(2) )-rhodium bond of a rhodacycle intermediate occurs via a highly strained transition state. Direct reductive elimination from the obtained rhodacyle intermediate proceeds to give a tricyclic product containing an 8-oxabicyclo[3.2.1]octane skeleton, while β-hydride elimination from the same intermediate gives products that contain fused five- and seven-membered rings in high yields. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Magnetic field drift shell splitting - Cause of unusual dayside particle pitch angle distributions during storms and substorms

NASA Technical Reports Server (NTRS)

Sibeck, D. G.; Mcentire, R. W.; Lui, A. T. Y.; Lopez, R. E.; Krimigis, S. M.

1987-01-01

This paper presents a magnetic field drift shell-splitting model for the unusual butterfly and head-and-shoulder energetic (E greater than 25 keV) particle pitch angle distributions (PADs) which appear deep within the dayside magnetosphere during the course of storms and substorms. Drift shell splitting separates the high and low pitch angle particles in nightside injections as they move to the dayside magnetosphere, so that the higher pitch angle particles move radially away from earth. Consequently, butterfly PADs with a surplus of low pitch angle particles form on the inner edge of the injection, but head-and-shoulder PADs with a surplus of high pitch angle particles form on the outer edge. A similar process removes high pitch angle particles from the inner dayside magnetosphere during storms, leaving the remaining lower pitch angle particles to form butterfly PADs on the inner edge of the ring current. A detailed case and statistical study of Charge Composition Explorer/Medium-energy Particle Analyzer observations, as well as a review of previous work, shows most examples of unusual PADs to be consistent with the model.

Ruptured profunda femoris aneurysm secondary to neurofibromatosis: vascular involvement in an unusual location.

PubMed

Emrecan, Bilgin; Onem, Gokhan; Susam, Ibrahim

2010-01-01

Neurofibromatosis is an autosomal dominant genetic disease characterized by abnormal growth that involves tissues of mesodermal and neuroectodermal origin. Aneurysms are rarely seen in peripheral arteries. This report presents a case of ruptured arterial aneurysm secondary to neurofibromatosis; the lesion occurred in the profunda femoris artery, a highly unusual location. Treatment of patients with ruptured arterial aneurysm secondary to neurofibromatosis may be interventional or surgical. In this case, a surgical approach was successful.

Hyperglycemia and Diabetic Ketoacidosis

MedlinePlus

... your child's age. Causes of High Blood Sugar Levels A major goal in controlling diabetes is to ... be unusually tired. Checking for High Blood Sugar Levels As part of the diabetes management plan, you' ...

Educational Differences in U.S. Adult Mortality: A Cohort Perspective*

PubMed Central

Masters, Ryan K.; Hummer, Robert A.; Powers, Daniel A.

2014-01-01

We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men’s and women’s mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk. PMID:25346542

Deadly intracranial bleed in patients with dengue fever: A series of nine patients and review of literature

PubMed Central

Sam, Jo Ee; Gee, Teak Sheng; Nasser, Abdul Wahab

2016-01-01

Introduction: Dengue fever is a global pandemic threat with increasing incidence. To date, there are no cures and the effectiveness of dengue vaccines is still uncertain. World Heath Organization introduced expanded dengue syndrome to include unusual presentations of dengue fever including severe neurologic complications. One of the deadly complications is intracranial hemorrhage (ICH). Methodology: We collected data of patients with ICH diagnosed via a plain computed tomography of the brain (CT brain) with thrombocytopenia and positive Dengue virus type 1 nonstructural protein (NS1) antigen test or positive dengue serology IgM from January 2014 till June 2015 at our center. Nine patients were included and all 20 other remaining patients reported in literature so far are discussed. Discussion: We found that all patients in our center requiring neurosurgical intervention died. Another interesting observation is that detection of Dengue IgG usually meant more severe ICH and poorer outcomes. From our series, platelet levels did not seem to influence the outcome. Conclusion: We recommend that for early detection of ICH, Dengue IgG should be routinely screened and a high index of suspicion be maintained. Future research should be focused on determining predictors of ICH in patients with dengue fever so that preventive steps can be taken as mortality is high and no treatment seems beneficial at the moment once severe ICH occurs. PMID:27365962

7 CFR 3201.41 - Metalworking fluids.

Code of Federal Regulations, 2013 CFR

2013-01-01

... feedstock during grinding and machining operations involving unusually high temperatures or corrosion... prevention when applied to metal feedstock during normal grinding and machining operations. (iii) High... percent. (3) High performance soluble, semi-synthetic, and synthetic oils—40 percent. (c) Preference...

7 CFR 3201.41 - Metalworking fluids.

Code of Federal Regulations, 2012 CFR

2012-01-01

... feedstock during grinding and machining operations involving unusually high temperatures or corrosion... prevention when applied to metal feedstock during normal grinding and machining operations. (iii) High... percent. (3) High performance soluble, semi-synthetic, and synthetic oils—40 percent. (c) Preference...

7 CFR 3201.41 - Metalworking fluids.

Code of Federal Regulations, 2014 CFR

2014-01-01

... feedstock during grinding and machining operations involving unusually high temperatures or corrosion... prevention when applied to metal feedstock during normal grinding and machining operations. (iii) High... percent. (3) High performance soluble, semi-synthetic, and synthetic oils—40 percent. (c) Preference...

Causes and implications of the correlation between forest productivity and tree mortality rates

USGS Publications Warehouse

Stephenson, Nathan L.; van Mantgem, Philip J.; Bunn, Andrew G.; Bruner, Howard; Harmon, Mark E.; O'Connell, Kari B.; Urban, Dean L.; Franklin, Jerry F.

2011-01-01

For only one of these four mechanisms, competition, can high mortality rates be considered to be a relatively direct consequence of high NPP. The remaining mechanisms force us to adopt a different view of causality, in which tree growth rates and probability of mortality can vary with at least a degree of independence along productivity gradients. In many cases, rather than being a direct cause of high mortality rates, NPP may remain high in spite of high mortality rates. The independent influence of plant enemies and other factors helps explain why forest biomass can show little correlation, or even negative correlation, with forest NPP.

A Diverticular ‘Pain in the Bottom’

PubMed Central

Bardhan, Suchi K; Morgan, Emma; Daniels, Ian R; Mortensen, Neil J

2006-01-01

This is the case of a 40-year-old man with a gluteal abscess as the first presentation of diverticular disease. As well as the unusual site, imaging revealed the lack of a connective tract between the abscess and the abdominal cavity or retroperitoneum. In addition, a lack of gastrointestinal symptoms made this case very unusual. Hence, this highlights the need for a high index of clinical suspicion when the usual clinical pointers that guide to the diagnosis of diverticulitis are absent. PMID:16834842

A diverticular 'pain in the bottom'.

PubMed

Bardhan, Suchi K; Morgan, Emma; Daniels, Ian R; Mortensen, Neil J

2006-07-01

This is the case of a 40-year-old man with a gluteal abscess as the first presentation of diverticular disease. As well as the unusual site, imaging revealed the lack of a connective tract between the abscess and the abdominal cavity or retroperitoneum. In addition, a lack of gastrointestinal symptoms made this case very unusual. Hence, this highlights the need for a high index of clinical suspicion when the usual clinical pointers that guide to the diagnosis of diverticulitis are absent.

Rare Orbital Infections ~ State of the Art ~ Part II

PubMed Central

Hamed-Azzam, Shirin; AlHashash, Islam; Briscoe, Daniel; Rose, Geoffrey E; Verity, David H.

2018-01-01

Infections of the orbit and periorbita are relatively frequent. Identifying unusual organisms is crucial because they can cause severe local and systemic morbidity, despite their rarity. Opportunistic infections of the orbit should be considered mainly in debilitated or immunocompromised patients. The key to successful management includes a high index of suspicion, prompt diagnosis, and addressing the underlying systemic disease. This review summarizes unusual infectious processes of the orbit, including mycobacterial, fungal, and parasitic infections, as well as their pathophysiology, symptoms, signs, and treatment. PMID:29719648

Queensland tick typhus: three cases with unusual clinical features.

PubMed

Wilson, P A; Tierney, L; Lai, K; Graves, S

2013-07-01

Queensland tick typhus (QTT), caused by Rickettsia australis, is usually a relatively mild illness but can occasionally be severe. We describe three cases of probable QTT with unusual clinical features, namely splenic infarction, fulminant myopericarditis and severe leukocytoclastic vasculitis. QTT may present with uncommon clinical features in addition to the more common manifestations. A high index of suspicion enables specific antibiotic therapy that may hasten recovery. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis.

PubMed

Ding, Zan; Guo, Pi; Xie, Fang; Chu, Huifang; Li, Kun; Pu, Jingbo; Pang, Shaojie; Dong, Hongli; Liu, Yahui; Pi, Fuhua; Zhang, Qingying

2015-09-01

Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age ≥75 years. The effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

Gestational Age Patterns of Fetal and Neonatal Mortality in Europe: Results from the Euro-Peristat Project

PubMed Central

Mohangoo, Ashna D.; Buitendijk, Simone E.; Szamotulska, Katarzyna; Chalmers, Jim; Irgens, Lorentz M.; Bolumar, Francisco; Nijhuis, Jan G.; Zeitlin, Jennifer

2011-01-01

Background The first European Perinatal Health Report showed wide variability between European countries in fetal (2.6–9.1‰) and neonatal (1.6–5.7‰) mortality rates in 2004. We investigated gestational age patterns of fetal and neonatal mortality to improve our understanding of the differences between countries with low and high mortality. Methodology/Principal Findings Data on 29 countries/regions participating in the Euro-Peristat project were analyzed. Most European countries had no limits for the registration of live births, but substantial variations in limits for registration of stillbirths before 28 weeks of gestation existed. Country rankings changed markedly after excluding deaths most likely to be affected by registration differences (22–23 weeks for neonatal mortality and 22–27 weeks for fetal mortality). Countries with high fetal mortality ≥28 weeks had on average higher proportions of fetal deaths at and near term (≥37 weeks), while proportions of fetal deaths at earlier gestational ages (28–31 and 32–36 weeks) were higher in low fetal mortality countries. Countries with high neonatal mortality rates ≥24 weeks, all new member states of the European Union, had high gestational age-specific neonatal mortality rates for all gestational-age subgroups; they also had high fetal mortality, as well as high early and late neonatal mortality. In contrast, other countries with similar levels of neonatal mortality had varying levels of fetal mortality, and among these countries early and late neonatal mortality were negatively correlated. Conclusions For valid European comparisons, all countries should register births and deaths from at least 22 weeks of gestation and should be able to distinguish late terminations of pregnancy from stillbirths. After excluding deaths most likely to be influenced by existing registration differences, important variations in both levels and patterns of fetal and neonatal mortality rates were found. These disparities raise questions for future research about the effectiveness of medical policies and care in European countries. PMID:22110575

Decompensated Heart Failure in Pregnancy

PubMed Central

Anthony, John

2016-01-01

Heart disease is a common cause of morbidity and mortality during pregnancy. Symptoms and signs of heart failure in a pregnant woman are an indication for urgent assessment to establish a diagnosis and appropriate management. This is best accomplished through a multidisciplinary approach in which both cardiologists and obstetricians need to participate in order to provide expert counselling and care in pursuit of safe motherhood. Congenital heart disease, although common, once corrected is an unusual source of complications, which are more likely to develop as a consequence of ventricular failure, pulmonary hypertension and aortic arch disease. Rheumatic valvular heart disease is a challenge because of the need for anticoagulation during pregnancy and the risk of sepsis associated with childbirth. This review outlines a contemporary approach to heart failure presenting during pregnancy. PMID:28785449

Cold induced mortality of the Burmese Python: An explanation via stochastic analysis

NASA Astrophysics Data System (ADS)

Quansah, Emmanuel; Parshad, Rana D.; Mondal, Sumona

2017-02-01

The Burmese python (Python bivitatus) is an invasive species, wreaking havoc on indigenous species in the Florida everglades. Data suggests an exponential growth in their population from 1995 to 2009, with a sharp decline however in 2010-2012 (Dorcas et al., 2012). In Mazzotti et al. (2011) an explanation is provided, citing the unusually cold winter that year, as the primary reason for this decline. We provide a first mathematical model, in the form of a system of stochastic differential equations, that supports the explanation in Mazzotti et al. (2011), by accurately matching the field data presented in Dorcas et al. (2012). More generally, our model provides a tool to predict the population dynamics of rapidly growing alien species, in the advent of climate change.

Unexpected metastatic pheochromocytoma - an unusual presentation.

PubMed

Birrenbach, Tanja; Stanga, Zeno; Cottagnoud, Philippe; Stucki, Armin

2008-01-01

The classic triad of pheochromocytoma consists of episodic headache, sweating, and tachycardia. General clinicians should be aware, however, that this rare entity might present with a wide spectrum of clinical symptoms. We recently observed a noteworthy case of malignant pheochromocytoma where there was a lack of specific symptoms despite an advanced tumor stage. Malignancy is an important cause of mortality. Reliable diagnosis of malignancy depends upon evidence of local invasion, distant metastases, or recurrence. As in our case, new scintigraphic methods, such as 111-In-pentetreotide scintigraphy (Octreoscan), may occasionally reveal 123-I-metaiodobenzylguanidine-negative distant metastases and help to establish an early diagnosis of malignancy. Tumor size, and perhaps even biochemical profile, may be factors increasing the likelihood of a malignant process and may contribute to early identification of patients at risk.

Multiple pilomatrixomas in a survivor of WNT-activated medulloblastoma leading to the discovery of a germline APC mutation and the diagnosis of familial adenomatous polyposis.

PubMed

Bendelsmith, Charles R; Skrypek, Mary M; Patel, Sachin R; Pond, Dinel A; Linabery, Amy M; Bendel, Anne E

2018-01-01

Because children diagnosed with WNT-activated medulloblastoma have a 10-year overall survival rate of 95%, active long-term follow-up is critically important in reducing mortality from other causes. Here, we describe an 11-year-old adopted female who developed multiple pilomatrixomas 3 years after diagnosis of WNT-activated medulloblastoma, an unusual finding that prompted deeper clinical investigation. A heterozygous germline APC gene mutation was discovered, consistent with familial adenomatous polyposis. Screening endoscopy revealed numerous precancerous polyps that were excised. This case highlights the importance of long-term follow-up of pediatric cancer survivors, including attention to unexpected symptoms, which might unveil an underlying cancer predisposition syndrome. © 2017 Wiley Periodicals, Inc.

Churg-Strauss syndrome associated with rapid deterioration of left ventricular diastolic dysfunction and conduction disturbance.

PubMed

Chin, Jung Yeon; Yi, Jeong Eun; Youn, Ho-Joong

2013-10-01

Cardiac involvement in Churg-Strauss syndrome (CSS) is a major cause of mortality. Here we report a case of a 75-year-old woman with eosinophilic endomyocarditis due to CSS. An electrocardiogram showed intraventricular conduction delay, and echocardiography showed an impaired relaxation pattern and biventricular apical thickening. Magnetic resonance imaging revealed subendocardial delayed enhancement with biventricular apical thrombi. Endomyocardial biopsy showed perivascular eosinophilic infiltration. Despite resolution of the hypereosinophilia after steroid therapy, her left ventricular (LV) diastolic function worsened into a restrictive pattern and she died with a ventricular escape rhythm on her 14th day in the hospital. This case is unusual in that there was rapid progression of the LV diastolic dysfunction and conduction disturbance due to CSS. © 2013, Wiley Periodicals, Inc.

Magnet balls stuck to the frenulum of the lip.

PubMed

Kondamudi, Noah P; Ayush Gupta; Kaur, Ranbir

2014-03-01

Accidents associated with magnets as foreign bodies pose a serious threat to the health of children and adolescents. Prompt management and removal of the magnet is important to avoid life-threatening complications. Our aim was to highlight an unusual health hazard associated with magnets in children. We report on a unique case of an adolescent girl who presented with two magnet balls stuck to the frenulum of her upper lip, resulting in intense pain and discomfort. The magnets were removed painlessly by induced magnetism through metallic mosquito forceps. As children experiment with toys and products containing detachable magnetic balls, more cases will likely present to emergency departments. Increased awareness and preventive measures should be undertaken to reduce the morbidity and mortality associated with magnets. Copyright © 2014 Elsevier Inc. All rights reserved.

Unusual transformation from strong negative to positive thermal expansion in PbTiO3-BiFeO3 perovskite.

PubMed

Chen, Jun; Fan, Longlong; Ren, Yang; Pan, Zhao; Deng, Jinxia; Yu, Ranbo; Xing, Xianran

2013-03-15

Tetragonal PbTiO(3)-BiFeO(3) exhibits a strong negative thermal expansion in the PbTiO(3)-based ferroelectrics that consist of one branch in the family of negative thermal expansion materials. Its strong negative thermal expansion is much weakened, and then unusually transforms into positive thermal expansion as the particle size is slightly reduced. This transformation is a new phenomenon in the negative termal expansion materials. The detailed structure, temperature dependence of unit cell volume, and lattice dynamics of PbTiO(3)-BiFeO(3) samples were studied by means of high-energy synchrotron powder diffraction and Raman spectroscopy. Such unusual transformation from strong negative to positive thermal expansion is highly associated with ferroelectricity weakening. An interesting zero thermal expansion is achieved in a wide temperature range (30-500 °C) by adjusting particle size due to the negative-to-positive transformation character. The present study provides a useful method to control the negative thermal expansion not only for ferroelectrics but also for those functional materials such as magnetics and superconductors.

An Intense Polarized Radio Flare from AR Lac

NASA Astrophysics Data System (ADS)

Mutel, R. L.; Neff, J. E.; Bookbinder, J.; Pagano, I.

1992-12-01

We have detected an intense, highly circularly polarized radio flare from the close binary system AR Lacertae during a 4 day multi-wavelength observing campaign in 1991 December. The flare lasted more than 6 hours and was preceded by a strong CIV flare one day earlier. The peak circular polarization was 70%, 38%,and 39% RCP at 1.4, 4.9, and 8.4 GHz respectively, with ~ 15% LCP at 15 and 22 GHZ. The high degree of circular polarization over such a large time scale and frequency range is highly unusual compared with previously observed radio flares from RS CVn binaries. Given these unusual characteristics, it is difficult to interpret the radiation mechanism either as a result of gyrosynchrotron emission or a coherent process such as an electron cyclotron maser.

Synthesis of sodium polyhydrides at high pressures

NASA Astrophysics Data System (ADS)

Struzhkin, Viktor V.; Kim, Duck Young; Stavrou, Elissaios; Muramatsu, Takaki; Mao, Ho-Kwang; Pickard, Chris J.; Needs, Richard J.; Prakapenka, Vitali B.; Goncharov, Alexander F.

2016-07-01

The only known compound of sodium and hydrogen is archetypal ionic NaH. Application of high pressure is known to promote states with higher atomic coordination, but extensive searches for polyhydrides with unusual stoichiometry have had only limited success in spite of several theoretical predictions. Here we report the first observation of the formation of polyhydrides of Na (NaH3 and NaH7) above 40 GPa and 2,000 K. We combine synchrotron X-ray diffraction and Raman spectroscopy in a laser-heated diamond anvil cell and theoretical random structure searching, which both agree on the stable structures and compositions. Our results support the formation of multicenter bonding in a material with unusual stoichiometry. These results are applicable to the design of new energetic solids and high-temperature superconductors based on hydrogen-rich materials.

An Award Winning Design for Downtown Manhattan High School

ERIC Educational Resources Information Center

Modern Schools, 1974

1974-01-01

New York City's downtown Commercial High School will be completely air conditioned with an unusual all-air, variable air volume system that will keep students and teachers comfortable throughout the year. (Author/MF)

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

Bozovic, I.; Wu, J.; He, X.

Over the course of three decades of intense study, apart from the exceptionally high critical temperature, many unusual properties of cuprates have been discovered, notably including resistivity linear in temperature, electronic Raman continuum and optical absorption extending throughout the infrared region, pseudogap, hour-glass spin excitation spectrum, etc. However, each of these features have been also observed in other materials, including some that are not even superconducting at all. Here, we describe an extensive experiment in which over 2,000 films of the La 2-xSr xCuO 4 have been synthesized and studied in detail over the course of the last twelve years.more » We argue here that, uniquely, in the cuprates an unusual superconducting state, that defies the standard BCS description, develops from an unusual metallic state, in which the rotational symmetry of the electron fluid is spontaneously broken.« less

Big Jump of Record Warm Global Mean Surface Temperature in 2014-2016 Related to Unusually Large Oceanic Heat Releases

NASA Astrophysics Data System (ADS)

Yin, Jianjun; Overpeck, Jonathan; Peyser, Cheryl; Stouffer, Ronald

2018-01-01

A 0.24°C jump of record warm global mean surface temperature (GMST) over the past three consecutive record-breaking years (2014-2016) was highly unusual and largely a consequence of an El Niño that released unusually large amounts of ocean heat from the subsurface layer of the northwestern tropical Pacific. This heat had built up since the 1990s mainly due to greenhouse-gas (GHG) forcing and possible remote oceanic effects. Model simulations and projections suggest that the fundamental cause, and robust predictor of large record-breaking events of GMST in the 21st century, is GHG forcing rather than internal climate variability alone. Such events will increase in frequency, magnitude, and duration, as well as impact, in the future unless GHG forcing is reduced.

'Snake River (SR)-type' volcanism at the Yellowstone hotspot track: Distinctive products from unusual, high-temperature silicic super-eruptions

USGS Publications Warehouse

Branney, M.J.; Bonnichsen, B.; Andrews, G.D.M.; Ellis, B.; Barry, T.L.; McCurry, M.

2008-01-01

A new category of large-scale volcanism, here termed Snake River (SR)-type volcanism, is defined with reference to a distinctive volcanic facies association displayed by Miocene rocks in the central Snake River Plain area of southern Idaho and northern Nevada, USA. The facies association contrasts with those typical of silicic volcanism elsewhere and records unusual, voluminous and particularly environmentally devastating styles of eruption that remain poorly understood. It includes: (1) large-volume, lithic-poor rhyolitic ignimbrites with scarce pumice lapilli; (2) extensive, parallel-laminated, medium to coarse-grained ashfall deposits with large cuspate shards, crystals and a paucity of pumice lapilli; many are fused to black vitrophyre; (3) unusually extensive, large-volume rhyolite lavas; (4) unusually intense welding, rheomorphism, and widespread development of lava-like facies in the ignimbrites; (5) extensive, fines-rich ash deposits with abundant ash aggregates (pellets and accretionary lapilli); (6) the ashfall layers and ignimbrites contain abundant clasts of dense obsidian and vitrophyre; (7) a bimodal association between the rhyolitic rocks and numerous, coalescing low-profile basalt lava shields; and (8) widespread evidence of emplacement in lacustrine-alluvial environments, as revealed by intercalated lake sediments, ignimbrite peperites, rhyolitic and basaltic hyaloclastites, basalt pillow-lava deltas, rhyolitic and basaltic phreatomagmatic tuffs, alluvial sands and palaeosols. Many rhyolitic eruptions were high mass-flux, large volume and explosive (VEI 6-8), and involved H2O-poor, low-??18O, metaluminous rhyolite magmas with unusually low viscosities, partly due to high magmatic temperatures (900-1,050??C). SR-type volcanism contrasts with silicic volcanism at many other volcanic fields, where the fall deposits are typically Plinian with pumice lapilli, the ignimbrites are low to medium grade (non-welded to eutaxitic) with abundant pumice lapilli or fiamme, and the rhyolite extrusions are small volume silicic domes and coule??es. SR-type volcanism seems to have occurred at numerous times in Earth history, because elements of the facies association occur within some other volcanic fields, including Trans-Pecos Texas, Etendeka-Paran, Lebombo, the English Lake District, the Proterozoic Keewanawan volcanics of Minnesota and the Yardea Dacite of Australia. ?? Springer-Verlag 2007.

A never-ending succession of epidemics? Mortality in early-modern York.

PubMed

Galley, C

1994-04-01

Early-modern cities are often perceived to be centres of high mortality and under constant siege from a barrage of epidemics. However, few urban mortality rates have been calculated and by employing parish register evidence from the regional capital of York, the thesis that the city was subjected to continual sudden increases in mortality can be firmly rejected. Infant mortality was high but remained virtually constant between 1561 and 1700. About a quarter of all infants did not survive to reach their first birthday and neonatal mortality was especially severe. From the mid-seventeenth century a series of epidemics increased child mortality although overall levels of mortality were not significantly affected. Relatively little can be said about adult mortality and apart from two periods of 'crisis' mortality there is little to suggest that adults were greatly affected by epidemics. Indeed, for many adults the urban environment appears to have posed no great threat to health and most could look forward to a relatively long life in the city. York's mortality regime was very similar to that of the smaller market town of Gainsborough where high levels of mortality remained stable throughout much of the early-modern period.

Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.

PubMed

Finegold, Judith A; Asaria, Perviz; Francis, Darrel P

2013-09-30

Ischaemic heart disease (IHD) is the leading cause of death worldwide. The World Health Organisation (WHO) collects mortality data coded using the International Statistical Classification of Diseases (ICD) code. We analysed IHD deaths world-wide between 1995 and 2009 and used the UN population database to calculate age-specific and directly and indirectly age-standardised IHD mortality rates by country and region. IHD is the single largest cause of death worldwide, causing 7,249,000 deaths in 2008, 12.7% of total global mortality. There is more than 20-fold variation in IHD mortality rates between countries. Highest IHD mortality rates are in Eastern Europe and Central Asian countries; lowest rates in high income countries. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries. Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries now account for more than 80% of global IHD deaths. The global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. In high income countries, population ageing maintains IHD as the leading cause of death. Nevertheless, the progressive decline in age-standardised IHD mortality in high income countries shows that increasing IHD mortality is not inevitable. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Dual impact of temperature on growth and mortality of marine fish larvae in a shallow estuarine habitat

NASA Astrophysics Data System (ADS)

Arula, Timo; Laur, Kerli; Simm, Mart; Ojaveer, Henn

2015-12-01

High individual growth and mortality rates of herring Clupea harengus membras and goby Pomatoschistus spp. larvae were observed in the estuarine habitat of the Gulf of Riga, Baltic Sea. Both instantaneous mortality (0.76-1.05) as well as growth rate (0.41-0.82 mm day-1) of larval herring were amongst highest observed elsewhere previously. Mortality rates of goby larvae were also high (0.57-1.05), while first ever data on growth rates were provided in this study (0.23-0.35 mm day-1). Our study also evidenced that higher growth rate of marine fish larvae did not result in lower mortalities. We suggest that high growth and mortality rates primarily resulted from a rapidly increasing and high (>18 °C) water temperature that masked potential food-web effects. The explanation for observed patterns lies in the interactive manner temperature contributed: i) facilitating prey production, which supported high growth rate and decreased mortalities; ii) exceeding physiological thermal optimum of larvae, which resulted in decreased growth rate and generally high mortalities. Our investigation suggests that the projected climate warming may have significant effect on early life history stages of the dominating marine fish species inhabiting shallow estuaries.

Diagnosis of systemic lupus erythematosus in an unusual presentation: what a primary care physician should know.

PubMed

Pramanik, Bimalendu

2014-01-01

Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease affecting millions of people worldwide. It can affect any organ systems of the body. However, all systems may not be involved initially rather than they may be affected gradually, sometimes over years. Diagnosis depends on characteristic clinical features and laboratory test results. Some features such as skin rash, joint symptoms and oral ulcers are common in SLE. But initial presentation of many patients is unusual because either they do not have these common features of the disease or the presentation mimics other illnesses. As a result, delayed diagnosis and misdiagnosis are common. Therefore, high index of initial suspicion of SLE is critical. In clinical practice, SLE should be suspected in any patient presenting with an unexplained disease process involving two or more organ systems. To make a diagnosis in an unusual presentation, thorough clinical evaluation with details history of both present and past illnesses as well as laboratory tests for SLE should be performed. Usually primary-care physicians first evaluate SLE patients; but there is no single article, where all the information on when to suspect SLE in an unusual presentation, is available in an integrated form. In this article, a list of conditions, when SLE should be suspected in an unusual presentation, has been given and some relatively common areas with diagnostic challenges of SLE have been briefly described. To prepare this manuscript, most articles have been identified through 'Pubmed' search using keywords-atypical/ unusual presentation of SLE, case reports on SLE, gastrointestinal manifestations of SLE, neuropsychiatric SLE, diagnostic challenges with SLE, etc. Selected most articles are from currently medline-indexed journals.

Mars Ascent Vehicle Needs Technology Development with a Focus on High Propellant Fractions

NASA Astrophysics Data System (ADS)

Whitehead, J. C.

2018-04-01

Launching from Mars to orbit requires a miniature launch vehicle, beyond any known spacecraft propulsion. The Mars Ascent Vehicle (MAV) needs an unusually high propellant mass fraction. MAV mass has high leverage for the cost of Mars Sample Return.

High blood glucose independent of pre-existing diabetic status predicts mortality in patients initiating peritoneal dialysis therapy.

PubMed

Chung, Sung Hee; Han, Dong Cheol; Noh, Hyunjin; Jeon, Jin Seok; Kwon, Soon Hyo; Lindholm, Bengt; Lee, Hi Bahl

2015-06-01

Poor glycemic control associates with increased mortality in diabetic (DM) dialysis patients, but it is less well established whether high blood glucose (BG) independent of pre-existing diabetic status associates with mortality in dialysis patients. We assessed factors affecting BG at the start of peritoneal dialysis (PD) and its mortality-predictive impact in Korean PD patients. In 174 PD patients (55 % males, 56 % DM), BG, nutritional status, comorbidity (CMD), and residual renal function (RRF) were assessed in conjunction with dialysis initiation. Determinants of BG and its association with mortality after a mean follow-up period of 30 ± 24 months were analyzed. On Cox proportional hazards analysis comprising all patients, old age, high CMD score, presence of protein energy wasting, and low serum albumin (Salb) concentration were independent predictors of mortality but not a high-BG level, while in patients without pre-existing diabetic status, high BG, together with old age and high CMD score, was an independent predictor of mortality. After adjustment for age, CMD score, and Salb, the risk ratio for mortality increased by 12 % per 1 mg/dL increase in BG in the non-DM patients. Patient survival in patients without pre-existing diabetic status with high BG did not differ from DM patients, but the survival of patients with high BG was significantly lower than in patients with low BG. In patients without pre-existing diabetic status, in multiple regression analysis, high BG at initiation of PD associated with high age, high body mass index, and low RRF. High blood glucose at initiation of PD associated with an increased mortality risk in PD patients without pre-existing diabetic status suggesting that blood glucose monitoring and surveillance of factors contributing to poor glycemic control are warranted in patients initiating PD therapy.

Mortality Attributable to Low Levels of Education in the United States.

PubMed

Krueger, Patrick M; Tran, Melanie K; Hummer, Robert A; Chang, Virginia W

2015-01-01

Educational disparities in U.S. adult mortality are large and have widened across birth cohorts. We consider three policy relevant scenarios and estimate the mortality attributable to: (1) individuals having less than a high school degree rather than a high school degree, (2) individuals having some college rather than a baccalaureate degree, and (3) individuals having anything less than a baccalaureate degree rather than a baccalaureate degree, using educational disparities specific to the 1925, 1935, and 1945 cohorts. We use the National Health Interview Survey data (1986-2004) linked to prospective mortality through 2006 (N=1,008,949), and discrete-time survival models, to estimate education- and cohort-specific mortality rates. We use those mortality rates and data on the 2010 U.S. population from the American Community Survey, to calculate annual attributable mortality estimates. If adults aged 25-85 in the 2010 U.S. population experienced the educational disparities in mortality observed in the 1945 cohort, 145,243 deaths could be attributed to individuals having less than a high school degree rather than a high school degree, 110,068 deaths could be attributed to individuals having some college rather than a baccalaureate degree, and 554,525 deaths could be attributed to individuals having anything less than a baccalaureate degree rather than a baccalaureate degree. Widening educational disparities between the 1925 and 1945 cohorts result in a doubling of attributable mortality. Mortality attributable to having less than a high school degree is proportionally similar among women and men and among non-Hispanic blacks and whites, and is greater for cardiovascular disease than for cancer. Mortality attributable to low education is comparable in magnitude to mortality attributable to individuals being current rather than former smokers. Existing research suggests that a substantial part of the association between education and mortality is causal. Thus, policies that increase education could significantly reduce adult mortality.

Mortality Attributable to Low Levels of Education in the United States

PubMed Central

Krueger, Patrick M.; Tran, Melanie K.; Hummer, Robert A.; Chang, Virginia W.

