Consumer Education for Kindergarten through Grade 8.

ERIC Educational Resources Information Center

Illinois State Office of Education, Springfield. Div. of Program Planning and Development.

This guide is intended to assist school administrative personnel in the integration of consumer education into the curriculum at the elementary level and to assist teachers in planning and implementing consumer education concepts at the primary, intermediate, and upper elementary levels in language arts, mathematics, science, and social studies…

Primary Productivity Regime and Nutrient Removal in the Danube Estuary

NASA Astrophysics Data System (ADS)

Humborg, C.

1997-11-01

The primary productivity regime, as well as the distribution of dissolved inorganic nutrients and particulate organic matter in the Danube estuary, were investigated during several cruises at different discharge regimes of the Danube River. The shallowness of the upper surface layer due to insignificant tidal mixing and strong stratification of the Danube estuary, as well as the high nutrient concentrations, are favourable for elevated primary production. The incident light levels at the bottom of the upper surface layer of the water column (0·5-3·0 m) were generally higher than 20% of the surface irradiance. Elevated chlorophyll (Chl) aconcentrations with maxima at mid salinities were found during each survey. Within the upper mixed layer estimated primary production of 0·2-4·4 g m-2day-1is very high compared with estuaries of other major world rivers. Mixing diagrams of dissolved inorganic nutrients reveal removal of significant quantities of nutrients during estuarine mixing. These observations were consistent with the distribution of particular organic matter, which was negatively correlated to the nutrient distribution during each survey. C:Chl aratios, as well as the elevated estimated production, indicate that biological transformation processes govern the nutrient distribution in this estuary.

Exploring Turkish Upper Primary Level Pupils' Understanding of Digestion

ERIC Educational Resources Information Center

Cakici, Yilmaz

2005-01-01

This article reports a study of Turkish children's understanding of digestion in Grades 4 and 5 (ages 10-11). Data collection was carried out through the use of an open-ended questionnaire administered to 283 children in three Turkish primary schools. Follow-up interviews were conducted with 30 children in Grade 4 and 72 children in Grade 5. The…

Isolated primary lymphedema tarda of the upper limb.

PubMed

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

Elevated Levels of Calcitonin Gene-Related Peptide in Upper Spinal Cord Promotes Sensitization of Primary Trigeminal Nociceptive Neurons

PubMed Central

Cornelison, Lauren E.; Hawkins, Jordan L.; Durham, Paul L.

2016-01-01

Orofacial pain conditions including temporomandibular joint disorder and migraine are characterized by peripheral and central sensitization of trigeminal nociceptive neurons. Although calcitonin gene-related peptide (CGRP) is implicated in the development of central sensitization, the pathway by which elevated spinal cord CGRP levels promote peripheral sensitization of primary trigeminal nociceptive neurons is not well understood. The goal of this study was to investigate the role of CGRP in promoting bidirectional signaling within the trigeminal system to mediate sensitization of primary trigeminal ganglion nociceptive neurons. Adult male Sprague Dawley rats were injected in the upper spinal cord with CGRP or co-injected with the receptor antagonist CGRP8-37 or KT 5720, an inhibitor of protein kinase A (PKA). Nocifensive head withdrawal response to mechanical stimulation of trigeminal nerves was investigated using von Frey filaments. Expression of PKA, GFAP, and Iba1 in the spinal cord and P-ERK in the trigeminal ganglion was studied using immunohistochemistry. Some animals were co-injected intracisternally with CGRP and Fast Blue dye and trigeminal ganglion imaged using fluorescent microscopy. Intracisternal CGRP increased nocifensive responses to mechanical stimulation when compared to control levels. Co-injection of CGRP8-37 or KT 5720 with CGRP inhibited the nocifensive response. CGRP stimulated expression of PKA and GFAP in the spinal cord, and P-ERK in trigeminal ganglion neurons. Seven days post injection, Fast Blue was observed in trigeminal ganglion neurons and satellite glial cells. Our results demonstrate that elevated levels of CGRP in the upper spinal cord promote sensitization of primary trigeminal nociceptive neurons via a mechanism that involves activation of PKA centrally and P-ERK in trigeminal ganglion neurons. Our findings provide evidence of bidirectional signaling within the trigeminal system that can facilitate increased neuron-glia communication within the trigeminal ganglion associated with peripheral sensitization. PMID:27746346

A 12-month phase 3 study of pasireotide in Cushing's disease.

PubMed

Colao, Annamaria; Petersenn, Stephan; Newell-Price, John; Findling, James W; Gu, Feng; Maldonado, Mario; Schoenherr, Ulrike; Mills, David; Salgado, Luiz Roberto; Biller, Beverly M K

2012-03-08

Cushing's disease is associated with high morbidity and mortality. Pasireotide, a potential therapy, has a unique, broad somatostatin-receptor-binding profile, with high binding affinity for somatostatin-receptor subtype 5. In this double-blind, phase 3 study, we randomly assigned 162 adults with Cushing's disease and a urinary free cortisol level of at least 1.5 times the upper limit of the normal range to receive subcutaneous pasireotide at a dose of 600 μg (82 patients) or 900 μg (80 patients) twice daily. Patients with urinary free cortisol not exceeding 2 times the upper limit of the normal range and not exceeding the baseline level at month 3 continued to receive their randomly assigned dose; all others received an additional 300 μg twice daily. The primary end point was a urinary free cortisol level at or below the upper limit of the normal range at month 6 without an increased dose. Open-label treatment continued through month 12. Twelve of the 82 patients in the 600-μg group and 21 of the 80 patients in the 900-μg group met the primary end point. The median urinary free cortisol level decreased by approximately 50% by month 2 and remained stable in both groups. A normal urinary free cortisol level was achieved more frequently in patients with baseline levels not exceeding 5 times the upper limit of the normal range than in patients with higher baseline levels. Serum and salivary cortisol and plasma corticotropin levels decreased, and clinical signs and symptoms of Cushing's disease diminished. Pasireotide was associated with hyperglycemia-related adverse events in 118 of 162 patients; other adverse events were similar to those associated with other somatostatin analogues. Despite declines in cortisol levels, blood glucose and glycated hemoglobin levels increased soon after treatment initiation and then stabilized; treatment with a glucose-lowering medication was initiated in 74 of 162 patients. The significant decrease in cortisol levels in patients with Cushing's disease who received pasireotide supports its potential use as a targeted treatment for corticotropin-secreting pituitary adenomas. (Funded by Novartis Pharma; ClinicalTrials.gov number, NCT00434148.).

The value of thyroid shielding in intraoral radiography

PubMed Central

Hazenoot, Bart; Sanderink, Gerard C H; Berkhout, W Erwin R

2016-01-01

Objectives: To evaluate the utility of the application of a thyroid shield in intraoral radiography when using rectangular collimation. Methods: Experimental data were obtained by measuring the absorbed dose at the position of the thyroid gland in a RANDO® (The Phantom Laboratory, Salem, NY) male phantom with a dosemeter. Four protocols were tested: round collimation and rectangular collimation, both with and without thyroid shield. Five exposure positions were deployed: upper incisor (Isup), upper canine (Csup), upper premolar (Psup), upper molar (Msup) and posterior bitewing (BW). Exposures were made with 70 kV and 7 mA and were repeated 10 times. The exposure times were as recommended for the exposure positions for the respective collimator type by the manufacturer for digital imaging. The data were statistically analyzed with a three-way ANOVA test. Significance was set at p < 0.01. Results: The ANOVA test revealed that the differences between mean doses of all protocols and geometries were statistically significant, p < 0.001. For the Isup, thyroid dose levels were comparable with both collimators at a level indicating primary beam exposure. Thyroid shield reduced this dose with circa 75%. For the Csup position, round collimation also revealed primary beam exposure, and thyroid shield yield was 70%. In Csup with rectangular collimation, the thyroid dose was reduced with a factor 4 compared with round collimation and thyroid shield yielded an additional 42% dose reduction. The thyroid dose levels for the Csup, Psup, Msup and BW exposures were lower with rectangular collimation without thyroid shield than with round collimation with thyroid shield. With rectangular collimation, the thyroid shield in Psup, Msup and BW reduced the dose 10% or less, where dose levels were already low, implying no clinical significance. Conclusions: For the exposures in the upper anterior region, thyroid shield results in an important dose reduction for the thyroid. For the other exposures, thyroid shield augments little to the reduction achieved by rectangular collimation. The use of thyroid shield is to be advised, when performing upper anterior radiography. PMID:27008105

Attitudes towards Science of Intellectually Gifted and Mainstream Upper Primary Students in Singapore

ERIC Educational Resources Information Center

Caleon, Imelda S.; Subramaniam, R.

2008-01-01

The attitudes towards science of upper-primary students in three ability strands (average, above average, and gifted) were investigated. A total of 580 upper primary students from co-educational government and government-aided schools in Singapore were involved in this study. The attitude subscales investigated were enjoyment of science,…

A comparison of observed and numerically predicted eddy kinetic energy budgets for a developing extratropical cyclone

NASA Technical Reports Server (NTRS)

Dare, P. M.; Smith, P. J.

1983-01-01

The eddy kinetic energy budget is calculated for a 48-hour forecast of an intense occluding winter cyclone associated with a strong well-developed jet stream. The model output consists of the initialized (1200 GMT January 9, 1975) and the 12, 24, 36, and 48 hour forecast fields from the Drexel/NCAR Limited Area Mesoscale Prediction System (LAMPS) model. The LAMPS forecast compares well with observations for the first 24 hours, but then overdevelops the low-level cyclone while inadequately developing the upper-air wave and jet. Eddy kinetic energy was found to be concentrated in the upper-troposphere with maxima flanking the primary trough. The increases in kinetic energy were found to be due to an excess of the primary source term of kinetic energy content, which is the horizontal flux of eddy kinetic energy over the primary sinks, and the generation and dissipation of eddy kinetic energy.

Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

PubMed Central

Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

2011-01-01

Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

Gram stain microbiological pattern of upper extremities suppuration at Baptist Medical Centre, Ogbomoso Nigeria: a fifteen month review.

PubMed

Oke, A J; Olaolorun, D A; Meier, D E; Tarpley, J L

2011-06-01

Sixty-eight (68) patients with serious upper extremity suppurative infections, presenting within a period of fifteen (15) months, were prospectively studied clinically, Gram stain of aspirates/pus were performed, specimen cultured, planted, and where indicated glucose levels and haemoglobin genotype determined. Half of the patients had hand infections. Staphylococcus aureus was isolated from thirty-nine (39) patients. Gram Negative bacilli, including Salmonella were more isolated from patients with diabetes mellitus or Hgb SS or SC. The Gram stain results correlated with the culture result 90%. When Gram Positive cocci were demonstrated in the primary microscopic examination, cultures were not mandatory. When no organism was demonstrated on primary Gram stain or the patient was diabetic or a sickler, cultures of the specimens were done. The Gram stain, well performed, remains a useful, inexpensive, technologically appropriate laboratory test for abetting decision making in patients with upper extremity suppurative infections. Organisms encountered in this study included: Staphylococcus aureus, Streptococcus pyogenes, Salmonella typhi, Proteus mirabilis, Pseudomonas aeruginosa, and Coliforms.

Investigations of Tissue-Level Mechanisms of Primary Blast Injury Through Modeling, Simulation, Neuroimaging and Neuropathological Studies

DTIC Science & Technology

2012-07-10

materials used, the complexity of the human anatomy , manufacturing limitations, and analysis capability prohibits exactly matching surrogate material...upper and lower bounds for possible loading behaviour. Although it is impossible to exactly match the human anatomy according to mechanical

Functional Morphology at the Mall

ERIC Educational Resources Information Center

Hippensteel, Scott P.

2012-01-01

The primary decorative flooring tile in the Southpark Mall in Charlotte, North Carolina, is fossiliferous limestone that contains Jurassic ammonoids and belemnoids. Visible in these tiles are more than 500 ammonoids, many of which have been cross sectioned equatorially perpendicular to the plane of coiling. Upper-level undergraduate students from…

101 Environmental Education Activities. Booklet 4--Science Activities.

ERIC Educational Resources Information Center

Whitney, Helen, Comp.

Fourth in the series "101 Environmental Education Activities" by the Upper Mississippi River ECO-Center, the booklet contains 39 environment-based science activities directed to students in primary, intermediate, and junior high classes. Organization of the activities usually includes grade level, objectives, procedures, and materials,…

Partial weight support differentially affects corticomotor excitability across muscles of the upper limb

PubMed Central

Runnalls, Keith D.; Anson, Greg; Wolf, Steven L.; Byblow, Winston D.