2015-01-01

Background Educational disparities in U.S. adult mortality are large and have widened across birth cohorts. We consider three policy relevant scenarios and estimate the mortality attributable to: (1) individuals having less than a high school degree rather than a high school degree, (2) individuals having some college rather than a baccalaureate degree, and (3) individuals having anything less than a baccalaureate degree rather than a baccalaureate degree, using educational disparities specific to the 1925, 1935, and 1945 cohorts. Methods We use the National Health Interview Survey data (1986–2004) linked to prospective mortality through 2006 (N=1,008,949), and discrete-time survival models, to estimate education- and cohort-specific mortality rates. We use those mortality rates and data on the 2010 U.S. population from the American Community Survey, to calculate annual attributable mortality estimates. Results If adults aged 25–85 in the 2010 U.S. population experienced the educational disparities in mortality observed in the 1945 cohort, 145,243 deaths could be attributed to individuals having less than a high school degree rather than a high school degree, 110,068 deaths could be attributed to individuals having some college rather than a baccalaureate degree, and 554,525 deaths could be attributed to individuals having anything less than a baccalaureate degree rather than a baccalaureate degree. Widening educational disparities between the 1925 and 1945 cohorts result in a doubling of attributable mortality. Mortality attributable to having less than a high school degree is proportionally similar among women and men and among non-Hispanic blacks and whites, and is greater for cardiovascular disease than for cancer. Conclusions Mortality attributable to low education is comparable in magnitude to mortality attributable to individuals being current rather than former smokers. Existing research suggests that a substantial part of the association between education and mortality is causal. Thus, policies that increase education could significantly reduce adult mortality. PMID:26153885

Identifying and Targeting Mortality Disparities: A Framework for Sub-Saharan Africa Using Adult Mortality Data from South Africa

PubMed Central

Sartorius, Benn; Sartorius, Kurt

2013-01-01

Background Health inequities in developing countries are difficult to eradicate because of limited resources. The neglect of adult mortality in Sub-Saharan Africa (SSA) is a particular concern. Advances in data availability, software and analytic methods have created opportunities to address this challenge and tailor interventions to small areas. This study demonstrates how a generic framework can be applied to guide policy interventions to reduce adult mortality in high risk areas. The framework, therefore, incorporates the spatial clustering of adult mortality, estimates the impact of a range of determinants and quantifies the impact of their removal to ensure optimal returns on scarce resources. Methods Data from a national cross-sectional survey in 2007 were used to illustrate the use of the generic framework for SSA and elsewhere. Adult mortality proportions were analyzed at four administrative levels and spatial analyses were used to identify areas with significant excess mortality. An ecological approach was then used to assess the relationship between mortality “hotspots” and various determinants. Population attributable fractions were calculated to quantify the reduction in mortality as a result of targeted removal of high-impact determinants. Results Overall adult mortality rate was 145 per 10,000. Spatial disaggregation identified a highly non-random pattern and 67 significant high risk local municipalities were identified. The most prominent determinants of adult mortality included HIV antenatal sero-prevalence, low SES and lack of formal marital union status. The removal of the most attributable factors, based on local area prevalence, suggest that overall adult mortality could be potentially reduced by ∼90 deaths per 10,000. Conclusions The innovative use of secondary data and advanced epidemiological techniques can be combined in a generic framework to identify and map mortality to the lowest administration level. The identification of high risk mortality determinants allows health authorities to tailor interventions at local level. This approach can be replicated elsewhere. PMID:23967209

Tree Mortality

Treesearch

Mark J. Ambrose

2011-01-01

Tree mortality is a natural process in all forest ecosystems, but it can also be an indicator of forest health issues. On a regional scale, high-mortality levels may indicate widespread insect or disease problems. Regionally high mortality may also occur if a large proportion of the forests in an area are made up of older, senescent stands.

Platelet count and total and cause-specific mortality in the Women's Health Initiative.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Verma, Amit K; Manson, JoAnn E; Lin, Juan; Lessin, Lawrence; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

2017-04-01

We used data from the Women's Health Initiative to examine the association of platelet count with total mortality, coronary heart disease (CHD) mortality, cancer mortality, and non-CHD/noncancer mortality. Platelet count was measured at baseline in 159,746 postmenopausal women and again in year 3 in 75,339 participants. Participants were followed for a median of 15.9 years. Cox proportional hazards models were used to estimate the relative mortality hazards associated with deciles of baseline platelet count and of the mean of baseline + year 3 platelet count. Low and high deciles of both baseline and mean platelet count were positively associated with total mortality, CHD mortality, cancer mortality, and non-CHD/noncancer mortality. The association was robust and was not affected by adjustment for a number of potential confounding factors, exclusion of women with comorbidity, or allowance for reverse causality. Low- and high-platelet counts were associated with all four outcomes in never smokers, former smokers, and current smokers. In this large study of postmenopausal women, both low- and high-platelet counts were associated with total and cause-specific mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of diurnal temperature range on mortality in Hefei city, China

NASA Astrophysics Data System (ADS)

Tang, Jing; Xiao, Chang-chun; Li, Yu-rong; Zhang, Jun-qing; Zhai, Hao-yuan; Geng, Xi-ya; Ding, Rui; Zhai, Jin-xia

2017-12-01

Although several studies indicated an association between diurnal temperature range (DTR) and mortality, the results about modifiers are inconsistent, and few studies were conducted in developing inland country. This study aims to evaluate the effects of DTR on cause-specific mortality and whether season, gender, or age might modify any association in Hefei city, China, during 2007-2016. Quasi-Poisson generalized linear regression models combined with a distributed lag non-linear model (DLNM) were applied to evaluate the relationships between DTR and non-accidental, cardiovascular, and respiratory mortality. We observed a J-shaped relationship between DTR and cause-specific mortality. With a DTR of 8.3 °C as the reference, the cumulative effects of extremely high DTR were significantly higher for all types of mortality than effects of lower or moderate DTR in full year. When stratified by season, extremely high DTR in spring had a greater impact on all cause-specific mortality than other three seasons. Male and the elderly (≥ 65 years) were consistently more susceptible to extremely high DTR effect than female and the youth (< 65 years) for non-accidental and cardiovascular mortality. To the contrary, female and the youth were more susceptible to extremely high DTR effect than male and the elderly for respiratory morality. The study suggests that extremely high DTR is a potential trigger for non-accidental mortality in Hefei city, China. Our findings also highlight the importance of protecting susceptible groups from extremely high DTR especially in the spring.

Effects of diurnal temperature range on mortality in Hefei city, China

NASA Astrophysics Data System (ADS)

Tang, Jing; Xiao, Chang-chun; Li, Yu-rong; Zhang, Jun-qing; Zhai, Hao-yuan; Geng, Xi-ya; Ding, Rui; Zhai, Jin-xia

2018-05-01

Although several studies indicated an association between diurnal temperature range (DTR) and mortality, the results about modifiers are inconsistent, and few studies were conducted in developing inland country. This study aims to evaluate the effects of DTR on cause-specific mortality and whether season, gender, or age might modify any association in Hefei city, China, during 2007-2016. Quasi-Poisson generalized linear regression models combined with a distributed lag non-linear model (DLNM) were applied to evaluate the relationships between DTR and non-accidental, cardiovascular, and respiratory mortality. We observed a J-shaped relationship between DTR and cause-specific mortality. With a DTR of 8.3 °C as the reference, the cumulative effects of extremely high DTR were significantly higher for all types of mortality than effects of lower or moderate DTR in full year. When stratified by season, extremely high DTR in spring had a greater impact on all cause-specific mortality than other three seasons. Male and the elderly (≥ 65 years) were consistently more susceptible to extremely high DTR effect than female and the youth (< 65 years) for non-accidental and cardiovascular mortality. To the contrary, female and the youth were more susceptible to extremely high DTR effect than male and the elderly for respiratory morality. The study suggests that extremely high DTR is a potential trigger for non-accidental mortality in Hefei city, China. Our findings also highlight the importance of protecting susceptible groups from extremely high DTR especially in the spring.

Detection of diisocyanates in nesting material associated with mortality in pigeon chicks.

PubMed

Mukai, Motoko; Woods, Leslie W; Stump, Samuel; Ebel, Joseph G; Levitt, Ariana S; Frey, Margaret W; Smith, Jeanne; Uzal, Francisco A; Poppenga, Robert H; Puschner, Birgit

2014-03-01

Diisocyanates, commonly used in the production of polyurethane foams, paints, elastomers, varnishes, and coatings, are considered among the most hazardous inhalation toxicants. The present report describes 2 unusual cases of mortality in pigeon chicks associated with nesting material contaminated by diisocyanates. Case 1 was submitted by a racing pigeon breeder who had lost all the hatchlings (n = 125) following replacement of the nesting material with a different lot. All adult birds appeared healthy, and hatchability was not significantly affected, but hatchlings became lethargic and dyspneic after a day of hatch. At necropsy, dark wet lungs were found in the hatchlings. Case 2 was submitted by a show-roller pigeon breeder. In this case, the owner reported lower hatchability, and all hatchlings (approximately 100) died within 2 days of hatching with clinical signs similar to the first case. Necropsy did not reveal any significant findings. For both cases, nesting materials were screened for toxic compounds using gas chromatography-mass spectrometry. Toluene-2,4-diisocyanate (approximately 190-290 ppm) and 4,4'-methylene diphenyl diisocyanate (unquantified) were detected in the nesting pads. While there is very limited information on toxicosis in birds, there are reports of inhalant exposure of diisocyanates causing pulmonary edema and death in various mammalian species. Although cause-effect relationship of mortality and the nesting material was not established in the present cases, the presence of toxic compounds in the nesting materials is a cause for concern. Further investigation is needed to determine the prevalence and toxicity of diisocyanates-contaminated nesting material in avian species.

Synthesis of sodium polyhydrides at high pressures

DOE PAGES

Struzhkin, Viktor V.; Kim, Duck Young; Stavrou, Elissaios; ...

2016-07-28

Archetypal ionic NaH is the only known compound of sodium and hydrogen. Application of high pressure is known to promote states with higher atomic coordination, but extensive searches for polyhydrides with unusual stoichiometry have had only limited success in spite of several theoretical predictions. Here we report the first observation of the formation of polyhydrides of Na (NaH 3 and NaH 7) above 40 GPa and 2,000 K. Moreover, we combine synchrotron X-ray diffraction and Raman spectroscopy in a laser-heated diamond anvil cell and theoretical random structure searching, which both agree on the stable structures and compositions. Our results supportmore » the formation of multicenter bonding in a material with unusual stoichiometry. These results are applicable to the design of new energetic solids and high-temperature superconductors based on hydrogen-rich materials.« less

Legionella feeleii: an unusual organism associated with cutaneous infection in an immunocompromised patient.

PubMed

Verykiou, S; Goodhead, C; Parry, G; Meggitt, S

2018-04-01

We report a 23-year-old immunocompromised woman who, following cardiac transplantation, presented with an unusual cutaneous eruption. She developed a widespread pustular rash, systemic symptoms and a high temperature with raised inflammatory markers. The diagnosis was reached when a skin biopsy was cultured onto Legionella agar (buffered charcoal yeast extract) and Legionella feeleii was isolated. The patient was treated with 6 weeks of moxifloxacin and her cutaneous lesions gradually resolved. Cutaneous Legionella infections are uncommon and usually affect immunocompromised patients. © 2017 British Association of Dermatologists.

Interplay of superconductivity and magnetic fluctuations in single crystals of BaFe2-xCoxAs2

NASA Astrophysics Data System (ADS)

Bag, Biplab; Kumar, Ankit; Banerjee, S. S.; Vinod, K.; Bharathi, A.

2018-04-01

We report unusual pinning response in optimally doped and overdoped single crystals of BaFe2-xCoxAs2. Here we use magneto-optical imaging technique to measure the local magnetization response which shows an unusual transformation from low temperature diamagnetic state to high temperature positive magnetization response. Our data suggests coexistence of magnetic fluctuation along with superconductivity in the optimally doped crystal. The strength of magnetic fluctuations is the strongest in the optimally doped compound with the highest Tc.

Consequences of localized frustration for the folding mechanism of the IM7 protein

PubMed Central

Sutto, Ludovico; Lätzer, Joachim; Hegler, Joseph A.; Ferreiro, Diego U.; Wolynes, Peter G.

2007-01-01

In the laboratory, IM7 has been found to have an unusual folding mechanism in which an “on-pathway” intermediate with nonnative interactions is formed. We show that this intermediate is a consequence of an unusual cluster of highly frustrated interactions in the native structure. This cluster is involved in the binding of IM7 to its target, Colicin E7. Redesign of residues in this cluster to eliminate frustration is predicted by simulations to lead to faster folding without the population of an intermediate ensemble. PMID:18077415

Highly hydroxylated steroids of the starfish Archaster typicus from the Vietnamese waters.

PubMed

Ivanchina, Natalia V; Kicha, Alla A; Huong, Trinh T T; Kalinovsky, Anatoly I; Dmitrenok, Pavel S; Agafonova, Irina G; Long, Pham Q; Stonik, Valentin A

2010-12-01

Five new steroidal compounds, including an unusual glucoside, along with several known steroids were isolated from the starfish Archaster typicus collected in shallow waters of Quang Ninh province (Vietnam). Three new compounds are 27-nor-cholestane derivatives and the other two are 24,26-dihydroxycholestane derivatives. A biogenesis pathway for the unusual side chain of 27-nor-cholestane derivatives is proposed. Isolated compounds presented moderate toxic effects in the sperm- and 8-blastomere tests on embryonal development of the sea urchin Strongylocentrotusintermedius. Copyright 2010 Elsevier Inc. All rights reserved.

An unusual fragmentation of oxetane-embedded tetracyclic ketal systems.

PubMed

Rao, G Hari Mangeswara; Khan, Faiz Ahmed

2013-11-01

An unusual route for the synthesis of functionalized cyclobutane derivatives starting from functionalized norbornane derivatives is reported. Base-induced fragmentation of an oxetanol-type moiety embedded in a tetracyclic norbornyl ketal leads to a cyclobutane-fused derivative as the major or exclusive product. The fragmentation reaction for bridgehead-bromine-substituted derivatives was much faster than for the corresponding chlorine-substituted substrates. The functionalized cyclobutane product was formed exclusively in high yield in the former case, while the latter furnished a minor uncyclized side product in varying yields.

An unusual presentation of primary malignant B-cell-type dural lymphoma

PubMed Central

Low, Yin Yee Sharon; Lai, Siang Hui; Ng, Wai Hoe

2014-01-01

Primary malignant B-cell-type dural lymphoma is a rare subtype of primary central nervous system lymphoma (PCNSL). We herein report an unusual case of diffuse B-cell lymphoma that presents as a chronic subdural haematoma without extracranial involvement. The notable aspects of this case include the patient’s immunocompetence, a short clinical history of symptom onset, rapid neurological deterioration and a final diagnosis of high-grade PCNSL. This case highlights the challenges neurosurgeons face, especially in the emergency setting, when the disease manifests in varied presentations. PMID:25631982

King Tides and Climate Change

EPA Pesticide Factsheets

The highest predicted high tide of the year at a coastal location can bring unusually high water levels and can cause flooding. Learn about these tides including what they are, when they occur, and what they can mean for the future.

2:1 Charge disproportionation in perovskite-structure oxide La{sub 1/3}Ca{sub 2/3}FeO{sub 3} with unusually-high-valence Fe{sup 3.67+}

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

Guo, Haichuan; Hosaka, Yoshiteru; Seki, Hayato

La{sub 1/3}Ca{sub 2/3}FeO{sub 3} with unusually-high-valence Fe{sup 3.67+} was synthesized at a high pressure and high temperature. The compound crystallizes in a √2a×2a×√2a perovskite cell in which the La and Ca ions at the A site are disordered. At 217 K the Fe{sup 3.67+} shows charge disproportionation to Fe{sup 3+} and Fe{sup 5+} in a ratio of 2:1, and this disproportionation is accompanied by transitions in magnetic and transport properties. The charge-disproportionated Fe{sup 3+} and Fe{sup 5+} are arranged along the <111> direction of the cubic perovskite cell. The local electronic and magnetic environments of Fe in La{sub 1/3}Ca{sub 2/3}FeO{submore » 3} are quite similar to those of Fe in La{sub 1/3}Sr{sub 2/3}FeO{sub 3}, and the 2:1 charge disproportionation pattern of Fe{sup 3+} and Fe{sup 5+} in La{sub 1/3}Ca{sub 2/3}FeO{sub 3} is also the same as that in La{sub 1/3}Sr{sub 2/3}FeO{sub 3}. - Graphical abstract: The perovskite-structure oxide La{sub 1/3}Ca{sub 2/3}FeO{sub 3} with unusually-high-valence Fe{sup 3.67+} shows charge disproportionation to Fe{sup 3+} and Fe{sup 5+} in a ratio of 2:1, and the charge-disproportionated Fe{sup 3+} and Fe{sup 5+} are arranged along the <111> direction of the cubic perovskite cell. - Highlights: • La{sub 1/3}Ca{sub 2/3}FeO{sub 3} with unusually-high-valence Fe{sup 3.67+} was synthesized at a high pressure and high temperature. • At 217 K the Fe{sup 3.67+} shows charge disproportionation (CD) to Fe{sup 3+} and Fe{sup 5+} in a ratio of 2:1. • The charge-disproportionated Fe{sup 3+} and Fe{sup 5+} are arranged along the <111> direction of the cubic perovskite cell. • The disproportionation is accompanied by transitions in magnetic and transport properties.« less

Chemical composition of HAL, an isotopically-unusual Allende inclusion

NASA Astrophysics Data System (ADS)

Davis, A. M.; Tanaka, T.; Grossman, L.; Lee, T.; Wasserburg, G. J.

1982-09-01

Samples of hibonite, black rim, and portions of friable rim from an unusual Allende inclusion, named HAL, were analyzed by INAA and RNAA for 37 major, minor, and trace elements. An unusually low amount of Ce was found in HAL, although it otherwise was highly enriched in REE compared to C1 chondrites. HAL is also depleted in Sr, Ba, U, V, Ru, Os, and Ir relative to other refractory elements. It is concluded that the distribution of REE between hibonite and rims was established when hibonite and other refractory minerals were removed at slightly different temperatures from a hot, oxidizing gas in which they previously coexisted as separate grains. Possible locations for the chemical and mass dependent isotopic fractionation are considered to be in ejecta from the low temperature helium-burning zone of a supernova and in the locally oxidizing environment generated by evaporation of interstellar grains of near-chondritic chemical composition.

Chemical composition of HAL, an isotopically-unusual Allende inclusion

NASA Technical Reports Server (NTRS)

Davis, A. M.; Tanaka, T.; Grossman, L.; Lee, T.; Wasserburg, G. J.

1982-01-01

Samples of hibonite, black rim, and portions of friable rim from an unusual Allende inclusion, named HAL, were analyzed by INAA and RNAA for 37 major, minor, and trace elements. An unusually low amount of Ce was found in HAL, although it otherwise was highly enriched in REE compared to C1 chondrites. HAL is also depleted in Sr, Ba, U, V, Ru, Os, and Ir relative to other refractory elements. It is concluded that the distribution of REE between hibonite and rims was established when hibonite and other refractory minerals were removed at slightly different temperatures from a hot, oxidizing gas in which they previously coexisted as separate grains. Possible locations for the chemical and mass dependent isotopic fractionation are considered to be in ejecta from the low temperature helium-burning zone of a supernova and in the locally oxidizing environment generated by evaporation of interstellar grains of near-chondritic chemical composition.

What is really extraordinary in cuprate superconductors?

DOE PAGES

Bozovic, I.; Wu, J.; He, X.; ...

2018-03-07

Over the course of three decades of intense study, apart from the exceptionally high critical temperature, many unusual properties of cuprates have been discovered, notably including resistivity linear in temperature, electronic Raman continuum and optical absorption extending throughout the infrared region, pseudogap, hour-glass spin excitation spectrum, etc. However, each of these features have been also observed in other materials, including some that are not even superconducting at all. Here, we describe an extensive experiment in which over 2,000 films of the La 2-xSr xCuO 4 have been synthesized and studied in detail over the course of the last twelve years.more » We argue here that, uniquely, in the cuprates an unusual superconducting state, that defies the standard BCS description, develops from an unusual metallic state, in which the rotational symmetry of the electron fluid is spontaneously broken.« less

Synthetic Vision System Commercial Aircraft Flight Deck Display Technologies for Unusual Attitude Recovery

NASA Technical Reports Server (NTRS)

Prinzel, Lawrence J., III; Ellis, Kyle E.; Arthur, Jarvis J.; Nicholas, Stephanie N.; Kiggins, Daniel

2017-01-01

A Commercial Aviation Safety Team (CAST) study of 18 worldwide loss-of-control accidents and incidents determined that the lack of external visual references was associated with a flight crew's loss of attitude awareness or energy state awareness in 17 of these events. Therefore, CAST recommended development and implementation of virtual day-Visual Meteorological Condition (VMC) display systems, such as synthetic vision systems, which can promote flight crew attitude awareness similar to a day-VMC environment. This paper describes the results of a high-fidelity, large transport aircraft simulation experiment that evaluated virtual day-VMC displays and a "background attitude indicator" concept as an aid to pilots in recovery from unusual attitudes. Twelve commercial airline pilots performed multiple unusual attitude recoveries and both quantitative and qualitative dependent measures were collected. Experimental results and future research directions under this CAST initiative and the NASA "Technologies for Airplane State Awareness" research project are described.

Unusually large Stokes shift for a near-infrared emitting DNA-stabilized silver nanocluster

NASA Astrophysics Data System (ADS)

Ammitzbøll Bogh, Sidsel; Carro-Temboury, Miguel R.; Cerretani, Cecilia; Swasey, Steven M.; Copp, Stacy M.; Gwinn, Elisabeth G.; Vosch, Tom

2018-04-01

In this paper we present a new near-IR emitting silver nanocluster (NIR-DNA-AgNC) with an unusually large Stokes shift between absorption and emission maximum (211 nm or 5600 cm-1). We studied the effect of viscosity and temperature on the steady state and time-resolved emission. The time-resolved results on NIR-DNA-AgNC show that the relaxation dynamics slow down significantly with increasing viscosity of the solvent. In high viscosity solution, the spectral relaxation stretches well into the nanosecond scale. As a result of this slow spectral relaxation in high viscosity solutions, a multi-exponential fluorescence decay time behavior is observed, in contrast to the more mono-exponential decay in low viscosity solution.

Variation in mortality of ischemic and hemorrhagic strokes in relation to high temperature.

PubMed

Lim, Youn-Hee; Kim, Ho; Hong, Yun-Chul

2013-01-01

Outdoor temperature has been reported to have a significant influence on the seasonal variations of stroke mortality, but few studies have investigated the effect of high temperature on the mortality of ischemic and hemorrhagic strokes. The main study goal was to examine the effect of temperature, particularly high temperature, on ischemic and hemorrhagic strokes. We investigated the association between outdoor temperature and stroke mortality in four metropolitan cities in Korea during 1992-2007. We used time series analysis of the age-adjusted mortality rate for ischemic and hemorrhagic stroke deaths by using generalized additive and generalized linear models, and estimated the percentage change of mortality rate associated with a 1°C increase of mean temperature. The temperature-responses for the hemorrhagic and ischemic stroke mortality differed, particularly in the range of high temperature. The estimated percentage change of ischemic stroke mortality above a threshold temperature was 5.4 % (95 % CI, 3.9-6.9 %) in Seoul, 4.1 % (95 % CI, 1.6-6.6 %) in Incheon, 2.3 % (-0.2 to 5.0 %) in Daegu and 3.6 % (0.7-6.6 %) in Busan, after controlling for daily mean humidity, mean air pressure, day of the week, season, and year. Additional adjustment of air pollution concentrations in the model did not change the effects. Hemorrhagic stroke mortality risk significantly decreased with increasing temperature without a threshold in the four cities after adjusting for confounders. These findings suggest that the mortality of hemorrhagic and ischemic strokes show different patterns in relation to outdoor temperature. High temperature was harmful for ischemic stroke but not for hemorrhagic stroke. The risk of high temperature to ischemic stroke did not differ by age or gender.

Variation in mortality of ischemic and hemorrhagic strokes in relation to high temperature

NASA Astrophysics Data System (ADS)

Lim, Youn-Hee; Kim, Ho; Hong, Yun-Chul

2013-01-01

Outdoor temperature has been reported to have a significant influence on the seasonal variations of stroke mortality, but few studies have investigated the effect of high temperature on the mortality of ischemic and hemorrhagic strokes. The main study goal was to examine the effect of temperature, particularly high temperature, on ischemic and hemorrhagic strokes. We investigated the association between outdoor temperature and stroke mortality in four metropolitan cities in Korea during 1992-2007. We used time series analysis of the age-adjusted mortality rate for ischemic and hemorrhagic stroke deaths by using generalized additive and generalized linear models, and estimated the percentage change of mortality rate associated with a 1°C increase of mean temperature. The temperature-responses for the hemorrhagic and ischemic stroke mortality differed, particularly in the range of high temperature. The estimated percentage change of ischemic stroke mortality above a threshold temperature was 5.4 % (95 % CI, 3.9-6.9 %) in Seoul, 4.1 % (95 % CI, 1.6-6.6 %) in Incheon, 2.3 % (-0.2 to 5.0 %) in Daegu and 3.6 % (0.7-6.6 %) in Busan, after controlling for daily mean humidity, mean air pressure, day of the week, season, and year. Additional adjustment of air pollution concentrations in the model did not change the effects. Hemorrhagic stroke mortality risk significantly decreased with increasing temperature without a threshold in the four cities after adjusting for confounders. These findings suggest that the mortality of hemorrhagic and ischemic strokes show different patterns in relation to outdoor temperature. High temperature was harmful for ischemic stroke but not for hemorrhagic stroke. The risk of high temperature to ischemic stroke did not differ by age or gender.

Development and Validation of a High-Quality Composite Real-World Mortality Endpoint.

PubMed

Curtis, Melissa D; Griffith, Sandra D; Tucker, Melisa; Taylor, Michael D; Capra, William B; Carrigan, Gillis; Holzman, Ben; Torres, Aracelis Z; You, Paul; Arnieri, Brandon; Abernethy, Amy P

2018-05-14

To create a high-quality electronic health record (EHR)-derived mortality dataset for retrospective and prospective real-world evidence generation. Oncology EHR data, supplemented with external commercial and US Social Security Death Index data, benchmarked to the National Death Index (NDI). We developed a recent, linkable, high-quality mortality variable amalgamated from multiple data sources to supplement EHR data, benchmarked against the highest completeness U.S. mortality data, the NDI. Data quality of the mortality variable version 2.0 is reported here. For advanced non-small-cell lung cancer, sensitivity of mortality information improved from 66 percent in EHR structured data to 91 percent in the composite dataset, with high date agreement compared to the NDI. For advanced melanoma, metastatic colorectal cancer, and metastatic breast cancer, sensitivity of the final variable was 85 to 88 percent. Kaplan-Meier survival analyses showed that improving mortality data completeness minimized overestimation of survival relative to NDI-based estimates. For EHR-derived data to yield reliable real-world evidence, it needs to be of known and sufficiently high quality. Considering the impact of mortality data completeness on survival endpoints, we highlight the importance of data quality assessment and advocate benchmarking to the NDI. © 2018 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

Effects of cryptic mortality and the hidden costs of using length limits in fishery management

USGS Publications Warehouse

Coggins, L.G.; Catalano, M.J.; Allen, M.S.; Pine, William E.; Walters, C.J.

2007-01-01

Fishery collapses cause substantial economic and ecological harm, but common management actions often fail to prevent overfishing. Minimum length limits are perhaps the most common fishing regulation used in both commercial and recreational fisheries, but their conservation benefits can be influenced by discard mortality of fish caught and released below the legal length. We constructed a computer model to evaluate how discard mortality could influence the conservation utility of minimum length regulations. We evaluated policy performance across two disparate fish life-history types: short-lived high-productivity (SLHP) and long-lived low-productivity (LLLP) species. For the life-history types, fishing mortality rates and minimum length limits that we examined, length limits alone generally failed to achieve sustainability when discard mortality rate exceeded about 0.2 for SLHP species and 0.05 for LLLP species. At these levels of discard mortality, reductions in overall fishing mortality (e.g. lower fishing effort) were required to prevent recruitment overfishing if fishing mortality was high. Similarly, relatively low discard mortality rates (>0.05) rendered maximum yield unobtainable and caused a substantial shift in the shape of the yield response surfaces. An analysis of fishery efficiency showed that length limits caused the simulated fisheries to be much less efficient, potentially exposing the target species and ecosystem to increased negative effects of the fishing process. Our findings suggest that for overexploited fisheries with moderate-to-high discard mortality rates, reductions in fishing mortality will be required to meet management goals. Resource managers should carefully consider impacts of cryptic mortality sources (e.g. discard mortality) on fishery sustainability, especially in recreational fisheries where release rates are high and effort is increasing in many areas of the world. ?? 2007 Blackwell Publishing Ltd.

Mortality among high-risk patients with acute myocardial infarction admitted to U.S. teaching-intensive hospitals in July: a retrospective observational study.

PubMed

Jena, Anupam B; Sun, Eric C; Romley, John A

2013-12-24

Studies of whether inpatient mortality in US teaching hospitals rises in July as a result of organizational disruption and relative inexperience of new physicians (July effect) find small and mixed results, perhaps because study populations primarily include low-risk inpatients whose mortality outcomes are unlikely to exhibit a July effect. Using the US Nationwide Inpatient sample, we estimated difference-in-difference models of mortality, percutaneous coronary intervention rates, and bleeding complication rates, for high- and low-risk patients with acute myocardial infarction admitted to 98 teaching-intensive and 1353 non-teaching-intensive hospitals during May and July 2002 to 2008. Among patients in the top quartile of predicted acute myocardial infarction mortality (high risk), adjusted mortality was lower in May than July in teaching-intensive hospitals (18.8% in May, 22.7% in July, P<0.01), but similar in non-teaching-intensive hospitals (22.5% in May, 22.8% in July, P=0.70). Among patients in the lowest three quartiles of predicted acute myocardial infarction mortality (low risk), adjusted mortality was similar in May and July in both teaching-intensive hospitals (2.1% in May, 1.9% in July, P=0.45) and non-teaching-intensive hospitals (2.7% in May, 2.8% in July, P=0.21). Differences in percutaneous coronary intervention and bleeding complication rates could not explain the observed July mortality effect among high risk patients. High-risk acute myocardial infarction patients experience similar mortality in teaching- and non-teaching-intensive hospitals in July, but lower mortality in teaching-intensive hospitals in May. Low-risk patients experience no such July effect in teaching-intensive hospitals.

Mortality among High Risk Patients with Acute Myocardial Infarction Admitted to U.S. Teaching-Intensive Hospitals in July: A Retrospective Observational Study

PubMed Central

Jena, Anupam B.; Sun, Eric C.; Romley, John A.

2014-01-01

Background Studies of whether inpatient mortality in U.S. teaching hospitals rises in July as a result of organizational disruption and relative inexperience of new physicians (‘July effect’) find small and mixed results, perhaps because study populations primarily include low-risk inpatients whose mortality outcomes are unlikely to exhibit a July effect. Methods and Results Using the U.S. Nationwide Inpatient sample, we estimated difference-in-difference models of mortality, percutaneous coronary intervention (PCI) rates, and bleeding complication rates, for high and low risk patients with acute myocardial infarction (AMI) admitted to 98 teaching-intensive and 1353 non-teaching-intensive hospitals during May and July 2002 to 2008. Among patients in the top quartile of predicted AMI mortality (high risk), adjusted mortality was lower in May than July in teaching-intensive hospitals (18.8% in May, 22.7% in July, p<0.01), but similar in non-teaching-intensive hospitals (22.5% in May, 22.8% in July, p=0.70). Among patients in the lowest three quartiles of predicted AMI mortality (low risk), adjusted mortality was similar in May and July in both teaching-intensive hospitals (2.1% in May, 1.9% in July, p=0.45) and non-teaching-intensive hospitals (2.7% in May, 2.8% in July, p=0.21). Differences in PCI and bleeding complication rates could not explain the observed July mortality effect among high risk patients. Conclusions High risk AMI patients experience similar mortality in teaching- and non-teaching-intensive hospitals in July, but lower mortality in teaching-intensive hospitals in May. Low risk patients experience no such “July effect” in teaching-intensive hospitals. PMID:24152859

Mortality prediction system for heart failure with orthogonal relief and dynamic radius means.

PubMed

Wang, Zhe; Yao, Lijuan; Li, Dongdong; Ruan, Tong; Liu, Min; Gao, Ju

2018-07-01

This paper constructs a mortality prediction system based on a real-world dataset. This mortality prediction system aims to predict mortality in heart failure (HF) patients. Effective mortality prediction can improve resources allocation and clinical outcomes, avoiding inappropriate overtreatment of low-mortality patients and discharging of high-mortality patients. This system covers three mortality prediction targets: prediction of in-hospital mortality, prediction of 30-day mortality and prediction of 1-year mortality. HF data are collected from the Shanghai Shuguang hospital. 10,203 in-patients records are extracted from encounters occurring between March 2009 and April 2016. The records involve 4682 patients, including 539 death cases. A feature selection method called Orthogonal Relief (OR) algorithm is first used to reduce the dimensionality. Then, a classification algorithm named Dynamic Radius Means (DRM) is proposed to predict the mortality in HF patients. The comparative experimental results demonstrate that mortality prediction system achieves high performance in all targets by DRM. It is noteworthy that the performance of in-hospital mortality prediction achieves 87.3% in AUC (35.07% improvement). Moreover, the AUC of 30-day and 1-year mortality prediction reach to 88.45% and 84.84%, respectively. Especially, the system could keep itself effective and not deteriorate when the dimension of samples is sharply reduced. The proposed system with its own method DRM can predict mortality in HF patients and achieve high performance in all three mortality targets. Furthermore, effective feature selection strategy can boost the system. This system shows its importance in real-world applications, assisting clinicians in HF treatment by providing crucial decision information. Copyright © 2018 Elsevier B.V. All rights reserved.

A Rare Dispersion of Low-Salinity, High-Gelbstoff, High-Primary Production Water in the East China Sea During the Summer of 2010: Possible Influence of the ENSO

NASA Astrophysics Data System (ADS)

Siswanto, Eko; Xu, Yongjiu; Ishizaka, Joji

2018-04-01

We applied ocean color algorithms and a primary production model to a 13-year ocean color data set to assess interannual variations of Changjiang-influenced water (CIW) dispersion, with an emphasis on the unusual CIW dispersion during July 2010. The characteristics of the CIW offshore dispersion were primarily driven by alongshore winds and secondarily by the Changjiang discharge, the interannual variations of which were linked to the El Niño/La Niña. The unusual southeastward dispersion of CIW in July 2010 was attributed to a relatively weak southwesterly wind (with southwesterly wind anomalies) and high Changjiang discharge (after the El Niño peak in winter). In July 2010, the CIW, which is characterized by low-salinity, high-gelbstoff, and high-primary production, intruded into the Kuroshio Current axis to form a rare band of CIW that flowed toward an area south of Japan. The southeastward dispersion of CIW in July 2003 was also unusual, but it did not extend as far as in July 2010, perhaps because of the relatively strong southwesterly winds and low Changjiang discharge in July 2003. During La Niña events, the dispersion of CIW retreated toward the coast due to prevailing northeasterly wind anomalies. We confirmed that the CIW in July 2010 was characterized by low-salinity, abundant phytoplankton biomass, and high biological production. The fact that high biological production and the peak of Changjiang discharge occurred in the same month (July) in 2010 indicated that biogeochemical production stimulated by nutrients from the Changjiang was higher than during normal summer conditions.

High-rate nano-crystalline Li 4Ti 5O 12 attached on carbon nano-fibers for hybrid supercapacitors

NASA Astrophysics Data System (ADS)

Naoi, Katsuhiko; Ishimoto, Shuichi; Isobe, Yusaku; Aoyagi, Shintaro

A lithium titanate (Li 4Ti 5O 12)-based electrode which can operate at unusually high current density (300 C) was developed as negative electrode for hybrid capacitors. The high-rate Li 4Ti 5O 12 electrode has a unique nano-structure consisting of unusually small nano-crystalline Li 4Ti 5O 12 (ca. 5-20 nm) grafted onto carbon nano-fiber anchors (nc-Li 4Ti 5O 12/CNF). This nano-structured nc-Li 4Ti 5O 12/CNF composite are prepared by simple sol-gel method under ultra-centrifugal force (65,000 N) followed by instantaneous annealing at 900 °C for 3 min. A model hybrid capacitor cell consisting of a negative nc-Li 4Ti 5O 12/CNF composite electrode and a positive activated carbon electrode showed high energy density of 40 Wh L -1 and high power density of 7.5 kW L -1 comparable to conventional EDLCs.

Stroke mortality in Tennessee: an eco-epidemiologic perspective.

PubMed

Flowers, Joanne; Vutla, Balaji; Aldrich, Tim E

2008-04-01

Prevention of stroke mortality in Tennessee is a statewide public health priority. These analyses describe how the distribution of Caucasian stroke mortality is greater among the state's Appalachian Counties. For African-American residents, the elevated stroke mortality risk is not distinctive for geographic regions, although Upper East Tennessee rates are elevated. If the Caucasian criteria for assigning "high" rates were used with African-American stroke mortality data, the entire state would be designated as having elevated levels for stroke mortality. Race-gender specific analyses at the county-level (ecological attributes) illustrate the greater risks for "high" county-level stroke mortality rates are present for urban and poor communities in our state. African-American males are a clear exception, where the poorer, rural communities show a protective effect for "high" county-level stroke mortality rates. We support implementing stroke prevention programming and public health interventions based on the mortality data distributions; compatible statewide initiatives are underway We recommend strategic over-sampling of the state's priority populations for stroke risk to facilitate the monitoring of prevention and intervention program impacts over time.

The Geography of the Alzheimer's Disease Mortality in Spain: Should We Focus on Industrial Pollutants Prevention?

PubMed

2017-11-25

Alzheimer's disease (AD) has a high worldwide prevalence but little is known about its aetiology and risk factors. Recent research suggests environmental factors might increase AD risk. We aim to describe the association between AD mortality and the presence of highly polluting industry in small areas in Spain between 1999 and 2010. We calculated AD age-adjusted Standardized Mortality Ratio (SMR), stratified by sex, grouped by industrial pollution density, compared for each small area of Spain. In the small areas with the highest mortality, the SMR among women was at least 25% greater than the national average (18% in men). The distribution of AD mortality was generally similar to that of high industrial pollution (higher mortality in the north, the Mediterranean coast and in some southern areas). The risk of AD mortality among women was 140% higher (123% among men) in areas with the highest industrial density in comparison to areas without polluting industries. This study has identified a geographical pattern of small areas with higher AD mortality risk and an ecological positive association with the density of highly polluting industry. Further research is needed on the potential impact of this type of industry pollution on AD aetiology and mortality.

Successful surgical management of ruptured umbilical hernias in cirrhotic patients

PubMed Central

Chatzizacharias, Nikolaos A; Bradley, J Andrew; Harper, Simon; Butler, Andrew; Jah, Asif; Huguet, Emmanuel; Praseedom, Raaj K; Allison, Michael; Gibbs, Paul

2015-01-01

Acute umbilical hernia rupture in patients with hepatic cirrhosis and ascites is an unusual, but potentially life-threatening complication, with postoperative morbidity about 70% and mortality between 60%-80% after supportive care and 6%-20% after urgent surgical repair. Management options include primary surgical repair with or without concomitant portal venous system decompression for the control of the ascites. We present a retrospective analysis of our centre’s experience over the last 6 years. Our cohort consisted of 11 consecutive patients (median age: 53 years, range: 36-63 years) with advanced hepatic cirrhosis and refractory ascites. Appropriate patient resuscitation and optimisation with intravenous fluids, prophylactic antibiotics and local measures was instituted. One failed attempt for conservative management was followed by a successful primary repair. In all cases, with one exception, a primary repair with non-absorbable Nylon, interrupted sutures, without mesh, was performed. The perioperative complication rate was 25% and the recurrence rate 8.3%. No mortality was recorded. Median length of hospital stay was 14 d (range: 4-31 d). Based on our experience, the management of ruptured umbilical hernias in patients with advanced hepatic cirrhosis and refractory ascites is feasible without the use of transjugular intrahepatic portosystemic shunt routinely in the preoperative period, provided that meticulous patient optimisation is performed. PMID:25780312

What plant hydraulics can tell us about responses to climate-change droughts.

PubMed

Sperry, John S; Love, David M

2015-07-01

Climate change exposes vegetation to unusual drought, causing declines in productivity and increased mortality. Drought responses are hard to anticipate because canopy transpiration and diffusive conductance (G) respond to drying soil and vapor pressure deficit (D) in complex ways. A growing database of hydraulic traits, combined with a parsimonious theory of tree water transport and its regulation, may improve predictions of at-risk vegetation. The theory uses the physics of flow through soil and xylem to quantify how canopy water supply declines with drought and ceases by hydraulic failure. This transpiration 'supply function' is used to predict a water 'loss function' by assuming that stomatal regulation exploits transport capacity while avoiding failure. Supply-loss theory incorporates root distribution, hydraulic redistribution, cavitation vulnerability, and cavitation reversal. The theory efficiently defines stomatal responses to D, drying soil, and hydraulic vulnerability. Driving the theory with climate predicts drought-induced loss of plant hydraulic conductance (k), canopy G, carbon assimilation, and productivity. Data lead to the 'chronic stress hypothesis' wherein > 60% loss of k increases mortality by multiple mechanisms. Supply-loss theory predicts the climatic conditions that push vegetation over this risk threshold. The theory's simplicity and predictive power encourage testing and application in large-scale modeling. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

Linking high parity and maternal and child mortality: what is the impact of lower health services coverage among higher order births?

PubMed

Sonneveldt, Emily; DeCormier Plosky, Willyanne; Stover, John

2013-01-01

A number of data sets show that high parity births are associated with higher child mortality than low parity births. The reasons for this relationship are not clear. In this paper we investigate whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality. We used DHS data from 10 high fertility countries to examine the relationship between parity and coverage for 8 child health intervention and 9 maternal health interventions. We also used the LiST model to estimate the effect on maternal and child mortality of the lower coverage associated with high parity births. Our results show a significant relationship between coverage of maternal and child health services and birth order, even when controlling for poverty. The association between coverage and parity for maternal health interventions was more consistently significant across countries all countries, while for child health interventions there were fewer overall significant relationships and more variation both between and within countries. The differences in coverage between children of parity 3 and those of parity 6 are large enough to account for a 12% difference in the under-five mortality rate and a 22% difference in maternal mortality ratio in the countries studied. This study shows that coverage of key health interventions is lower for high parity children and the pattern is consistent across countries. This could be a partial explanation for the higher mortality rates associated with high parity. Actions to address this gap could help reduce the higher mortality experienced by high parity birth.

Tropical flatback turtle (Natator depressus) embryos are resilient to the heat of climate change.

PubMed

Howard, Robert; Bell, Ian; Pike, David A

2015-10-01

Climate change is threatening reproduction of many ectotherms by increasing nest temperatures, potentially making it more difficult for females to locate nest sites that provide suitable incubation regimes during embryonic development. Elevated nest temperatures could increase the incidence of embryonic mortality and/or maladaptive phenotypes. We investigated whether elevated nest temperatures reduce hatching success in tropical flatback turtles (Natator depressus) nesting in the Gulf of Carpentaria, Australia. Egg incubation treatments began at 29.5°C and progressively increased in temperature throughout incubation, up to maxima of 31, 32, 33, 34 and 35°C. Elevated nest temperatures did not reduce hatching success or hatchling body size relative to control temperatures (29.5°C), but did speed up embryonic development. A combination of sudden exposure to high temperatures during the first 2 weeks of incubation (>36°C for 48 h) and prolonged warming throughout incubation (from 29.5-35°C) did not reduce hatching success. We also recorded an unusually high pivotal sex-determining temperature in this flatback turtle population relative to other sea turtle populations: an equal ratio of male and female hatchlings is produced at ∼30.4°C. This adaptation may allow some flatback turtle populations to continue producing large numbers of hatchlings of both sexes under the most extreme climate change scenarios. Some tropical populations of nesting flatbacks may possess important adaptations to high-temperature incubation environments, which are not found in more southerly temperate populations. © 2015. Published by The Company of Biologists Ltd.

Elucidating early CT after pancreatico-duodenectomy: a primer for radiologists.

PubMed

Tonolini, Massimo; Ierardi, Anna Maria; Carrafiello, Gianpaolo

2018-04-13

Pancreatico-duodenectomy (PD) represents the standard surgical treatment for resectable malignancies of the pancreatic head, distal common bile duct, periampullary region and duodenum, and is also performed to manage selected benign tumours and refractory chronic pancreatitis. Despite improved surgical techniques and acceptable mortality, PD remains a technically demanding, high-risk operation burdened with high morbidity (complication rates 40-50% of patients). Multidetector computed tomography (CT) represents the mainstay modality to rapidly investigate the postoperative abdomen, and to provide a consistent basis for an appropriate choice between conservative, interventional or surgical treatment. However, radiologists require familiarity with the surgically altered anatomy, awareness of expected imaging appearances and possible complications to correctly interpret early post-PD CT studies. This paper provides an overview of surgical indications and techniques, discusses risk factors and clinical manifestations of the usual postsurgical complications, and suggests appropriate techniques and indications for early postoperative CT imaging. Afterwards, the usual, normal early post-PD CT findings are presented, including transient fluid, pneumobilia, delayed gastric emptying, identification of pancreatic gland remnant and of surgical anastomoses. Finally, several imaging examples review the most common and some unusual complications such as pancreatic fistula, bile leaks, abscesses, intraluminal and extraluminal haemorrhage, and acute pancreatitis. • Pancreatico-duodenectomy (PD) is a technically demanding surgery burdened with high morbidity (40-50%). • Multidetector CT is the mainstay technique to investigate suspected complications following PD. • Interpreting post-PD CT requires knowledge of surgically altered anatomy and expected findings. • CT showing collection at surgical site supports clinico-biological diagnosis of pancreatic fistula. • Other complications include biliary leaks, haemorrhage, abscesses and venous thrombosis.

Transient Diabetes Insipidus Following Thermal Burn; A Case Report and Literature Review.

PubMed

Dash, Suvashis; Ghosh, Shibajyoti

2017-10-01

Diabetes insipidus is a disease charaterised by increased urine production and thrist. Neurogenic diabetes insipidus following head trauma,autoimmune disease and infection is quite common but diabetes insipidus following thermal burn injury is a rare complication.We should know about this complication as its management need a comprehensive approach for satisfactory outcome. Thermal burn can cause different complications in early post burn period like electrolyte imbalance, dehydration, acute renal failure, but diabetes insipidus is a very rare and unusual complication that may come across in thermal burn. We should be aware about this condition to prevent and treat mortality and morbidity in burn patients. We have reported a case of transient diabetes insipidus in a patient of thermal burn in early post burn period. Patient was treated accordingly, leading to complete recovery.

Obstructive Sleep Apnea: An Unusual Cause of Hemorrhagic Stroke.

PubMed

Pawar, Nilesh H; O'Riordan, Jennifer A; Malik, Preeti; Vasanwala, Farhad F

2017-09-27

Stroke is one of the most common causes of mortality and morbidity worldwide. Hemorrhagic stroke comprises 10-20% of strokes. Here, we present a case report of hemorrhagic stroke that may have been secondary to untreated Obstructive Sleep Apnea (OSA) in a young man with no other cardiovascular risk factors or features of metabolic syndrome. A 32-year-old man was admitted for hemorrhagic stroke. An initial thorough workup for the etiology of stroke was inconclusive. Eventually, a polysomnography was done, which demonstrated OSA suggesting that untreated OSA may have contributed to his stroke. OSA may cause hemorrhagic stroke by nocturnal blood pressure surge. So, all physicians should consider doing polysomnography for unexplained hemorrhagic stroke or in patients at risk. Diagnosing and treating OSA would be critical in preventing hemorrhagic stroke and its recurrences.

An Unusual Complication Following Transarterial Chemoembolization: Acute Myocardial Infarction

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

Lai Yiliang; Chang Weichou; Kuo Wuhsien

Transarterial chemoembolization has been widely used to treat unresectable hepatocellular carcinoma. Various complications have been reported, but they have not included acute myocardial infarction. Acute myocardial infarction results mainly from coronary artery occlusion by plaques that are vulnerable to rupture or from coronary spasm, embolization, or dissection of the coronary artery. It is associated with significant morbidity and mortality. We present a case report that describes a patient with hepatocellular carcinoma who underwent transarterial chemoembolization and died subsequently of acute myocardial infarction. To our knowledge, there has been no previous report of this complication induced by transarterial chemoembolization for hepatocellularmore » carcinoma. This case illustrates the need to be aware of acute myocardial infarction when transarterial chemoembolization is planned for the treatment of hepatocellular carcinoma, especially in patients with underlying coronary artery disease.« less

Contextualizing Genetics for Regional Heart Failure Care

PubMed Central

Iyngkaran, Pupalan; Thomas, Merlin C.; Johnson, Renee; French, John; Ilton, Marcus; McDonald, Peter; Hare, David L.; Fatkin, Diane

2016-01-01

Congestive heart failure (CHF) is a chronic and often devastating cardiovascular disorder with no cure. There has been much advancement in the last two decades that has seen improvements in morbidity and mortality. Clinicians have also noted variations in the responses to therapies. More detailed observations also point to clusters of diseases, phenotypic groupings, unusual severity and the rates at which CHF occurs. Medical genetics is playing an increasingly important role in answering some of these observations. This developing field in many respects provides more information than is currently clinically applicable. This includes making sense of the established single gene mutations or uncommon private mutations. In this thematic series which discusses the many factors that could be relevant for CHF care, once established treatments are available in the communities; this section addresses a contextual role for medical genetics. PMID:27280306

Mortality predictors in a 60-year follow-up of adolescent males: exploring delinquency, socioeconomic status, IQ, high-school drop-out status, and personality.

PubMed

Trumbetta, Susan L; Seltzer, Benjamin K; Gottesman, Irving I; McIntyre, Kathleen M

2010-01-01

To examine whether socioeconomic status (SES), high school (HS) completion, IQ, and personality traits that predict delinquency in adolescence also could explain men's delinquency-related (Dq-r) mortality risk across the life span. Through a 60-year Social Security Death Index (SSDI) follow-up of 1812 men from Hathaway's adolescent normative Minnesota Multiphasic Personality Inventory (MMPI) sample, we examined mortality risk at various ages and at various levels of prior delinquency severity. We examined SES (using family rent level), HS completion, IQ, and MMPI indicators simultaneously as mortality predictors and tested for SES (rent level) interactions with IQ and personality. We ascertained 418 decedents. Dq-r mortality peaked between ages 45 years to 64 years and continued through age 75 years, with high delinquency severity showing earlier and higher mortality risk. IQ and rent level failed to explain Dq-r mortality. HS completion robustly conferred mortality protection through ages 55 years and 75 years, explained IQ and rent level-related risk, but did not fully explain Dq-r risk. Dq-r MMPI scales, Psychopathic Deviate, and Social Introversion, respectively, predicted risk for and protection from mortality by age 75 years, explaining mortality risk otherwise attributable to delinquency. Wiggins' scales also explained Dq-r mortality risk, as Authority Conflict conferred risk for and Social Maladjustment and Hypomania conferred protection from mortality by age 75 years. HS completion robustly predicts mortality by ages 55 years and 75 years. Dq-r personality traits predict mortality by age 75 years, accounting, in part, for Dq-r mortality.

Biomarkers of sepsis

PubMed Central

2013-01-01

Sepsis is an unusual systemic reaction to what is sometimes an otherwise ordinary infection, and it probably represents a pattern of response by the immune system to injury. A hyper-inflammatory response is followed by an immunosuppressive phase during which multiple organ dysfunction is present and the patient is susceptible to nosocomial infection. Biomarkers to diagnose sepsis may allow early intervention which, although primarily supportive, can reduce the risk of death. Although lactate is currently the most commonly used biomarker to identify sepsis, other biomarkers may help to enhance lactate’s effectiveness; these include markers of the hyper-inflammatory phase of sepsis, such as pro-inflammatory cytokines and chemokines; proteins such as C-reactive protein and procalcitonin which are synthesized in response to infection and inflammation; and markers of neutrophil and monocyte activation. Recently, markers of the immunosuppressive phase of sepsis, such as anti-inflammatory cytokines, and alterations of the cell surface markers of monocytes and lymphocytes have been examined. Combinations of pro- and anti-inflammatory biomarkers in a multi-marker panel may help identify patients who are developing severe sepsis before organ dysfunction has advanced too far. Combined with innovative approaches to treatment that target the immunosuppressive phase, these biomarkers may help to reduce the mortality rate associated with severe sepsis which, despite advances in supportive measures, remains high. PMID:23480440

Red Dot Basal Cell Carcinoma: An Unusual Variant of a Common Malignancy.

PubMed

Loh, Tiffany Y; Cohen, Philip R

2016-05-01

Red dot basal cell carcinoma is a distinct but rare subtype of basal cell carcinoma (BCC). It presents as a red macule or papule; therefore, in most cases, it may easily be mistaken for a benign vascular lesion, such as a telangiectasia or angioma.
A red dot BCC in an older woman is described. Clinical and histological differences between red dot BCCs and telangiectasias are described.
A 72-year-old woman initially presented with a painless red macule on her nose. Biopsy of the lesion established the diagnosis of a red dot BCC. Pubmed was searched for the following terms: angioma, basal cell carcinoma, dermoscope, diascopy, red dot, non-melanoma skin cancer, telangiectasia, and vascular. The papers were reviewed for cases of red dot basal cell carcinoma. Clinical and histological characteristics of red dot basal cell carcinoma and telangiectasias were compared.
Red dot BCC is an extremely rare variant of BCC that may be confused with benign vascular lesions. Although BCCs rarely metastasize and are associated with low mortality, they have the potential to become locally invasive and destructive if left untreated. Thus, a high index of suspicion for red dot BCC is necessary.

J Drugs Dermatol. 2016;15(5):645-647.

The parasite Ichthyophonus sp. in Pacific herring from the coastal NE Pacific

USGS Publications Warehouse

Hershberger, Paul K.; Gregg, Jacob L.; Hart, Lucas M.; Moffitt, Steve; Brenner, Richard L.; Stick, K.; Coonradt, Eric; Otis, E. O.; Vollenweider, Johanna J.; Garver, Kyle A.; Lovy, Jan; Meyers, T.R.

2016-01-01

The protistan parasite Ichthyophonus occurred in populations of Pacific herring Clupea pallasii Valenciennes throughout coastal areas of the NE Pacific, ranging from Puget Sound, WA north to the Gulf of Alaska, AK. Infection prevalence in local Pacific herring stocks varied seasonally and annually, and a general pattern of increasing prevalence with host size and/or age persisted throughout the NE Pacific. An exception to this zoographic pattern occurred among a group of juvenile, age 1+ year Pacific herring from Cordova Harbor, AK in June 2010, which demonstrated an unusually high infection prevalence of 35%. Reasons for this anomaly were hypothesized to involve anthropogenic influences that resulted in locally elevated infection pressures. Interannual declines in infection prevalence from some populations (e.g. Lower Cook Inlet, AK; from 20–32% in 2007 to 0–3% during 2009–13) or from the largest size cohorts of other populations (e.g. Sitka Sound, AK; from 62.5% in 2007 to 19.6% in 2013) were likely a reflection of selective mortality among the infected cohorts. All available information for Ichthyophonus in the NE Pacific, including broad geographic range, low host specificity and presence in archived Pacific herring tissue samples dating to the 1980s, indicate a long-standing host–pathogen relationship.

Unusual Complication of Surgical Abortion with Pelvic Extrusion of Fetal Head: A Case Report.

PubMed

Begum, Jasmina; Samal, Sunita; Ghose, Seetesh

2015-11-01

Unsafe abortion is one of the causes of maternal mortality and morbidity in developing countries. The complications mostly results following unsafe abortion procedure done by unskilled provider with or without minimal medical knowledge in rural part of developing countries. These complications can endanger the life of mother if proper medical or surgical interventions are not offered in time. A majority of these complications remains confidential. The uterine perforation is one of the serious but preventable complications of surgical abortion. A 21-year-old woman G4P2L2A1, presented in the emergency ward with complaints of lower abdominal pain for four days after attempting twice surgical termination of pregnancy at 19 weeks of gestation for an unwanted pregnancy. Transabdominal sonography and MRI revealed uterine rent with pelvic extrusion of fetal head. Emergency laparotomy with removal of fetal head and uterine rent repair was done. This case illustrates the importance of maintaining a high index of suspicion by the gynaecologist for uterine perforation in patient presenting with abdominal pain a few days after undergoing surgical abortion, also shows the complementary role of sonography and MRI in evaluation of the similar patient and this case also highlights the rampant illegal unsafe abortion procedure in rural India despite of legalization of abortion act.

Rabies: the clinical features, management and prevention of the classic zoonosis.

PubMed

Warrell, Mary J; Warrell, David A

2015-02-01

The diagnosis of rabies encephalitis relies on awareness of the varied clinical features and eliciting a history of unusual contact with a mammal throughout the endemic area. The diagnosis is easily missed. Laboratory tests are not routine and only confirm clinical suspicion. Rabies infection carries a case fatality exceeding 99.9%. Palliation is appropriate, except for previously-vaccinated patients or those infected by American bats, for whom intensive care is probably indicated. However, as rabies vaccines are outstandingly effective, no one should die of dog-transmitted infection. Vaccines and rabies immunoglobulin are expensive and usually scarce in Asia and Africa. All travellers to dog rabies enzootic areas should be strongly encouraged to have pre-exposure immunisation before departure. There is no contraindication to vaccination but the cost can be prohibitive. Intradermal immunisation, using 0.1 ml and sharing vials of vaccine, is cheaper and is now permitted by UK regulations. Returning travellers may need post-exposure prophylaxis. Economical intradermal post-exposure vaccination is practicable and should be introduced into rural areas of Africa and Asia immediately. Eliminating rabies in dogs is now feasible and would dramatically reduce human mortality, if funds were made available. The high current economic burden of human prophylaxis would then be largely relieved. © 2015 Royal College of Physicians.

Revisiting doxycycline in pregnancy and early childhood – time to rebuild its reputation?

PubMed Central

Cross, Ruby; Ling, Clare; Day, Nicholas P. J.; McGready, Rose; Paris, Daniel H.

2016-01-01

ABSTRACT Introduction: Doxycycline is highly effective, inexpensive with a broad therapeutic spectrum and exceptional bioavailability. However these benefits have been overshadowed by its classification alongside the tetracyclines – class D drugs, contraindicated in pregnancy and in children under 8 years of age. Doxycycline-treatable diseases are emerging as leading causes of undifferentiated febrile illness in Southeast Asia. For example scrub typhus and murine typhus have an unusually severe impact on pregnancy outcomes, and current mortality rates for scrub typhus reach 12-13% in India and Thailand. The emerging evidence for these important doxycycline-treatable diseases prompted us to revisit doxycycline usage in pregnancy and childhood. Areas Covered: A systematic review of the available literature on doxycycline use in pregnant women and children revealed a safety profile of doxycycline that differed significantly from that of tetracycline; no correlation between the use of doxycycline and teratogenic effects during pregnancy or dental staining in children was found. Expert Opinion: The change of the US FDA pregnancy classification scheme to an evidence-based approach will enable adequate evaluation of doxycycline in common tropical illnesses and in vulnerable populations in clinical treatment trials, dosage-optimization pharmacokinetic studies and for the empirical treatment of undifferentiated febrile illnesses, especially in pregnant women and children. PMID:26680308

Epidemiology of neoplasia in captive black-footed ferrets (Mustela nigripes), 1986-1996.

PubMed

Lair, Stéphane; Barker, Ian K; Mehren, Kay G; Williams, Elizabeth S

2002-09-01

The epidemiology of neoplastic disease was studied retrospectively in the captive population of black-footed ferrets (Mustela nigripes). Postmortem reports were reviewed and archived tissues examined from 184 of the 227 adult (>1 yr old) black-footed ferrets that died from the beginning of the current captive propagation program in late 1985 to the end of 1996. A total of 185 neoplasms, of 28 distinct phenotypes, were seen in 102 (55.4%) of these ferrets. There was more than one tumor type present in 51 ferrets. Tumors of the apocrine glands (28.3%), renal tubular neoplasms (20.7%), and biliary cystadenoma or carcinoma (20.1%) were the most common neoplasms. The probability of developing most types of neoplasms increased with age. Neoplasms of the apocrine glands were more common in males and may be hormonally influenced. The unusually high prevalence of biliary cystadenocarcinoma may be secondary to the common occurrence of intrahepatic biliary cysts in this population. Although neoplasia is an important cause of mortality in captive adult black-footed ferrets, its impact on captive propagation of the species, and on the wild population, is probably limited because clinically significant tumors are encountered almost exclusively in postreproductive ferrets (>3 yr old) and because ferrets released into their natural habitat rarely reach susceptible age.

Roads to ruin: conservation threats to a sentinel species across an urban gradient.

PubMed

Feist, Blake E; Buhle, Eric R; Baldwin, David H; Spromberg, Julann A; Damm, Steven E; Davis, Jay W; Scholz, Nathaniel L

2017-12-01

Urbanization poses a global challenge to species conservation. This is primarily understood in terms of physical habitat loss, as agricultural and forested lands are replaced with urban infrastructure. However, aquatic habitats are also chemically degraded by urban development, often in the form of toxic stormwater runoff. Here we assess threats of urbanization to coho salmon throughout developed areas of the Puget Sound Basin in Washington, USA. Puget Sound coho are a sentinel species for freshwater communities and also a species of concern under the U.S. Endangered Species Act. Previous studies have demonstrated that stormwater runoff is unusually lethal to adult coho that return to spawn each year in urban watersheds. To further explore the relationship between land use and recurrent coho die-offs, we measured mortality rates in field surveys of 51 spawning sites across an urban gradient. We then used spatial analyses to measure landscape attributes (land use and land cover, human population density, roadways, traffic intensity, etc.) and climatic variables (annual summer and fall precipitation) associated with each site. Structural equation modeling revealed a latent urbanization gradient that was associated with road density and traffic intensity, among other variables, and positively related to coho mortality. Across years within sites, mortality increased with summer and fall precipitation, but the effect of rainfall was strongest in the least developed areas and was essentially neutral in the most urbanized streams. We used the best-supported structural equation model to generate a predictive mortality risk map for the entire Puget Sound Basin. This map indicates an ongoing and widespread loss of spawners across much of the Puget Sound population segment, particularly within the major regional north-south corridor for transportation and development. Our findings identify current and future urbanization-related threats to wild coho, and show where green infrastructure and similar clean water strategies could prove most useful for promoting species conservation and recovery. © 2017 by the Ecological Society of America.

Impact of Intravenous Immunoglobulin on Survival in Necrotizing Fasciitis With Vasopressor-Dependent Shock: A Propensity Score-Matched Analysis From 130 US Hospitals.

PubMed

Kadri, Sameer S; Swihart, Bruce J; Bonne, Stephanie L; Hohmann, Samuel F; Hennessy, Laura V; Louras, Peter; Evans, Heather L; Rhee, Chanu; Suffredini, Anthony F; Hooper, David C; Follmann, Dean A; Bulger, Eileen M; Danner, Robert L

2017-04-01

Shock frequently complicates necrotizing fasciitis (NF) caused by group A Streptococcus (GAS) or Staphylococcus aureus. Intravenous immunoglobulin (IVIG) is sometimes administered for presumptive toxic shock syndrome (TSS), but its frequency of use and efficacy are unclear. Adult patients with NF and vasopressor-dependent shock undergoing surgical debridement from 2010 to 2014 were identified at 130 US hospitals. IVIG cases were propensity-matched and risk-adjusted. The primary outcome was in-hospital mortality and the secondary outcome was median length of stay (LOS). Of 4127 cases of debrided NF with shock at 121 centers, only 164 patients (4%) at 61 centers received IVIG. IVIG subjects were younger with lower comorbidity indices, but higher illness severity. Clindamycin and vasopressor intensity were higher among IVIG cases, as was coding for TSS and GAS. In-hospital mortality did not differ between matched IVIG and non-IVIG groups (crude mortality, 27.3% vs 23.6%; adjusted odds ratio, 1.00 [95% confidence interval, .55-1.83]; P = .99). Early IVIG (≤2 days) did not alter this effect (P = .99). Among patients coded for TSS, GAS, and/or S. aureus, IVIG use was still unusual (59/868 [6.8%]) and lacked benefit (P = .63). Median LOS was similar between IVIG and non-IVIG groups (26 [13-49] vs 26 [11-43]; P = .84). Positive predictive values for identifying true NF and debridement among IVIG cases using our algorithms were 97% and 89%, respectively, based on records review at 4 hospitals. Adjunctive IVIG was administered infrequently in NF with shock and had no apparent impact on mortality or hospital LOS beyond that achieved with debridement and antibiotics. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Lynch Syndrome: Genomics Update and Imaging Review.