2014-01-01

Abstract Partial weight support may hold promise as a therapeutic adjuvant during rehabilitation after stroke by providing a permissive environment for reducing the expression of abnormal muscle synergies that cause upper limb impairment. We explored the neurophysiological effects of upper limb weight support in 13 healthy young adults by measuring motor‐evoked potentials (MEPs) from transcranial magnetic stimulation (TMS) of primary motor cortex and electromyography from anterior deltoid (AD), biceps brachii (BB), extensor carpi radialis (ECR), and first dorsal interosseous (FDI). Five levels of weight support, varying from none to full, were provided to the arm using a commercial device (Saebo Mobile Arm Support). For each level of support, stimulus–response (SR) curves were derived from MEPs across a range of TMS intensities. Weight support affected background EMG activity in each of the four muscles examined (P <0.0001 for each muscle). Tonic background activity was primarily reduced in the AD. Weight support had a differential effect on the size of MEPs across muscles. After curve fitting, the SR plateau for ECR increased at the lowest support level (P =0.004). For FDI, the SR plateau increased at the highest support level (P =0.0003). These results indicate that weight support of the proximal upper limb modulates corticomotor excitability across the forearm and hand. The findings support a model of integrated control of the upper limb and may inform the use of weight support in clinical settings. PMID:25501435

The History of Sympathetic Surgery.

PubMed

Hashmonai, Moshe

2016-11-01

At present, primary hyperhidrosis is the main indication for sympathectomy. For upper thoracic sympathetic ablation, excision of the second thoracic ganglion alone or with the first and/or third ganglia was the standard during the open surgery era. With the advent of thoracoscopy, modifications related to the level, extent, and type of ablation were proposed to attenuate compensatory hyperhidrosis. The ideal operation for sympathetic denervation of the face and upper limbs remain to be defined. Controlled double-blind studies with quantitave measurements of sweat production are required. Copyright © 2016 Elsevier Inc. All rights reserved.

Supplemental Carbon Dioxide Stabilizes the Upper Airway in Volunteers Anesthetized with Propofol.

PubMed

Ruscic, Katarina Jennifer; Bøgh Stokholm, Janne; Patlak, Johann; Deng, Hao; Simons, Jeroen Cedric Peter; Houle, Timothy; Peters, Jürgen; Eikermann, Matthias

2018-05-10

Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (PETCO2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response. Ventilation, mask pressure, negative pharyngeal pressure, upper airway closing pressure, genioglossus electromyogram, bispectral index, and change in end-expiratory lung volume were measured as a function of elevation of PETCO2 above baseline and depth of propofol anesthesia. PETCO2 augmentation dose-dependently lowered upper airway closing pressure with a decrease of 3.1 cm H2O (95% CI, 2.2 to 3.9; P < 0.001) under deep anesthesia, indicating improved upper airway stability. In parallel, the phasic genioglossus electromyogram increased by 28% (23 to 34; P < 0.001). We found that genioglossus electromyogram activity was a significant modifier of the effect of PETCO2 elevation on closing pressure (P = 0.005 for interaction term). Upper airway collapsibility induced by propofol anesthesia can be reversed in a dose-dependent manner by insufflation of supplemental carbon dioxide. This effect is at least partly mediated by increased genioglossus muscle activity.

Multiple output power supply circuit for an ion engine with shared upper inverter

NASA Technical Reports Server (NTRS)

Cardwell, Jr., Gilbert I. (Inventor); Phelps, Thomas K. (Inventor)

2001-01-01

A power supply circuit for an ion engine suitable for a spacecraft is coupled to a bus having a bus input and a bus return. The power supply circuit has a first primary winding of a first transformer. An upper inverter circuit is coupled to the bus input and the first primary winding. The power supply circuit further includes a first lower inverter circuit coupled to the bus return and the first primary winding. The second primary winding of a second transformer is coupled to the upper inverter circuit. A second lower inverter circuit is coupled to the bus return and the second primary winding.

Archaeology of Early Colonial Life. Teaching with Primary Sources Series, Volume 13.

ERIC Educational Resources Information Center

West, Jean

This kit, for grades 5 and up, helps students master the content of Colonial American history and develops students' historiographic and upper level thinking skills. The documents and activities included in this volume allow students to become "historical detectives," peeling back the layers, deciphering archaic lettering, reassembling…

The Canadian experience: why Canada decided against an upper limit for cholesterol.

PubMed

McDonald, Bruce E

2004-12-01

Canada, like the United States, held a "consensus conference on cholesterol" in 1988. Although the final report of the consensus panel recommended that total dietary fat not exceed 30 percent and saturated fat not exceed 10 percent of total energy intake, it did not specify an upper limit for dietary cholesterol. Similarly, the 1990, Health Canada publication "Nutrition Recommendations: The Report of the Scientific Review Committee" specified upper limits for total and saturated fat in the diet but did not specify an upper limit for cholesterol. Canada's Guidelines for Healthy Eating, a companion publication from Health Canada, suggested that Canadians "choose low-fat dairy products, lean meats, and foods prepared with little or no fat" while enjoying "a variety of foods." Many factors contributed to this position but a primary element was the belief that total dietary fat and saturated fat were primary dietary determinants of serum total and low-density lipoprotein (LDL) cholesterol levels, not dietary cholesterol. Hence, Canadian health authorities focused on reducing saturated fat and trans fats in the Canadian diet to help lower blood cholesterol levels rather than focusing on limiting dietary cholesterol. In an effort to allay consumer concern with the premise that blood cholesterol level is linked to dietary cholesterol, organizations such as the Canadian Egg Marketing Agency (CEMA) reminded health professionals, including registered dietitians, family physicians and nutrition educators, of the extensive data showing that there is little relationship between dietary cholesterol intake and cardiovascular mortality. In addition, it was pointed out that for most healthy individuals, endogenous synthesis of cholesterol by the liver adjusts to the level of dietary cholesterol intake. Educating health professionals about the relatively weak association between dietary cholesterol and the relatively strong association between serum cholesterol and saturated fat and trans fats helped keep consumers informed about healthy diets and ways to control blood cholesterol.

Follow-Up Care for Older Women With Breast Cancer

DTIC Science & Technology

2000-05-01

better predictor of upper body mor therapy, all cause mortality, self -reported function and overall physical function than upper body function, and...outcomes, including primary tu- Major Analytic Variables mor therapy and all cause mortality, as well as self -reported upper body and overall physical ...comorbidity and their relation to a range of patient outcomes, including primary tumor therapy and mortality, self -reported upper body function, and overall

The influence of premature loss of temporary upper molars on permanent molars.

PubMed

Cernei, E R; Maxim, Dana Cristiana; Zetu, Irina Nicoleta

2015-01-01

Premature loss of primary molars due to dental caries and their complications has been associated with space loss and eruptive difficulties, especially when the loss occurs early. The aim of our study was to determine the impact of premature loss of temporary upper molars upon the longitudinal axis of the first and second upper permanent molar. The study group included 64 patients 6-9 years old with premature loss of primary molars and a control group of 48 patients with intact temporary teeth. It was evaluated the angle between longitudinal axis of first and second upper permanent molars and occlusal plane. The sofware used is Easy Dent 4 Viewer®.The data were analyzed by using the Statistical Package for the Social Sciences (version 20.0; SPSS, Chicago, III). It was observed that premature loss of upper second deciduous molars modifies greater the vertical axis of the permanent molars than the premature loss of first upper primary molar. First upper primary molar loss cause an acceleration eruption of first premolar, which will produce a distal inclintion of the both permanent molars. The use of space maintainers after premature loss of the second upper temporary molar is a last solution in preventing tridimensional lesions in the dental arch and occlusion.

Paleomagnetic and magnetostratigraphic investigations of the whitehorse group/quartermaster (Dewey Lake) formation (upper permian-lowermost triassic) in the Palo Duro basin, northwest Texas, USA

NASA Astrophysics Data System (ADS)

Collins, Dylan R.

In northwest Texas, upper Permian to lowermost Triassic hematite-cemented detrital sedimentary rocks, which include a small number of regionally extensive ash beds, were deposited during the time interval of the greatest mass extinction event sequences in Earth history. The magnetic polarity stratigraphy, as well as key rock magnetic properties, of the upper Whitehorse Group (WH) and Quartermaster formations (QM) at selected sections in the Palo Duro Basin, have been determined using thermal, and chemical demagnetization approaches and anisotropy of magnetic susceptibility, acquisition of isothermal remanent magnetization (IRM) and backfield demagnetization, and thermal demagnetization of three component IRM methods. Demagnetization results show that the WH/QM contains a primary/near-primary characteristic remanent magnetization at each level sampled and thus the magnetic polarity stratigraphy for each section can be compared with existing polarity time scales across the Permian-Triassic boundary. Estimated site mean directions yield a paleomagnetic pole for the latest Permian for North America of 57.8°N, 130.6°E from 38 sampled sites.

Intraseasonal variability of upper-ocean currents and photosynthetic primary production along the U.S. west coast associated with the Madden-Julian Oscillation

NASA Astrophysics Data System (ADS)

Barrett, B.; Davies, A. R.; Steppe, C. N.; Hackbarth, C.

2017-12-01

In the first part of this study, time-lagged composites of upper-ocean currents from February to May of 1993-2016 were binned by active phase of the leading atmospheric mode of intraseasonal variability, the Madden-Julian Oscillation (MJO). Seven days after the convectively active phase of the MJO enters the tropical Indian Ocean, anomalously strong south-southeastward upper-ocean currents are observed along the majority of U.S. west coast. Seven days after the convectively active phase enters the tropical western Pacific Ocean, upper-ocean current anomalies reverse along the U.S. west coast, with weaker southward flow. A physical pathway to the ocean was found for both of these: (a) tropical MJO convection modulates upper-tropospheric heights and circulation over the Pacific Ocean; (b) those anomalous atmospheric heights adjust the strength and position of the Aleutian Low and Hawaiian High; (c) surface winds change in response to the adjusted atmospheric pressure patterns; and (d) those surface winds project onto upper-ocean currents. In the second part of this study, we investigated if the MJO modulated intraseasonal variability of surface wind forcing and upper-ocean currents projected onto phytoplankton abundance along the U.S. west coast. Following a similar methodology, time-lagged, level 3 chlorophyll-a satellite products (a proxy for photosynthetic primary production) were binned by active MJO phase and analyzed for statistical significance using the Student's t test. Results suggest that intraseasonal variability of biological production along the U.S. west coast may be linked to the MJO, particularly since the time scale of the life cycle of phytoplankton is similar to the time scale of the MJO.

The Practices of Student Network as Cooperative Learning in Ethiopia

ERIC Educational Resources Information Center

Reda, Weldemariam Nigusse; Hagos, Girmay Tsegay

2015-01-01

Student network is a teaching strategy introduced as cooperative learning to all educational levels above the upper primary schools (grade 5 and above) in Ethiopia. The study was, therefore, aimed at investigating to what extent the student network in Ethiopia is actually practiced in line with the principles of cooperative learning. Consequently,…

Consolidated Transfer Report. Transfer Policy and Upper-Division Baccalaureate Capacity

ERIC Educational Resources Information Center

Washington Higher Education Coordinating Board, 2006

2006-01-01

Transfer is a primary strategy for providing access to baccalaureate-level education in Washington State. For thousands of students, transfer is an effective and efficient way to complete their studies. About 41 percent of the 16,800 students awarded degrees at Washington public baccalaureate institutions in the 2000-2001 academic year had…

An Improved Model of Cryogenic Propellant Stratification in a Rotating, Reduced Gravity Environment

NASA Technical Reports Server (NTRS)

Oliveira, Justin; Kirk, Daniel R.; Schallhorn, Paul A.; Piquero, Jorge L.; Campbell, Mike; Chase, Sukhdeep

2007-01-01

This paper builds on a series of analytical literature models used to predict thermal stratification within rocket propellant tanks. The primary contribution to the literature is to add the effect of tank rotation and to demonstrate the influence of rotation on stratification times and temperatures. This work also looks levels of thermal stratification for generic propellant tanks (cylindrical shapes) over a parametric range of upper-stage coast times, heating levels, rotation rates, and gravity levels.

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

PubMed

Drakos, Nicholas; Gausche-Hill, Marianne

2013-03-01

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

The ecological module of BOATS-1.0: a bioenergetically-constrained model of marine upper trophic levels suitable for studies of fisheries and ocean biogeochemistry

NASA Astrophysics Data System (ADS)

Carozza, D. A.; Bianchi, D.; Galbraith, E. D.