PubMed

Cox, Veronica L; Saeed Bamashmos, Anas A; Foo, Wai Chin; Gupta, Shiva; Yedururi, Sireesha; Garg, Naveen; Kang, Hyunseon Christine

2018-01-01

Lynch syndrome is the most common hereditary cancer syndrome, the most common cause of heritable colorectal cancer, and the only known heritable cause of endometrial cancer. Other cancers associated with Lynch syndrome include cancers of the ovary, stomach, urothelial tract, and small bowel, and less frequently, cancers of the brain, biliary tract, pancreas, and prostate. The oncogenic tendency of Lynch syndrome stems from a set of genomic alterations of mismatch repair proteins. Defunct mismatch repair proteins cause unusually high instability of regions of the genome called microsatellites. Over time, the accumulation of mutations in microsatellites and elsewhere in the genome can affect the production of important cellular proteins, spurring tumorigenesis. Universal testing of colorectal tumors for microsatellite instability (MSI) is now recommended to (a) prevent cases of Lynch syndrome being missed owing to the use of clinical criteria alone, (b) reduce morbidity and mortality among the relatives of affected individuals, and (c) guide management decisions. Organ-specific cancer risks and associated screening paradigms vary according to the sex of the affected individual and the type of germline DNA alteration causing the MSI. Furthermore, Lynch syndrome-associated cancers have different pathologic, radiologic, and clinical features compared with their sporadic counterparts. Most notably, Lynch syndrome-associated tumors tend to be more indolent than non-Lynch syndrome-associated neoplasms and thus may respond differently to traditional chemotherapy regimens. The high MSI in cases of colorectal cancer reflects a difference in the biologic features of the tumor, possibly with a unique susceptibility to immunotherapy. © RSNA, 2018.

Infant mortality in South Africa - distribution, associations and policy implications, 2007: an ecological spatial analysis

PubMed Central

2011-01-01

Background Many sub-Saharan countries are confronted with persistently high levels of infant mortality because of the impact of a range of biological and social determinants. In particular, infant mortality has increased in sub-Saharan Africa in recent decades due to the HIV/AIDS epidemic. The geographic distribution of health problems and their relationship to potential risk factors can be invaluable for cost effective intervention planning. The objective of this paper is to determine and map the spatial nature of infant mortality in South Africa at a sub district level in order to inform policy intervention. In particular, the paper identifies and maps high risk clusters of infant mortality, as well as examines the impact of a range of determinants on infant mortality. A Bayesian approach is used to quantify the spatial risk of infant mortality, as well as significant associations (given spatial correlation between neighbouring areas) between infant mortality and a range of determinants. The most attributable determinants in each sub-district are calculated based on a combination of prevalence and model risk factor coefficient estimates. This integrated small area approach can be adapted and applied in other high burden settings to assist intervention planning and targeting. Results Infant mortality remains high in South Africa with seemingly little reduction since previous estimates in the early 2000's. Results showed marked geographical differences in infant mortality risk between provinces as well as within provinces as well as significantly higher risk in specific sub-districts and provinces. A number of determinants were found to have a significant adverse influence on infant mortality at the sub-district level. Following multivariable adjustment increasing maternal mortality, antenatal HIV prevalence, previous sibling mortality and male infant gender remained significantly associated with increased infant mortality risk. Of these antenatal HIV sero-prevalence, previous sibling mortality and maternal mortality were found to be the most attributable respectively. Conclusions This study demonstrates the usefulness of advanced spatial analysis to both quantify excess infant mortality risk at the lowest administrative unit, as well as the use of Bayesian modelling to quantify determinant significance given spatial correlation. The "novel" integration of determinant prevalence at the sub-district and coefficient estimates to estimate attributable fractions further elucidates the "high impact" factors in particular areas and has considerable potential to be applied in other locations. The usefulness of the paper, therefore, not only suggests where to intervene geographically, but also what specific interventions policy makers should prioritize in order to reduce the infant mortality burden in specific administration areas. PMID:22093084

Evidence for chronic stress in captive but not free-ranging cheetahs (Acinonyx jubatus) based on adrenal morphology and function.

PubMed

Terio, Karen A; Marker, Laurie; Munson, Linda

2004-04-01

The cheetah (Acinonyx jubatus) is highly endangered because of loss of habitat in the wild and failure to thrive in captivity. Cheetahs in zoos reproduce poorly and have high prevalences of unusual diseases that cause morbidity and mortality. These diseases are rarely observed in free-ranging cheetahs but have been documented in cheetahs that have been captured and held in captive settings either temporarily or permanently. Because captivity may be stressful for this species and stress is suspected as contributing to poor health and reproduction, this study aimed to measure chronic stress by comparing baseline concentrations of fecal corticoid metabolites and adrenal gland morphology between captive and free-ranging cheetahs. Additionally, concentrations of estradiol and testosterone metabolites were quantified to determine whether concentrations of gonadal steroids correlated with corticoid concentration and to assure that corticosteroids in the free-ranging samples were not altered by environmental conditions. Concetntrations of fecal corticoids, estradiol, and testosterone were quantified by radioimmunoassay in 20 free-ranging and 20 captive cheetahs from samples collected between 1994 and 1999. Concentrations of baseline fecal corticoids were significantly higher (p = 0.005) in captive cheetahs (196.08 +/- 36.20 ng/g dry feces) than free-ranging cheetahs (71.40 +/- 14.35 ng/g dry feces). Testosterone concentrations were lower in captive male cheetahs (9.09 +/- 2.84 ng/g dry feces) than in free-ranging cheetahs (34.52 +/- 12.11 ng/g dry feces), which suggests suppression by elevated corticoids in the captive males. Evidence for similar sulppression of estradiol concentrations in females was not present. Adrenal corticomedullary ratios were determined on midsagittal sections of adrenal glands from 13 free-ranging and 13 captive cheetahs obtained between 1991 and 2002. The degree of vacuolation of cortical cells in the zona fasciculata was graded for each animal. Corticomedullary ratios were larger (p = 0.05) in captive cheetahs; however, there was no difference (p = 0.31) in the degree of corticocyte vacnolation between the two populations. These data proxile both mnorphologic and functional evidence suggestive of chronic stress in captive cheetahs. Further research into the role of hypercortisolemia in the pathogenesis of the reproductive abnormalities and unusual diseases of captive cheetahs is needed.

Assessing and mapping spatial associations among oral cancer mortality rates, concentrations of heavy metals in soil, and land use types based on multiple scale data.

PubMed

Lin, Wei-Chih; Lin, Yu-Pin; Wang, Yung-Chieh; Chang, Tsun-Kuo; Chiang, Li-Chi

2014-02-21

In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman's rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk.

The Dynamics of Rapidly Emplaced Terrestrial Lava Flows and Implications for Planetary Volcanism

NASA Technical Reports Server (NTRS)

Baloga, Stephen; Spudis, Paul D.; Guest, John E.

1995-01-01

The Kaupulehu 1800-1801 lava flow of Hualalai volcano and the 1823 Keaiwa flow from the Great Crack of the Kilauea southwest rift zone had certain unusual and possibly unique properties for terrestrial basaltic lava flows. Both flows apparently had very low viscosities, high effusion rates, and uncommonly rapid rates of advance. Ultramafic xenolith nodules in the 1801 flow form stacks of cobbles with lava rinds of only millimeter thicknesses. The velocity of the lava stream in the 1801 flow was extremely high, at least 10 m/s (more than 40 km/h). Observations and geological evidence suggest similarly high velocities for the 1823 flow. The unusual eruption conditions that produced these lava flows suggest a floodlike mode of emplacement unlike that of most other present-day flows. Although considerable effort has gone into understanding the viscous fluid dynamics and thermal processes that often occur in basaltic flows, the unusual conditions prevalent for the Kaupulehu and Keaiwa flows necessitate different modeling considerations. We propose an elementary flood model for this type of lava emplacement and show that it produces consistent agreement with the overall dimensions of the flow, channel sizes, and other supporting field evidence. The reconstructed dynamics of these rapidly emplaced terrestrial lava flows provide significant insights about the nature of these eruptions and their analogs in planetary volcanism.

Improved high-intensity microwave discharge lamp for atomic resonance absorption and fluorescence spectrometry.

PubMed

Lifshitz, A; Skinner, G B; Wood, D R

1978-09-01

An unusually good combination of high intensity and narrow line has been achieved in a microwave discharge lamp by placing the optical window in the center of the microwave cavity. Construction details and performance characteristics are described.

Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea.

PubMed

Zulu, Isaac; Hassan, Ghaniah; Njobvu R N, Lungowe; Dhaliwal, Winnie; Sianongo, Sandie; Kelly, Paul

2008-11-13

Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)-gamma and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-gamma, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. High serum concentrations of TNFR p55, IFN-gamma, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN-gamma and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa.

THE CAUSAL RELATIONSHIP BETWEEN CONSANGUINEOUS MARRIAGES AND INFANT MORTALITY IN TURKEY.

PubMed

Koç, İsmet; Eryurt, Mehmet Alİ

2017-07-01

Turkey has high levels of infant mortality and consanguineous marriages. It has had a high level of infant mortality for its economic level for many years. Over recent decades, although adult mortality rates have not been very different from those of other countries with similar socioeconomic structures, its life expectancy at birth has remained low due to its high infant mortality rate. This has been called the Turkish Puzzle. According to the Turkey Family Structure and Population Issues Survey, 27% of women had a consanguineous marriage in 1968. Subsequent Turkish Demographic and Health Surveys (TDHSs) found the rate of consanguineous marriages to be stagnated at 22-24%, with a resistance to reduction. According to the TDHS-2008, 24% of women had a consanguineous marriage. Numerous studies in various countries of the world have indicated that consanguineous marriages, particularly of first-degree, have the effect of increasing infant mortality. The main aim of this study was to assess the causal impact of consanguineous, particularly first-degree consanguineous, marriages on infant mortality, controlling for individual, cultural, bio-demographic and environmental factors. Data were merged from four Turkish DHS data sets (1993, 1998, 2003 and 2008). Multivariate analysis revealed that first-degree consanguineous marriages have increased infant mortality by 45% in Turkey: 57% in urban areas and 39% in rural areas. The results indicate that there is a causal relationship between consanguineous marriages and infant mortality. This finding should be taken into account when planning policies to reduce infant mortality in Turkey, and in other countries with high rates of consanguineous marriage and infant mortality.

Hypothyroidism and acute kidney injury: an unusual association.

PubMed

Neves, Precil Diego Miranda de Menezes; Bridi, Ramaiane Aparecida; Balbi, André Luis; Ponce, Daniela

2013-08-09

Association between severe hypothyroidism and acute kidney injury (AKI) is rare. A 40-year-old woman presented with 15 days history of generalised muscle pain, weakness, weight gain and oedema. hypertension and hypothyroidism. dry skin, peripheral/periorbital oedema, slow thought and speaking, thyroid increased. Laboratory examinations: high levels of creatine kinase , creatinine, uric acid and lactate dehydrogenase. Free T4 was very low (<0.3 ng/dL) and thyroid-stimulating hormone was high (21.7 µIU/mL). Urinalysis showed haem pigment without haematuria. We performed the diagnosis of AKI secondary to hypothyroidism-induced rhabdomyolysis. Intravenous fluids were started, urinary alkalisation and increased l-thyroxine dose replacement. On the day after admission, forced diuresis with furosemide was introduced leading to a progressive improvement of symptoms. Although hypothyroidism and AKI is unusual, it should be suspected in patients presenting decrease of renal function and high creatine kinase in the absence of other causes of rhabdomyolysis.

Acoustic Levitation Containerless Processing

NASA Technical Reports Server (NTRS)

Whymark, R. R.; Rey, C. A.

1985-01-01

This research program consists of the development of acoustic containerless processing systems with applications in the areas of research in material sciences, as well as the production of new materials, solid forms with novel and unusual microstructures, fusion target spheres, and improved optical fibers. Efforts have been focused on the containerless processing at high temperatures for producing new kinds of glasses. Also, some development has occurred in the areas of containerlessly supporting liquids at room temperature, with applications in studies of fluid dynamics, potential undercooling of liquids, etc. The high temperature area holds the greatest promise for producing new kinds of glasses and ceramics, new alloys, and possibly unusual structural shapes, such as very uniform hollow glass shells for fusion target applications. High temperature acoustic levitation required for containerless processing has been demonstrated in low-g environments as well as in ground-based experiments. Future activities include continued development of the signals axis acoustic levitator.

Can the fatty acid selectivity of plant lipases be predicted from the composition of the seed triglyceride?

PubMed

Hellyer, S A; Chandler, I C; Bosley, J A

1999-09-22

To address the question can the fatty acid selectivity of plant lipases be predicted from the composition of the seed triglyceride, we have characterised the selectivity of lipases from a wide range of oilseeds with diverse fatty acid compositions. For this study, a novel hydrolysis assay using a fully randomised oil, was developed. From some seed sources (e.g. Cinnamomum camphora), lipases show high preference for particular fatty acids, whilst from others (e.g. Brassica napus, Theobroma cacao80% saturated or 'unusual' fatty acids may contain lipases which exhibit selectivity. It therefore follows that since the majority of seeds are composed of unsaturated fatty acids, that highly selective lipases will be unusual in nature. However lipases from some species of the Cuphea genera show exceptionally high preference for particular fatty acids. For example, lipase from seeds of Cuphea procumbans has over 20-fold selectivity for C10:0.

Asymmetric mass acquisition in LaBi. Topological semimetal candidate

DOE PAGES

Wu, Yun; Kong, Tai; Wang, Lin-Lin; ...

2016-08-18

We use our high resolution He-lamp-based, tunable laser-based angle-resolved photoemission spectroscopy measurements and density functional theory calculations to study the electronic properties of LaBi, a binary system that was proposed to be a member of a new family of topological semimetals. Both bulk and surface bands are present in the spectra. Furthermore, the dispersion of the surface state is highly unusual. It resembles a Dirac cone, but upon closer inspection we can clearly detect an energy gap. The bottom band follows roughly a parabolic dispersion. The dispersion of the top band remains very linear, “V” -shape like, with the tipmore » approaching very closely to the extrapolated location of Dirac point. Finally, such asymmetric mass acquisition is highly unusual and opens a possibility of a new topological phenomenon that has yet to be understood.« less

Increased Prevalence of Unusual Sensory Behaviors in Infants at Risk for, and Teens with, Autism Spectrum Disorder.

PubMed

Van Etten, Hannah M; Kaur, Maninderjit; Srinivasan, Sudha M; Cohen, Shereen J; Bhat, Anjana; Dobkins, Karen R

2017-11-01

The current study investigated the prevalence and pattern of unusual sensory behaviors (USBs) in teens with Autism Spectrum Disorder (ASD) and infants (3-36 months) at risk for ASD. From two different sites (UCSD and UConn), caregivers of infants at high (n = 32) and low risk (n = 33) for ASD, and teenagers with (n = 12) and without ASD (n = 11), completed age-appropriate Sensory Profile questionnaires (Infant/Toddler Sensory Profile; Dunn 2002; Adolescent/Adult Sensory Profile; Brown and Dunn 2002). The results show that high-risk infants and teenagers with ASD exhibit higher-than-typical prevalence of USBs. Results of our distribution analyses investigating the direction of sensory atypicalities (greater-than-typical vs. less-than-typical) revealed a fair degree of consistency amongst teens, however, USB patterns were more varied in high-risk infants.

Exotic Light Nuclei

ERIC Educational Resources Information Center

Cerny, Joseph; Poskanzer, Arthur M.

1978-01-01

Among the light elements, nuclei with unequal numbers of protons and neutrons are highly unstable. Some survive just long enough to be detected and exhibit unusual regimes of radioactive decay. ( Autor/MA)

Patterns of bleaching and mortality following widespread warming events in 2014 and 2015 at the Hanauma Bay Nature Preserve, Hawai'i.

PubMed

Rodgers, Ku'ulei S; Bahr, Keisha D; Jokiel, Paul L; Richards Donà, Angela

2017-01-01

Drastic increases in global carbon emissions in the past century have led to elevated sea surface temperatures that negatively affect coral reef organisms. Worldwide coral bleaching-related mortality is increasing and data has shown even isolated and protected reefs are vulnerable to the effects of global climate change. In 2014 and 2015, coral reefs in the main Hawaiian Islands (MHI) suffered up to 90% bleaching, with higher than 50% subsequent mortality in some areas. The location and severity of bleaching and mortality was strongly influenced by the spatial and temporal patterns of elevated seawater temperatures. The main objective of this research was to understand the spatial extent of bleaching mortality in Hanauma Bay Nature Preserve (HBNP), O'ahu, Hawai'i to gain a baseline understanding of the physical processes that influence localized bleaching dynamics. Surveys at HBNP in October 2015 and January 2016 revealed extensive bleaching (47%) and high levels of coral mortality (9.8%). Bleaching was highly variable among the four HBNP sectors and ranged from a low of ∼31% in the central bay at Channel (CH) to a high of 57% in the area most frequented by visitors (Keyhole; KH). The highest levels of bleaching occurred in two sectors with different circulation patterns: KH experienced comparatively low circulation velocity and a low temperature increase while Witches Brew (WB) and Backdoors (BD) experienced higher circulation velocity and higher temperature increase. Cumulative mortality was highest at WB (5.0%) and at BD (2.9%) although WB circulation velocity is significantly higher. HBNP is minimally impacted by local factors that can lead to decline such as high fishing pressure or sedimentation although human use is high. Despite the lack of these influences, high coral mortality occurred. Visitor impacts are strikingly different in the two sectors that experienced the highest mortality evidenced by the differences in coral cover associated with visitor use however, coral mortality was similar. These results suggest that elevated temperature was more influential in coral bleaching and the associated mortality than high circulation or visitor use.

Patterns of bleaching and mortality following widespread warming events in 2014 and 2015 at the Hanauma Bay Nature Preserve, Hawai‘i

PubMed Central

2017-01-01

Drastic increases in global carbon emissions in the past century have led to elevated sea surface temperatures that negatively affect coral reef organisms. Worldwide coral bleaching-related mortality is increasing and data has shown even isolated and protected reefs are vulnerable to the effects of global climate change. In 2014 and 2015, coral reefs in the main Hawaiian Islands (MHI) suffered up to 90% bleaching, with higher than 50% subsequent mortality in some areas. The location and severity of bleaching and mortality was strongly influenced by the spatial and temporal patterns of elevated seawater temperatures. The main objective of this research was to understand the spatial extent of bleaching mortality in Hanauma Bay Nature Preserve (HBNP), O‘ahu, Hawai‘i to gain a baseline understanding of the physical processes that influence localized bleaching dynamics. Surveys at HBNP in October 2015 and January 2016 revealed extensive bleaching (47%) and high levels of coral mortality (9.8%). Bleaching was highly variable among the four HBNP sectors and ranged from a low of ∼31% in the central bay at Channel (CH) to a high of 57% in the area most frequented by visitors (Keyhole; KH). The highest levels of bleaching occurred in two sectors with different circulation patterns: KH experienced comparatively low circulation velocity and a low temperature increase while Witches Brew (WB) and Backdoors (BD) experienced higher circulation velocity and higher temperature increase. Cumulative mortality was highest at WB (5.0%) and at BD (2.9%) although WB circulation velocity is significantly higher. HBNP is minimally impacted by local factors that can lead to decline such as high fishing pressure or sedimentation although human use is high. Despite the lack of these influences, high coral mortality occurred. Visitor impacts are strikingly different in the two sectors that experienced the highest mortality evidenced by the differences in coral cover associated with visitor use however, coral mortality was similar. These results suggest that elevated temperature was more influential in coral bleaching and the associated mortality than high circulation or visitor use. PMID:28584703

Primary Renal Hybrid Low-grade Fibromyxoid Sarcoma-Sclerosing Epithelioid Fibrosarcoma: An Unusual Pediatric Case With EWSR1-CREB3L1 Fusion.

PubMed

Mok, Yingting; Pang, Yin Huei; Sanjeev, Jain Sudhanshi; Kuick, Chik Hong; Chang, Kenneth Tou-En

2018-01-01

Low-grade fibromyxoid sarcoma (LGFMS) and sclerosing epithelioid fibrosarcoma (SEF) are rare tumors with distinct sets of morphological features, both characterized by MUC4 immunoreactivity. Tumors exhibiting features of both entities are considered hybrid LGFMS-SEF lesions. While the majority of LGFMS cases are characterized by FUS-CREB3L2 gene fusions, most cases of pure SEF show EWSR1 gene rearrangements. In the largest study of hybrid LGFMS-SEF tumors to date, all cases exhibited FUS rearrangements, a similar genetic profile to LGFMS. We herein describe the clinicopathological features and genetic findings of a case of primary renal hybrid LGFMS-SEF occurring in a 10-year-old child, with disseminated metastases. Fusion gene detection using a next-generation sequencing-based anchored multiplex PCR technique (Archer FusionPlex Sarcoma Panel) was performed on both the primary renal tumor that showed the morphology of a LGFMS, and a cervical metastasis that showed the morphology of SEF. An EWSR1-CREB3L1 gene fusion occurring between exon 11 of EWSR1 and exon 6 of CREB3L1 was present in both the LGFMS and SEF components. This unusual case provides evidence that a subset of hybrid LGFMS-SEF harbor EWSR1-CREB3L1 gene fusions. In this case, these features were associated with an aggressive clinical course, with disease-associated mortality occurring within 12 months of diagnosis.

Intersection of Race/Ethnicity and Socioeconomic Status in Mortality After Breast Cancer

PubMed Central

Yang, Juan; John, Esther M.; Kurian, Allison W.; Cheng, Iona; Leung, Rita; Koo, Jocelyn; Monroe, Kristine R.; Henderson, Brian E.; Bernstein, Leslie; Lu, Yani; Kwan, Marilyn L.; Sposto, Richard; Vigen, Cheryl L. P.; Wu, Anna H.; Keegan, Theresa H. M.; Gomez, Scarlett Lin

2015-01-01

We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993–2007 in California with follow-up through 2010) from four racial/ ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/ low-nSES [hazard ratio (HR) (95 % confidence interval) 1.24 (1.08–1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03–1.49); low-education HR 1.19 (0.99–1.44)]. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54–0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Similar patterns were seen for BC-specific mortality. Individual- and neighborhood-level measures of SES interact with race/ ethnicity to impact mortality after BC diagnosis. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health. PMID:26072260

Hospital experience and mortality in patients with systemic lupus erythematosus: which patients benefit most from treatment at highly experienced hospitals?

PubMed

Ward, Michael M

2002-06-01

To determine if hospitalization at a hospital experienced in the treatment of systemic lupus erythematosus (SLE), compared to hospitalization at a less experienced hospital, is associated with decreased in-hospital mortality in all subsets of patients with SLE, or if the decrease in mortality is greater for patients with particular demographic characteristics, manifestations of SLE, or reasons for hospitalization. Data on in-hospital mortality were available for 9989 patients with SLE hospitalized in acute care hospitals in California from 1991 to 1994. Differences in in-hospital mortality between patients hospitalized at highly experienced hospitals (those hospitals with more than 50 urgent or emergent hospitalizations of patients with SLE per year) and those hospitalized at less experienced hospitals were compared in patient subgroups defined by age, sex, ethnicity, type of medical insurance, the presence of common SLE manifestations, and each of the 10 most common principal reasons for hospitalization. In univariate analyses, in-hospital mortality was lower among those hospitalized at a highly experienced hospital for women, blacks, and Hispanics, and those with public medical insurance or no insurance. The risk of in-hospital mortality was similar between highly experienced and less experienced hospitals for men, whites, and those with private insurance. Patients with nephritis also had lower risks of in-hospital mortality if they were hospitalized at highly experienced hospitals, but this risk did not differ in subgroups with other SLE manifestations or subgroups with different principal reasons for hospitalization. In multivariate analyses, only the interaction between medical insurance and hospitalization at a highly experienced hospital was significant. Results were similar in the subgroup of patients with an emergency hospitalization (n = 2,372), but more consistent benefits of hospitalization at a highly experienced hospital were found across subgroups of patients with an emergency hospitalization due to SLE (n = 405). Risks of in-hospital mortality for patients with SLE were similar between highly experienced hospitals and less experienced hospitals for patients with private medical insurance, but patients without private insurance had much lower risks of mortality if hospitalized at highly experienced hospitals. The benefit of hospitalization at highly experienced hospitals was more consistent across subgroups of patients with a hospitalization due to SLE, suggesting that differences specifically in the treatment of SLE, rather than differences in the general quality of medical care, account for the lower mortality among patients with SLE hospitalized at highly experienced hospitals.

Characterization of PM2.5 and identification of transported secondary and biomass burning contribution in Seoul, Korea.

PubMed

Kim, Yumi; Seo, Jihoon; Kim, Jin Young; Lee, Ji Yi; Kim, Hwajin; Kim, Bong Mann

2018-02-01

The chemical and seasonal characteristics of fine particulates in Seoul, Korea, were investigated based on 24-h integrated PM 2.5 measurements made over four 1-month periods in each season between October 2012 and September 2013. The four-season average concentration of PM 2.5 was 37 μg m -3 , and the major chemical components were secondary inorganic aerosol (SIA) species of sulfate, nitrate, and ammonium (49%), followed by organic matter (34%). The mass concentration and most of the chemical components of PM 2.5 showed clear seasonal variation, with a winter-high and summer-low pattern. The winter-to-summer sulfate ratio and the winter organic carbon (OC)-to-elemental carbon (EC) ratio were unusually high compared with those in previous studies. Strong correlations of both the sulfate level and the sulfur oxidation ratio with relative humidity, and between water-soluble OC (WSOC) and SIA in winter, suggest the importance of aqueous phase chemistry for secondary aerosols. A strong correlation between non-sea salt sulfate and Na + levels, a high Cl - /Na + ratio, and an unusual positive correlation between the nitrogen oxidation ratio and temperature during the winter indicate the influence of transported secondary emission sources from upwind urban areas and from China across the Yellow Sea. Despite the absence of local forest fires and the regulation of wood burning, a high levoglucosan concentration and its correlations with OC and WSOC indicate that Seoul was affected by biomass burning sources in the winter. The unusually high water-insoluble OC (WIOC)-to-EC ratio in winter implies additional transported combustion sources of WIOC. The strong correlation between WIOC and levoglucosan suggests the likely influence of transported biomass burning sources on the high WIOC/EC ratio during the winter.

Cancer in Korean war navy technicians: mortality survey after 40 years.

PubMed

Groves, Frank D; Page, William F; Gridley, Gloria; Lisimaque, Laure; Stewart, Patricia A; Tarone, Robert E; Gail, Mitchell H; Boice, John D; Beebe, Gilbert W

2002-05-01

This study reports on over 40 years of mortality follow-up of 40,581 Navy veterans of the Korean War with potential exposure to high-intensity radar. The cohort death rates were compared with mortality rates for White US men using standardized mortality ratios, and the death rates for men in occupations considered a priori to have high radar exposure were compared with the rates for men in low-exposure occupations using Poisson regression. Deaths from all diseases and all cancers were significantly below expectation overall and for the 20,021 sailors with high radar exposure potential. There was no evidence of increased brain cancer in the entire cohort (standardized mortality ratio (SMR) = 0.9, 95% confidence interval (CI): 0.7, 1.1) or in high-exposure occupations (SMR = 0.7, 95% CI: 0.5, 1.0). Testicular cancer deaths also occurred less frequently than expected in the entire cohort and high-exposure occupations. Death rates for several smoking-related diseases were significantly lower in the high-exposure occupations. Nonlymphocytic leukemia was significantly elevated among men in high-exposure occupations but in only one of the three high-exposure occupations, namely, electronics technicians in aviation squadrons (SMR = 2.2, 95% CI: 1.3, 3.7). Radar exposure had little effect on mortality in this cohort of US Navy veterans.

High adult mortality among Hiwi hunter-gatherers: implications for human evolution.

PubMed

Hill, Kim; Hurtado, A M; Walker, R S

2007-04-01

Extant apes experience early sexual maturity and short life spans relative to modern humans. Both of these traits and others are linked by life-history theory to mortality rates experienced at different ages by our hominin ancestors. However, currently there is a great deal of debate concerning hominin mortality profiles at different periods of evolutionary history. Observed rates and causes of mortality in modern hunter-gatherers may provide information about Upper Paleolithic mortality that can be compared to indirect evidence from the fossil record, yet little is published about causes and rates of mortality in foraging societies around the world. To our knowledge, interview-based life tables for recent hunter-gatherers are published for only four societies (Ache, Agta, Hadza, and Ju/'hoansi). Here, we present mortality data for a fifth group, the Hiwi hunter-gatherers of Venezuela. The results show comparatively high death rates among the Hiwi and highlight differences in mortality rates among hunter-gatherer societies. The high levels of conspecific violence and adult mortality in the Hiwi may better represent Paleolithic human demographics than do the lower, disease-based death rates reported in the most frequently cited forager studies.

A different type of 'glue ear': report of an unusual case of prominent ears.

PubMed

Purcell, Elizabeth M; O'Neill, Ann C; Regan, Padraic J

2003-09-01

Prominent ears is a condition that can cause extreme psychological distress in young people. This cosmetic deformity can be corrected by otoplasty, an outpatient surgical procedure that is associated with a high rate of patient satisfaction. We report the unusual case of a teenage boy who had repeatedly applied cyanoacrylate adhesive ("superglue") to his postauricular skin in an attempt to pin back his prominent ears. This case of "glue ear" was ultimately resolved by successful otoplasty, although the residual effects of the glue resulted in delayed healing of the surgical wound.

An unusual slowdown of fast diffusion in a room temperature

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

Chathoth,; Mamontov, Eugene; Fulvio, Pasquale F

2013-01-01

Using quasielastic neutron scattering in the temperature range from 290 to 350 K, we show that the diffusive motions in a room temperature ionic liquid [H2NC(dma)2][BETI] become faster for a fraction of cations when the liquid is confined in a mesoporous carbon. This applies to both the localized and long-range translational diffusive motions of the highly mobile cations, although the former exhibit an unusual trend of slowing-down as the temperature is increased, until the localized diffusivity is reduced to the bulk ionic liquid value at a temperature of 350 K.

Uniportal anatomic combined unusual segmentectomies.

PubMed

González-Rivas, Diego; Lirio, Francisco; Sesma, Julio

2017-01-01

Nowadays, sublobar anatomic resections are gaining momentum as a valid alternative for early stage lung cancer. Despite being technically demanding, anatomic segmentectomies can be performed by uniportal video-assisted thoracic surgery (VATS) approach to combine the benefits of minimally invasiveness with the maximum lung sparing. This procedure can be even more complex if a combined resection of multiple segments from different lobes has to be done. Here we report five cases of combined and unusual segmentectomies done by the same experienced surgeon in high volume institutions to show uniportal VATS is a feasible approach for these complex resections and to share an excellent educational resource.

Refractory inclusions in the Ornans C30 chondrite

NASA Technical Reports Server (NTRS)

Davis, A. M.

1985-01-01

Several types of metedorites contain unusual objects 10 micrometers to 2 centimeters across that are enriched in refractory elements such as calcium, aluminum and titanium. These objects, commonly known as refractory inclusions, are most abundant in the meteorites known as carbonaceous chondrites. The refractory inclusions that have been found in the Ornans metedorite, a member of a little-studied group of carbonaceous chondrites are described. Some refractory inclusions in Ornans resemble those found in other meteorites, while others are unlike any seen before. The unusual inclusions in Ornans contain minerals with extraordinary enrichments in highly refractory elements.

Migrating foreign body in the tracheobronchial tree: an unusual case of firework penetrating neck injury.

PubMed

Khan, M Sarwar; Kirkland, P M; Kumar, R

2002-02-01

Firework injuries can manifest themselves in many different ways; usually as an explosive or burn injury. This case describes an unusual presentation of a firework penetrating injury resulting in a sharp coiled metal foreign body travelling through a small entry wound in the neck and subsequently lodging itself in the tracheobronchial tree. A foreign body such as this can potentially travel a considerable distance through the soft tissues and end up in an unsuspecting distant site. There must, therefore, be a high index of suspicion with the appropriate radiological investigations for appropriate management of such cases.

Unusually severe food poisoning from vanilla slices.

PubMed Central

Fenton, P. A.; Dobson, K. W.; Eyre, A.; McKendrick, M. W.