2015-12-01

Environmental change and the exploitation of marine resources have had profound impacts on marine communities, with potential implications for ocean biogeochemistry and food security. In order to study such global-scale problems, it is helpful to have computationally efficient numerical models that predict the first-order features of fish biomass production as a function of the environment, based on empirical and mechanistic understandings of marine ecosystems. Here we describe the ecological module of the BiOeconomic mArine Trophic Size-spectrum (BOATS) model, which takes an Earth-system approach to modeling fish biomass at the global scale. The ecological model is designed to be used on an Earth System model grid, and determines size spectra of fish biomass by explicitly resolving life history as a function of local temperature and net primary production. Biomass production is limited by the availability of photosynthetic energy to upper trophic levels, following empirical trophic efficiency scalings, and by well-established empirical temperature-dependent growth rates. Natural mortality is calculated using an empirical size-based relationship, while reproduction and recruitment depend on both the food availability to larvae from net primary production and the production of eggs by mature adult fish. We describe predicted biomass spectra and compare them to observations, and conduct a sensitivity study to determine how the change as a function of net primary production and temperature. The model relies on a limited number of parameters compared to similar modeling efforts, while retaining realistic representations of biological and ecological processes, and is computationally efficient, allowing extensive parameter-space analyses even when implemented globally. As such, it enables the exploration of the linkages between ocean biogeochemistry, climate, and upper trophic levels at the global scale, as well as a representation of fish biomass for idealized studies of fisheries.

The ecological module of BOATS-1.0: a bioenergetically constrained model of marine upper trophic levels suitable for studies of fisheries and ocean biogeochemistry

NASA Astrophysics Data System (ADS)

Carozza, David Anthony; Bianchi, Daniele; Galbraith, Eric Douglas

2016-04-01

Environmental change and the exploitation of marine resources have had profound impacts on marine communities, with potential implications for ocean biogeochemistry and food security. In order to study such global-scale problems, it is helpful to have computationally efficient numerical models that predict the first-order features of fish biomass production as a function of the environment, based on empirical and mechanistic understandings of marine ecosystems. Here we describe the ecological module of the BiOeconomic mArine Trophic Size-spectrum (BOATS) model, which takes an Earth-system approach to modelling fish biomass at the global scale. The ecological model is designed to be used on an Earth-system model grid, and determines size spectra of fish biomass by explicitly resolving life history as a function of local temperature and net primary production. Biomass production is limited by the availability of photosynthetic energy to upper trophic levels, following empirical trophic efficiency scalings, and by well-established empirical temperature-dependent growth rates. Natural mortality is calculated using an empirical size-based relationship, while reproduction and recruitment depend on both the food availability to larvae from net primary production and the production of eggs by mature adult fish. We describe predicted biomass spectra and compare them to observations, and conduct a sensitivity study to determine how they change as a function of net primary production and temperature. The model relies on a limited number of parameters compared to similar modelling efforts, while retaining reasonably realistic representations of biological and ecological processes, and is computationally efficient, allowing extensive parameter-space analyses even when implemented globally. As such, it enables the exploration of the linkages between ocean biogeochemistry, climate, and upper trophic levels at the global scale, as well as a representation of fish biomass for idealized studies of fisheries.

Green Chemistry Decision-Making in an Upper-Level Undergraduate Organic Laboratory

ERIC Educational Resources Information Center

Edgar, Landon J. G.; Koroluk, Katherine J.; Golmakani, Mehrnaz; Dicks, Andrew P.

2014-01-01

A self-directed independent synthesis experiment was developed for a third-year undergraduate organic laboratory. Students were provided with the CAS numbers of starting and target compounds and devised a synthetic plan to be executed over two 4.5 h laboratory periods. They consulted the primary literature in order to develop and carry out an…

Exploring Turkish Upper Primary Level Science Textbooks' Coverage of Scientific Literacy Themes

ERIC Educational Resources Information Center

Çakici, Yilmaz

2012-01-01

Problem Statement: Since the 1970s, scientific literacy has been a major goal of national educational systems throughout the world, and thus reform movements in science education call for all students to be scientifically literate. Despite some good curricular changes and developments across the globe, much remains to be achieved. Given that…

Improving Student Motivation and Engagement in Mathematics through One-to-One Interactions

ERIC Educational Resources Information Center

Way, Jennifer; Reece, Amelia; Bobis, Janette; Anderson, Judy; Martin, Andrew

2015-01-01

The phenomenon of the "middle-years dip" in mathematics engagement and achievement has been a cause of concern for over a decade. This paper presents an example of one upper-primary classroom identified as having higher than average levels of student engagement, with the purpose of documenting specific teaching strategies that align with…

How do we recognize the child with OSAS?

PubMed

Joosten, Koen F; Larramona, Helena; Miano, Silvia; Van Waardenburg, Dick; Kaditis, Athanasios G; Vandenbussche, Nele; Ersu, Refika

2017-02-01

Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e.g., parental report of snoring, apneic events) and into morbidity resulting from the upper airway obstruction (e.g., increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate or enuresis). History of premature birth and a family history of OSAS as well as obesity and African American ethnicity are associated with increased risk of sleep-disordered breathing in childhood. Polysomnography is the gold standard method for the diagnosis of OSAS but may not be always feasible, especially in low-income countries or non-tertiary hospitals. Nocturnal oximetry and/or sleep questionnaires may be used to identify the child at high risk of OSAS when polysomnography is not an option. Endoscopy and MRI of the upper airway may help to identify the level(s) of upper airway obstruction and to evaluate the dynamic mechanics of the upper airway, especially in children with combined abnormalities. Pediatr Pulmonol. 2017;52:260-271. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma.

PubMed

Cosentino, Marco; Palou, Joan; Gaya, Josep M; Breda, Alberto; Rodriguez-Faba, Oscar; Villavicencio-Mavrich, Humberto

2013-02-01

To investigate the existence of predictive factors for concomitant, primary UUT-UCC and BC. Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a pan-urothelial disease of the transitional epithelial cells. Although several studies have shown the association of bladder recurrence following UUT-UCC, little is known on the incidence of concomitant UUT-UCC and bladder cancer (BC) without previous BC. A retrospective review of 673 patients diagnosed and treated for UUT-UCC was performed. Patients with history of BC were excluded. We investigated age, sex, location of the upper tract tumor (calyx, renal pelvis, upper ureter, mid-ureter, lower ureter), multifocality, clinical symptoms, tumor grade and pathological stage. Contingency tables and chi-square test were used for categorical variables and analysis of variance (ANOVA) for quantitative variables. 450 patients eligible for inclusion were identified. Of these, 76 (17 %) presented concomitant primary UUT-UCC and BC. Location of primary UUT-UCC was in calyx and/or renal pelvis in 25 patients (34 %), upper ureter 8 (11 %) and lower ureter 37 (49 %). In 6 patients (8 %), data were missing. Concomitant BC was found in 10, 18, and 33 % of patients with primary caliceal/renal pelvis, upper ureter and lower ureter UUT-UCC, respectively. On multivariate analysis, location of UUT-UCC was the only predictive factor for concomitant bladder tumor (OR: 1.7; 95 % CI, 1.007-2.906 p = 0.047). Our findings suggest that the possibility of concomitant BC in primary diagnosed patient with UUT-UCC is as high as 33 % and mainly depends on upper tract tumor location.

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

PubMed Central

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

2012-01-01

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

An Analysis of the Social Impact of the Stipend Program for Secondary School Girls of Khyber Pakhtunkhwa

ERIC Educational Resources Information Center

Ahmed, Vaqar; Zeshan, Muhammad

2014-01-01

The present study carries out an impact analysis of a conditional cash transfer (CCT) program for secondary-school girls in seven districts of Khyber Pakhtunkhwa province in Pakistan, including Battagram, Bonair, Hangu, Kohistan, Shangla, Tank, and Upper Dir. In 2012 we collected household-level primary data and used a probit model for…

Interested Reader or Uninterested Dissembler?: The Identities Constructed by Upper Primary Aged Dyslexic Pupils during Silent Reading Sessions

ERIC Educational Resources Information Center

Anderson, Rosemary

2009-01-01

This article discusses the identities that may be constructed by upper primary aged pupils during silent reading sessions. The findings presented are taken from a 2-year ethnographic case study, which investigated how four dyslexic pupils, aged 10-11 (Y5-6), coped with the classroom reading they encountered at a large primary school in northern…

Exploring the Reduction of Fuel Consumption for Ship-to-Shore Connectors of the Marine Expeditionary Brigade

DTIC Science & Technology

2013-12-01

include the Command Element (CE), the Aviation Combat Element (ACE), the Ground Combat Element ( GCE ), and the Combat Service Support Element (CSSE) (from...35 Figure 9. The upper level functional architecture for EW12 shows the three primary functions of F1-Assemble the Seabase, F2...Function F2-Perform Assault is decomposed to obtain the lower level specific functions. From this decomposition, the sub-function of F2.2- Gain Entry

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report.

PubMed

Lin, Tzu-Chieh; Tsai, Chung-Lin; Chang, Yao-Tien; Hu, Sung-Yuan

2018-06-07

Primary aortoduodenal fistula (ADF) is a rare cause of gastrointestinal (GI) bleeding and is difficult to diagnose as the clinical presentation is subtle. Clinicians should keep a high level of suspicion for an unknown etiology of GI bleeding, especially in older patients with or without abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA) can be used to detect primary ADF. Open surgery or endovascular aortic repair (EVAR) for ADF with bleeding will improve the survival rate. We report a rare case of AAA complicating ADF with massive GI bleeding in a 73-year-old Taiwanese man. He presented with abdominal pain and tarry stool for 5 days and an initial upper GI endoscopy at a rural hospital showed gastric ulcer only, but hypotension with tachycardia and a drop in hemoglobin of 9 g/dl from 12 g/dl occurred the next day. He was referred to our hospital for EVAR and primary closure of fistula defect due to massive GI bleeding with shock from ADF caused by AAA. Diagnosis was made by CTA of aorta. A timely and accurate diagnosis of primary ADF may be challenging due to insidious episodes of GI bleeding, which are frequently under-diagnosed until the occurrence of massive hemorrhage. Clinical physicians should keep a high index of awareness for primary ADF, especially in elderly patients with unknown etiology of upper GI bleeding with or without a known AAA.

[Routine fluoroscopic investigations after primary bariatric surgery].

PubMed

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children

PubMed Central

Aglipay, Mary; Birken, Catherine S.; Parkin, Patricia C.; Loeb, Mark B.; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S.; Mazzulli, Tony

2017-01-01

Importance Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. Objective To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. Design, Setting, and Participants A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice–based research network in Toronto, Ontario, Canada. Interventions Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. Main Outcome Measures The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Results Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, −0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Conclusions and Relevance Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. Trial Registration clinicaltrials.gov Identifier: NCT01419262 PMID:28719693

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children.

PubMed

Aglipay, Mary; Birken, Catherine S; Parkin, Patricia C; Loeb, Mark B; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S; Mazzulli, Tony; Maguire, Jonathon L

2017-07-18

Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice-based research network in Toronto, Ontario, Canada. Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, -0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. clinicaltrials.gov Identifier: NCT01419262.

Bidirectional Relations between Text Reading Prosody and Reading Comprehension in the Upper Primary School Grades: A Longitudinal Perspective

PubMed Central

Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo

2016-01-01

The purpose of this study was to examine the directionality of the relationship between text reading prosody and reading comprehension in the upper grades of primary school. We compared three theoretical possibilities: Two unidirectional relations from text reading prosody to reading comprehension and from reading comprehension to text reading prosody and a bidirectional relation between text reading prosody and reading comprehension. Further, we controlled for autoregressive effects and included decoding efficiency as a measure of general reading skill. Participants were 99 Dutch children, followed longitudinally, from fourth- to sixth-grade. Structural equation modeling showed that the bidirectional relation provided the best fitting model. In fifth-grade, text reading prosody was related to prior decoding and reading comprehension, whereas in sixth-grade, reading comprehension was related to prior text reading prosody. As such, the results suggest that the relation between text reading prosody and reading comprehension is reciprocal, but dependent on grade level. PMID:27667916

Prognostic factors for melanoma patients with lesions 0.76 - 1.69 mm in thickness. An appraisal of "thin" level IV lesions.

PubMed Central

Day, C L; Mihm, M C; Sober, A J; Harris, M N; Kopf, A W; Fitzpatrick, T B; Lew, R A; Harrist, T J; Golomb, F M; Postel, A; Hennessey, P; Gumport, S L; Raker, J W; Malt, R A; Cosimi, A B; Wood, W C; Roses, D F; Gorstein, F; Rigel, D; Friedman, R J; Mintzis, M M

1982-01-01

Fourteen variables were tested for their prognostic usefulness in 203 patients with clinical Stage I melanoma and primary tumor 0.76-169 mm thick. Only two variables, primary tumor location and level of invasion, were useful in predicting death from melanoma for these patients. Of the 12 deaths from melanoma, 11 occurred in patients with primary tumors located on the upper back, posterior arm, posterior neck, and posterior scalp (=BANS). There has been only one death from melanoma in 136 patients with melanoma located at other sites (11/67 vs 1/136, p less than 0.0001 Fisher's Exact Test). Of the 67 BANS patients, 51 had level II or level III lesions and five (10%0 died of melanoma. This compared with six deaths from melanoma in 16 patients (37.5%) with level IV BANS lesions (5/51 vs 6/16, p = 0.01 Fisher's Exact Test). The relatively high incidence of both melanoma deaths and regional node metastases for the BANS group merits consideration for testing the efficacy of elective regional node dissection for these patients. PMID:7055381

The Use of English as Medium of Instruction at the Upper Basic Level (Primary Four to Junior High School) in Ghana: From Theory to Practice

ERIC Educational Resources Information Center

Owu-Ewie, Charles; Eshun, Emma Sarah

2015-01-01

The language of education is crucial to learners' academic success. As a result, nations whose native languages are not the languages of education have promulgated language policies to solve communication problems in their school systems. Most multilingual nations have adopted bilingual education systems that recognize the child's native language…

Initial Spanish Proficiency and English Language Development among Spanish-Speaking English Learner Students in New Mexico. REL 2018-286

ERIC Educational Resources Information Center

Arellano, Brenda; Liu, Feng; Stoker, Ginger; Slama, Rachel

2018-01-01

To what extent do Spanish-speaking English learner students develop English proficiency and grade-level readiness in English language arts and math from early elementary school to upper elementary school? Is there a relationship between proficiency in a student's primary home language, Spanish, and the amount of time needed to attain fluency in…

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

PubMed

Vaideeswar, P; Ghodke, R

2012-01-01

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

Sensory evaluation of tender beef strip loin steaks of varying marbling levels and quality treatments.