1984-01-01

Thirty six people suffered from severe vomiting and diarrhoea 15 min to 3 h after eating vanilla slices from the same bakery. Five patients were admitted to hospital, and one developed unusual skin lesions after admission. Staphylococcus aureus was isolated in large numbers from vanilla slices of the same batch as those giving rise to symptoms, and from five faecal specimens obtained from affected persons. Bacillus cereus and Bacillus subtilis were also isolated from the slices. Unbaked custard provides an ideal environment for bacterial multiplication, especially when (as on this occasion) the ambient temperature is persistently high. PMID:6438231

Ebola Virus and Severe Acute Respiratory Syndrome Coronavirus Display Late Cell Entry Kinetics: Evidence that Transport to NPC1+ Endolysosomes Is a Rate-Defining Step

PubMed Central

Mingo, Rebecca M.; Simmons, James A.; Shoemaker, Charles J.; Nelson, Elizabeth A.; Schornberg, Kathryn L.; D'Souza, Ryan S.; Casanova, James E.

2014-01-01

ABSTRACT Ebola virus (EBOV) causes hemorrhagic fevers with high mortality rates. During cellular entry, the virus is internalized by macropinocytosis and trafficked through endosomes until fusion between the viral and an endosomal membrane is triggered, releasing the RNA genome into the cytoplasm. We found that while macropinocytotic uptake of filamentous EBOV viruslike particles (VLPs) expressing the EBOV glycoprotein (GP) occurs relatively quickly, VLPs only begin to enter the cytoplasm after a 30-min lag, considerably later than particles bearing the influenza hemagglutinin or GP from lymphocytic choriomeningitis virus, which enter through late endosomes (LE). For EBOV, the long lag is not due to the large size or unusual shape of EBOV filaments, the need to prime EBOV GP to the 19-kDa receptor-binding species, or a need for unusually low endosomal pH. In contrast, since we observed that EBOV entry occurs upon arrival in Niemann-Pick C1 (NPC1)-positive endolysosomes (LE/Lys), we propose that trafficking to LE/Lys is a key rate-defining step. Additional experiments revealed, unexpectedly, that severe acute respiratory syndrome (SARS) S-mediated entry also begins only after a 30-min lag. Furthermore, although SARS does not require NPC1 for entry, SARS entry also begins after colocalization with NPC1. Since the only endosomal requirement for SARS entry is cathepsin L activity, we tested and provide evidence that NPC1+ LE/Lys have higher cathepsin L activity than LE, with no detectable activity in earlier endosomes. Our findings suggest that both EBOV and SARS traffic deep into the endocytic pathway for entry and that they do so to access higher cathepsin activity. IMPORTANCE Ebola virus is a hemorrhagic fever virus that causes high fatality rates when it spreads from zoonotic vectors into the human population. Infection by severe acute respiratory syndrome coronavirus (SARS-CoV) causes severe respiratory distress in infected patients. A devastating outbreak of EBOV occurred in West Africa in 2014, and there was a significant outbreak of SARS in 2003. No effective vaccine or treatment has yet been approved for either virus. We present evidence that both viruses traffic late into the endocytic pathway, to NPC1+ LE/Lys, in order to enter host cells, and that they do so to access high levels of cathepsin activity, which both viruses use in their fusion-triggering mechanisms. This unexpected similarity suggests an unexplored vulnerability, trafficking to NPC1+ LE/Lys, as a therapeutic target for SARS and EBOV. PMID:25552710

Is the high ischemic heart disease mortality rate in New York State just an urban effect?

PubMed Central

McNutt, L A; Strogatz, D S; Coles, F B; Fehrs, L J

1994-01-01

To determine whether New York State's high ischemic heart disease mortality rate was due primarily to an urban effect, rates for regions in the State were compared with each other and with national data. New York State mortality rates for the period 1980-87 were highest for New York City (344.5 per 100,000 residents), followed by upstate urban and rural areas (267.1-285.1), and New York City suburbs (272.5). However, the overall 1986 age-adjusted rate for the New York State region with the lowest mortality rate (265.7) exceeded that of 42 States. New York State's number one ischemic heart disease mortality ranking reflects the need for statewide intervention programs, because even regions with relatively low mortality rates are high when they are compared with national rates. PMID:8041858

Space Radiation Effects and Reliability Consideration for the Proposed Jupiter Europa Orbiter

NASA Technical Reports Server (NTRS)

Johnston, Allan

2011-01-01

The proposed Jupiter Europa Orbiter (JEO) mission to explore the Jovian moon Europa poses a number of challenges. The spacecraft must operate for about seven years during the transit time to the vicinity of Jupiter, and then endure unusually high radiation levels during exploration and orbiting phases. The ability to withstand usually high total dose levels is critical for the mission, along with meeting the high reliability standards for flagship NASA missions. Reliability of new microelectronic components must be sufficiently understood to meet overall mission requirements.The proposed Jupiter Europa Orbiter (JEO) mission to explore the Jovian moon Europa poses a number of challenges. The spacecraft must operate for about seven years during the transit time to the vicinity of Jupiter, and then endure unusually high radiation levels during exploration and orbiting phases. The ability to withstand usually high total dose levels is critical for the mission, along with meeting the high reliability standards for flagship NASA missions. Reliability of new microelectronic components must be sufficiently understood to meet overall mission requirements.

Doppler line profiles measurement of the Jovian Lyman Alpha emission with OAO-C

NASA Technical Reports Server (NTRS)

Barker, E. S.; Cochran, W. D.; Smith, H. J.

1982-01-01

Observation of Jupiter made with the high resolution ultraviolet spectrometer of the Orbiting Astronomical Observatory copernicus in April and May, 1980, yield a Jovian Lyman alpha emission intensity of 7 + or 2.5 RR. This indicates a decrease by about a factor of two since the Voyager ultraviolet spectrometer measurements, nearly a year earlier. An unusually high column abundance of hydrogen atoms above the methane homopause at the Voyager epoch is indicated. Since the auroral charged particle bombardment of molecular hydrogen is expected to contribute significantly to the global population of the hydrogen atoms, it is suggested that at the time of the Voyager Jupiter encounter unusually high auroral activity existed, perhaps d to the high concentration of the Io plasma torus. The temporal variation of the Saturn lyman alpha emission, when contrasted with the Jovian data, reveals that the auroral processes are not nearly as important in determining the Saturn Lyman alpha intensity in the nonauroral region.

The biosynthesis of nitrogen-, sulfur-, and high-carbon chain-containing sugars.

PubMed

Lin, Chia-I; McCarty, Reid M; Liu, Hung-wen

2013-05-21

Carbohydrates serve many structural and functional roles in biology. While the majority of monosaccharides are characterized by the chemical composition (CH2O)n, modifications including deoxygenation, C-alkylation, amination, O- and N-methylation, which are characteristic of many sugar appendages of secondary metabolites, are not uncommon. Interestingly, some sugar molecules are formed via modifications including amine oxidation, sulfur incorporation, and "high-carbon" chain attachment. Most of these unusual sugars have been identified over the past several decades as components of microbially produced natural products, although a few high-carbon sugars are also found in the lipooligosaccharides of the outer cell walls of Gram-negative bacteria. Despite their broad distribution in nature, these sugars are considered "rare" due to their relative scarcity. The biosynthetic steps that underlie their formation continue to perplex researchers to this day and many questions regarding key transformations remain unanswered. This review will focus on our current understanding of the biosynthesis of unusual sugars bearing oxidized amine substituents, thio-functional groups, and high-carbon chains.

Educational Attainment and Adult Mortality in the United States: A Systematic Analysis of Functional Form*

PubMed Central

Montez, Jennifer Karas; Hummer, Robert A.; Hayward, Mark D.

2012-01-01

A vast literature has documented the inverse association between educational attainment and U.S. adult mortality risk, but given little attention to identifying the optimal functional form of the association. A theoretical explanation of the association hinges on our ability to empirically describe it. Using the 1979–1998 National Longitudinal Mortality Study for non-Hispanic white and black adults aged 25–100 years during the mortality follow-up period (N=1,008,215), we evaluated 13 functional forms across race-gender-age subgroups to determine which form(s) best captured the association. Results revealed that a functional form that includes a linear decline in mortality risk from 0–11 years of education, followed by a step-change reduction in mortality risk upon attainment of a high school diploma, at which point mortality risk resumes a linear decline but with a steeper slope than that prior to a high school diploma was generally preferred. The findings provide important clues for theoretical development of explanatory mechanisms: an explanation for the selected functional form may require integrating a credentialist perspective to explain the step-change reduction in mortality risk upon attainment of a high school diploma, with a human capital perspective to explain the linear declines before and after a high school diploma. PMID:22246797

Low physical activity as a predictor for total and cardiovascular disease mortality in middle-aged men and women in Finland.

PubMed

Barengo, Noël C; Hu, Gang; Lakka, Timo A; Pekkarinen, Heikki; Nissinen, Aulikki; Tuomilehto, Jaakko

2004-12-01

To investigate separately for men and women whether moderate or high leisure time physical activity, occupational physical activity, and commuting activity are associated with a reduced cardiovascular disease (CVD) and all-cause mortality, independent of CVD risk factors and other forms of physical activity. Prospective follow-up of 15,853 men and 16,824 women aged 30-59 years living in eastern and south-western Finland (median follow-up time 20 years). CVD and all-cause mortality were lower (9-21%) in men and women (2-17%) who were moderately or highly physically active during leisure time. Moderate and high levels of occupational physical activity decreased CVD and all-cause mortality by 21-27% in both sexes. Women spending daily 15 min or more in walking or cycling to and from work had a reduced CVD and all-cause mortality before adjustment for occupational and leisure time physical activity. Commuting activity was not associated with CVD or all-cause mortality in men. Moderate and high levels of leisure time and occupational physical activity are associated with a reduced CVD and all-cause mortality among both sexes. Promoting already moderate levels of leisure time and occupational physical activity are essential to prevent premature CVD and all-cause mortality.

Lower Mortality for Abdominal Aortic Aneurysm Repair in High-Volume Hospitals Is Contingent upon Nurse Staffing

PubMed Central

Wiltse Nicely, Kelly L; Sloane, Douglas M; Aiken, Linda H

2013-01-01

Objective To determine whether and to what extent the lower mortality rates for patients undergoing abdominal aortic aneurysm (AAA) repair in high-volume hospitals is explained by better nursing. Data Sources State hospital discharge data, Multi-State Nursing Care and Patient Safety Survey, and hospital characteristics from the AHA Annual Survey. Study Design Cross-sectional analysis of linked patient outcomes for individuals undergoing AAA repair in four states. Data Collection Secondary data sources. Principal Findings Favorable nursing practice environments and higher hospital volumes of AAA repair are associated with lower mortality and fewer failures-to-rescue in main-effects models. Furthermore, nurse staffing interacts with volume such that there is no mortality advantage observed in high-volume hospitals with poor nurse staffing. When hospitals have good nurse staffing, patients in low-volume hospitals are 3.4 times as likely to die and 2.6 times as likely to die from complications as patients in high-volume hospitals (p < .001). Conclusions Nursing is part of the explanation for lower mortality after AAA repair in high-volume hospitals. Importantly, lower mortality is not found in high-volume hospitals if nurse staffing is poor. PMID:23088426

Residual confounding explains the association between high parity and child mortality.

PubMed

Kozuki, Naoko; Sonneveldt, Emily; Walker, Neff

2013-01-01

This study used data from recent Demographic and Health Surveys (DHS) to examine the impact of high parity on under-five and neonatal mortality. The analyses used various techniques to attempt eliminating selection issues, including stratification of analyses by mothers' completed fertility. We analyzed DHS datasets from 47 low- and middle-income countries. We only used data from women who were age 35 or older at the time of survey to have a measure of their completed fertility. We ran log-binominal regression by country to calculate relative risk between parity and both under-five and neonatal mortality, controlled for wealth quintile, maternal education, urban versus rural residence, maternal age at first birth, calendar year (to control for possible time trends), and birth interval. We then controlled for maternal background characteristics even further by using mothers' completed fertility as a proxy measure. We found a statistically significant association between high parity and child mortality. However, this association is most likely not physiological, and can be largely attributed to the difference in background characteristics of mothers who complete reproduction with high fertility versus low fertility. Children of high completed fertility mothers have statistically significantly increased risk of death compared to children of low completed fertility mothers at every birth order, even after controlling for available confounders (i.e. among children of birth order 1, adjusted RR of under-five mortality 1.58, 95% CI: 1.42, 1.76). There appears to be residual confounders that put children of high completed fertility mothers at higher risk, regardless of birth order. When we examined the association between parity and under-five mortality among mothers with high completed fertility, it remained statistically significant, but negligible in magnitude (i.e. adjusted RR of under-five mortality 1.03, 95% CI: 1.02-1.05). Our analyses strongly suggest that the observed increased risk of mortality associated with high parity births is not driven by a physiological link between parity and mortality. We found that at each birth order, children born to women who have high fertility at the end of their reproductive period are at significantly higher mortality risk than children of mothers who have low fertility, even after adjusting for available confounders. With each unit increase in birth order, a larger proportion of births at the population level belongs to mothers with these adverse characteristics correlated with high fertility. Hence it appears as if mortality rates go up with increasing parity, but not for physiological reasons.

Variation in hospital mortality rates with inpatient cancer surgery.

PubMed

Wong, Sandra L; Revels, ShaʼShonda L; Yin, Huiying; Stewart, Andrew K; McVeigh, Andrea; Banerjee, Mousumi; Birkmeyer, John D

2015-04-01

To elucidate clinical mechanisms underlying variation in hospital mortality after cancer surgery : Thousands of Americans die every year undergoing elective cancer surgery. Wide variation in hospital mortality rates suggest opportunities for improvement, but these efforts are limited by uncertainty about why some hospitals have poorer outcomes than others. Using data from the 2006-2007 National Cancer Data Base, we ranked 1279 hospitals according to a composite measure of perioperative mortality after operations for bladder, esophagus, colon, lung, pancreas, and stomach cancers. We then conducted detailed medical record review of 5632 patients at 1 of 19 hospitals with low mortality rates (2.1%) or 30 hospitals with high mortality rates (9.1%). Hierarchical logistic regression analyses were used to compare risk-adjusted complication incidence and case-fatality rates among patients experiencing serious complications. The 7.0% absolute mortality difference between the 2 hospital groups could be attributed to higher mortality from surgical site, pulmonary, thromboembolic, and other complications. The overall incidence of complications was not different between hospital groups [21.2% vs 17.8%; adjusted odds ratio (OR) = 1.34, 95% confidence interval (CI): 0.93-1.94]. In contrast, case-fatality after complications was more than threefold higher at high mortality hospitals than at low mortality hospitals (25.9% vs 13.6%; adjusted OR = 3.23, 95% CI: 1.56-6.69). Low mortality and high mortality hospitals are distinguished less by their complication rates than by how frequently patients die after a complication. Strategies for ensuring the timely recognition and effective management of postoperative complications will be essential in reducing mortality after cancer surgery.

5 CFR 337.206 - Terminations, modifications, extensions, and reporting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... advertised under the direct-hire authority, the number of qualified applicants, the specific qualification... assessment of the effectiveness of the authority in attracting employees with unusually high qualifications...

Lyme Disease Tests

MedlinePlus

... by the laboratory that performed your test to evaluate whether your results are "within normal limits." For ... causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. The Lancet Infectious Diseases . Available online at ...

High PRF high current switch

DOEpatents

Moran, Stuart L.; Hutcherson, R. Kenneth

1990-03-27

A triggerable, high voltage, high current, spark gap switch for use in pu power systems. The device comprises a pair of electrodes in a high pressure hydrogen environment that is triggered by introducing an arc between one electrode and a trigger pin. Unusually high repetition rates may be obtained by undervolting the switch, i.e., operating the trigger at voltages much below the self-breakdown voltage of the device.

48 CFR 1332.114 - Unusual contract financing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Unusual contract financing... CONTRACTING REQUIREMENTS CONTRACT FINANCING Non-Commercial Item Purchase Financing 1332.114 Unusual contract financing. The designee authorized to approve unusual contract financing arrangements is set forth in CAM...

48 CFR 32.114 - Unusual contract financing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Unusual contract financing... CONTRACTING REQUIREMENTS CONTRACT FINANCING Non-Commercial Item Purchase Financing 32.114 Unusual contract financing. Any contract financing arrangement that deviates from this part is unusual contract financing...

48 CFR 432.114 - Unusual contract financing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Unusual contract financing... CONTRACTING REQUIREMENTS CONTRACT FINANCING Non-Commercial Item Purchase Financing 432.114 Unusual contract financing. The HCA is authorized to approve unusual contract financing. The signed determination and finding...

Characterizing the relationship between temperature and mortality in tropical and subtropical cities: a distributed lag non-linear model analysis in Hue, Viet Nam, 2009-2013.

PubMed

Dang, Tran Ngoc; Seposo, Xerxes T; Duc, Nguyen Huu Chau; Thang, Tran Binh; An, Do Dang; Hang, Lai Thi Minh; Long, Tran Thanh; Loan, Bui Thi Hong; Honda, Yasushi

2016-01-01

The relationship between temperature and mortality has been found to be U-, V-, or J-shaped in developed temperate countries; however, in developing tropical/subtropical cities, it remains unclear. Our goal was to investigate the relationship between temperature and mortality in Hue, a subtropical city in Viet Nam. We collected daily mortality data from the Vietnamese A6 mortality reporting system for 6,214 deceased persons between 2009 and 2013. A distributed lag non-linear model was used to examine the temperature effects on all-cause and cause-specific mortality by assuming negative binomial distribution for count data. We developed an objective-oriented model selection with four steps following the Akaike information criterion (AIC) rule (i.e. a smaller AIC value indicates a better model). High temperature-related mortality was more strongly associated with short lags, whereas low temperature-related mortality was more strongly associated with long lags. The low temperatures increased risk in all-category mortality compared to high temperatures. We observed elevated temperature-mortality risk in vulnerable groups: elderly people (high temperature effect, relative risk [RR]=1.42, 95% confidence interval [CI]=1.11-1.83; low temperature effect, RR=2.0, 95% CI=1.13-3.52), females (low temperature effect, RR=2.19, 95% CI=1.14-4.21), people with respiratory disease (high temperature effect, RR=2.45, 95% CI=0.91-6.63), and those with cardiovascular disease (high temperature effect, RR=1.6, 95% CI=1.15-2.22; low temperature effect, RR=1.99, 95% CI=0.92-4.28). In Hue, the temperature significantly increased the risk of mortality, especially in vulnerable groups (i.e. elderly, female, people with respiratory and cardiovascular diseases). These findings may provide a foundation for developing adequate policies to address the effects of temperature on health in Hue City.

Characterizing the relationship between temperature and mortality in tropical and subtropical cities: a distributed lag non-linear model analysis in Hue, Viet Nam, 2009–2013

PubMed Central

Dang, Tran Ngoc; Seposo, Xerxes T.; Duc, Nguyen Huu Chau; Thang, Tran Binh; An, Do Dang; Hang, Lai Thi Minh; Long, Tran Thanh; Loan, Bui Thi Hong; Honda, Yasushi

2016-01-01

Background The relationship between temperature and mortality has been found to be U-, V-, or J-shaped in developed temperate countries; however, in developing tropical/subtropical cities, it remains unclear. Objectives Our goal was to investigate the relationship between temperature and mortality in Hue, a subtropical city in Viet Nam. Design We collected daily mortality data from the Vietnamese A6 mortality reporting system for 6,214 deceased persons between 2009 and 2013. A distributed lag non-linear model was used to examine the temperature effects on all-cause and cause-specific mortality by assuming negative binomial distribution for count data. We developed an objective-oriented model selection with four steps following the Akaike information criterion (AIC) rule (i.e. a smaller AIC value indicates a better model). Results High temperature-related mortality was more strongly associated with short lags, whereas low temperature-related mortality was more strongly associated with long lags. The low temperatures increased risk in all-category mortality compared to high temperatures. We observed elevated temperature-mortality risk in vulnerable groups: elderly people (high temperature effect, relative risk [RR]=1.42, 95% confidence interval [CI]=1.11–1.83; low temperature effect, RR=2.0, 95% CI=1.13–3.52), females (low temperature effect, RR=2.19, 95% CI=1.14–4.21), people with respiratory disease (high temperature effect, RR=2.45, 95% CI=0.91–6.63), and those with cardiovascular disease (high temperature effect, RR=1.6, 95% CI=1.15–2.22; low temperature effect, RR=1.99, 95% CI=0.92–4.28). Conclusions In Hue, the temperature significantly increased the risk of mortality, especially in vulnerable groups (i.e. elderly, female, people with respiratory and cardiovascular diseases). These findings may provide a foundation for developing adequate policies to address the effects of temperature on health in Hue City. PMID:26781954

Dying in their prime: determinants and space-time risk of adult mortality in rural South Africa

PubMed Central

Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A.; Sartorius, Kurt; Tollman, Stephen M.

2013-01-01

A longitudinal dataset was used to investigate adult mortality in rural South Africa in order to determine location, trends, high impact determinants and policy implications. Adult (15-59 years) mortality data for the period 1993-2010 were extracted from the health and socio-demographic surveillance system (HDSS) in the rural sub-district of Agincourt. A Bayesian geostatistical frailty survival model was used to quantify significant associations between adult mortality and various multilevel (individual, household and community) variables. It was found that adult mortality significantly increased over time with a reduction observed late in the study period. Non-communicable disease mortality appeared to increase and decrease in parallel with communicable mortality, whilst deaths due to external causes remained constant. Male gender, unemployment, circular (labour) migrant status, age and gender of household heads, partner and/or other household death, low education and low household socioeconomic status (SES) were identified as significant and highly attributable determinants of adult mortality. Health facility remoteness was also a risk for adult mortality and households falling outside a critical buffering zone were identified. Spatial foci of higher adult mortality risk were observed indicating a strong non-random pattern. Communicable diseases differed from non-communicable diseases with respect to spatial distribution of mortality. Areas with significant excess mortality risk (hotspots) were found to be part of a complex interaction of highly attributable factors that continues to drive differential space-time risk patterns of communicable (HIV/AIDS and Tuberculosis) mortality in Agincourt. The impact of HIV mortality and its subsequent lowering due to the introduction of antiretroviral therapy (ART) was found to be clearly evident in this rural population. PMID:23733287

Dying in their prime: determinants and space-time risk of adult mortality in rural South Africa.

PubMed

Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A; Sartorius, Kurt; Tollman, Stephen M

2013-05-01

A longitudinal dataset was used to investigate adult mortality in rural South Africa in order to determine location, trends, high impact determinants and policy implications. Adult (15-59 years) mortality data for the period 1993-2010 were extracted from the health and demographic surveillance system in the rural sub-district of Agincourt. A Bayesian geostatistical frailty survival model was used to quantify significant associations between adult mortality and various multilevel (individual, household and community) variables. It was found that adult mortality significantly increased over time with a reduction observed late in the study period. Non-communicable disease mortality appeared to increase and decrease in parallel with communicable mortality, whilst deaths due to external causes remained constant. Male gender, unemployment, circular (labour) migrant status, age and gender of household heads, partner and/or other household death, low education and low household socio-economic status were identified as significant and highly attributable determinants of adult mortality. Health facility remoteness was a risk for adult mortality and households falling outside a critical buffering zone were identified. Spatial foci of higher adult mortality risk were observed, indicating a strong non-random pattern. Communicable diseases differed from non-communicable diseases with respect to spatial distribution of mortality. Areas with significant excess mortality risk (hot spots) were found to be part of a complex interaction of highly attributable factors that continues to drive differential space-time risk patterns of communicable (HIV/AIDS and tuberculosis) mortality in Agincourt. The impact of HIV mortality and its subsequent lowering due to the introduction of antiretroviral therapy was found to be clearly evident in this rural population.

Tiotropium might improve survival in subjects with COPD at high risk of mortality

PubMed Central

2014-01-01

Background Inhaled therapies reduce risk of chronic obstructive pulmonary disease (COPD) exacerbations, but their effect on mortality is less well established. We hypothesized that heterogeneity in baseline mortality risk influenced the results of drug trials assessing mortality in COPD. Methods The 5706 patients with COPD from the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT®) study that had complete clinical information for variables associated with mortality (age, forced expiratory volume in 1 s, St George’s Respiratory Questionnaire, pack-years and body mass index) were classified by cluster analysis. Baseline risk of mortality between clusters, and impact of tiotropium were evaluated during the 4-yr follow up. Results Four clusters were identified, including low-risk (low mortality rate) patients (n = 2339; 41%; cluster 2), and high-risk patients (n = 1022; 18%; cluster 3), who had a 2.6- and a six-fold increase in all-cause and respiratory mortality compared with cluster 2, respectively. Tiotropium reduced exacerbations in all clusters, and reduced hospitalizations in high-risk patients (p < 0.05). The beneficial effect of tiotropium on all-cause mortality in the overall population (hazard ratio, 0.87; 95% confidence interval, 0.75–1.00, p = 0.054) was explained by a 21% reduction in cluster 3 (p = 0.07), with no effect in other clusters. Conclusions Large variations in baseline risks of mortality existed among patients in the UPLIFT® study. Inclusion of numerous low-risk patients may have reduced the ability to show beneficial effect on mortality. Future clinical trials should consider selective inclusion of high-risk patients. PMID:24913266

Effect of increased leptin and C-reactive protein levels on mortality: results from the National Health and Nutrition Examination Survey.

PubMed

Amrock, Stephen M; Weitzman, Michael

2014-09-01

Leptin and C-reactive protein (CRP) have each been linked to adverse cardiovascular events, and prior cross-sectional research suggests that increased levels of both biomarkers pose an even greater risk. The effect of increased levels of both leptin and CRP on mortality has not, however, been previously assessed. We used data from the third National Health and Nutrition Examination Survey (NHANES III) to estimate the mortality effect of high leptin and high CRP levels. Outcomes were compared with the use of inverse-probability-weighting adjustment. Among 6259 participants included in the analysis, 766 were in their sex-specific, population-weighted highest quartiles of both leptin and CRP. Median follow-up time was 14.3 years. There was no significant difference in adjusted all-cause mortality between the groups (risk ratio 1.22, 95% confidence interval [CI], 0.97-1.54). Similar results were noted with the use of several different analytic methods and in many subgroups, though high leptin and CRP levels may increase all-cause mortality in males (hazard ratio, 1.80, 95% CI, 1.32-2.46; P for interaction, 0.011). A significant difference in cardiovascular mortality was also noted (risk ratio, 1.54, 95% CI, 1.08-2.18), though that finding was not confirmed in all sensitivity analyses.. In this observational study, no significant difference in overall all-cause mortality rates in those with high leptin and high CRP levels was found, though high leptin and CRP levels appear associated with increased mortality in males. High leptin and CRP levels also likely increase risk for cardiovascular death.. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis

PubMed Central

Kumar, Chandan; Singh, Prashant Kumar; Rai, Rajesh Kumar

2012-01-01

Background This paper examines if, when controlling for biophysical and geographical variables (including rainfall, productivity of agricultural lands, topography/temperature, and market access through road networks), socioeconomic and health care indicators help to explain variations in the under-five mortality rate across districts from nine high focus states in India. The literature on this subject is inconclusive because the survey data, upon which most studies of child mortality rely, rarely include variables that measure these factors. This paper introduces these variables into an analysis of 284 districts from nine high focus states in India. Methodology/Principal Findings Information on the mortality indicator was accessed from the recently conducted Annual Health Survey of 2011 and other socioeconomic and geographic variables from Census 2011, District Level Household and Facility Survey (2007–08), Department of Economics and Statistics Divisions of the concerned states. Displaying high spatial dependence (spatial autocorrelation) in the mortality indicator (outcome variable) and its possible predictors used in the analysis, the paper uses the Spatial-Error Model in an effort to negate or reduce the spatial dependence in model parameters. The results evince that the coverage gap index (a mixed indicator of district wise coverage of reproductive and child health services), female literacy, urbanization, economic status, the number of newborn care provided in Primary Health Centers in the district transpired as significant correlates of under-five mortality in the nine high focus states in India. The study identifies three clusters with high under-five mortality rate including 30 districts, and advocates urgent attention. Conclusion Even after controlling the possible biophysical and geographical variables, the study reveals that the health program initiatives have a major role to play in reducing under-five mortality rate in the high focus states in India. PMID:22629412

Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea

PubMed Central

Zulu, Isaac; Hassan, Ghaniah; Njobvu RN, Lungowe; Dhaliwal, Winnie; Sianongo, Sandie; Kelly, Paul

2008-01-01

Background Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Methods Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)-γ and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Results Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-γ, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. Conclusion High serum concentrations of TNFR p55, IFN-γ, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN-γ and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa. PMID:19014537

The Repellent DEET Potentiates Carbamate Effects via Insect Muscarinic Receptor Interactions: An Alternative Strategy to Control Insect Vector-Borne Diseases.

PubMed

Abd-Ella, Aly; Stankiewicz, Maria; Mikulska, Karolina; Nowak, Wieslaw; Pennetier, Cédric; Goulu, Mathilde; Fruchart-Gaillard, Carole; Licznar, Patricia; Apaire-Marchais, Véronique; List, Olivier; Corbel, Vincent; Servent, Denis; Lapied, Bruno

2015-01-01

Insect vector-borne diseases remain one of the principal causes of human mortality. In addition to conventional measures of insect control, repellents continue to be the mainstay for personal protection. Because of the increasing pyrethroid-resistant mosquito populations, alternative strategies to reconstitute pyrethroid repellency and knock-down effects have been proposed by mixing the repellent DEET (N,N-Diethyl-3-methylbenzamide) with non-pyrethroid insecticide to better control resistant insect vector-borne diseases. By using electrophysiological, biochemichal, in vivo toxicological techniques together with calcium imaging, binding studies and in silico docking, we have shown that DEET, at low concentrations, interacts with high affinity with insect M1/M3 mAChR allosteric site potentiating agonist effects on mAChRs coupled to phospholipase C second messenger pathway. This increases the anticholinesterase activity of the carbamate propoxur through calcium-dependent regulation of acetylcholinesterase. At high concentrations, DEET interacts with low affinity on distinct M1/M3 mAChR site, counteracting the potentiation. Similar dose-dependent dual effects of DEET have also been observed at synaptic mAChR level. Additionally, binding and in silico docking studies performed on human M1 and M3 mAChR subtypes indicate that DEET only displays a low affinity antagonist profile on these M1/M3 mAChRs. These results reveal a selective high affinity positive allosteric site for DEET in insect mAChRs. Finally, bioassays conducted on Aedes aegypti confirm the synergistic interaction between DEET and propoxur observed in vitro, resulting in a higher mortality of mosquitoes. Our findings reveal an unusual allosterically potentiating action of the repellent DEET, which involves a selective site in insect. These results open exciting research areas in public health particularly in the control of the pyrethroid-resistant insect-vector borne diseases. Mixing low doses of DEET and a non-pyrethroid insecticide will lead to improvement in the efficiency treatments thus reducing both the concentration of active ingredients and side effects for non-target organisms. The discovery of this insect specific site may pave the way for the development of new strategies essential in the management of chemical use against resistant mosquitoes.