PubMed

Corbin, C H; O'Quinn, T G; Garmyn, A J; Legako, J F; Hunt, M R; Dinh, T T N; Rathmann, R J; Brooks, J C; Miller, M F

2015-02-01

The palatability of tender [Warner-Bratzler shear force values <33.34N (3.4kg)] beef strip loins of 10 different treatments [USDA Prime, High Choice (upper 1/3 Choice), Low Choice (lower 1/3 Choice), Select, Standard, Australian Wagyu, American Wagyu, Holstein Select, Holstein Top Choice (upper 2/3 Choice) and Grass-finished] was evaluated by consumers and a trained flavor panel. In general, tenderness, juiciness, flavor, and overall liking ratings as well as acceptability percentage for each trait, increased with increased fat levels. Moreover, overall liking was highly correlated (P<0.01) with flavor liking (r=0.96) as well as fat percentage (r=0.79). Beef flavor scores were positively associated (P<0.01) with fat-like (r=0.67) and umami (r=0.59) flavors. Fat level was the primary driver of beef flavor acceptability in all samples when no undesirable off-flavors were present. Copyright © 2014 Elsevier Ltd. All rights reserved.

Atmospheric products from the Upper Atmosphere Research Satellite (UARS)

NASA Technical Reports Server (NTRS)

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

2003-01-01

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

Pathways to Professional Growth: Investigating Upper Primary School Teachers' Perspectives on Learning to Teach Algebra

ERIC Educational Resources Information Center

Wilkie, Karina J.; Clarke, Doug

2015-01-01

This paper discusses upper primary school teachers' perspectives on changes to their knowledge and practice through participation in a design-based research project. It analyses their experiences using Clarke and Hollingsworth's (2002) empirically-founded model for professional growth to understand more about the mechanisms for change that might…

How Do Interest in Sciences Vary with Gender?

ERIC Educational Resources Information Center

Gafoor, K. Abdul

2011-01-01

This study explores interest in physics, chemistry and biology among school students in Kerala. It used a sample of 3236 (1659 boys, 1577 girls) students studying in upper primary to higher secondary classes. Three separate versions of scale of interest in science were used to quantify interest in science of upper primary, secondary and higher…

Sources and Dynamics of Inorganic Carbon within the Upper Reaches of the Xi River Basin, Southwest China

PubMed Central

Zou, Junyu

2016-01-01

The carbon isotopic composition (δ13C) of dissolved and particulate inorganic carbon (DIC; PIC) was used to compare and analyze the origin, dynamics and evolution of inorganic carbon in two headwater tributaries of the Xi River, Southwest China. Carbonate dissolution and soil CO2 were regarded as the primary sources of DIC on the basis of δ13CDIC values which varied along the Nanpan and Beipan Rivers, from −13.9‰ to 8.1‰. Spatial trends in DIC differed between the two rivers (i.e., the tributaries), in part because factors controlling pCO2, which strongly affected carbonate dissolution, differed between the two river basins. Transport of soil CO2 and organic carbon through hydrologic conduits predominately controlled the levels of pCO2 in the Nanpan River. However, pCO2 along the upper reaches of the Nanpan River also was controlled by the extent of urbanization and industrialization relative to agriculture. DIC concentrations in the highly urbanized upper reaches of the Nanpan River were typical higher than in other carbonate-dominated areas of the upper Xi River. Within the Beipan River, the oxidation of organic carbon is the primary process that maintains pCO2 levels. The pCO2 within the Beipan River was more affected by sulfuric acid from coal industries, inputs from a scenic spot, and groundwater than along the Nanpan River. With regards to PIC, the contents and δ13C values in the Nanpan River were generally lower than those in the Beipan River, indicating that chemical and physical weathering contributes more marine carbonate detritus to the PIC along the Beipan River. The CO2 evasion flux from the Nanpan River was higher than that in the Beipan River, and generally higher than along the middle and lower reaches of the Xi River, demonstrating that the Nanpan River is an important net source of atmospheric CO2 in Southwest China. PMID:27513939

[Levers in Primary Health Care - Identifying Strategic Success Factors for Improved Primary Care in Upper Austria].

PubMed

Kriegel, J; Rebhandl, E; Reckwitz, N; Hockl, W

2016-12-01

Current and projected general practitioner (GP) and primary care in Austria shows structural and process inadequacies in the quality as well as assurance of healthcare supply. The aim is therefore to develop solution- and patient-oriented measures that take patient-related requirements and medical perspectives into account. Using an effect matrix, subjective expert and user priorities were ascertained, cause and effect relationships were examined, and an expanded circle of success for the optimization of GP and primary care in Upper Austria was developed. Through this, the relevant levers for target-oriented development and optimization of the complex system of GP and primary care in Upper Austria were identified; these are training to become general practitioners, entrepreneurs as well as management and coordination. It is necessary to further adapt the identified levers conceptually and operationally in a targeted approach. This is to be achieved by means of the primary health care (PHC) concept as well as management tools and information and communication technologies (ICT) associated with it. © Georg Thieme Verlag KG Stuttgart · New York.

Primary production export flux in Marguerite Bay (Antarctic Peninsula): Linking upper water-column production to sediment trap flux

NASA Astrophysics Data System (ADS)

Weston, Keith; Jickells, Timothy D.; Carson, Damien S.; Clarke, Andrew; Meredith, Michael P.; Brandon, Mark A.; Wallace, Margaret I.; Ussher, Simon J.; Hendry, Katharine R.

2013-05-01

A study was carried out to assess primary production and associated export flux in the coastal waters of the western Antarctic Peninsula at an oceanographic time-series site. New, i.e., exportable, primary production in the upper water-column was estimated in two ways; by nutrient deficit measurements, and by primary production rate measurements using separate 14C-labelled radioisotope and 15N-labelled stable isotope uptake incubations. The resulting average annual exportable primary production estimates at the time-series site from nutrient deficit and primary production rates were 13 and 16 mol C m-2, respectively. Regenerated primary production was measured using 15N-labelled ammonium and urea uptake, and was low throughout the sampling period. The exportable primary production measurements were compared with sediment trap flux measurements from 2 locations; the time-series site and at a site 40 km away in deeper water. Results showed ˜1% of the upper mixed layer exportable primary production was exported to traps at 200 m depth at the time-series site (total water column depth 520 m). The maximum particle flux rate to sediment traps at the deeper offshore site (total water column depth 820 m) was lower than the flux at the coastal time-series site. Flux of particulate organic carbon was similar throughout the spring-summer high flux period for both sites. Remineralisation of particulate organic matter predominantly occurred in the upper water-column (<200 m depth), with minimal remineralisation below 200 m, at both sites. This highly productive region on the Western Antarctic Peninsula is therefore best characterised as 'high recycling, low export'.

A Conceptual Framework for Assessing the Impacts of GIS on the Motivation and Achievement in Geography among Underachieving Students of Smart School in Sabah, Malaysia

ERIC Educational Resources Information Center

Singh, Soon Singh Bikar; Kleeman, Grant; Van Bergen, Penny

2013-01-01

In 1988, the integrated secondary school curriculum was introduced as a continuation of the curriculum changes introduced in the primary school. These changes have impacted geography subject in the secondary school. Geography becomes a compulsory subject for lower secondary and elective subject at the upper secondary school level. As a result,…

Upper Primary School Teachers' Mathematical Knowledge for Teaching Functional Thinking in Algebra

ERIC Educational Resources Information Center

Wilkie, Karina J.

2014-01-01

This article is based on a project that investigated teachers' knowledge in teaching an important aspect of algebra in the middle years of schooling--functions, relations and joint variation. As part of the project, 105 upper primary teachers were surveyed during their participation in Contemporary Teaching and Learning of Mathematics, a research…

INSTRUCTIONAL TELEVISION FOR THE UPPER PRIMARY. A TEACHER GUIDE, SEMESTER II.

ERIC Educational Resources Information Center

DELIKAN, ALFRED; AND OTHERS

TELECAST PROGRAMS FOR THE UPPER PRIMARY GRADES WERE IN ART, MUSIC, PHYSICAL EDUCATION AND SCIENCE. A PREVIEW OF THE CONTENT OF EACH UNIT WAS GIVEN, TOGETHER WITH DETAILED INFORMATION FOR FOLLOWUP ACTIVITY. IN THE ART SERIES, IT WAS RECOMMENDED THAT PUPIL PARTICIPATION TAKE PLACE AS SOON AS POSSIBLE AFTER THE TELECAST. INDIVIDUAL CREATIVITY WAS…

Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS)

PubMed Central

2016-01-01

Aim Education is one of the strongest social determinants of health, yet previous literature has focused on primary education. We examined whether there are additional benefits to completing upper secondary compared to lower secondary education in a middle-income country. Methods We performed a longitudinal analysis of the Cape Area Panel Study, a survey of adolescents living in South Africa. We undertook causal modeling using structural marginal models to examine the association between level of education and various health outcomes, using inverse probability weighting to control for sex, age, ethnicity, home language, income, whether employed in past year, region of birth, maternal educational status, marital status, whether currently pregnant and cognitive ability. Educational attainment was defined as primary (grades 1–7), lower secondary (grades 8–9) or upper secondary (grades 10–12). Results Of 3,432 participants, 165 (4.8%) had completed primary education, 646 (18.8%) lower secondary and 2,621 (76.3%) upper secondary. Compared to those completing lower secondary, males completing upper secondary education were less likely to have a health problem (OR 0.49; 95%CI 0.27–0.88; p = 0.02); describe their health as poor (0.52; 0.29–0.95; p = 0.03) or report that health interferes with daily life (0.54; 0.29–0.99; p = 0.047). Females were less likely to have been pregnant (0.45; 0.33–0.61; p<0.001) or pregnant under 18 (0.32; 0.22–0.46; p<0.001); and having had sex under 16 was also less likely (males 0.63; 0.44–0.91; p = 0.01; females 0.39; 0.26–0.58; p<0.001). Cigarette smoking was less likely (males 0.52; 0.38–0.70; p = <0.001; females 0.56; 0.41–0.76; p<0.001), as was taking illicit drugs in males (0.6; 0.38–0.96; p = 0.03). No associations were found between education and alcohol use, psychological distress, obesity, increased waist circumference or hypertension. Conclusion Completing upper secondary education was associated with improved health outcomes compared with lower secondary education. Expanding upper secondary education offers middle-income countries an effective way of improving adolescent health. PMID:27280408

Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS).

PubMed

Ward, Joseph L; Viner, Russell M

2016-01-01

Education is one of the strongest social determinants of health, yet previous literature has focused on primary education. We examined whether there are additional benefits to completing upper secondary compared to lower secondary education in a middle-income country. We performed a longitudinal analysis of the Cape Area Panel Study, a survey of adolescents living in South Africa. We undertook causal modeling using structural marginal models to examine the association between level of education and various health outcomes, using inverse probability weighting to control for sex, age, ethnicity, home language, income, whether employed in past year, region of birth, maternal educational status, marital status, whether currently pregnant and cognitive ability. Educational attainment was defined as primary (grades 1-7), lower secondary (grades 8-9) or upper secondary (grades 10-12). Of 3,432 participants, 165 (4.8%) had completed primary education, 646 (18.8%) lower secondary and 2,621 (76.3%) upper secondary. Compared to those completing lower secondary, males completing upper secondary education were less likely to have a health problem (OR 0.49; 95%CI 0.27-0.88; p = 0.02); describe their health as poor (0.52; 0.29-0.95; p = 0.03) or report that health interferes with daily life (0.54; 0.29-0.99; p = 0.047). Females were less likely to have been pregnant (0.45; 0.33-0.61; p<0.001) or pregnant under 18 (0.32; 0.22-0.46; p<0.001); and having had sex under 16 was also less likely (males 0.63; 0.44-0.91; p = 0.01; females 0.39; 0.26-0.58; p<0.001). Cigarette smoking was less likely (males 0.52; 0.38-0.70; p = <0.001; females 0.56; 0.41-0.76; p<0.001), as was taking illicit drugs in males (0.6; 0.38-0.96; p = 0.03). No associations were found between education and alcohol use, psychological distress, obesity, increased waist circumference or hypertension. Completing upper secondary education was associated with improved health outcomes compared with lower secondary education. Expanding upper secondary education offers middle-income countries an effective way of improving adolescent health.

Meteoric calcite cementation: diagenetic response to relative fall in sea-level and effect on porosity and permeability, Las Negras area, southeastern Spain

NASA Astrophysics Data System (ADS)

Li, Zhaoqi; Goldstein, Robert H.; Franseen, Evan K.

2017-03-01

A dolomitized Upper Miocene carbonate system in southeast Spain contains extensive upper and lower zones of calcite cementation that cut across the stratigraphy. Cement textures including isopachous and circumgranular, which are consistent with phreatic-zone cementation. Cements in the upper cemented zone are non-luminescent, whereas those in the lower cemented zone exhibit multiple bands of luminescent and non-luminescent cements. In the upper cemented zone, isotopic data show two meteoric calcite lines (MCL) with mean δ18O at - 5.1‰ and - 5.8‰ VPDB, whereas no clear MCL is defined in the lower cemented zone where mean δ18O for calcite cement is at - 6.7‰ VPDB. δ13C values in both cement zones are predominantly negative, ranging from - 10 to + 2‰ VPDB, suggestive of carbon from soil gas or decayed organics. Measurements of Tm ice in primary fluid inclusions yield a mode of 0.0 °C in both zones, indicating calcite cementation from fresh water. These two zones define the positions of two different paleo-water tables that formed during a relative sea-level fall and erosional downcutting during the Plio-Pleistocene. The upper cemented zone pre-dated the lower cemented zone on the basis of known relative sea-level history. Meteoric calcite cementation reduced porosity and permeability, but measured values are inconsistent with simple filling of open pore space. Each texture, boundstone, grainstone, packstone, wackestone, produces a different relationship between percent calcite cement and porosity/permeability. Distribution of cements may be predictable on the basis of known sea-level history, and the effect of the cementation can be incorporated into subsurface geomodels by defining surfaces of rock boundaries that separate cemented zones from uncemented zones, and applying texture-specific relationships among cementation, porosity and permeability.

A cross-sectional analysis of prescription and stakeholder surveys following essential medicine reform in Guangdong Province, China.

PubMed

Zhang, Wen-yuan; Li, Ying-ran; Li, Yun-jing; Li, Xue-qin; Zhao, Wei-guo; Lu, Rong-zhi

2015-03-13

An essential medicine (EM) system has been implemented in China to reduce patients' financial burden and to make the use of drugs more rational. This study aims to evaluate the current state of the EM system in Guangdong Province. We conducted surveys in 21 cities in 2012, covering 98 medical institutions, 1,509 doctors, 17 medicine manufacturers, and 17 distribution companies. We also reviewed outpatient prescriptions (n = 9,941) for treating hypertension, diabetes, bacterial infections and gout to measure the rational use of drugs in secondary and tertiary (upper-level) hospitals. The percentage of non-priority EM use ranged from 8.1% to 10.7% in upper-level hospitals, and this non-priority use significantly increased prescription drug costs. Other types of inappropriate medicine use were found more frequently in treating bacterial infections (7.4%) than in treating hypertension (1.6%), diabetes (1.3%) and gout (1.7%). Tertiary hospitals prescribed fewer EMs than secondary hospitals; moreover, tertiary hospitals had higher prescription drug costs. The zero mark-up policy decreased prescription drug costs in secondary hospitals. The survey revealed that forced full-prescription EM use might lead to fewer patient visits to primary hospitals. Manufacturers had halted the production of four (1, 23) types of EMs at the time of the survey. Encouraging the priority use of EMs and implementation of the zero mark-up policy were effective in curtailing prescription medicine costs in upper-level hospitals. Further work should focus on the following: creating guidelines to enhance rational prescription behavior, establishing policies to support EM use in upper-level hospitals and improving the bidding system to ensure a steady supply of the lowest-priced generic drugs.

Individual muscle contributions to push and recovery subtasks during wheelchair propulsion.

PubMed

Rankin, Jeffery W; Richter, W Mark; Neptune, Richard R

2011-04-29

Manual wheelchair propulsion places considerable physical demand on the upper extremity and is one of the primary activities associated with the high prevalence of upper extremity overuse injuries and pain among wheelchair users. As a result, recent effort has focused on determining how various propulsion techniques influence upper extremity demand during wheelchair propulsion. However, an important prerequisite for identifying the relationships between propulsion techniques and upper extremity demand is to understand how individual muscles contribute to the mechanical energetics of wheelchair propulsion. The purpose of this study was to use a forward dynamics simulation of wheelchair propulsion to quantify how individual muscles deliver, absorb and/or transfer mechanical power during propulsion. The analysis showed that muscles contribute to either push (i.e., deliver mechanical power to the handrim) or recovery (i.e., reposition the arm) subtasks, with the shoulder flexors being the primary contributors to the push and the shoulder extensors being the primary contributors to the recovery. In addition, significant activity from the shoulder muscles was required during the transition between push and recovery, which resulted in increased co-contraction and upper extremity demand. Thus, strengthening the shoulder flexors and promoting propulsion techniques that improve transition mechanics have much potential to reduce upper extremity demand and improve rehabilitation outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

77 FR 26154 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-03

... stabilizer actuator (THSA), the THSA upper secondary attachment engaged because it could only withstand the... [trimmable horizontal stabilizer actuator] upper primary attachment, which may result in a loading of the... of the trimmable horizontal stabilizer actuator (THSA), the THSA upper secondary attachment engaged...

Antibiotic prescribing of village doctors for children under 15 years with upper respiratory tract infections in rural China

PubMed Central

Zhang, Zhixia; Zhan, Xingxin; Zhou, Hongjun; Sun, Fang; Zhang, Heng; Zwarenstein, Merrick; Liu, Qian; Li, Yingxue; Yan, Weirong

2016-01-01

Abstract The aim of this study was to explore the knowledge, attitudes, and practices of village doctors regarding the prescribing of antibiotics for children under 15 years with upper respiratory tract infections (URTIs) in rural China. Twelve focus group discussions (FGDs) were conducted in Xianning, a prefecture-level city in rural China, during December 2014. We conducted 6 FGDs with 35 village doctors, 3 with 13 primary caregivers (11 parents), and 3 with 17 directors of township hospitals, county-level health bureaus, county-level Centers for Disease Control and Prevention, or county-level Chinese Food and Drug Administration offices. Audio records of the interviews were transcribed verbatim and analyzed using the thematic analysis approach. Participants believed that unnecessary antibiotic prescribing for children under 15 years with The occurrence of URTIs was a problem in village clinics in rural China. The discussions revealed that most of the village doctors had inadequate knowledge and misconceptions about antibiotic use, which was an important factor in the unnecessary prescribing. Village doctors and directors reported that the doctors’ fear of complications, the primary caregivers’ pressure for antibiotic treatment, and the financial considerations of patient retention were the main factors influencing the decision to prescribe antibiotics. Most of the primary caregivers insisted on antibiotics, even when the village doctors were reluctant to prescribe them, and they preferred to go to see those village doctors who prescribed antibiotics. The interviewees also gave their opinions on what would be the most effective measures for optimizing antibiotic prescriptions; these included educational/training campaigns, strict regulations on antibiotic prescription, and improved supervision. Findings emphasized the need to improve the dissemination of information and training/education, and implement legislation on the rational use of antibiotics. And it also provided helpful information to guide the design of more effective interventions to promote prudent antibiotic use and good antimicrobial stewardship. PMID:27281082

Bidirectional Relations between Text Reading Prosody and Reading Comprehension in the Upper Primary School Grades: A Longitudinal Perspective

ERIC Educational Resources Information Center

Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo

2016-01-01

The purpose of this study was to examine the directionality of the relationship between text reading prosody and reading comprehension in the upper grades of primary school. We compared 3 theoretical possibilities: Two unidirectional relations from text reading prosody to reading comprehension and from reading comprehension to text reading prosody…

Academic Tasks to Identify Students with Reading Disability in Malayalam among Upper Primary Students

ERIC Educational Resources Information Center

Gafoor, K. Abdul; Remia, K. R.

2013-01-01

This study is to identify tasks which can be used to spot students with Reading Disability in Malayalam among Upper Primary students. It used secondary data collected from students of Kerala. Students were categorized as dyslexic and low achievers based on their performance in reading, writing and arithmetic tests. Data on performance of normal…

Mode of Parainfluenza Virus Transmission Determines the Dynamics of Primary Infection and Protection from Reinfection

PubMed Central

Burke, Crystal W.; Bridges, Olga; Brown, Sherri; Rahija, Richard; Russell, Charles J.

2013-01-01

Little is known about how the mode of respiratory virus transmission determines the dynamics of primary infection and protection from reinfection. Using non-invasive imaging of murine parainfluenza virus 1 (Sendai virus) in living mice, we determined the frequency, timing, dynamics, and virulence of primary infection after contact and airborne transmission, as well as the tropism and magnitude of reinfection after subsequent challenge. Contact transmission of Sendai virus was 100% efficient, phenotypically uniform, initiated and grew to robust levels in the upper respiratory tract (URT), later spread to the lungs, grew to a lower level in the lungs than the URT, and protected from reinfection completely in the URT yet only partially in the lungs. Airborne transmission through 7.6-cm and 15.2-cm separations between donor and recipient mice was 86%–100% efficient. The dynamics of primary infection after airborne transmission varied between individual mice and included the following categories: (a) non-productive transmission, (b) tracheal dominant, (c) tracheal initiated yet respiratory disseminated, and (d) nasopharyngeal initiated yet respiratory disseminated. Any previous exposure to Sendai virus infection protected from mortality and severe morbidity after lethal challenge. Furthermore, a higher level of primary infection in a given respiratory tissue (nasopharynx, trachea, or lungs) was inversely correlated with the level of reinfection in that same tissue. Overall, the mode of transmission determined the dynamics and tropism of primary infection, which in turn governed the level of seroconversion and protection from reinfection. These data are the first description of the dynamics of respiratory virus infection and protection from reinfection throughout the respiratory tracts of living animals after airborne transmission. This work provides a basis for understanding parainfluenza virus transmission and protective immunity and for developing novel vaccines and non-pharmaceutical interventions. PMID:24278024

Microfibrillar-associated protein 4 variation in symptomatic peripheral artery disease.

PubMed

Hemstra, Line Ea; Schlosser, Anders; Lindholt, Jes Sanddal; Sorensen, Grith L

2018-06-08

Symptomatic peripheral artery disease (PAD) is an atherosclerotic occlusive disease affecting the lower extremities. The cause of symptomatic PAD is atherosclerosis, vascular dysfunctions, impaired angiogenesis and neointima formation. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein, which is highly expressed in the heart and arteries and recently introduced as a potential mediator of pathological vascular remodeling and neointima formation. We aimed to investigate the relationship between serum MFAP4 (sMFAP4) and symptomatic PAD outcomes. A total of 286 PAD patients were analyzed if they had either intermittent claudication or critical lower-extremity ischemia (CLI) and followed for 7 years. The level of serum MFAP4 (sMFAP4) was measured by alphaLISA. Kaplan-Meier, Cox proportional hazard and logistic regression analysis were used to analyze the associations between upper tertile sMFAP4 and symptomatic PAD outcomes. Patients with upper tertile sMFAP4 had an odds ratio (OR) of 2.65 (p < 0.001) for having CLI diagnosis. Further analysis indicated that patients with upper tertile sMFAP4 had a hazard ratio (HR) of 1.97 (p = 0.04) for cardiovascular death during the 7-years follow-up. However, analysis of 2-year primary patency showed that patients with upper tertile sMFAP4 had decreased risk of vascular occlusion after reconstructive surgery with HR of 0.15 (p = 0.02). sMFAP4 has potential as a prognostic marker for cardiovascular death, primary patency of reconstructed vessels and CLI diagnosis in symptomatic PAD patients. Confirmation of observations in larger cohorts is warranted.

Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis

PubMed Central

Kuroda, Hiroaki; Sakao, Yukinori; Mun, Mingyon; Uehara, Hirofumi; Nakao, Masayuki; Matsuura, Yousuke; Mizuno, Tetsuya; Sakakura, Noriaki; Motoi, Noriko; Ishikawa, Yuichi; Yatabe, Yasushi; Nakagawa, Ken; Okumura, Sakae

2015-01-01

Background Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC) located in the left upper division. Methods We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy) with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako’s method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station. Results We enrolled 417 patients (237 men, 180 women). Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC. Conclusions Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC. PMID:26247881

A prospective study for upper-extremity cumulative trauma disorders of workers in aircraft manufacturing.