The Repellent DEET Potentiates Carbamate Effects via Insect Muscarinic Receptor Interactions: An Alternative Strategy to Control Insect Vector-Borne Diseases

PubMed Central

Abd-Ella, Aly; Stankiewicz, Maria; Mikulska, Karolina; Nowak, Wieslaw; Pennetier, Cédric; Goulu, Mathilde; Fruchart-Gaillard, Carole; Licznar, Patricia; Apaire-Marchais, Véronique; List, Olivier; Corbel, Vincent; Servent, Denis; Lapied, Bruno

2015-01-01

Insect vector-borne diseases remain one of the principal causes of human mortality. In addition to conventional measures of insect control, repellents continue to be the mainstay for personal protection. Because of the increasing pyrethroid-resistant mosquito populations, alternative strategies to reconstitute pyrethroid repellency and knock-down effects have been proposed by mixing the repellent DEET (N,N-Diethyl-3-methylbenzamide) with non-pyrethroid insecticide to better control resistant insect vector-borne diseases. By using electrophysiological, biochemichal, in vivo toxicological techniques together with calcium imaging, binding studies and in silico docking, we have shown that DEET, at low concentrations, interacts with high affinity with insect M1/M3 mAChR allosteric site potentiating agonist effects on mAChRs coupled to phospholipase C second messenger pathway. This increases the anticholinesterase activity of the carbamate propoxur through calcium-dependent regulation of acetylcholinesterase. At high concentrations, DEET interacts with low affinity on distinct M1/M3 mAChR site, counteracting the potentiation. Similar dose-dependent dual effects of DEET have also been observed at synaptic mAChR level. Additionally, binding and in silico docking studies performed on human M1 and M3 mAChR subtypes indicate that DEET only displays a low affinity antagonist profile on these M1/M3 mAChRs. These results reveal a selective high affinity positive allosteric site for DEET in insect mAChRs. Finally, bioassays conducted on Aedes aegypti confirm the synergistic interaction between DEET and propoxur observed in vitro, resulting in a higher mortality of mosquitoes. Our findings reveal an unusual allosterically potentiating action of the repellent DEET, which involves a selective site in insect. These results open exciting research areas in public health particularly in the control of the pyrethroid-resistant insect-vector borne diseases. Mixing low doses of DEET and a non-pyrethroid insecticide will lead to improvement in the efficiency treatments thus reducing both the concentration of active ingredients and side effects for non-target organisms. The discovery of this insect specific site may pave the way for the development of new strategies essential in the management of chemical use against resistant mosquitoes. PMID:25961834

Association of Hemoglobin Concentration With Total and Cause-Specific Mortality in a Cohort of Postmenopausal Women.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Verma, Amit K; Manson, JoAnn E; Lessin, Lawrence S; Kamensky, Victor; Lin, Juan; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

2016-05-15

Anemia and low and high levels of hemoglobin have been associated with increased mortality and morbidity. However, most studies have measured hemoglobin at only 1 time point, and few studies have considered possible reverse causation. We used data from the Women's Health Initiative, in which baseline hemoglobin was measured in 160,081 postmenopausal women and year 3 hemoglobin was measured in 75,658 participants, to examine the associations of hemoglobin concentration with total mortality, coronary heart disease mortality, and cancer mortality. Women were enrolled from 1993 to 1998 and followed for a median of 16 years. Cox proportional hazards models were used to estimate the relative mortality hazards associated with deciles of baseline hemoglobin and the mean of baseline + year 3 hemoglobin. Both low and high deciles of baseline hemoglobin were positively associated with all 3 outcomes in the total cohort. In analyses restricted to women with 2 measurements, a low mean hemoglobin level was robustly and positively associated with all 3 outcomes, after exclusion of the early years of follow-up. High mean hemoglobin was also associated with increased risk of total mortality, whereas associations with heart disease mortality and cancer mortality were weaker and inconsistent. Our results provide evidence that low and high levels of hemoglobin are associated with increased risk of mortality in otherwise healthy women. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Small Area Health Statistics Unit: a national facility for investigating health around point sources of environmental pollution in the United Kingdom.

PubMed Central

Elliott, P; Westlake, A J; Hills, M; Kleinschmidt, I; Rodrigues, L; McGale, P; Marshall, K; Rose, G

1992-01-01

STUDY OBJECTIVE--The Small Area Health Statistics Unit (SAHSU) was established at the London School of Hygiene and Tropical Medicine in response to a recommendation of the enquiry into the increased incidence of childhood leukaemia near Sellafield, the nuclear reprocessing plant in West Cumbria. The aim of this paper was to describe the Unit's methods for the investigation of health around point sources of environmental pollution in the United Kingdom. DESIGN--Routine data currently including deaths and cancer registrations are held in a large national database which uses a post code based retrieval system to locate cases geographically and link them to the underlying census enumeration districts, and hence to their populations at risk. Main outcome measures were comparison of observed/expected ratios (based on national rates) within bands delineated by concentric circles around point sources of environmental pollution located anywhere in Britain. MAIN RESULTS--The system is illustrated by a study of mortality from mesothelioma and asbestosis near the Plymouth naval dockyards during 1981-87. Within a 3 km radius of the docks the mortality rate for mesothelioma was higher than the national rate by a factor of 8.4, and that for asbestosis was higher by a factor of 13.6. CONCLUSIONS--SAHSU is a new national facility which is rapidly able to provide rates of mortality and cancer incidence for arbitrary circles drawn around any point in Britain. The example around Plymouth of mesothelioma and asbestosis demonstrates the ability of the system to detect an unusual excess of disease in a small locality, although in this case the findings are likely to be related to occupational rather than environmental exposure. PMID:1431704

Effects of Climate Change and Fisheries Bycatch on Shy Albatross (Thalassarche cauta) in Southern Australia

PubMed Central

2015-01-01

The impacts of climate change on marine species are often compounded by other stressors that make direct attribution and prediction difficult. Shy albatrosses (Thalassarche cauta) breeding on Albatross Island, Tasmania, show an unusually restricted foraging range, allowing easier discrimination between the influence of non-climate stressors (fisheries bycatch) and environmental variation. Local environmental conditions (rainfall, air temperature, and sea-surface height, an indicator of upwelling) during the vulnerable chick-rearing stage, have been correlated with breeding success of shy albatrosses. We use an age-, stage- and sex-structured population model to explore potential relationships between local environmental factors and albatross breeding success while accounting for fisheries bycatch by trawl and longline fisheries. The model uses time-series of observed breeding population counts, breeding success, adult and juvenile survival rates and a bycatch mortality observation for trawl fishing to estimate fisheries catchability, environmental influence, natural mortality rate, density dependence, and productivity. Observed at-sea distributions for adult and juvenile birds were coupled with reported fishing effort to estimate vulnerability to incidental bycatch. The inclusion of rainfall, temperature and sea-surface height as explanatory variables for annual chick mortality rate was statistically significant. Global climate models predict little change in future local average rainfall, however, increases are forecast in both temperatures and upwelling, which are predicted to have detrimental and beneficial effects, respectively, on breeding success. The model shows that mitigation of at least 50% of present bycatch is required to offset losses due to future temperature changes, even if upwelling increases substantially. Our results highlight the benefits of using an integrated modeling approach, which uses available demographic as well as environmental data within a single estimation framework, to provide future predictions. Such predictions inform the development of management options in the face of climate change. PMID:26057739

AN EPIZOOTIC OF EMERGING NOVEL AVIAN POX IN CARRION CROWS (CORVUS CORONE) AND LARGE-BILLED CROWS (CORVUS MACRORHYNCHOS) IN JAPAN.

PubMed

Fukui, Daisuke; Nakamura, Makiko; Yamaguchi, Tsuyoshi; Takenaka, Makiko; Murakami, Mami; Yanai, Tokuma; Fukushi, Hideto; Yanagida, Kazumi; Bando, Gen; Matsuno, Keita; Nagano, Masashi; Tsubota, Toshio

2016-04-28

In 2006-10, an epizootic of emerging avian pox occurred in Carrion Crows ( Corvus corone ) and Large-billed Crows ( Corvus macrorhynchos ), leading to mortality of juvenile crows in Hokkaido, the northernmost island of Japan. We diagnosed 27 crows with proliferative skin lesions (19 carcasses and eight biopsied cases [one in zoo captivity]) as avian pox clinically, histopathologically by detection of Avipoxvirus-specific 4b core protein (P4b) gene, and epidemiologically. The fatal cases demonstrated intensively severe infection and aggressive lesions with secondary bacterial infection. Since the first identification of avian pox in Sapporo, Japan, in 2006, the frequency of mortality events has increased, peaking in 2007-08. Mortalities have subsequently occurred in other areas, suggesting disease expansion. In Sapporo, prevalence of avian pox evaluated by field censuses during 2007-12 was 17.6% (6.6-27.2%), peaked during 2007-08 and 2008-09, and then decreased. All diseased crows were juveniles, except for one adult. The number of crows assembling in the winter roosts had been stable for >10 yr; however, it declined in 2007-08, decreased by about 50% in 2008-09, and recovered to the previous level in 2009-10, correlated with the avian pox outbreak. Thus, avian pox probably contributed to the unusual crow population decline. All P4b sequences detected in six specimens in Sapporo were identical and different from any previously reported sequences. The sequence detected in the zoo-kept crow was distinct from any reported clades, and interspecies transmission was suspected. This report demonstrates an emerging novel avian pox in the Japanese avifauna and in global populations of Carrion Crows and Large-billed Crows. Longitudinal monitoring is needed to evaluate its impact on the crow population.

Effects of Climate Change and Fisheries Bycatch on Shy Albatross (Thalassarche cauta) in Southern Australia.

PubMed

Thomson, Robin B; Alderman, Rachael L; Tuck, Geoffrey N; Hobday, Alistair J

2015-01-01

The impacts of climate change on marine species are often compounded by other stressors that make direct attribution and prediction difficult. Shy albatrosses (Thalassarche cauta) breeding on Albatross Island, Tasmania, show an unusually restricted foraging range, allowing easier discrimination between the influence of non-climate stressors (fisheries bycatch) and environmental variation. Local environmental conditions (rainfall, air temperature, and sea-surface height, an indicator of upwelling) during the vulnerable chick-rearing stage, have been correlated with breeding success of shy albatrosses. We use an age-, stage- and sex-structured population model to explore potential relationships between local environmental factors and albatross breeding success while accounting for fisheries bycatch by trawl and longline fisheries. The model uses time-series of observed breeding population counts, breeding success, adult and juvenile survival rates and a bycatch mortality observation for trawl fishing to estimate fisheries catchability, environmental influence, natural mortality rate, density dependence, and productivity. Observed at-sea distributions for adult and juvenile birds were coupled with reported fishing effort to estimate vulnerability to incidental bycatch. The inclusion of rainfall, temperature and sea-surface height as explanatory variables for annual chick mortality rate was statistically significant. Global climate models predict little change in future local average rainfall, however, increases are forecast in both temperatures and upwelling, which are predicted to have detrimental and beneficial effects, respectively, on breeding success. The model shows that mitigation of at least 50% of present bycatch is required to offset losses due to future temperature changes, even if upwelling increases substantially. Our results highlight the benefits of using an integrated modeling approach, which uses available demographic as well as environmental data within a single estimation framework, to provide future predictions. Such predictions inform the development of management options in the face of climate change.

High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake?

PubMed

Bellavia, Andrea; Stilling, Frej; Wolk, Alicja

2016-10-01

High red meat consumption is associated with a shorter survival and higher risk of cardiovascular disease (CVD), cancer, and all-cause mortality. Fruit and vegetable (FV) consumption is associated with a longer survival and lower mortality risk. Whether high FV consumption can counterbalance the negative impact of high red meat consumption is unknown. We evaluated 2 large prospective cohorts of Swedish men and women (the Swedish Mammography Cohort and the Cohort of Swedish Men) to determine whether the association between red meat consumption and the risk of all-cause, CVD, and cancer-specific mortality differs across amounts of FV intake. The study population included 74,645 Swedish men and women. Red meat and FV consumption were assessed through a self-administered questionnaire. We estimated HRs of all-cause, CVD, and cancer mortality according to quintiles of total red meat consumption. We next investigated possible interactions between red meat and FV consumption and evaluated the dose-response associations at low, medium, and high FV intake. Compared with participants in the lowest quintile of total red meat consumption, those in the highest quintile had a 21% increased risk of all-cause mortality (HR: 1.21; 95% CI: 1.13, 1.29), a 29% increased risk of CVD mortality (HR: 1.29; 95% CI: 1.14, 1.46), and no increase in the risk of cancer mortality (HR: 1.00; 95% CI: 0.88, 1.43). Results were remarkably similar across amounts of FV consumption, and no interaction between red meat and FV consumption was detected. High intakes of red meat were associated with a higher risk of all-cause and CVD mortality. The increased risks were consistently observed in participants with low, medium, and high FV consumption. The Swedish Mammography Cohort and the Cohort of Swedish Men were registered at clinicaltrials.gov as NCT01127698 and NCT01127711, respectively. © 2016 American Society for Nutrition.

High levels of cynical distrust partly predict premature mortality in middle-aged to ageing men.

PubMed

Šmigelskas, Kastytis; Joffė, Roza; Jonynienė, Jolita; Julkunen, Juhani; Kauhanen, Jussi

2017-08-01

The aim of this study was to evaluate the effect of cynical distrust on mortality in middle-aged and aging men. The analysis is based on Kuopio Ischemic Heart Disease study, follow-up from 1984 to 2011. Sample consisted of 2682 men, aged 42-61 years at baseline. Data on mortality was provided by the National Death Registry, causes of death were classified by the National Center of Statistics of Finland. Cynical distrust was measured at baseline using Cynical Distrust Scale. Survival analyses were conducted using Cox regression models. In crude estimates after 28 years of follow-up, high cynical distrust was associated with 1.5-1.7 higher hazards for earlier death compared to low cynical distrust. Adjusted for conventional risk factors, high cynical distrust was significantly associated regarding CVD-free men and CVD mortality, while non-CVD mortality in study sample was consistently but not significantly associated. The risk effects were more expressed after 12-20 years rather than in earlier or later follow-up. To conclude, high cynical distrust associates with increased risk of CVD mortality in CVD-free men. The associations with non-CVD mortality are weaker and not reach statistical significance.

The historical development of suicide mortality in Russia, 1870-2007.

PubMed

Jukkala, Tanya; Mäkinen, Ilkka Henrik; Stickley, Andrew

2015-01-01

Russia has one of the highest suicide mortality rates in the world. This study investigates the development of Russian suicide mortality over a longer time period in order to provide a context within which the contemporary high level might be better understood. Annual sex- and age-specific suicide-mortality data for Russia for the period 1870-2007 were studied, where available. Russian suicide mortality increased 11-fold over the period. Trends in male and female suicide developed similarly, although male suicide rates were consistently much higher. From the 1990s suicide has increased in a relative sense among the young (15-34), while the high suicide mortality among middle-aged males has reduced. Changes in Russian suicide mortality over the study period may be attributable to modernization processes.

Forecasting sex differences in mortality in high income nations: The contribution of smoking

PubMed Central

Pampel, Fred

2011-01-01

To address the question of whether sex differences in mortality will in the future rise, fall, or stay the same, this study uses relative smoking prevalence among males and females to forecast future changes in relative smoking-attributed mortality. Data on 21 high income nations from 1975 to 2000 and a lag between smoking prevalence and mortality allow forecasts up to 2020. Averaged across nations, the results for logged male/female ratios in smoking mortality reveal equalization of the sex differential. However, continued divergence in non-smoking mortality rates would counter convergence in smoking mortality rates and lead to future increases in the female advantage overall, particularly in nations at late stages of the cigarette epidemic (such as the United States and the United Kingdom). PMID:21874120

Unusually high genetic diversity in COI sequences of Chimarra obscura (Trichoptera: Philopotamidae)

EPA Science Inventory

Chimarra obscura (Walker 1852) is a philopotamid caddisfly found throughout much of North America. Using the COI DNA barcode locus, we have found unexpectedly high amounts of genetic diversity and distances within C. obscura. Of the approximately 150 specimens sampled, we have fo...

77 FR 54951 - Disadvantaged Business Enterprise: Program Implementation Modifications

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... tension with one another, particularly when information collection can be viewed as burdensome to... payments, this approach could smooth out statistical anomalies (e.g., years with unusually high or... (particularly high valued assets), and more stringent guidelines for deposits of funds used to acquire the...

Troubling Trends: The Health of America's Next Generation.

ERIC Educational Resources Information Center

National Commission To Prevent Infant Mortality, Washington, DC.

Trends during the 1980s are described including high infant mortality, no decline in low birthweight percentages, an increase in the black-white infant mortality gap, more high-risk pregnancies, and inadequate prenatal care. Inadequate progress in reducing infant mortality is attributed in part to the limited technological ability to save…

Perioperative mortality in cats and dogs undergoing spay or castration at a high-volume clinic.

PubMed

Levy, J K; Bard, K M; Tucker, S J; Diskant, P D; Dingman, P A

2017-06-01

High volume spay-neuter (spay-castration) clinics have been established to improve population control of cats and dogs to reduce the number of animals admitted to and euthanazed in animal shelters. The rise in the number of spay-neuter clinics in the USA has been accompanied by concern about the quality of animal care provided in high volume facilities, which focus on minimally invasive, time saving techniques, high throughput and simultaneous management of multiple animals under various stages of anesthesia. The aim of this study was to determine perioperative mortality for cats and dogs in a high volume spay-neuter clinic in the USA. Electronic medical records and a written mortality log were used to collect data for 71,557 cats and 42,349 dogs undergoing spay-neuter surgery from 2010 to 2016 at a single high volume clinic in Florida. Perioperative mortality was defined as deaths occurring in the 24h period starting with the administration of the first sedation or anesthetic drugs. Perioperative mortality was reported for 34 cats and four dogs for an overall mortality of 3.3 animals/10,000 surgeries (0.03%). The risk of mortality was more than twice as high for females (0.05%) as for males (0.02%) (P=0.008) and five times as high for cats (0.05%) as for dogs (0.009%) (P=0.0007). High volume spay-neuter surgery was associated with a lower mortality rate than that previously reported in low volume clinics, approaching that achieved in human surgery. This is likely to be due to the young, healthy population of dogs and cats, and the continuous refinement of techniques based on experience and the skills and proficiency of teams that specialize in a limited spectrum of procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Farmers' perceptions of goat kid mortality under communal farming in Eastern Cape, South Africa.

PubMed

Slayi, Mhlangabezi; Maphosa, Viola; Fayemi, Olutope Peter; Mapfumo, Lizwell

2014-10-01

Rearing of goats under communal farming conditions is characterised by high kid mortality and low weaning percentages. A survey was conducted to determine farmers' perceptions on the causes of kid mortality during summer under the communal farming system in Nkonkobe Local Municipality in the Eastern Cape, South Africa. This was done by administering questionnaires to a total of 162 respondents in 14 villages around Nkonkobe Local Municipality. The study showed that majority of farmers (75 %) keep flock sizes of less than 10 goats and kids, and this indicates that goat production in Nkonkobe Local Municipality is suppressed. According to the farmers, diseases (89 %), endo-parasites (72 %) and ecto-parasites (68 %) were perceived as the major causes of kid mortality. Other causes reported include starvation (15 %), extreme weather conditions (28 %), abortion (7 %), theft (35 %), diarrhoea (43 %), accidents (10 %) and wounds (9 %). The low number of goats could be attributed to high mortalities. It was also found that all causes reported by farmers played a role in high kid mortality in Nkonkobe Local Municipality. However, the causes which require more emphasis to formulate extension support were tick-borne diseases and parasites. This study provided baseline information on possible causes of kid mortalities in Nkonkobe Local Municipality. There is, however, a need to conduct further studies to determine actual causes of high kid mortalities so as to develop preventive strategies that would minimize kid mortality for good economic returns.

The role of macromolecular crowding in the evolution of lens crystallins with high molecular refractive index.

PubMed

Zhao, Huaying; Magone, M Teresa; Schuck, Peter

2011-08-01

Crystallins are present in the lens at extremely high concentrations in order to provide transparency and generate a high refractive power of the lens. The crystallin families prevalent in the highest density lens tissues are γ-crystallins in vertebrates and S-crystallins in cephalopods. As shown elsewhere, in parallel evolution, both have evolved molecular refractive index increments 5-10% above those of most proteins. Although this is a small increase, it is statistically very significant and can be achieved only by very unusual amino acid compositions. In contrast, such a molecular adaptation to aid in the refractive function of the lens did not occur in crystallins that are preferentially located in lower density lens tissues, such as vertebrate α-crystallin and taxon-specific crystallins. In the current work, we apply a model of non-interacting hard spheres to examine the thermodynamic contributions of volume exclusion at lenticular protein concentrations. We show that the small concentration decrease afforded by the higher molecular refractive index increment of crystallins can amplify nonlinearly to produce order of magnitude differences in chemical activities, and lead to reduced osmotic pressure and the reduced propensity for protein aggregation. Quantitatively, this amplification sets in only at protein concentrations as high as those found in hard lenses or the nucleus of soft lenses, in good correspondence to the observed crystallin properties in different tissues and different species. This suggests that volume exclusion effects provide the evolutionary driving force for the unusual refractive properties and the unusual amino acid compositions of γ-crystallins and S-crystallins.

Limnonectins: a new class of antimicrobial peptides from the skin secretion of the Fujian large-headed frog (Limnonectes fujianensis).

PubMed

Wu, Youjia; Wang, Lei; Zhou, Mei; Ma, Chengbang; Chen, Xiaole; Bai, Bing; Chen, Tianbao; Shaw, Chris

2011-06-01

Amphibian skin secretions are rich sources of biologically-active peptides with antimicrobial peptides predominating in many species. Several studies involving molecular cloning of biosynthetic precursor-encoding cDNAs from skin or skin secretions have revealed that these exhibit highly-conserved domain architectures with an unusually high degree of conserved nucleotide and resultant amino acid sequences within the signal peptides. This high degree of nucleotide sequence conservation has permitted the design of primers complementary to such sites facilitating "shotgun" cloning of skin or skin secretion-derived cDNA libraries from hitherto unstudied species. Here we have used such an approach using a skin secretion-derived cDNA library from an unstudied species of Chinese frog - the Fujian large-headed frog, Limnonectes fujianensis - and have discovered two 16-mer peptides of novel primary structures, named limnonectin-1Fa (SFPFFPPGICKRLKRC) and limnonectin-1Fb (SFHVFPPWMCKSLKKC), that represent the prototypes of a new class of amphibian skin antimicrobial peptide. Unusually these limnonectins display activity only against a Gram-negative bacterium (MICs of 35 and 70 μM) and are devoid of haemolytic activity at concentrations up to 160 μM. Thus the "shotgun" cloning approach described can exploit the unusually high degree of nucleotide conservation in signal peptide-encoding domains of amphibian defensive skin secretion peptide precursor-encoding cDNAs to rapidly expedite the discovery of novel and functional defensive peptides in a manner that circumvents specimen sacrifice without compromising robustness of data. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

The role of macromolecular crowding in the evolution of lens crystallins with high molecular refractive index

PubMed Central

Zhao, Huaying; Magone, M. Teresa; Schuck, Peter

2011-01-01

Crystallins are present in the lens at extremely high concentrations in order to provide transparency and generate a high refractive power of the lens. The crystallin families prevalent in the highest density lens tissues are γ crystallins in vertebrates and S crystallins in cephalopods. In parallel evolution, both have evolved molecular refractive index increments 5 – 10 % above those of most proteins. Although this is a small increase, it is statistically very significant and can be achieved only by very unusual amino acid compositions. In contrast, such a molecular adaptation to aid in the refractive function of the lens did not occur in crystallins that are preferentially located in lower density lens tissues, such as vertebrate α crystallin and taxon specific crystallins. In the current work, we apply a model of non-interacting hard spheres to examine the thermodynamic contributions of volume exclusion at lenticular protein concentrations. We show that the small concentration decrease afforded by the higher molecular refractive index increment of crystallins can amplify nonlinearly to produce order of magnitude differences in chemical activities, and lead to reduced osmotic pressure and the reduced propensity for protein aggregation. Quantitatively, this amplification sets in only at protein concentrations as high as those found in hard lenses or the nucleus of soft lenses, in good correspondence to the observed crystalline properties in different tissues and different species. This suggests that volume exclusion effects provide the evolutionary driving force for the unusual refractive properties and the unusual amino acid compositions of γ crystallins and S crystallins. PMID:21566271

Rise and Persistence of Global M1T1 Clone of Streptococcus pyogenes

PubMed Central

Kotb, Malak

2008-01-01

The resurgence of severe invasive group A streptococcal infections in the 1980s is a typical example of the reemergence of an infectious disease. We found that this resurgence is a consequence of the diversification of particular strains of the bacteria. Among these strains is a highly virulent subclone of serotype M1T1 that has exhibited unusual epidemiologic features and virulence, unlike all other streptococcal strains. This clonal strain, commonly isolated from both noninvasive and invasive infection cases, is most frequently associated with severe invasive diseases. Because of its unusual prevalence, global spread, and increased virulence, we investigated the unique features that likely confer its unusual properties. In doing so, we found that the increased virulence of this clonal strain can be attributed to its diversification through phage mobilization and its ability to sense and adapt to different host environments; accordingly, the fittest members of this diverse bacterial community are selected to survive and invade host tissue. PMID:18826812

Unusual target site disruption by the rare-cutting HNH restriction endonuclease PacI

PubMed Central

Shen, Betty; Heiter, Daniel F.; Chan, Siu-Hong; Wang, Hua; Xu, Shuang-Yong; Morgan, Richard D.; Wilson, Geoffrey G.; Stoddard, Barry L.

2010-01-01

The crystal structure of the rare-cutting HNH restriction endonuclease PacI in complex with its eight base pair target recognition sequence 5'-TTAATTAA-3' has been determined to 1.9 Å resolution. The enzyme forms an extended homodimer, with each subunit containing two zinc-bound motifs surrounding a ββα-metal catalytic site. The latter is unusual in that a tyrosine residue likely initiates strand-cleavage. PacI dramatically distorts its target sequence from Watson-Crick duplex DNA basepairing, with every base separated from its original partner. Two bases on each strand are unpaired, four are engaged in non-canonical A:A and T:T base pairs, and the remaining two bases are matched with new Watson-Crick partners. This represents a highly unusual DNA binding mechanism for a restriction endonuclease, and implies that initial recognition of the target site might involve significantly different contacts from those visualized in the DNA-bound cocrystal structures. PMID:20541511

Unusual fentanyl patch administration.

PubMed

Thomas, Sandra; Winecker, Ruth; Pestaner, Joseph P

2008-06-01

Fentanyl is an extremely potent narcotic analgesic that is becoming more popular as a drug of abuse. Because of the unique way in which the drug is packaged and delivered, the potential for unusual methods of abuse exists. We report the first case of true fentanyl patch ingestion in the medical literature. Initially, though unusual, cases of fentanyl ingestion were thought to have been reported, but further investigation of the literature revealed that in other case reports the patches had been held in the mouth and chewed. Because no reports of swallowing the patch had been published, suicide was initially a strong consideration in this case; however, further investigation showed that the decedent and his brother enjoyed swallowing the patches for quick "highs." Cases such as these serve to remind medical examiners and law enforcement officials of the value of performing thorough death investigations by performing complete autopsies with toxicological testing and correlating with investigation information to form an opinion with regard to the cause and manner of death.

Unusual magnetoelectric memory and polarization reversal in the kagome staircase compound N i3V2O8

NASA Astrophysics Data System (ADS)

Liu, Y. J.; Wang, J. F.; He, Z. Z.; Lu, C. L.; Xia, Z. C.; Ouyang, Z. W.; Liu, C. B.; Chen, R.; Matsuo, A.; Kohama, Y.; Kindo, K.; Tokunaga, M.

2018-05-01

We study the electric polarization of the kagome staircase N i3V2O8 in magnetic fields up to 30 T and report a magnetoelectric memory effect controlled by bias electric fields. The explored ferroelectric phase in 19 -24 T is electrically controlled, whereas the ferroelectric phase in 2 -11 T exhibits unusual memory effects. We determine a characteristic critical magnetic field H3=11 T , below which strong memory exists and the polarization is frozen even in opposite bias fields. But when magnetic fields exceed H3, the frozen polarization is released and polarization reversal appears by tuning bias electric fields. We ascribe these phenomena to the pinning-depinning mechanism: nucleation and the accompanying pinning of chiral domain walls cooperatively induce the frozen behavior; the polarization reversal results from the depinning through the ferroelectrtic-to-paraelectric phase transition in high magnetic fields. Our experimental results reveal that the first-order phase transition plays an important role in these unusual memory effects.

The large contribution of twins to neonatal and post-neonatal mortality in The Gambia, a 5-year prospective study.

PubMed

Miyahara, Reiko; Jasseh, Momodou; Mackenzie, Grant Austin; Bottomley, Christian; Hossain, M Jahangir; Greenwood, Brian M; D'Alessandro, Umberto; Roca, Anna

2016-03-15

A high twinning rate and an increased risk of mortality among twins contribute to the high burden of infant mortality in Africa. This study examined the contribution of twins to neonatal and post-neonatal mortality in The Gambia, and evaluated factors that contribute to the excess mortality among twins. We analysed data from the Basse Health and Demographic Surveillance System (BHDSS) collected from January 2009 to December 2013. Demographic and epidemiological variables were assessed for their association with mortality in different age groups. We included 32,436 singletons and 1083 twins in the analysis (twining rate 16.7/1000 deliveries). Twins represented 11.8 % of all neonatal deaths and 7.8 % of post-neonatal deaths. Mortality among twins was higher than in singletons [adjusted odds ratio (AOR) 4.33 (95 % CI: 3.09, 6.06) in the neonatal period and 2.61 (95 % CI: 1.85, 3.68) in the post-neonatal period]. Post-neonatal mortality among twins increased in girls (P for interaction = 0.064), being born during the dry season (P for interaction = 0.030) and lacking access to clean water (P for interaction = 0.042). Mortality among twins makes a significant contribution to the high burden of neonatal and post-neonatal mortality in The Gambia and preventive interventions targeting twins should be prioritized.

The Chilean infant mortality decline: improvement for whom? Socioeconomic and geographic inequalities in infant mortality, 1990-2005.

PubMed

Hertel-Fernandez, Alexander Warren; Giusti, Alejandro Esteban; Sotelo, Juan Manuel

2007-10-01

To measure socioeconomic inequalities and differential risk in infant mortality on national and regional levels in Chile from 1990 to 2005, and propose new policy targets. The study analysed Chilean vital events registries from 1990 to 2005 for infant mortality by maternal education, head of household occupational status, cause, age and location of death. Annual infant mortality rates and relative risk were calculated by maternal education and head of household occupational status for each cause and age of death. Socioeconomic inequalities were then mapped to 29 regional health services. Reductions in the national infant mortality rate were driven by reductions among highly educated mothers, while recent stagnation in the national rate is caused by high levels of infant mortality among uneducated mothers. These vulnerable households are particularly prone to infant mortality risk due to infectious disease and trauma. We also identify clustering of high socioeconomic inequalities in infant mortality throughout the poorer north, indigenous south and densely populated metropolitan centre of Santiago. Finally, we report large inequities in vital statistics coverage, with infant deaths among vulnerable households much more likely to be inadequately defined than in the remaining population. These results indicate that the socioeconomically disadvantaged in Chile are at a significantly higher risk for infant mortality by infectious diseases and trauma during the first month of life. Efforts to reduce national infant mortality in Chile and other countries must involve policies that target child survival for at-risk populations for specific diseases, ages and locations.

Weird planets and odd relations: Atmospheric Circulation on Hot Jupiters

NASA Astrophysics Data System (ADS)

Zhang, Michael; Knutson, Heather; Kataria, Tiffany; Burrows, Adam; Fortney, Jonathan

2018-01-01

We extract phase curves from Spitzer photometry for the highly irradiated hot Jupiter WASP-33b and the unusually dense Saturn-mass planet HD 149026b. To do so, we develop a new variant of Pixel Level Decorrelation that is effective at removing intrapixel sensitivity variations for long observations (> 10 hours) where the position of the star can vary by a significant fraction of a pixel. Using this algorithm, we derive eclipse depths, phase amplitudes, and phase offsets for both planets at 3.6 um and 4.5 um. We use a simple toy model to show that WASP-33b's phase offset, albedo, and heat recirculation efficiency are largely similar to those of other hot Jupiters despite its very high irradiation. On the other hand, our fits for HD 149026b prefer a very high albedo and an unusually high recirculation efficiency. We also compare our results to predictions from GCM models, and find that while neither provide a good match to the data, the discrepancies for HD 149026b are unusually large. We speculate that this may be related to its high bulk metallicity, which could lead to enhanced atmospheric opacities and the formation of reflective cloud layers in localized regions of the atmosphere. We then place these two planets in a broader context by exploring relationships between the temperatures, albedos, efficiencies, and phase offsets of all planets with published thermal phase curves. We find a striking relationship between phase offset and irradiation temperature--the former dips with temperature until around 3300 K, and rises thereafter. Although some aspects of this trend are mirrored in GCM models, there are notable differences that provide important clues for future modeling efforts.

The Hydrothermal System at Home Plate in Gusev Crater, Mars: Formation of High Silica Material by Acid-Sulfate Alteration of Basalt

NASA Technical Reports Server (NTRS)

Morris, R. V.; Ming, D. W.; Gellert, R.; Yen, A.; Clark, B. C.; Gnaff, T. G.; Arvidson, R. E.; Squyres, S. W.