PubMed

Melhorn, J M

1996-12-01

Occupational diseases affect 15 to 20% of all Americans. Cumulative trauma disorders (CTDs) account for 56% of all occupational injuries. The recognition and control of occupational injuries has become a major concern of employees, employers, medicine, and the federal government because of health risk and related costs. Upper-extremity CTDs are identified by the National Institute for Occupational Safety and Health as one of the ten most significant occupational health problems in the United States. It is estimated by the year 2000 that 50 cents on the dollar will be spent on CTDs. Although enlightened aircraft employers have developed primary prevention strategies, primary prevention can never be expected to eliminate 100% of the cases. To evaluate several preventive activities, a CTD risk-assessment program was developed and implemented in cooperation with a major aircraft manufacturer employing over 8000 workers. This program was focused on objectively identifying the relationship of work and other activities to an individual worker experiencing CTDs. Early identification has been linked, when applicable, to intervention algorithms for medical care, job task modification, workplace accommodation, and training. A prospective study group of 212 workers who used rivet guns was placed into a four-way experimental design for ergonomic posture training, exercise training, and rivet-gun type (primary factors). A statistical model was developed for the level of CTD risk and evaluated using the SAS software program (SAS Institute, Inc, Carry, NC). Statistical analysis of the primary factors without regard to associated variables (covariates) demonstrated that only posture training had a beneficial risk reduction for the individual. The impact (beneficial or detrimental) for exercise training and for vibration-dampening rivet guns was probably obscured because of the large variability of the responses regarding the associated variables (covariates). When the covariates were analyzed in conjunction with the four experimental groups, a positive benefit from ergonomic posture training and exercise training was demonstrated for the following groups: the dominant han, time spend in an awkward position, number of standard rivets bucked, number of parts routed, number of parts ground, number of vibration-dampening rivets bucked, and newly hired individuals. A negative effect (increase in individual risk level) for current employees using a vibration-dampening rivet gun was demonstrated. This prospective study helps to identify the possible benefit of education and training for controlling CTDs and demonstrates the usefulness of being able to evaluate materials, methods, machines, and environments as they relate to the individual's risk level for the development of upper-extremity CTDs.

Inquiry and groups: student interactions in cooperative inquiry-based science

NASA Astrophysics Data System (ADS)

Woods-McConney, Amanda; Wosnitza, Marold; Sturrock, Keryn L.

2016-03-01

Science education research has recommended cooperative inquiry based science in the primary science context for more than two decades but after more than 20 years, student achievement in science has not substantially improved. This study, through direct observation and analysis, investigated content-related student interactions in an authentic inquiry based primary science class setting. Thirty-one upper primary students were videotaped working in cooperative inquiry based science activities. Cooperative talk and negotiation of the science content was analysed to identify any high-level group interactions. The data show that while all groups have incidences of high-level content-related group interactions, the frequency and duration of these interactions were limited. No specific pattern of preceding events was identified and no episodes of high-level content-related group interactions were immediately preceded by the teacher's interactions with the groups. This in situ study demonstrated that even without any kind of scaffolding, specific skills in knowing how to implement cooperative inquiry based science, high-level content-related group interactions did occur very briefly. Support for teachers to develop their knowledge and skills in facilitating cooperative inquiry based science learning is warranted to ensure that high-level content-related group interactions and the associated conceptual learning are not left to chance in science classrooms.

Human factors studies of control configurations for advanced transport aircraft

NASA Technical Reports Server (NTRS)

Snyder, Harry L.; Monty, Robert W.; Old, Joe

1985-01-01

This research investigated the threshold levels of display luminance contrast which were required to interpret static, achromatic, integrated displays of primary flight information. A four-factor within-subjects design was used to investigate the influences of type of flight variable information, the level of ambient illumination, the type of control input, and the size of the display symbology on the setting of these interpretability thresholds. A three-alternative forced choice paradigm was used in conjunction with the method of adjustments to obtain a measure of the upper limen of display luminance contrast needed to interpret a complex display of primary flight information. The pattern of results and the absolute magnitudes of the luminance contrast settings were found to be in good agreement with previously reported data from psychophysical investigations of display luminance contrast requirements.

"My Favourite Subject Is Maths. For Some Reason No-One Really Agrees with Me": Student Perspectives of Mathematics Teaching and Learning in the Upper Primary Classroom

ERIC Educational Resources Information Center

Attard, Catherine

2011-01-01

The levels of engagement in mathematics experienced by students during the middle years of schooling (Years 5 to 8 in New South Wales) has been of concern in Australia for some years. Lowered engagement in school has been attributed to factors such as inappropriate teaching strategies, curricula that is unchallenging and irrelevant, and cultural…

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

PubMed

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

2005-02-01

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

The chronology and sequence of eruption of human permanent teeth in Northern Ireland.

PubMed

Kochhar, R; Richardson, A

1998-12-01

To ascertain the average and range of ages and sequence of eruption of human permanent teeth, taking into account the effect of premature loss of primary antecedents. Longitudinal study. Caucasian subjects in Northern Ireland. Study casts at 6-monthly intervals from age 5 to 15 years of 276 children (146 males and 130 females) enrolled in the Belfast Growth Study. The mean and range of ages of eruption of each individual tooth were computed. Comparisons were made between the mean ages of eruption with and without premature loss of primary antecedents, between upper and lower arches, between right and left sides and between males and females. The sequence of eruption was also investigated. The means and ranges of eruption ages are reported. Premature loss of primary antecedents delayed eruption of permanent successors except for the upper premolars which were accelerated. The differences relating to the upper first premolar and lower canine were not statistically significant. Each lower tooth erupted before its upper counterpart except for the premolars. There was no significant difference in age of eruption between right and left sides. Females tended to erupt teeth before males with the exception of the second molars in both arches; however, the only differences to reach statistical significance related to upper and lower canines and upper lateral incisors. The most frequent orders of eruption were unique to the subject. These occurred in 22% of upper and 33% of lower arches. The classic sequences: first molar-central incisor-lateral incisor-first premolar-canine-second premolar-second molar (M1-I1-I2-PM1-C-PM2-M2) in the upper arch and I1-M1-I2-C-PM1-PM2-M2 in the lower arch occurred in only 16% of upper arches and 13% of lower arches. Males adhered to the textbook sequence (20% upper, 17% lower) more than females (12% upper, 8% lower). In the upper arch of females, the order M1-I1-I2-PM1-PM2-C-M2 in 10% of subjects was almost as frequent as the classic sequence. The ages, ranges and orders of eruption found in this study are more reliable than many which are frequently quoted on account of its longitudinal nature and the fact that the effect of premature loss of primary antecedents is taken into account. The exclusively Caucasian sample makes the data quite precise but limits applicability to patients of this ethnic origin.

Teaching a Selection of Heaney's Troubles Poetry to Upper Post-Primary Pupils in Northern Ireland's Divided Schools: Educational Contexts and Pedagogical Opportunities

ERIC Educational Resources Information Center

Hanratty, Brian

2017-01-01

Centred on a carefully chosen selection of Heaney's Troubles poems, this paper explores pedagogical opportunities that the poems present in the context of upper post-primary classrooms in Northern Ireland's divided schools. Five poems are evaluated in total. These are: "The Other Side", "A Constable calls", "The Toome…

Enhanced method of fast re-routing with load balancing in software-defined networks

NASA Astrophysics Data System (ADS)

Lemeshko, Oleksandr; Yeremenko, Oleksandra

2017-11-01

A two-level method of fast re-routing with load balancing in a software-defined network (SDN) is proposed. The novelty of the method consists, firstly, in the introduction of a two-level hierarchy of calculating the routing variables responsible for the formation of the primary and backup paths, and secondly, in ensuring a balanced load of the communication links of the network, which meets the requirements of the traffic engineering concept. The method provides implementation of link, node, path, and bandwidth protection schemes for fast re-routing in SDN. The separation in accordance with the interaction prediction principle along two hierarchical levels of the calculation functions of the primary (lower level) and backup (upper level) routes allowed to abandon the initial sufficiently large and nonlinear optimization problem by transiting to the iterative solution of linear optimization problems of half the dimension. The analysis of the proposed method confirmed its efficiency and effectiveness in terms of obtaining optimal solutions for ensuring balanced load of communication links and implementing the required network element protection schemes for fast re-routing in SDN.

A forager–herder trade-off, from broad-spectrum hunting to sheep management at Aşıklı Höyük, Turkey

PubMed Central

Stiner, Mary C.; Buitenhuis, Hijlke; Duru, Güneş; Kuhn, Steven L.; Mentzer, Susan M.; Munro, Natalie D.; Pöllath, Nadja; Quade, Jay; Tsartsidou, Georgia; Özbaşaran, Mihriban

2014-01-01

Aşıklı Höyük is the earliest known preceramic Neolithic mound site in Central Anatolia. The oldest Levels, 4 and 5, spanning 8,200 to approximately 9,000 cal B.C., associate with round-house architecture and arguably represent the birth of the Pre-Pottery Neolithic in the region. Results from upper Level 4, reported here, indicate a broad meat diet that consisted of diverse wild ungulate and small animal species. The meat diet shifted gradually over just a few centuries to an exceptional emphasis on caprines (mainly sheep). Age-sex distributions of the caprines in upper Level 4 indicate selective manipulation by humans by or before 8,200 cal B.C. Primary dung accumulations between the structures demonstrate that ruminants were held captive inside the settlement at this time. Taken together, the zooarchaeological and geoarchaeological evidence demonstrate an emergent process of caprine management that was highly experimental in nature and oriented to quick returns. Stabling was one of the early mechanisms of caprine population isolation, a precondition to domestication. PMID:24778242

Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial.

PubMed

Wei, Xiaolin; Zhang, Zhitong; Walley, John D; Hicks, Joseph P; Zeng, Jun; Deng, Simin; Zhou, Yu; Yin, Jia; Newell, James N; Sun, Qiang; Zou, Guanyang; Guo, Yan; Upshur, Ross E G; Lin, Mei

2017-12-01

Inappropriate antibiotic prescribing contributes to the generation of drug resistance worldwide, and is particularly common in China. We assessed the effectiveness of an antimicrobial stewardship programme aiming to reduce inappropriate antibiotic prescribing in paediatric outpatients by targeting providers and caregivers in primary care hospitals in rural China. We did a pragmatic, cluster-randomised controlled trial with a 6-month intervention period. Clusters were primary care township hospitals in two counties of Guangxi province in China, which were randomly allocated to the intervention group or the control group (in a 1:1 ratio in Rong county and in a 5:6 ratio in Liujiang county). Randomisation was stratified by county. Eligible participants were children aged 2-14 years who attended a township hospital as an outpatient and were given a prescription following a primary diagnosis of an upper respiratory tract infection. The intervention included clinician guidelines and training on appropriate prescribing, monthly prescribing peer-review meetings, and brief caregiver education. In hospitals allocated to the control group, usual care was provided, with antibiotics prescribed at the individual clinician's discretion. Patients were masked to their allocated treatment group but doctors were not. The primary outcome was the antibiotic prescription rate in children attending the hospitals, defined as the cluster-level proportion of prescriptions for upper respiratory tract infections in 2-14-year-old outpatients, issued during the final 3 months of the 6-month intervention period (endline), that included one or more antibiotics. The outcome was based on prescription records and analysed by modified intention-to-treat. This study is registered with the ISRCTN registry, number ISRCTN14340536. We recruited all 25 eligible township hospitals in the two counties (14 hospitals in Rong county and 11 in Liujiang county), and randomly allocated 12 to the intervention group and 13 to the control group. We implemented the intervention in three internal pilot clusters between July 1, 2015, and Dec 31, 2015, and in the remaining nine intervention clusters between Oct 1, 2016 and March 31, 2016. Between baseline (the 3 months before implementation of the intervention) and endline (the final 3 months of the 6-month intervention period) the antibiotic prescription rate at the individual level decreased from 82% (1936/2349) to 40% (943/2351) in the intervention group, and from 75% (1922/2548) to 70% (1782/2552) in the control group. After adjusting for the baseline antibiotic prescription rate, stratum (county), and potentially confounding patient and prescribing doctor covariates, this endline difference between the groups represented an intervention effect (absolute risk reduction in antibiotic prescribing) of -29% (95% CI -42 to -16; p=0·0002). In China's primary care setting, pragmatic interventions on antimicrobial stewardship targeting providers and caregivers substantially reduced prescribing of antibiotics for childhood upper respiratory tract infections. Department of International Development (UKAID) through Communicable Diseases Health Service Delivery. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Immunohistochemistry in the Diagnosis of Mucinous Neoplasms Involving the Ovary: The Added Value of SATB2 and Biomarker Discovery Through Protein Expression Database Mining.

PubMed

Strickland, Sarah; Wasserman, Jason K; Giassi, Ana; Djordjevic, Bojana; Parra-Herran, Carlos

2016-05-01

Immunohistochemistry is frequently used to identify ovarian mucinous neoplasms as primary or metastatic; however, there is significant overlap in expression patterns. We compared traditional markers (CK7, CK20, CDX2, PAX8, estrogen receptor, β-catenin, MUC1, MUC2, and MUC5AC) to 2 novel proteins identified through mining of the Human Protein Atlas expression database: SATB2 and POF1B. The study cohort included 49 primary gastrointestinal (GI) mucinous adenocarcinomas (19 colorectal, 15 gastric, 15 pancreatobiliary), 60 primary ovarian mucinous neoplasms (19 cystadenomas, 21 borderline tumors, 20 adenocarcinomas), and 19 metastatic carcinomas to the ovary (14 lower and 5 upper GI primaries). Immunohistochemistry was performed on tissue microarrays, scored and interpreted as negative (absent or focal/weak) or positive. Metastatic tumors were frequently unilateral (42.8% of tumors from lower and 40% of tumors from upper tract) and ≥10 cm (85.7% of tumors from lower and 80% of tumors from upper tract). CK7 was positive in 88.5% upper GI and 88.3% primary ovarian compared with 24.3% lower GI neoplasms. CK20 and CDX2 were positive in 84.8% and 100% of lower GI tumors, respectively; however, expression was also common in upper GI (CK20 42.8%, CDX2 50%) and primary ovarian neoplasms (CK20 65.7%, CDX2 38.3%). Conversely, SATB2 was more specific for lower GI origin, being positive in 78.8% lower GI but only 11.5% upper GI and 1.7% primary ovarian neoplasms. PAX8 expression was common in primary ovarian neoplasms (75% of all neoplasms, 65% of carcinomas); only 1 (1.5%) GI tumor was positive. MUC2 and β-catenin were frequently positive in lower GI tumors (96.9% and 51.5%, respectively). Estrogen receptor expression was only seen in primary ovarian neoplasms (13.3%). Nuclear premature ovarian failure 1B (POF1B) expression was seen in malignant tumors regardless of their origin. A panel including CK7, SATB2, and PAX8 separated primary from secondary GI neoplasms with up to 77.1% sensitivity and 99% specificity, outperforming tumor laterality and size. Second-line markers such as CDX2, MUC2, estrogen receptor, MUC1, and β-catenin increased the sensitivity of immunohistochemistry in excluding lower GI origin. Biomarker search using proteomic databases has a value in diagnostic pathology, as shown with SATB2; however, as seen with POF1B, expression profiles in these databases are not always reproduced in larger cohorts.

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

PubMed

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

2017-01-01

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

Reductive Augmentation of the Breast.

PubMed

Chasan, Paul E

2018-06-01

Although breast reduction surgery plays an invaluable role in the correction of macromastia, it almost always results in a breast lacking in upper pole fullness and/or roundness. We present a technique of breast reduction combined with augmentation termed "reductive augmentation" to solve this problem. The technique is also extremely useful for correcting breast asymmetry, as well as revising significant pseudoptosis in the patient who has previously undergone breast augmentation with or without mastopexy. An evolution of techniques has been used to create a breast with more upper pole fullness and anterior projection in those patients desiring a more round, higher-profile appearance. Reductive augmentation is a one-stage procedure in which a breast augmentation is immediately followed by a modified superomedial pedicle breast reduction. Often, the excision of breast tissue is greater than would normally be performed with breast reduction alone. Thirty-five patients underwent reductive augmentation, of which 12 were primary surgeries and 23 were revisions. There was an average tissue removal of 255 and 227 g, respectively, per breast for the primary and revision groups. Six of the reductive augmentations were performed for gross asymmetry. Fourteen patients had a previous mastopexy, and 3 patients had a previous breast reduction. The average follow-up was 26 months. Reductive augmentation is an effective one-stage method for achieving a more round-appearing breast with upper pole fullness both in primary breast reduction candidates and in revisionary breast surgery. This technique can also be applied to those patients with significant asymmetry. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up

PubMed Central

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

PubMed

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

Processes controlling dissolved oxygen and pH in the upper Willamette River basin, Oregon, 1994

USGS Publications Warehouse

Pogue, Ted R.; Anderson, Chauncey W.

1995-01-01

In July and August of 1994, the U. S. Geological Survey in cooperation with the Oregon Department of Environmental Quality (ODEQ) collected data to document the spatial extent and diel variability of dissolved oxygen (DO) concentrations and pH levels in selected reaches of streams in the upper Willamette River Basin. These data were also collected to identify primary factors that control DO concentrations downstream from major point sources as well as to provide ODEQ with data to refine calibration of their steady-state DO and nutrient models for the upper Willamette River Basin. All of the reaches studied had diel variations in DO and pH. The magnitude of the diel variations in DO ranged from 0.2 to 3.9 milligrams per liter (7 to 50 percent-saturation units based on ambient water temperature and barometric pressure) and in pH from 0.3 to 1.4 units. However, of the reaches studied, only the Coast Fork Willamette River from river mile (RM) 21.7 to 12.5 and the Willamette River from RM 151 to 141.6 had field measured violations of State standards for DO and pH. DO concentration and pH in water depend on many factors. Data were collected to examine several major factors, including BOD (biochemical oxygen demand), carbonaceous BOD, nitrogenous BOD, and measures of photosynthetic activity. Of the four study reaches, only a short stretch of the Coast Fork Willamette River has potential for important levels of oxygen consumption from BOD or nitrification. Additionally, water-column primary-productivity measurements indicated that respiration and photosynthesis by free-floating algae did not explain the observed diel variations in DO in the study reaches. Results from a simple mathematical model incorporating measures of community respiration and net primary productivities indicated that periphyton are capable of producing a diel variation of the order of magnitude observed during the August study period. In the Willamette River near Peoria, the combined periphyton DO consumption and production estimate at RM 151 (2.4 mg/L) and RM 144.6 (1.7 mg/L) would account for 90 and 63 percent, respectively, of the observed diel fluctuation. The estimates for the Corvallis reach at RM 132.6 (0.4 mg/L) and RM 130.7 (2.9 mg/L) had a considerably larger range of 36 to 264 percent of DO saturation, respectively. Therefore, because BOD and phytoplankton do not appear to be important contributors to diel DO fluctuations, periphyton are likely the primary contributor to diel fluctuations in the upper Willamette River Basin during July and August.

[Dropped head syndrome as first manifestation of primary hyperparathyroid myopathy].

PubMed

Ota, Kiyobumi; Koseki, Sayo; Ikegami, Kenji; Onishi, Iichiroh; Tomimitsu, Hiyoryuki; Shintani, Shuzo

2018-03-28

75 years old woman presented with 6-month history of progressive dropped head syndrome. Neurological examination revealed moderate weakness of flexor and extensor of neck and mild weakness of proximal appendicular muscles with normal deep tendon reflexes. The needle electromyography showed short duration and low amplitude motor unit potential. No fibrillation potentials or positive sharp waves were seen. Biopsy of deltoid muscle was normal. Laboratory studies showed elevated levels of serum calcium (11.8 mg/dl, upper limit of normal 10.1) and intact parathyroid hormone (104 pg/ml, upper limit of normal 65), and decreased level of serum phosphorus (2.3 mg/dl, lower limit of normal 2.7). Ultrasonography and enhanced computed tomography revealed a parathyroid tumor. The tumor was removed surgically. Pathological examination proved tumor to be parathyroid adenoma. Dropped head and weakness of muscles were dramatically improved within a week after the operation. Although hyperparathyroidism is a rare cause of dropped head syndrome, neurologists must recognize hyperparathyroidism as a treatable cause of dropped head syndrome.

The Status of National Values in the Books of Social Studies for the Grades of the Upper Primary Stage in Jordan

ERIC Educational Resources Information Center

Subheyyin, Eid H.; Mawajdeh, Baker S.; Talhouni, Mansour H.; Rfou', Mohammad O.

2017-01-01

This study aimed at determining the most important national values that should be included in the textbooks of social studies for the upper-primary stage grades in Jordan; and then identifying the degree of their inclusion in those books. The study used a descriptive-analytical approach. A study tool which includes twelve national values was…

Augmenting Learning in an Out-of-School Context: The Cognitive and Affective Impact of Two Cryogenics-Based Enrichment Programmes on Upper Primary Students

ERIC Educational Resources Information Center

Caleon, Imelda S.; Subramaniam, R.

2007-01-01

Concepts learned in the classroom were reinforced and augmented by presenting them in a different context using cryogenics-based enrichment programmes (CBEPs) held in an out-of-school setting. The effectiveness of two CBEPs, which involve the use of liquid nitrogen and liquid oxygen, was explored. Using a sample of 265 upper primary students, it…

Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

ERIC Educational Resources Information Center

Quinlan, Susan E.

Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

Geohydrology and evaluation of water-resource potential of the upper Floridan Aquifer in the Albany area, southwestern Georgia

USGS Publications Warehouse

Torak, L.J.; Davis, G.S.; Strain, G.A.; Herndon, J.G.

1993-01-01

In the Albany area of southwestern Georgia, the Upper Floridan aquifer lies entirely within the Dougherty Plain district of the Coastal Plain physiographic province, and consists of the Ocala Limestone of late Eocene age. The aquifer is divided throughout most of the study area into an upper and a lower lithologic unit, which creates an upper and a lower water-bearing zone. The lower waterbearing zone consists of alternating layers of sandy limestone and medium-brown, recrystallized dolomitic limestone, and ranges in thickness from about 50 ft to 100 ft. It is highly fractured and exhibits well-developed permeability by solution features that are responsible for transmitting most of the ground water in the aquifer. Transmissivity of the lower water-bearing zone ranges from about 90,000 to 178,000 ft2/d. The upper water-bearing zone is a finely crystallized-to-oolitic, locally dolomitic limestone having an average thickness of about 60 ft. Transmissivities are considerably less in the upper water-bearing zone than in the lower water-bearing zone. The Upper Floridan aquifer is overlain by about 20-120 ft of undifferentiated overburden consisting of fine-to-coarse quartz sand and noncalcareous clay. A clay zone about 10-30 ft thick may be continuous throughout the southwestern part of the Albany area and, where present, causes confinement of the Upper Floridan aquifer and creates perched ground water after periods of heavy rainfall. The Upper Floridan aquifer is confined below by the Lisbon Formation, a mostly dolomitic limestone that contains trace amounts of glauconite. The Lisbon Formation is at least 50 ft thick in the study area and acts as an impermeable base to the Upper Floridan aquifer. The quality of ground water in the Upper Floridan aquifer is suitable for most uses; wells generally yield water of the hard, calcium-bicarbonate type that meets the U.S. Environmental Protection Agency's Primary or Secondary Drinking-Water Regulations. The water-resource potential of the Upper Floridan aquifer was evaluated by compiling results of drilling and aquifer testing in the study area, and by conducting computer simulations of the ground-water flow system under the seasonally low conditions of November 1985, and under conditions of pumping within a 12-mi 2 area located southwest of Albany. Results of test drilling, aquifer testing, and water-quality analyses indicate that, in the area southwest of Albany, geohydrologic conditions in the Upper Floridan aquifer, undifferentiated overburden, and Lisbon Formation were favorable for the aquifer to provide a large quantity of water without having adverse effects on the groundwater system. The confinement of the Upper Floridan aquifer by the undifferentiated overburden and the rural setting of the area of potential development decrease the likelihood that chemical constituents will enter the aquifer during development of the ground-water resources. Computer simulations of ground-water flow in the Upper Floridan aquifer, incorporating conditions for regional flow across model boundaries, leakage from rivers and other surface-water features, and vertical leakage from the undifferentiated overburden, were conducted by using a finite-element model for ground-water flow in two dimensions. Comparison of computed and measured water levels in the Upper Floridan aquifer for November 1985 at 74 locations indicated that computed water levels generally were within 5 ft of the measured values, which is the accuracy to which measured water levels were known. Water-level altitudes ranged from about 260 ft to 130 ft above sea level in the study area during calibration. Aquifer discharge to the Flint River downstream from the Lake Worth dam was computed by the calibrated model to be about 1 billion gallons per day; about 300 million gallons per day (Mgal/d) greater than was measured for similar lowflow conditions. The excess computed discharge was attributed partially to stream withdrawals for

Perspectives on classical controversies about the motor cortex.