2008-01-01

The Alpha Particle X-ray Spectrometer (APXS) instrument on the Mars Exploration Rover (MER) Spirit measured three targets on or adjacent to Home Plate in Gusev Crater that have unusually high SiO2 concentrations (68% to 91%), unusually low FeO concentrations (1% to 7%, with total Fe as FeO), and unusually high TiO2/FeO ratios (0.2 to 1.2 by weight) [1]. Two targets (Kenosha Comets and Lefty Ganote) are located on high albedo soil (Gertrude Weise) that was exposed by the rover wheels, and one target is a float rock called Fuzzy Smith. Kenosha Comets has the highest SiO2 concentration, lowest FeO concentration, and highest TiO2/FeO ratio. Mineralogical evidence from the MER Miniature Thermal Emission Spectrometer (Mini-TES) suggests that the SiO2 is present as amorphous (noncrystalline) SiO2 at Gertrude Weise and nearby targets [2,3]. Mini-TES data were not acquired for Fuzzy Smith. Home Plate is considered to have an explosive volcanic origin, resulting when basaltic magma came into contact with ground water or ice [4]. Within 50 m to 1 km of Home Plate are sulfate rich soil deposits (Paso Robles class soils with 22-35% SO3) which are considered to be probable fumarolic and/or hydrothermal deposits associated with the volcanism [5]. We develop the model here, suggested by [5], that the high-silica materials are another manifestation of acid-sulfate processes associated with fumarolic and hydrothermal activity at Home Plate. This is done by analogy with basaltic materials altered by acid sulfate processes on the Island of Hawaii.

Using an isolated population boom to explore barriers to recovery in the keystone Caribbean coral reef herbivore Diadema antillarum

NASA Astrophysics Data System (ADS)

Bodmer, Max D. V.; Rogers, Alex D.; Speight, Martin R.; Lubbock, Natalie; Exton, Dan A.

2015-12-01

Recovery of the keystone herbivore Diadema antillarum after the 1983-1984 mass mortality event poses one of the greatest challenges to Caribbean coral reef conservation, yet our understanding of the problem remains severely limited. Whilst some recovery has been observed, this has been restricted to the shallows (≤5 m). We report a newly discovered, isolated population recovery on Banco Capiro, Honduras, representing the largest recorded post-mortality densities beyond the shallowest environments (0.74-2.27 individuals m-2 at depths ≥10 m) alongside an unusually high mean percentage scleractinian coral cover of 49-62 %, likely no coincidence. On the nearby island of Utila, we report D. antillarum densities of 0.003-0.012 individuals m-2 and scleractinian coral cover of 12 % at depths ≥10 m, "typical" for a contemporary Caribbean coral reef. The three order of magnitude disparity in population density between sites separated by <60 km presents a unique opportunity to investigate barriers preventing their region-wide recovery by simultaneously addressing a range of previously proposed hypotheses. Despite concerns over the impacts of asynchronous spawning in low-density populations, we find that recruitment is occurring on Utila. This suggests that, whilst Allee effects are likely to be a contributing factor, the major barriers suppressing recovery are instead impacting juvenile survival into adulthood. Similarly, variations in heterospecific echinoids, interspecific competitors, and nutrient availability fail to account for population differences. Instead, we highlight a lack of structural complexity on contemporary Caribbean reefs as the most likely explanation for the limited recovery through a lack of provision of juvenile predation refugia, representing a further consequence of the recent ubiquitous phase shifts throughout the region. Using these findings, we propose future management strategies to stimulate recovery and, consequently, reef health throughout the Caribbean.

Diagnostic findings in the 1992 epornitic of neurotropic velogenic Newcastle disease in double-crested cormorants from the upper midwestern United States.

USGS Publications Warehouse

Meteyer, Carol U.; Docherty, Douglas E.; Glaser, Linda C.; Franson, J.C.; Senne, Dennis A.; Duncan, Ruth

1997-01-01

Neurotropic velogenic Newcastle disease (NVND) occurred in juvenile double-crested cormorants,Phalacrocorax auritus, simultaneously in nesting colonies in Minnesota, North Dakota, South Dakota, and Nebraska and in Lakes Michigan, Superior, Huron, and Ontario during the summer of 1992. Mortality as high as 80%-90% was estimated in some of the nesting colonies. Clinical signs observed in 4- to -6wk-old cormorants included torticollis, tremors, ataxia, curled toes, and paresis or weakness of legs, wings or both, which was sometimes unilateral. No significant mortality or unusual clinical signs were seen in adult cormorants. Necropsy of 88 cormorants yielded no consistent gross observations. Microscopic lesions in the brain and spinal cord were consistently present in all cormorants from which Newcastle disease virus (NDV) was isolated. Characteristic brain lesions provided rapid identification of new suspect sites of NVND. Lesions were also present in the heart, kidney, proventriculus, spleen, and pancreas but were less consistent or nonspecific. NDV was isolated at the National Wildlife Health Center from 27 of 93 cormorants tested. Virus was most frequently isolated from intestine or brain tissue of cormorants submitted within the first 4wk of the epornitic. Sera collected from cormorants with neurologic signs were consistently positive for NDV antibody.The NDV isolate from cormorants was characterized as NVND virus at the National Veterinary Services Laboratories Ames, Iowa. The NVND virus was also identified as the cause of neurologic disease in a North Dakota turkey flock during the summer of 1992. Although no virus was isolated from cormorants tested after the first month of submissions, brain and spinal cord lesions characteristic of NVND were observed in cormorants from affected sites for 2 mo, at which time nesting colonies dispersed and no more submissions were received. Risk to susceptible populations of both wild avian species and domestic poultry makes early recognition and confirmation of NVND in wild birds a priority.

Forced migration in childhood: are there long-term health effects?

PubMed

Saarela, Jan M; Elo, Irma T

2016-12-01

Studies on the health of migrants have increased considerably in number in recent years, but little is still known about the long-term health effects associated with forced migration, and particularly for people who were forced to migrate as children. Data shortcomings together with the methodological challenges of studying migrant populations limit the ability to disentangle the roles of various factors that influence migrant health outcomes. Finland provides an unusual opportunity to study long-term health consequences associated with forced migration. During World War II, twelve per cent of the Finnish population was forced to leave the region nowadays referred to as Ceded Karelia. After the war, these Karelians could not return home because the area was relinquished to the Soviet Union. Using high quality, linked register-based data for the period 1988-2012, we investigate whether this forced migration had long-term health consequences for those who were forced to migrate as children. Comparison groups are non-displaced persons born on the adjacent side of the new border, and people born elsewhere in Finland. Health at ages 43-65 years is measured by receipt of sickness benefit, which is an indicator of short-term illness, and receipt of disability pension, which reflects long-term illness or permanent disability. All-cause and cause-specific mortality is analysed at ages 43-84 years. We find no support for the hypothesis that the traumatic event of being forced to migrate during childhood has long-term negative health consequences. The forced child migrants have lower odds for receipt of sickness benefit, and women also have lower odds for receipt of disability pension. The mortality results are largely driven by patterns specific for eastern-born populations of Finland. A likely reason behind the absence of negative health consequences is that these migrants seem to have integrated well into post-war Finnish society.

Leukocyte Telomere Length in Major Depression: Correlations with Chronicity, Inflammation and Oxidative Stress - Preliminary Findings

PubMed Central

Wolkowitz, Owen M.; Mellon, Synthia H.; Epel, Elissa S.; Lin, Jue; Dhabhar, Firdaus S.; Su, Yali; Reus, Victor I.; Rosser, Rebecca; Burke, Heather M.; Kupferman, Eve; Compagnone, Mariana; Nelson, J. Craig; Blackburn, Elizabeth H.

2011-01-01

Background Depression is associated with an unusually high rate of aging-related illnesses and early mortality. One aspect of “accelerated aging” in depression may be shortened leukocyte telomeres. When telomeres critically shorten, as often occurs with repeated mitoses or in response to oxidation and inflammation, cells may die. Indeed, leukocyte telomere shortening predicts early mortality and medical illnesses in non-depressed populations. We sought to determine if leukocyte telomeres are shortened in Major Depressive Disorder (MDD), whether this is a function of lifetime depression exposure and whether this is related to putative mediators, oxidation and inflammation. Methodology Leukocyte telomere length was compared between 18 unmedicated MDD subjects and 17 controls and was correlated with lifetime depression chronicity and peripheral markers of oxidation (F2-isoprostane/Vitamin C ratio) and inflammation (IL-6). Analyses were controlled for age and sex. Principal Findings The depressed group, as a whole, did not differ from the controls in telomere length. However, telomere length was significantly inversely correlated with lifetime depression exposure, even after controlling for age (p<0.05). Average telomere length in the depressed subjects who were above the median of lifetime depression exposure (≥9.2 years' cumulative duration) was 281 base pairs shorter than that in controls (p<0.05), corresponding to approximately seven years of “accelerated cell aging.” Telomere length was inversely correlated with oxidative stress in the depressed subjects (p<0.01) and in the controls (p<0.05) and with inflammation in the depressed subjects (p<0.05). Conclusions These preliminary data indicate that accelerated aging at the level of leukocyte telomeres is proportional to lifetime exposure to MDD. This might be related to cumulative exposure to oxidative stress and inflammation in MDD. This suggest that telomere shortening does not antedate depression and is not an intrinsic feature. Rather, telomere shortening may progress in proportion to lifetime depression exposure. PMID:21448457

A Cesium Rare-Earth Silicate Cs3 RESi6 O15 (RE=Dy-Lu, Y, In): The Parent of an Unusual Structural Class Featuring a Remarkable 57 Å Unit Cell Axis.

PubMed

Terry, Rylan; Vinton, Daniel; McMillen, Colin D; Kolis, Joseph W

2018-02-19

The structure of Cs 3 RESi 6 O 15 , where RE=Dy-Lu, Y, In, is unusual in that it contains octahedrally coordinated rare-earth ions; their relative orientation dictates the structure, as they rotate about the c-axis supported by the cyclic Si 6 O 15 framework. The repeat unit of the rotation is eight units generating a very long (ca. 57 Å) unit cell axis. This unusual repeat unit is created by the structural flexibility of the hexasilicate ring, which is in turn affected by the size of the rare earth ion as well as the size of alkali ion residing within the silicate layers. Previous work showed for the smaller Sc 3+ ion, the rotation of the octahedra is not sufficient to achieve closure at an integral repeat unit and an incommensurate structure results. The products are prepared as large, high quality single crystals using a high-temperature (650 °C) hydrothermal method with CsOH and F - mineralizers. The presence of fluoride is essential to the formation of the product. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Dietary patterns and the risk of CVD and all-cause mortality in older British men.

PubMed

Atkins, Janice L; Whincup, Peter H; Morris, Richard W; Lennon, Lucy T; Papacosta, Olia; Wannamethee, S Goya

2016-10-01

Dietary patterns are a major risk factor for cardiovascular morbidity and mortality; however, few studies have examined this relationship in older adults. We examined prospective associations between dietary patterns and the risk of CVD and all-cause mortality in 3226 older British men, aged 60-79 years and free from CVD at baseline, from the British Regional Heart Study. Baseline FFQ data were used to generate thirty-four food groups. Principal component analysis identified dietary patterns that were categorised into quartiles, with higher quartiles representing higher adherence to the dietary pattern. Cox proportional hazards examined associations between dietary patterns and risk of all-cause mortality and cardiovascular outcomes. We identified three interpretable dietary patterns: 'high fat/low fibre' (high in red meat, meat products, white bread, fried potato, eggs), 'prudent' (high in poultry, fish, fruits, vegetables, legumes, pasta, rice, wholemeal bread, eggs, olive oil) and 'high sugar' (high in biscuits, puddings, chocolates, sweets, sweet spreads, breakfast cereals). During 11 years of follow-up, 899 deaths, 316 CVD-related deaths, 569 CVD events and 301 CHD events occurred. The 'high-fat/low-fibre' dietary pattern was associated with an increased risk of all-cause mortality only, after adjustment for confounders (highest v. lowest quartile; hazard ratio 1·44; 95 % CI 1·13, 1·84). Adherence to a 'high-sugar' diet was associated with a borderline significant trend for an increased risk of CVD and CHD events. The 'prudent' diet did not show a significant trend with cardiovascular outcomes or mortality. Avoiding 'high-fat/low-fibre' and 'high-sugar' dietary components may reduce the risk of cardiovascular events and all-cause mortality in older adults.

Portal vein thrombosis: a clinician-oriented and practical review.

PubMed

Handa, Pankaj; Crowther, Mark; Douketis, James D

2014-07-01

With advances in modern imaging techniques, portal vein thrombosis (PVT) is being increasingly diagnosed. It has a wide ranging clinical spectrum from being an asymptomatic state to a potentially life-threatening situation. It is not unusual to find it as an incidental finding in the abdominal imagings done for other reasons. It is commonly associated with cirrhosis and abdominal malignancies and also has a strong association with prothrombotic disorders. It is often difficult for the clinicians to decide whether PVT is acute or chronic. This poses great challenges to its management strategies that include anticoagulants, thrombolysis, and surgical options. Timely diagnosis and appropriate management have great bearings on its outcomes of morbidity and mortality. In this clinician-oriented review, we have provided a concise review of clinical aspects of PVT and discussed various management strategies while addressing the common questions that come to a physician's mind dealing with such a patient. © The Author(s) 2013.

Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever

PubMed Central

Wani, Abdul Majid; Mejally, Mousa Ali Al; Hussain, Waleed Mohd; Maimani, Wail Al; Hanif, Sadia; Khoujah, Amer Mohd; Siddiqi, Ahmad; Akhtar, Mubeena; Bafaraj, Mazen G; Fareed, Khurram

2010-01-01

Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide and 2.5 billion people are at risk. At present, dengue is endemic in 112 countries. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. We present an interesting case of dengue fever with headache, skin rash and abnormal behaviour who had a massive intracranial haemorrhage with fatal outcome. PMID:22242067

Perimortem fractures in Lucy suggest mortality from fall out of tall tree.

PubMed

Kappelman, John; Ketcham, Richard A; Pearce, Stephen; Todd, Lawrence; Akins, Wiley; Colbert, Matthew W; Feseha, Mulugeta; Maisano, Jessica A; Witzel, Adrienne

2016-09-22

The Pliocene fossil 'Lucy' (Australopithecus afarensis) was discovered in the Afar region of Ethiopia in 1974 and is among the oldest and most complete fossil hominin skeletons discovered. Here we propose, on the basis of close study of her skeleton, that her cause of death was a vertical deceleration event or impact following a fall from considerable height that produced compressive and hinge (greenstick) fractures in multiple skeletal elements. Impacts that are so severe as to cause concomitant fractures usually also damage internal organs; together, these injuries are hypothesized to have caused her death. Lucy has been at the centre of a vigorous debate about the role, if any, of arboreal locomotion in early human evolution. It is therefore ironic that her death can be attributed to injuries resulting from a fall, probably out of a tall tree, thus offering unusual evidence for the presence of arborealism in this species.

Unusual association of adrenal pheochromocytoma and para-aortic neurofibroma in pregnancy.

PubMed

Moretti, A; Minuto, M; Berti, P; Bernini, G P; Mannelli, M; Miccoli, P

2006-09-01

The association of pheochromocytoma (PHEO) and pregnancy is uncommon and life threatening for both the fetus and the mother. Early diagnosis and treatment is essential to decrease maternal and fetal mortality and to differentiate the disease from the more common pre-eclampsia. While medical treatment should be started immediately after diagnosis, the timing of surgical treatment is still debated. We describe the case of a 27-yr-old woman in the 18th week of pregnancy who showed a biochemical pattern typical of PHEO and, by imaging studies, 2 tumors with the same characteristics: the first localized on the right adrenal gland, the second at the right renal hilum. The patient underwent surgery because of suspicion of malignant PHEO with local metastasis, while histology revealed a rare association of a solitary PHEO and para-aortic neurofibroma, both tumors embryologically deriving from a common cell precursor.

Giant left paraduodenal hernia

PubMed Central

Cundy, Thomas P; Di Marco, Aimee N; Hamady, Mohamad; Darzi, Ara

2014-01-01

Left paraduodenal hernia (LPDH) is a retrocolic internal hernia of congenital origin that develops through the fossa of Landzert, and extends into the descending mesocolon and left portion of the transverse mesocolon. It carries significant overall risk of mortality, yet delay in diagnosis is not unusual due to subtle and elusive features. Familiarisation with the embryological and anatomical features of this rare hernia is essential for surgical management. This is especially important with respect to vascular anatomy as major mesenteric vessels form intimate relationships with the ventral rim and anterior portion of the hernia. As an illustrative case, we describe our experience with a striking example of LPDH, particularly focusing on the inherent diagnostic challenges and associated critical vascular anatomy. We advocate the role of diagnostic laparoscopy; however caution that decision to safely proceed with laparoscopic repair must occur only with confident identification of the vascular anatomy involved. PMID:24792018

Geomyces and Pseudogymnoascus: Emergence of a primary pathogen, the causative agent of bat white-nose syndrome: Chapter 28

USGS Publications Warehouse

Verant, Michelle L.; Minnis, Andrew M.; Lindner, Daniel L.; Blehert, David

2017-01-01

Geomyces and Pseudogymnoascus (Fungi, Ascomycota, Leotiomycetes, aff. Thelebolales) are closely related groups of globally occurring soil-associated fungi. Recently, these genera of fungi have received attention because a newly identified species, Pseudogymnoascus (initially classified as Geomyces) destructans, was discovered in association with significant and unusual mortality of hibernating bats in North America (Blehert et al. 2009; Gargas et al. 2009; Minnis and Linder 2013). This emergent disease called bat white-nose syndrome (WNS), has since caused drastic declines in populations of hibernating bats in the United States and Canada (Turner, Reeder, and Coleman 2011; Thogmartin et al. 2012) and threatens some species with regional extinction (Frick et al. 2010; Langwig et al. 2012; Thogmartin et al. 2013). As primary predators of insects and keystone species for cave ecosystems, the loss of bats due to WNS has important economic and ecological implications.

Phocine Distemper Virus in Seals, East Coast, United States, 2006

PubMed Central

Earle, J.A. Philip; Melia, Mary M.; Doherty, Nadine V.; Nielsen, Ole

2011-01-01

In 2006 and 2007, elevated numbers of deaths among seals, constituting an unusual mortality event, occurred off the coasts of Maine and Massachusetts, United States. We isolated a virus from seal tissue and confirmed it as phocine distemper virus (PDV). We compared the viral hemagglutinin, phosphoprotein, and fusion (F) and matrix (M) protein gene sequences with those of viruses from the 1988 and 2002 PDV epizootics. The virus showed highest similarity with a PDV 1988 Netherlands virus, which raises the possibility that the 2006 isolate from the United States might have emerged independently from 2002 PDVs and that multiple lineages of PDV might be circulating among enzootically infected North American seals. Evidence from comparison of sequences derived from different tissues suggested that mutations in the F and M genes occur in brain tissue that are not present in lung, liver, or blood, which suggests virus persistence in the central nervous system. PMID:21291591

Effects of rainfall exclusion on leaf gas exchange traits and osmotic adjustment in mature canopy trees of Dryobalanops aromatica (Dipterocarpaceae) in a Malaysian tropical rain forest.

PubMed

Inoue, Yuta; Ichie, Tomoaki; Kenzo, Tanaka; Yoneyama, Aogu; Kumagai, Tomo'omi; Nakashizuka, Tohru

2017-10-01

Climate change exposes vegetation to unusual levels of drought, risking a decline in productivity and an increase in mortality. It still remains unclear how trees and forests respond to such unusual drought, particularly Southeast Asian tropical rain forests. To understand leaf ecophysiological responses of tropical rain forest trees to soil drying, a rainfall exclusion experiment was conducted on mature canopy trees of Dryobalanops aromatica Gaertn.f. (Dipterocarpaceae) for 4 months in an aseasonal tropical rain forest in Sarawak, Malaysia. The rainfall was intercepted by using a soft vinyl chloride sheet. We compared the three control and three treatment trees with respect to leaf water use at the top of the crown, including stomatal conductance (gsmax), photosynthesis (Amax), leaf water potential (predawn: Ψpre; midday: Ψmid), leaf water potential at turgor loss point (πtlp), osmotic potential at full turgor (π100) and a bulk modulus of elasticity (ε). Measurements were taken using tree-tower and canopy-crane systems. During the experiment, the treatment trees suffered drought stress without evidence of canopy dieback in comparison with the control trees; e.g., Ψpre and Ψmid decreased with soil drying. Minimum values of Ψmid in the treatment trees decreased during the experiment, and were lower than πtlp in the control trees. However, the treatment trees also decreased their πtlp by osmotic adjustment, and the values were lower than the minimum values of their Ψmid. In addition, the treatment trees maintained gs and Amax especially in the morning, though at midday, values decreased to half those of the control trees. Decreasing leaf water potential by osmotic adjustment to maintain gs and Amax under soil drying in treatment trees was considered to represent anisohydric behavior. These results suggest that D. aromatica may have high leaf adaptability to drought by regulating leaf water consumption and maintaining turgor pressure to improve its leaf water relations. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

High School Mathematics Teaching in the USA

ERIC Educational Resources Information Center

Sherman, Brian

2010-01-01

The United States of America is a large and diverse country; nevertheless, high schools have a lot in common across the nation. In particular, mathematics teaching in American high schools, while not stereotyped, has some accepted norms which would be seen as unusual here in Australia. In order for the Australians to learn from the Americans, as…

The Association of Geographic Coordinates with Mortality in People with Lower and Higher Education and with Mortality Inequalities in Spain.

PubMed

Regidor, Enrique; Reques, Laura; Giráldez-García, Carolina; Miqueleiz, Estrella; Santos, Juana M; Martínez, David; de la Fuente, Luis

2015-01-01

Geographic patterns in total mortality and in mortality by cause of death are widely known to exist in many countries. However, the geographic pattern of inequalities in mortality within these countries is unknown. This study shows mathematically and graphically the geographic pattern of mortality inequalities by education in Spain. Data are from a nation-wide prospective study covering all persons living in Spain's 50 provinces in 2001. Individuals were classified in a cohort of subjects with low education and in another cohort of subjects with high education. Age- and sex-adjusted mortality rate from all causes and from leading causes of death in each cohort and mortality rate ratios in the low versus high education cohort were estimated by geographic coordinates and province. Latitude but not longitude was related to mortality. In subjects with low education, latitude had a U-shaped relation to mortality. In those with high education, mortality from all causes, and from cardiovascular, respiratory and digestive diseases decreased with increasing latitude, whereas cancer mortality increased. The mortality-rate ratio for all-cause death was 1.27 in the southern latitudes, 1.14 in the intermediate latitudes, and 1.20 in the northern latitudes. The mortality rate ratios for the leading causes of death were also higher in the lower and upper latitudes than in the intermediate latitudes. The geographic pattern of the mortality rate ratios is similar to that of the mortality rate in the low-education cohort: the highest magnitude is observed in the southern provinces, intermediate magnitudes in the provinces of the north and those of the Mediterranean east coast, and the lowest magnitude in the central provinces and those in the south of the Western Pyrenees. Mortality inequalities by education in Spain are higher in the south and north of the country and lower in the large region making up the central plateau. This geographic pattern is similar to that observed in mortality in the low-education cohort.

An Alignment/Transfer Experiment with Low Socioeconomic Level Students.

ERIC Educational Resources Information Center

Elia, June Isaacs

1994-01-01

This study examined the amount of variance explained by alignment of testing to instruction among low socioeconomic level fourth graders, proposing two instructional alignment hypotheses. Results indicated that alignment had an unusually high effect. Low performing low socioeconomic level students achieved high success levels when conditions of…

Visual Neuroscience: A Retinal Ganglion Cell to Report Image Focus?

PubMed

Baden, Tom; Schaeffel, Frank; Berens, Philipp

2017-02-20

A recent study describes a mouse neuron projecting from the retina to the brain that exhibits exquisitely high sensitivity to high spatial frequency patterns presented over an unusually large receptive field: could this cell be a (de)focus detector? Copyright © 2017 Elsevier Ltd. All rights reserved.

A non-multimacrocyclic heteroditopic receptor that cooperatively binds and effectively extracts KAcO salt.

PubMed

Zakrzewski, Maciej; Kwietniewska, Natalia; Walczak, Wojciech; Piątek, Piotr

2018-06-06

Prepared in only three synthetic steps, a non-multimacrocyclic heteroditopic receptor binds potassium salts of halides and carboxylates with unusually high cooperativity, suggesting salt binding as associated ion-pairs. Unprecedented extraction of highly hydrophilic KAcO salt from water to organic solution is also demonstrated.

Using High-Precision Specific Gravity Measurements to Study Minerals in Undergraduate Geoscience Courses

ERIC Educational Resources Information Center

Brandriss, Mark E.

2010-01-01

This article describes ways to incorporate high-precision measurements of the specific gravities of minerals into undergraduate courses in mineralogy and physical geology. Most traditional undergraduate laboratory methods of measuring specific gravity are suitable only for unusually large samples, which severely limits their usefulness for student…

Low-, medium- and high-dose steroids with or without aminocaproic acid in adult hematopoietic SCT patients with diffuse alveolar hemorrhage.

PubMed

Rathi, N K; Tanner, A R; Dinh, A; Dong, W; Feng, L; Ensor, J; Wallace, S K; Haque, S A; Rondon, G; Price, K J; Popat, U; Nates, J L

2015-03-01

Diffuse alveolar hemorrhage (DAH) is a poorly understood complication of transplantation carrying a high mortality. Patients commonly deteriorate and require intensive care unit (ICU) admission. Treatment with high-dose steroids and aminocaproic acid (ACA) has been suggested. The current study examined 119 critically ill adult hematopoietic transplant patients treated for DAH. Patients were subdivided into low-, medium- and high-dose steroid groups with or without ACA. All groups had similar baseline characteristics and severity of illness scores. Primary objectives were 30, 60, 100 day, ICU and hospital mortality. Overall mortality (n=119) on day 100 was high at 85%. In the steroids and ACA cohort (n=82), there were no significant differences in 30, 60, 100, day, ICU and hospital mortality between the dosing groups. In the steroids only cohort (n=37), the low-dose steroid group had a lower ICU and hospital mortality (P=0.02). Adjunctive treatment with ACA did not produce differences in outcomes. In the multivariate analysis, medium- and high-dose steroids were associated with a higher ICU mortality (P=0.01) as compared with the low-dose group. Our data suggest that treatment strategies may need to be reanalyzed to avoid potentially unnecessary and potentially harmful therapies.

Textures in Utopia Planitia

NASA Image and Video Library

2002-12-20

In this image from NASA Mars Odyssey spacecraft, bizarre textures cover the surface of eastern Utopia Planitia, where there is a high probability that ground ice has played a role in the formation of this unusual landscape.

Gas-separation process

DOEpatents

Toy, Lora G.; Pinnau, Ingo; Baker, Richard W.

1994-01-01

A process for separating condensable organic components from gas streams. The process makes use of a membrane made from a polymer material that is glassy and that has an unusually high free volume within the polymer material.

High-pressure phase transitions of nitinol NiTi to a semiconductor with an unusual topological structure

NASA Astrophysics Data System (ADS)

Liu, Guangtao; Liu, Hanyu; Feng, Xiaolei; Redfern, Simon A. T.

2018-04-01

Systematic ab initio structure simulations have been used to explore the high-pressure behavior of nitinol (NiTi) at zero temperature. Our crystal structure prediction and first-principles calculations reveal that the known B 19 phase is dynamically unstable, and an orthorhombic structure (Pbcm) and a face-centered-cubic B 32 structure (F d 3 ¯m ) become stable above ˜4 and 29 GPa, respectively. The predicted, highest-pressure, B 32 phase is composed of two interpenetrating diamond structures, with a structural topology that is quite distinct from that of the other phases of NiTi. Interestingly, the B 32 phase shows an unusual semiconducting characteristic as a result of its unique band structure and the nature of 3 d orbitals localization, whose expected synthesis pressure is accessible to current experimental techniques.

Reconstructing the prevailing meteorological and optical environment during the time of the Titanic disaster

NASA Astrophysics Data System (ADS)

Basu, Sukanta; Nunalee, Christopher G.; He, Ping; Fiorino, Steven T.; Vorontsov, Mikhail A.

2014-10-01

In this paper, we reconstruct the meteorological and optical environment during the time of Titanic's disaster utilizing a state-of-the-art meteorological model, a ray-tracing code, and a unique public-domain dataset called the Twentieth Century Global Reanalysis. With high fidelity, our simulation captured the occurrence of an unusually high Arctic pressure system over the disaster site with calm wind. It also reproduced the movement of a polar cold front through the region bringing a rapid drop in air temperature. The simulated results also suggest that unusual meteorological conditions persisted several hours prior to the Titanic disaster which contributed to super-refraction and intermittent optical turbulence. However, according to the simulations, such anomalous conditions were not present at the time of the collision of Titanic with an iceberg.

An extreme anomaly in stratospheric ozone over Europe in 1940-1942

NASA Astrophysics Data System (ADS)

Brönnimann, S.; Luterbacher, J.; Staehelin, J.; Svendby, T. M.

2004-04-01

Reevaluated historical total ozone data reveal extraordinarily high values over several European sites in 1940-1942, concurrent with extreme climatic anomalies at the Earth's surface. Using historical radiosonde data, reconstructed upper-level fields, and total ozone data from Arosa (Switzerland), Dombås, and Tromsø (Norway), this unusual case of stratosphere-troposphere coupling is analyzed. At Arosa, numerous strong total ozone peaks in all seasons were due to unusually frequent upper troughs over central Europe and related ozone redistribution in the lower stratosphere. At the Norwegian sites, high winter total ozone was most likely caused by major stratospheric warmings in Jan./Feb. 1940, Feb./Mar. 1941, and Feb. 1942. Results demonstrate that the dynamically driven interannual variability of total ozone can be much larger than that estimated based on the past 25-40 years.

Highly deformable bones: unusual deformation mechanisms of seahorse armor.

PubMed

Porter, Michael M; Novitskaya, Ekaterina; Castro-Ceseña, Ana Bertha; Meyers, Marc A; McKittrick, Joanna

2013-06-01

Multifunctional materials and devices found in nature serve as inspiration for advanced synthetic materials, structures and robotics. Here, we elucidate the architecture and unusual deformation mechanisms of seahorse tails that provide prehension as well as protection against predators. The seahorse tail is composed of subdermal bony plates arranged in articulating ring-like segments that overlap for controlled ventral bending and twisting. The bony plates are highly deformable materials designed to slide past one another and buckle when compressed. This complex plate and segment motion, along with the unique hardness distribution and structural hierarchy of each plate, provide seahorses with joint flexibility while shielding them against impact and crushing. Mimicking seahorse armor may lead to novel bio-inspired technologies, such as flexible armor, fracture-resistant structures or prehensile robotics. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Aspiration cytology of mammary analogue secretory carcinoma of the salivary gland.

PubMed

Jung, Min Jung; Kim, Sang Yoon; Nam, Soon Yuhl; Roh, Jong-Lyel; Choi, Seung-Ho; Lee, Jeong Hyun; Baek, Jung Hwan; Cho, Kyung-Ja

2015-04-01

Aspiration cytologic findings of mammary analogue secretory carcinoma (MASC), a newly established salivary gland neoplasm defined by a t(12;15)(p13;q25) ETV6-NTRK3 translocation, are not fully characterized to date. We report cytologic descriptions of nine cases of molecularly confirmed MASC, including two with unusual findings. Aspiration smears from nine MASCs of the salivary glands were retrospectively reviewed and analyzed according to the cellular and structural features of the corresponding surgical specimens. Aspiration smears of MASC generally reflected the histologic diversity of the tumors. Among usual histologic findings, a micropapillary pattern was associated with a predominance of vacuolated individual cells on aspiration smears, a papillary-cystic pattern with a predominance of thin branching papillary structures, and a microcystic pattern with a predominance of irregular sheets of eosinophilic cells. There were two unusual cases, one with three-dimensional groups of high-grade atypical cells, and one with epithelial clusters floating in a notably mucinous background. These cases represented MASC with high-grade transformation and MASC with cystadenocarcinoma-like features, respectively. The secretory activity of MASC was not prominent in the aspiration specimens. Although unusual cases were present, most MASC cases showed characteristic cytologic findings, which could aid the cytologic diagnosis of MASC. And knowledge of the histologic spectrum of MASC, including high-grade transformation, could be valuable for cytological differential diagnoses of salivary gland tumors, and the management of patients with MASC. © 2014 Wiley Periodicals, Inc.

Mortality in hyperglycemic crisis: a high association with infections and cerebrovascular disease.

PubMed

Ekpebegh, C; Longo-Mbenza, B

2013-06-01

Aim of the present study was to determine syndrome specific mortality rates and the precipitating factors associated with deaths following admission for hyperglycemic crisis to a high care unit. Retrospective review of medical records for hyperglycemic crisis at Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province of South Africa from February 1 2010 to January 31 2011. All admissions were initially into the high care unit. The overall mortality rates (per admissions) was 13.9% (N.=15/108) with syndrome specific mortality rates (per admissions) of 11.9% (N.=8/67), 0% (N.=0/8) and 21.2% (N.=7/33) respectively for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hyperglycemia with dehydration (HD). The precipitating factors that were mainly associated with mortality were infections and cerebrovascular disease (CVD). The patients with CVD who died were all unconscious. There were no deaths where non-compliance with hypoglycaemic agents (14.8%, N.=16/108) was the precipitating factor. The overall mortality rates (per admissions) following high care unit admissions for hyperglycemic crisis was 13.9% with infections and CVD as the precipitating factors most associated with deaths.

The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores

PubMed Central

Park, Sun Wook; Song, Young Wook; Tak, Dae Hyun; Ahn, Byung Moo; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

2015-01-01

Background/Aims: To validate the AIMS65 score for predicting mortality of patients with nonvariceal upper gastrointestinal bleeding and to evaluate the effectiveness of urgent (<8 hours) endoscopic procedures in patients with high AIMS65 scores. Methods: This was a 5-year single-center, retrospective study. Nonvariceal, upper gastrointestinal bleeding was assessed by using the AIM65 and Rockall scores. Scores for mortality were assessed by calculating the area under the receiver-operating characteristic curve (AUROC). Patients with high AIMS65 scores (≥2) were allocated to either the urgent or non-urgent endoscopic procedure group. In-hospital mortality, success of endoscopic procedure, recurrence of bleeding, admission period, and dose of transfusion were compared between groups. Results: A total of 634 patients were analyzed. The AIMS65 score successfully predicted mortality (AUROC=0.943; 95% confidence interval [CI], 0.876 to 0.99) and was superior to the Rockall score (AUROC=0.856; 95% CI, 0.743 to 0.969) in predicting mortality. The group with high AIMS65 score included 200 patients. The urgent endoscopic procedure group had reduced hospitalization periods (p<0.05) Conclusions: AIMS65 score may be useful in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding. Urgent endoscopic procedures in patients with high scores may be related to reduced hospitalization periods. PMID:26668799

Causes of Death in Men With Prevalent Diabetes and Newly Diagnosed High- Versus Favorable-Risk Prostate Cancer

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

D'Amico, Anthony V., E-mail: adamico@partners.or; Braccioforte, Michelle H.; Moran, Brian J.

2010-08-01

Purpose: To determine whether prevalent diabetes mellitus (pDM) affects the presentation, extent of radiotherapy, or prostate cancer (PCa)-specific mortality (PCSM) and whether PCa aggressiveness affects the risk of non-PCSM, DM-related mortality, and all-cause mortality in men with pDM. Methods: Between October 1997 and July 2907, 5,279 men treated at the Chicago Prostate Cancer Center with radiotherapy for PCa were included in the study. Logistic and competing risk regression analyses were performed to assess whether pDM was associated with high-grade PCa, less aggressive radiotherapy, and an increased risk of PCSM. Competing risks and Cox regression analyses were performed to assess whethermore » PCa aggressiveness described by risk group in men with pDM was associated with the risk of non-PCSM, DM-related mortality, and all-cause mortality. Analyses were adjusted for predictors of high-grade PCa and factors that could affect treatment extent and mortality. Results: Men with pDM were more likely (adjusted hazard ratio [AHR], 1.9; 95% confidence interval [CI], 1.3-2.7; p = .002) to present with high-grade PCa but were not treated less aggressively (p = .33) and did not have an increased risk of PCSM (p = .58) compared to men without pDM. Among the men with pDM, high-risk PCa was associated with a greater risk of non-PCSM (AHR, 2.2; 95% CI, 1.1-4.5; p = .035), DM-related mortality (AHR, 5.2; 95% CI, 2.0-14.0; p = .001), and all-cause mortality (AHR, 2.4; 95% CI, 1.2-4.7; p = .01) compared to favorable-risk PCa. Conclusion: Aggressive management of pDM is warranted in men with high-risk PCa.« less

Neonatal size and infant mortality at high altitude in the western Himalaya.

PubMed

Wiley, A S

1994-07-01

A prospective study was undertaken in Ladakh, India, a high-altitude region of the Himalaya, to investigate the effects of small average birth size on neonatal mortality. While such studies exist from high-altitude regions of the New World and shed light on the adaptive status of high-altitude-dwelling populations there, this is the first to examine this relationship in the Himalaya. In a sample of 168 newborns, birthweight and other anthropometric measurements were reduced relative to Andean and Tibetan newborns. Logistic regression and hazard analysis showed that neonatal biological characteristics such as weight, fatness, and circumferences were important predictors of survival probabilities of infants, especially in the neonatal period. Low Rohrer's Ponderal Index (PI) was particularly strongly related to poor survival outcome. Males and females showed no significant differences in mortality risk. Data derived from reproductive histories revealed that neonatal mortality accounted for 70-80% of total infant mortality in Ladakh. Compared to other high-altitude studies, small newborn size in Ladakh was associated with much higher mortality risks; mortality risk rose dramatically with birthweights below the mean (2,764 grams), which characterized 50% of all newborns. It is argued that newborns in Ladakh are subject to strong directional selective forces that favor higher birthweights that incur lower risks of neonatal mortality, while Andean infants are subject to relatively mild selection pressure at both ends of the birthweight distribution. Given the overall small size at birth of Ladakhi newborns and the poor survival outcomes of newborns below the mean, it is suggested that this population is less well adapted in a biological sense to the stresses inherent in this high-altitude environment than are Andean populations, perhaps due to the relatively recent colonization of the area and the substantial genetic admixture that has occurred in the past.

Improving life expectancy: how many years behind has the USA fallen? A cross-national comparison among high-income countries from 1958 to 2007.

PubMed

Verguet, Stéphane; Jamison, Dean T

2013-01-01

Many studies have documented higher mortality levels in the USA compared to other high-income nations. We add to this discussion by quantifying how many years behind comparison countries the USA has fallen and by identifying when US mortality rates began to diverge. We use full life tables, for men and women, for 17 high-income countries including the USA. We extract the life expectancy at birth and compute the mortality rates for each 5-year age group from birth up to age 80. Using the metric of how many 'years behind' a country has fallen, we compare US mortality levels with those in other high-income countries ('comparators'). We report life expectancy for 17 high-income countries, for the period 1958-2007. Up to the late 1970s, US men and especially women closely tracked comparators in life expectancy. In the late 1970s in the USA, most strikingly women began to diverge from comparators so that the US female life expectancy in 2007 corresponded to that of the comparators' average 10 years earlier. Mortality rates also began to diverge from the late 1970s, and the largest mortality gap was in the 15-49 age group, for both men and women, where the USA had fallen about 40 years behind the comparators by 2007. Some causes proposed for the relatively high US mortality today-racial differences, lack of universal health insurance, US exceptionalism-changed little while the mortality gap emerged and grew. This suggests that explanations for the growing gap lie elsewhere. Quantification of how many years behind the USA has fallen can help provide clues about where to look for potential causes and remedies.

Comparison of the Impact of High-Flux Dialysis on Mortality in Hemodialysis Patients with and without Residual Renal Function

PubMed Central

Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo; Kim, Yong Kyun

2014-01-01

Background The effect of flux membranes on mortality in hemodialysis (HD) patients is controversial. Residual renal function (RRF) has shown to not only be as a predictor of mortality but also a contributor to β2-microglobulin clearance in HD patients. Our study aimed to determine the interaction of residual renal function with dialyzer membrane flux on mortality in HD patients. Methods HD Patients were included from the Clinical Research Center registry for End Stage Renal Disease, a prospective observational cohort study in Korea. Cox proportional hazards regression models were used to study the association between use of high-flux dialysis membranes and all-cause mortality with RRF and without RRF. The primary outcome was all-cause mortality. Results This study included 893 patients with 24 h-residual urine volume ≥100 ml (569 and 324 dialyzed using low-flux and high-flux dialysis membranes, respectively) and 913 patients with 24 h-residual urine volume <100 ml (570 and 343 dialyzed using low-flux and high-flux dialysis membranes, respectively). After a median follow-up period of 31 months, mortality was not significantly different between the high and low-flux groups in patients with 24 h-residual urine volume ≥100 ml (HR 0.86, 95% CI, 0.38–1.95, P = 0.723). In patients with 24 h-residual urine volume <100 ml, HD using high-flux dialysis membrane was associated with decreased mortality compared to HD using low-flux dialysis membrane in multivariate analysis (HR 0.40, 95% CI, 0.21–0.78, P = 0.007). Conclusions Our data showed that HD using high-flux dialysis membranes had a survival benefit in patients with 24 h-residual urine volume <100 ml, but not in patients with 24 h-residual urine volume ≥100 ml. These findings suggest that high-flux dialysis rather than low-flux dialysis might be considered in HD patients without RRF. PMID:24906205

Uniportal anatomic combined unusual segmentectomies

PubMed Central

Lirio, Francisco; Sesma, Julio

2017-01-01

Nowadays, sublobar anatomic resections are gaining momentum as a valid alternative for early stage lung cancer. Despite being technically demanding, anatomic segmentectomies can be performed by uniportal video-assisted thoracic surgery (VATS) approach to combine the benefits of minimally invasiveness with the maximum lung sparing. This procedure can be even more complex if a combined resection of multiple segments from different lobes has to be done. Here we report five cases of combined and unusual segmentectomies done by the same experienced surgeon in high volume institutions to show uniportal VATS is a feasible approach for these complex resections and to share an excellent educational resource. PMID:29078653

Thyroid tuberculosis: presenting symptom of mediastinal tuberculous lymphadenitis--an unusual case.

PubMed

Chandanwale, Shirish S; Buch, Archana C; Vimal, Shruti S; Sachdeva, Punita

2014-01-01

Tuberculosis of thyroid gland is extremely rare. It spreads to thyroid by lymphogenous or heamatogenous route or from adjacent focus, either from larynx or cervical and mediastinal adenitis. We report an unusual case of a 33-year-old male with thyroid swelling. Fine needle aspiration (FNA) smears showed epithelioid cells without necrosis and acid fast bacilli (AFB). Subsequent investigation revealed mediastinal tuberculous lymphadenitis on Computerized Tomography (CT) scan. FNA confirmed the diagnosis of mediastinal tuberculous lymphadenitis. We conclude, when epithelioid cells are seen on FNA thyroid, tuberculosis must be ruled out especially in regions where there is high prevalence of tuberculosis.

A painful pulsatile abdominal mass in a young man with elevated blood pressures: an unusual presentation of phaeochromocytoma.

PubMed

Lee, B M K; Ti, L K

2002-08-01

We report an unusual presentation of phaeochromocytoma in a young man with a painful, pulsatile abdominal mass and elevated blood pressures. This led to a delay in diagnosis and resulted in the administration of triggers of catecholamine release, possibly causing a catecholamine surge. This caused the development of catecholamine-induced cardiomyopathy and multiple organ failure, requiring inotropic and ventilatory support, intra-aortic balloon pump and dialysis. Fortunately, his condition reversed with supportive treatment and alpha-adrenergic blockade. This illustrates the importance of having a high index of suspicion of phaeochromocytoma, especially in young patients with elevated blood pressures.

myBlackBox: Blackbox Mobile Cloud Systems for Personalized Unusual Event Detection.

PubMed

Ahn, Junho; Han, Richard

2016-05-23

We demonstrate the feasibility of constructing a novel and practical real-world mobile cloud system, called myBlackBox, that efficiently fuses multimodal smartphone sensor data to identify and log unusual personal events in mobile users' daily lives. The system incorporates a hybrid architectural design that combines unsupervised classification of audio, accelerometer and location data with supervised joint fusion classification to achieve high accuracy, customization, convenience and scalability. We show the feasibility of myBlackBox by implementing and evaluating this end-to-end system that combines Android smartphones with cloud servers, deployed for 15 users over a one-month period.

myBlackBox: Blackbox Mobile Cloud Systems for Personalized Unusual Event Detection

PubMed Central

Ahn, Junho; Han, Richard

2016-01-01

We demonstrate the feasibility of constructing a novel and practical real-world mobile cloud system, called myBlackBox, that efficiently fuses multimodal smartphone sensor data to identify and log unusual personal events in mobile users’ daily lives. The system incorporates a hybrid architectural design that combines unsupervised classification of audio, accelerometer and location data with supervised joint fusion classification to achieve high accuracy, customization, convenience and scalability. We show the feasibility of myBlackBox by implementing and evaluating this end-to-end system that combines Android smartphones with cloud servers, deployed for 15 users over a one-month period. PMID:27223292

An unusual case of intraorbital foreign body and its management

PubMed Central

Mukherjee, Bipasha; Goel, Shubhra; Subramanian, Nirmala

2011-01-01

Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacuring unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory. PMID:21157077

Unusual Carrier Thermalization in a Dilute GaAs1-xNx Alloy

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

Tan, P. H.; Xu, Z. Y.; Luo, X. D.

2007-01-01

Photoluminescence (PL) properties of the E{sub 0}, E{sub 0} + {Delta}{sub 0}, and E{sub +} bands in an x=0.62% GaAs{sub 1-x}N{sub x} alloy were investigated in detail, including their peak position, linewidth, and line shape dependences on the excitation energy, excitation power, and temperature, using micro-PL. The hot electrons within the E{sub +} band are found to exhibit highly unusual thermalization, which results in a large blueshift in its PL peak energy by >2k{sub B}T, suggesting peculiar density of states and carrier dynamics of the E{sub +} band.

Mortality in former Olympic athletes: retrospective cohort analysis

PubMed Central

Zwiers, R; Zantvoord, F W A; van Bodegom, D; van der Ouderaa, F J G; Westendorp, R G J

2012-01-01

Objective To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity. Design Retrospective cohort study. Setting Former Olympic athletes. Participants 9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact. Main outcome measure All cause mortality. Results Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact. Conclusions Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life. PMID:23241269

Mortality among immigrants in England and Wales by major causes of death, 1971-2012: A longitudinal analysis of register-based data.

PubMed

Wallace, Matthew; Kulu, Hill

2015-12-01

Recent research has found a migrant mortality advantage among immigrants relative to the UK-born population living in England and Wales. However, while all-cause mortality is useful to show differences in mortality between immigrants and the host population, it can mask variation in mortality patterns from specific causes of death. This study analyses differences in the causes of death among immigrants living in England and Wales. We extend previous research by applying competing-risks survival analysis to study a large-scale longitudinal dataset from 1971 to 2012 to directly compare causes of death. We confirm low all-cause mortality among nearly all immigrants, except immigrants from Scotland, Northern Ireland and the Republic of Ireland (who have high mortality). In most cases, low all-cause mortality among immigrants is driven by lower mortality from chronic diseases (in nearly all cases by lower cancer mortality and in some cases by lower mortality from cardiovascular diseases (CVD)). This low all-cause mortality often coexists with low respiratory disease mortality and among non-western immigrants, coexists with high mortality from infectious diseases; however, these two causes of death contribute little to mortality among immigrants. For men, CVD is the leading cause of death (particularly among South Asians). For women, cancer is the leading cause of death (except among South Asians, for whom CVD is also the leading cause). Differences in CVD mortality over time remain constant between immigrants relative to UK-born, but immigrant cancer patterns shows signs of some convergence to the cancer mortality among the UK-born (though cancer mortality is still low among immigrants by age 80). The study provides the most up-to-date, reliable UK-based analysis of immigrant mortality. Copyright © 2015 Elsevier Ltd. All rights reserved.

Serum Bicarbonate and Mortality in Stage 3 and Stage 4 Chronic Kidney Disease

PubMed Central

Schold, Jesse D.; Arrigain, Susana; Jolly, Stacey E.; Wehbe, Edgard; Raina, Rupesh; Simon, James F.; Srinivas, Titte R.; Jain, Anil; Schreiber, Martin J.; Nally, Joseph V.

2011-01-01

Summary Background and objectives The incidence and prevalence of metabolic acidosis increase with declining kidney function. We studied the associations of both low and high serum bicarbonate levels with all-cause mortality among stage 3 and 4 chronic kidney disease (CKD) patients. Design, setting, participants, & measurements We examined factors associated with low (<23 mmol/L) and high (>32 mmol/L) serum bicarbonate levels using logistic regression models and associations between bicarbonate and all-cause mortality using Cox-proportional hazard models, Kaplan–Meier survival curves, and time-dependent analysis. Results Out of 41,749 patients, 13.9% (n = 5796) had low and 1.6% (n = 652) had high serum bicarbonate levels. After adjusting for relevant covariates, there was a significant association between low serum bicarbonate and all-cause mortality (hazard ratio [HR] 1.23, 95% CI 1.16, 1.31). This association was not statistically significant among patients with stage 4 CKD and diabetes. The time-dependent analysis demonstrated a significant mortality risk associated with a decline from normal to low bicarbonate level (HR 1.59, 95% CI 1.49, 1.69). High serum bicarbonate levels were associated with death irrespective of the level of kidney function (HR 1.74, 95% CI 1.52, 2.00). When serum bicarbonate was examined as a continuous variable, a J-shaped relationship was noted between serum bicarbonate and mortality. Conclusions Low serum bicarbonate levels are associated with increased mortality among stage 3 CKD patients and patients without diabetes. High serum bicarbonate levels are associated with mortality in both stage 3 and stage 4 CKD patients. PMID:21885787

The contribution of hospital nursing leadership styles to 30-day patient mortality.

PubMed

Cummings, Greta G; Midodzi, William K; Wong, Carol A; Estabrooks, Carole A

2010-01-01

Nursing work environment characteristics, in particular nurse and physician staffing, have been linked to patient outcomes (adverse events and patient mortality). Researchers have stressed the need for nursing leadership to advance change in healthcare organizations to create safer practice environments for patients. The relationship between styles of nursing leadership in hospitals and patient outcomes has not been well examined. The purpose of this study was to examine the contribution of hospital nursing leadership styles to 30-day mortality after controlling for patient demographics, comorbidities, and hospital factors. Ninety acute care hospitals in Alberta, Canada, were categorized into five styles of nursing leadership: high resonant, moderately resonant, mixed, moderately dissonant, and high dissonant. In the secondary analysis, existing data from three sources (nurses, patients, and institutions) were used to test a hypothesis that the styles of nursing leadership at the hospital level contribute to patient mortality rates. Thirty-day mortality was 7.8% in the study sample of 21,570 medical patients; rates varied across hospital categories: high resonant (5.2%), moderately resonant (7.4%), mixed (8.1%), moderately dissonant (8.8%), and high dissonant (4.3%). After controlling for patient demographics, comorbidities, and institutional and hospital nursing characteristics, nursing leadership styles explained 5.1% of 72.2% of total variance in mortality across hospitals, and high-resonant leadership was related significantly to lower mortality. Hospital nursing leadership styles may contribute to 30-day mortality of patients. This relationship may be moderated by homogeneity of leadership styles, clarity of communication among leaders and healthcare providers, and work environment characteristics.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China

PubMed Central

Wang, Xuying; Li, Guoxing; Liu, Liqun; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan

2015-01-01

Objective: Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. Methods: We collected data from Beijing and Shanghai, China, during 2007–2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. Results: For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0–27, while the hot effects reached the strongest at lag 0–14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. Conclusion: People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days. PMID:26703637

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China.

PubMed

Wang, Xuying; Li, Guoxing; Liu, Liqun; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan

2015-12-21

Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Trends in under-5 mortality rates and the HIV/AIDS epidemic.

PubMed Central

Adetunji, J.

2000-01-01

INTRODUCTION: The prevalence of human immunodeficiency virus (HIV) among adults and mortality rates among under-5-year-olds have increased or stagnated in many countries. The objective of this study was to investigate whether there is a link between under-5 mortality trends and the prevalence of HIV among adults and, if so, to assess the magnitude of the effect of adult HIV prevalence on under-5 mortality rates. METHOD: Data from Demographic and Health Surveys were used to establish the trends in under-5 mortality rates for 25 countries for which there are data for at least two points in time. Countries were ranked according to the most recent adult HIV prevalence data and grouped in three categories: those with very high HIV prevalence (> or = 5%); those with moderately high prevalence (1-4.9%); and those with low prevalence (< 1%). A mathematical model was fitted to obtain an estimate of the contribution of HIV/AIDS to the level of under-5 mortality in each country. RESULTS: Under-5 mortality rates showed an increase in most countries with high adult HIV prevalence, but a decrease in almost every country with moderately high or low prevalence. The estimated contribution of adult HIV prevalence to the observed level of under-5 mortality was highest (up to 61%) in Zimbabwe (where HIV prevalence was highest) and tended to decrease with the level of HIV prevalence. DISCUSSION: The contribution of HIV/AIDS to childhood mortality therefore appears to be most noticeable in settings where the epidemic is most severe. PMID:11100615

Unintentional falls mortality among elderly in the United States: time for action.

PubMed

Alamgir, Hasanat; Muazzam, Sana; Nasrullah, Muazzam

2012-12-01

Fall injury is a leading cause of death and disability among older adults. The objective of this study is to identify the groups among the ≥ 65 population by age, gender, race, ethnicity and state of residence which are most vulnerable to unintentional fall mortality and report the trends in falls mortality in the United States. Using mortality data from the Centers for Disease Control and Prevention, the age specific and age-adjusted fall mortality rates were calculated by gender, age, race, ethnicity and state of residence for a five year period (2003-2007). Annual percentage changes in rates were calculated and linear regression using natural logged rates were used for time-trend analysis. There were 79,386 fall fatalities (rate: 40.77 per 100,000 population) reported. The annual mortality rate varied from a low of 36.76 in 2003 to a high of 44.89 in 2007 with a 22.14% increase (p=0.002 for time-related trend) during 2003-2007. The rates among whites were higher compared to blacks (43.04 vs. 18.83; p=0.01). While comparing falls mortality rate for race by gender, white males had the highest mortality rate followed by white females. The rate was as low as 20.19 for Alabama and as high as 97.63 for New Mexico. The relative attribution of falls mortality among all unintentional injury mortality increased with age (23.19% for 65-69 years and 53.53% for 85+ years), and the proportion of falls mortality was significantly higher among females than males (46.9% vs. 40.7%: p<0.001) and among whites than blacks (45.3% vs. 24.7%: p<0.001). The burden of fall related mortality is very high and the rate is on the rise; however, the burden and trend varied by gender, age, race and ethnicity and also by state of residence. Strategies will be more effective in reducing fall-related mortality when high risk population groups are targeted. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Importance of linking In Situ Observation to Flux Measurement in Understanding Rhizosphere Dynamics in Scaling to Global Processes

NASA Astrophysics Data System (ADS)

Allen, M. F.; Taggart, M. C.; Hernandez, R. R.; Harmon, T. C.; Rundel, P.

2017-12-01

Observation is essential for organizing outputs from sensor data to describe dynamic phenomena regulating core processes. The rhizosphere is that region of the soil layer that regulates soil carbon acquisition, turnover, and sequestration and that is most sensitive to rapid changes in soil moisture, temperature, and gases. Virtually every process regulating carbon and nutrient immobilization and mineralization occur here at the maximum rates. However, the observation of root, microbial, and animal growth, movement, and mortality are rarely undertaken at time scales of crucial events. While multiple cores or observations can be taken in space, replications in time are rarely undertaken. We coupled automated (AMR) and manual minirhizotrons (MMR) with soil and aboveground sensors for temperature (T), water content (q), CO2, and O2 to measure short-term dynamics that regulate carbon cycling. AMRs imaged rhizospheres, multiple times daily. From these images, we observed timing of root and hyphal growth and mortality in response to changes in photosynthesis, diurnal temperature fluctuations, and precipitation and drought events. Replicate manual minirhizotron tubes describe the spatial structure of those events, and replicate core samples provide measurements of standing crop at known times. We present four examples showing how observation led to understanding unusual C flux patterns in mixed-conifer forest (belowground photosynthate allocation), hot desert (CaCO3 formation and weathering), grassland (root grazing), and tropical rainforest (soil gas flux patterns).

Management strategies for neoplastic and vascular brain lesions presenting during pregnancy: A series of 29 patients.

PubMed

Pereira, Celestino Esteves; Lynch, Jose Carlos

2017-01-01

The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis. The Neurosurgery Department teamed up with Obstetrics Anesthesiology Departments in establishing the procedures. The patients' records, surgical descriptions, imaging studies, and histopathological material were reviewed. Among 12 patients presenting with brain tumors, there were neither operative mortality nor fetal deaths. Among the vascular lesions, aneurysm rupture was responsible for bleeding in 6 instances. Arteriovenous malformation was diagnosed in 7 patients. In this subgroup, the maternal and fetal mortality rates were 11.7% and 23.7%, respectively. We can assert that the association between a brain tumor and vascular lesions with pregnancy is a very unusual event, which jeopardizes both the lives of the mother and infant. It remains incompletely characterized due to the rare nature of these potentially devastating events. Knowing the exact mechanism responsible for the interaction of pregnancy and with these lesions will improve the treatment of these patients.

Mysis diluviana population and cohort dynamics in Lake Ontario before and after the establishment of Dreissena spp., Cercopagis pengoi, and Bythotrephes longimanus

USGS Publications Warehouse

Johannsson, Ora E.; Bowen, Kelly L.; Holeck, Kristen T.; Walsh, Maureen G.

2011-01-01

We investigated population responses of Mysis to ecosystem changes induced by invasion of dreissenids and predatory cladocerans, Cercopagis and Bythotrephes. Lake productivity declined as dreissenids invaded the offshore region. Whole-lake mysid biomass was compared before (early 1990s) and after (2002–2007) the invasion period; it declined 40%–45%. Abundance of young mysids and presence of a summer cohort increased with summer, epilmnetic, nighttime zooplankton biomass (i.e., food biomass index). Cercopagis + Bythotrephes biomass was negatively correlated with this index, implicating them in the mysid decline. Eggs per gravid female increased with autumn, total-water-column zooplankton biomass, reflecting the greater use of hypolimnetic waters by adults. Reproductive success was below replacement during the period 2002–2005. First-year mysid growth rate was maintained while population abundance declined, suggesting selection for individuals that feed effectively at low food concentrations. Mortality rates in the first and second years were dependent on cohort density, indicating that competition for food limited abundance in the first 2 years. Fish predation indices (smelt and alewife combined) were correlated positively with mortality rates and negatively with abundance in the third year. Thus, mysids cannot support as many fish in invaded compared with non-invaded lakes. They may also not be a stable food resource; unusual cohort losses occurred in some years.

Association of Women’s Reproductive History With Long-Term Mortality and Effect of Socioeconomic Factors

PubMed Central

Halland, Frode; Morken, Nils-Halvdan; DeRoo, Lisa A; Klungsøyr, Kari; Wilcox, Allen J; Skjærven, Rolv

2017-01-01

Objective To assess the effects of socioeconomic factors on the association between parity and long-term maternal mortality. Methods This was a population-based cohort study of mothers with births registered in the Medical Birth Registry of Norway (MBRN) during the period 1967 to 2009. We estimated age-specific (40 to 69 years) cardiovascular and non-cardiovascular mortality ratios by number of births using Cox proportional-hazard models. To assess effect modification by mothers’ attained education we stratified on low (<11 years) and high (≥11 years) educational level. We further evaluated fathers’ mortality by number of births using the same analytical approach. Results Mothers with low education had higher mortality (cardiovascular: hazard ratio (HR) 2.62, 95% confidence interval (CI) 2.34–2.93, non-cardiovascular: HR 1.67, 95% CI 1.62–1.73). Among mothers with low education, cardiovascular mortality increased linearly with each additional birth above one, (p-trend=0.02). In contrast, among mothers with high education, cardiovascular mortality declined with added births, (p-trend=0.045). For non-cardiovascular mortality there was no association among mothers with low education, while mortality declined with increasing number of births among mothers with high education, (p-trend<0.01). Father’s mortality showed similar associations with number of births when stratified on maternal education. Conclusions Women’s long-term mortality rose with number of births only for cardiovascular causes of death, and only among mothers with low education. Partners of women with low education had similar increasing risk with increasing number of births. Maternal educational level is a strong modifier of the association between parity and long-term mortality. PMID:26551179

Spatial variability of excess mortality during prolonged dust events in a high-density city: a time-stratified spatial regression approach.

PubMed

Wong, Man Sing; Ho, Hung Chak; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Chan, Ta-Chien

2017-07-24

Dust events have long been recognized to be associated with a higher mortality risk. However, no study has investigated how prolonged dust events affect the spatial variability of mortality across districts in a downwind city. In this study, we applied a spatial regression approach to estimate the district-level mortality during two extreme dust events in Hong Kong. We compared spatial and non-spatial models to evaluate the ability of each regression to estimate mortality. We also compared prolonged dust events with non-dust events to determine the influences of community factors on mortality across the city. The density of a built environment (estimated by the sky view factor) had positive association with excess mortality in each district, while socioeconomic deprivation contributed by lower income and lower education induced higher mortality impact in each territory planning unit during a prolonged dust event. Based on the model comparison, spatial error modelling with the 1st order of queen contiguity consistently outperformed other models. The high-risk areas with higher increase in mortality were located in an urban high-density environment with higher socioeconomic deprivation. Our model design shows the ability to predict spatial variability of mortality risk during an extreme weather event that is not able to be estimated based on traditional time-series analysis or ecological studies. Our spatial protocol can be used for public health surveillance, sustainable planning and disaster preparation when relevant data are available.

The Relationship between Clinical Presentation and Unusual Sensory Interests in Autism Spectrum Disorders: A Preliminary Investigation

ERIC Educational Resources Information Center

Zachor, Ditza A.; Ben-Itzchak, Esther

2014-01-01

Unusual responses to sensory stimuli have been described in autism spectrum disorder (ASD).The study examined the frequencies of "unusual sensory interests" and "negative sensory responses" and their relation to functioning in a large ASD population (n = 679). Having "unusual sensory interests" was reported in 70.4%…

Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areas.

PubMed

Chen, Kai; Wolf, Kathrin; Breitner, Susanne; Gasparrini, Antonio; Stafoggia, Massimo; Samoli, Evangelia; Andersen, Zorana Jovanovic; Bero-Bedada, Getahun; Bellander, Tom; Hennig, Frauke; Jacquemin, Bénédicte; Pekkanen, Juha; Hampel, Regina; Cyrys, Josef; Peters, Annette; Schneider, Alexandra

2018-07-01

Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature. We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 μm (PM 2.5 ) and ≤ 10 μm (PM 10 ), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999-2013. We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis. Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm 3 in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (<25th percentile) [-0.18% (95% CI: -0.97%, 0.62%)]. On days with high air pollution (>50th percentile), both heat- and cold-related mortality risks increased. Our findings showed that high temperature could modify the effects of air pollution on daily mortality and high air pollution might enhance the air temperature effects. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spatiotemporal influence of temperature, air quality, and urban environment on cause-specific mortality during hazy days.

PubMed

Ho, Hung Chak; Wong, Man Sing; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Bilal, Muhammad; Chan, Ta-Chien

2018-03-01

Haze is an extreme weather event that can severely increase air pollution exposure, resulting in higher burdens on human health. Few studies have explored the health effects of haze, and none have investigated the spatiotemporal interaction between temperature, air quality and urban environment that may exacerbate the adverse health effects of haze. We investigated the spatiotemporal pattern of haze effects and explored the additional effects of temperature, air pollution and urban environment on the short-term mortality risk during hazy days. We applied a Poisson regression model to daily mortality data from 2007 through 2014, to analyze the short-term mortality risk during haze events in Hong Kong. We evaluated the adverse effect on five types of cause-specific mortality after four types of haze event. We also analyzed the additional effect contributed by the spatial variability of urban environment on each type of cause-specific mortality during a specific haze event. A regular hazy day (lag 0) has higher all-cause mortality risk than a day without haze (odds ratio: 1.029 [1.009, 1.049]). We have also observed high mortality risks associated with mental disorders and diseases of the nervous system during hazy days. In addition, extreme weather and air quality contributed to haze-related mortality, while cold weather and higher ground-level ozone had stronger influences on mortality risk. Areas with a high-density environment, lower vegetation, higher anthropogenic heat, and higher PM 2.5 featured stronger effects of haze on mortality than the others. A combined influence of haze, extreme weather/air quality, and urban environment can result in extremely high mortality due to mental/behavioral disorders or diseases of the nervous system. In conclusion, we developed a data-driven technique to analyze the effects of haze on mortality. Our results target the specific dates and areas with higher mortality during haze events, which can be used for development of health warning protocols/systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

44 CFR 9.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subject to high velocity waters including but not limited to hurricane wave wash or tsunamis. On a Flood... normally dry land areas from the overflow of inland and/or tidal waters, and/or the unusual and rapid...