PubMed

Omrani, Mohsen; Kaufman, Matthew T; Hatsopoulos, Nicholas G; Cheney, Paul D

2017-09-01

Primary motor cortex has been studied for more than a century, yet a consensus on its functional contribution to movement control is still out of reach. In particular, there remains controversy as to the level of control produced by motor cortex ("low-level" movement dynamics vs. "high-level" movement kinematics) and the role of sensory feedback. In this review, we present different perspectives on the two following questions: What does activity in motor cortex reflect? and How do planned motor commands interact with incoming sensory feedback during movement? The four authors each present their independent views on how they think the primary motor cortex (M1) controls movement. At the end, we present a dialogue in which the authors synthesize their views and suggest possibilities for moving the field forward. While there is not yet a consensus on the role of M1 or sensory feedback in the control of upper limb movements, such dialogues are essential to take us closer to one. Copyright © 2017 the American Physiological Society.

Early MAVEN Deep Dip campaign reveals thermosphere and ionosphere variability.

PubMed

Bougher, S; Jakosky, B; Halekas, J; Grebowsky, J; Luhmann, J; Mahaffy, P; Connerney, J; Eparvier, F; Ergun, R; Larson, D; McFadden, J; Mitchell, D; Schneider, N; Zurek, R; Mazelle, C; Andersson, L; Andrews, D; Baird, D; Baker, D N; Bell, J M; Benna, M; Brain, D; Chaffin, M; Chamberlin, P; Chaufray, J-Y; Clarke, J; Collinson, G; Combi, M; Crary, F; Cravens, T; Crismani, M; Curry, S; Curtis, D; Deighan, J; Delory, G; Dewey, R; DiBraccio, G; Dong, C; Dong, Y; Dunn, P; Elrod, M; England, S; Eriksson, A; Espley, J; Evans, S; Fang, X; Fillingim, M; Fortier, K; Fowler, C M; Fox, J; Gröller, H; Guzewich, S; Hara, T; Harada, Y; Holsclaw, G; Jain, S K; Jolitz, R; Leblanc, F; Lee, C O; Lee, Y; Lefevre, F; Lillis, R; Livi, R; Lo, D; Ma, Y; Mayyasi, M; McClintock, W; McEnulty, T; Modolo, R; Montmessin, F; Morooka, M; Nagy, A; Olsen, K; Peterson, W; Rahmati, A; Ruhunusiri, S; Russell, C T; Sakai, S; Sauvaud, J-A; Seki, K; Steckiewicz, M; Stevens, M; Stewart, A I F; Stiepen, A; Stone, S; Tenishev, V; Thiemann, E; Tolson, R; Toublanc, D; Vogt, M; Weber, T; Withers, P; Woods, T; Yelle, R

2015-11-06

The Mars Atmosphere and Volatile Evolution (MAVEN) mission, during the second of its Deep Dip campaigns, made comprehensive measurements of martian thermosphere and ionosphere composition, structure, and variability at altitudes down to ~130 kilometers in the subsolar region. This altitude range contains the diffusively separated upper atmosphere just above the well-mixed atmosphere, the layer of peak extreme ultraviolet heating and primary reservoir for atmospheric escape. In situ measurements of the upper atmosphere reveal previously unmeasured populations of neutral and charged particles, the homopause altitude at approximately 130 kilometers, and an unexpected level of variability both on an orbit-to-orbit basis and within individual orbits. These observations help constrain volatile escape processes controlled by thermosphere and ionosphere structure and variability. Copyright © 2015, American Association for the Advancement of Science.

Modeling the three-dimensional structure of macroscopic magma transport systems: Application to Kilauea volcano, Hawaii

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

Ryan, M.P.; Koyanagi, R.Y.; Fiske, R.S.

1981-08-10

We report the results of modeling the three-dimensional internal structure of Kilauea's magmatic passageways. The approach uses a clear plexiglass model containing equally-spaced levels upon which well-located seismic hypocenters are plotted. Application of constraining geologic and geophysical criteria to this distributed volume of earthquakes permits the interpretation of seismic structures produced by fracturing in response to locally high fluid pressures. Four magma transport and storage structures produce have been identified within and beneath Kilauea: (1) Primary conduit. The conduit transporting magma into Kilauea's summit storage reservoir rises from the model base (14.6 km) to 6.5 km depth level. It ismore » a zone of intense fracturing and inferred intrusion, whose horizontal sections are elliptical in planform. Over its height, the average major axis of component horizontal section is 3.3 km, with an average minor axis of 1.7 km. This yields an aspect ratio of xi = 0.52. At the 14.6 km level, the strike of the major axis is N67 /sup 0/E. During passage from the upper mantle through the oceanic crust, this axis rotates in a right-handed sense, until the strike is N41 /sup 0/W at the 6.5 km level. (2) Magma chamber complex floor. The interval from 6.5 to 5.7 km, immediately over the primary conduit, is aseismic. This suggests differentially high fluid-to-rock ratios, and relatively weak pathways for further vertical transport into higher levels of the storage complex, as well as lateral leakage eastward into the Mauna Ulu staging area: for later vertical ascent beneath the upper east rift zone. Seismicity within the immediately subjacent rocks that form the top of the primary conduit (at 6.5 km) suggests that this inferred magma-rich horizon forms the effective floor of the summit storage complex. (3) Magma chamber crown. Intense seismicity over the 1.1--1.9 km depth interval defines an elliptical region in plan view.« less

Search For the Rare Decay K L → π 0π 0γ

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

Smith, David Edward

2006-08-01

This thesis describes a search for the rare decay K L → π 0π 0γ using data from the KTeV experiment, using the topology K L → π 0πmore » $$0\\atop{D}$$γ (where π$$0\\atop{D}$$ → γe +e -). Due to Bose statistics and the real nature of the photon, the K L → π 0π 0γ decay can proceed at lowest order only by the Cp conserving direct emission of an E2 photon. The decay vanishes to O(p 4) in chiral perturbation theory and is a probe of the theory to the sixth order. The primary background to this decay consists of K L → π 0π$$0\\atop{D}$$ events with one lost photon. The upper limit for the decay K L π 0π 0γ presented in this thesis is 2.32 x 10 -7 at the 90% confidence level. This upper limit was derived from both 1997 and 1999 data, using a blind analysis. The upper limit was derived from a Feldman-Cousins method, based on a weighted total of 0.53 data events in the signal region with an expected K L → π 0π 0π$$0\\atop{D}$$ background of 0.37 ± 0.28 events. The previous upper limit for this decay was 5.6 x 10 -6 at the 90% confidence level.« less

Epidemiology of traumatic upper limb amputations.

PubMed

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

2018-04-01

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

Nutritional and cognitive status of entry-level primary school children in Zomba, rural Malawi.

PubMed

Nkhoma, Owen W W; Duffy, Maresa E; Davidson, Philip W; Cory-Slechta, Deborah A; McSorley, Emeir M; Strain, J J; O'Brien, Gerard M

2013-05-01

Entry-level Malawian children (n = 226) aged 6-8 years from two public primary schools, one a participant in a national school feeding programme (FP), the other not, were investigated for differences in nutritional and cognitive status. Stunted growth (42%) and underweight (25%) were prevalent, with no significant differences between the schools, although the school attended was a significant predictor of mid-upper arm circumference. Previous attendance at a community-based childcare centre was significantly associated with lower body weight and height. There were no significant differences in memory, reversal learning and attention outcomes between the schools. These findings report no major significant difference in nutrition or cognitive statuses between the schools, and on this basis suggest that both schools were equally in need of FP participation. More inclusive interventions and broadening/review of FP participation criteria are recommended.

Vagus nerve stimulation during rehabilitative training improves forelimb strength following ischemic stroke.

PubMed

Khodaparast, N; Hays, S A; Sloan, A M; Hulsey, D R; Ruiz, A; Pantoja, M; Rennaker, R L; Kilgard, M P

2013-12-01

Upper limb impairment is a common debilitating consequence of ischemic stroke. Physical rehabilitation after stroke enhances neuroplasticity and improves limb function, but does not typically restore normal movement. We have recently developed a novel method that uses vagus nerve stimulation (VNS) paired with forelimb movements to drive specific, long-lasting map plasticity in rat primary motor cortex. Here we report that VNS paired with rehabilitative training can enhance recovery of forelimb force generation following infarction of primary motor cortex in rats. Quantitative measures of forelimb function returned to pre-lesion levels when VNS was delivered during rehab training. Intensive rehab training without VNS failed to restore function back to pre-lesion levels. Animals that received VNS during rehab improved twice as much as rats that received the same rehabilitation without VNS. VNS delivered during physical rehabilitation represents a novel method that may provide long-lasting benefits towards stroke recovery. © 2013.

Yucca Mountain Project Subsurface Facilities Design

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

A. Linden; R.S. Saunders; R.J. Boutin

2002-11-19

Four units of the Topopah Springs formation (volcanic tuff) are considered for the proposed repository: the upper lithophysal, the middle non-lithophysal, the lower lithophysal, and the lower non-lithophysal. Yucca Mountain was recently designated the site for a proposed repository to dispose of spent nuclear fuel and high-level radioactive waste. Work is proceeding to advance the design of subsurface facilities to accommodate emplacing waste packages in the proposed repository. This paper summarized recent progress in the design of subsurface layout of the proposed repository. The original Site Recommendation (SR) concept for the subsurface design located the repository largely within the lowermore » lithophysal zone (approximately 73%) of the Topopah The Site Recommendation characterized area suitable for emplacement consisted of the primary upper block, the lower block and the southern upper block extension. The primary upper block accommodated the mandated 70,000 metric tons of heavy metal (MTHM) at a 1.45 kW/m hear heat load. Based on further study of the Site Recommendation concept, the proposed repository siting area footprint was modified to make maximum use of available site characterization data, and thus, reduce uncertainties associated with performance assessment. As a result of this study, a modified repository footprint has been proposed and is presently being review for acceptance by the DOE. A panel design concept was developed to reduce overall costs and reduce the overall emplacement schedule. This concept provides flexibility to adjust the proposed repository subsurface layout with time, as it makes it unnecessary to ''commit'' to development of a large single panel at the earliest stages of construction. A description of the underground layout configuration and influencing factors that affect the layout configuration are discussed in the report.« less

Diagnosing and Managing IBD

MedlinePlus

... of your abdomen. Newer scanners have an open design to minimize claustrophobia. A CT of the abdomen ... CE) Upper tract Crohn’s disease EGD-Upper GI Series (UGIS) Perianal Crohn’s disease MRI-EUS PSC (primary ...

Hemispheric differences in recognizing upper and lower facial displays of emotion.

PubMed

Prodan, C I; Orbelo, D M; Testa, J A; Ross, E D

2001-01-01

To determine if there are hemispheric differences in processing upper versus lower facial displays of emotion. Recent evidence suggests that there are two broad classes of emotions with differential hemispheric lateralization. Primary emotions (e.g. anger, fear) and associated displays are innate, are recognized across all cultures, and are thought to be modulated by the right hemisphere. Social emotions (e.g., guilt, jealousy) and associated "display rules" are learned during early child development, vary across cultures, and are thought to be modulated by the left hemisphere. Display rules are used by persons to alter, suppress or enhance primary emotional displays for social purposes. During deceitful behaviors, a subject's true emotional state is often leaked through upper rather than lower facial displays, giving rise to facial blends of emotion. We hypothesized that upper facial displays are processed preferentially by the right hemisphere, as part of the primary emotional system, while lower facial displays are processed preferentially by the left hemisphere, as part of the social emotional system. 30 strongly right-handed adult volunteers were tested tachistoscopically by randomly flashing facial displays of emotion to the right and left visual fields. The stimuli were line drawings of facial blends with different emotions displayed on the upper versus lower face. The subjects were tested under two conditions: 1) without instructions and 2) with instructions to attend to the upper face. Without instructions, the subjects robustly identified the emotion displayed on the lower face, regardless of visual field presentation. With instructions to attend to the upper face, for the left visual field they robustly identified the emotion displayed on the upper face. For the right visual field, they continued to identify the emotion displayed on the lower face, but to a lesser degree. Our results support the hypothesis that hemispheric differences exist in the ability to process upper versus lower facial displays of emotion. Attention appears to enhance the ability to explore these hemispheric differences under experimental conditions. Our data also support the recent observation that the right hemisphere has a greater ability to recognize deceitful behaviors compared with the left hemisphere. This may be attributable to the different roles the hemispheres play in modulating social versus primary emotions and related behaviors.

Primary conjunctival amyloidosis.

PubMed

Chakraborti, Chandana; Chaudhury, Krittika P; Biswas, Ranu Roy

2014-01-01

A 19-year-old previously healthy male presented with a 4 year history of painless drooping of right upper eyelid. On eversion of the right upper eyelid, a yellowish pink mass was seen in the tarsal region. Rest of the ocular examination was normal in both the eyes. Initial biopsy showed chronic inflammation. Subsequently, the entire mass was excised and histopathological examination showed the presence of amyloid in the subconjunctival stroma. At 3 months follow-up, similar lesion was detected in the right lower, left upper, and lower lid, which were treated with cryotherapy, with partial resolution. Patient has been followed up for more than 2 years without any complaints. To our knowledge, this is the first case report of an isolated primary conjunctival amyloidosis with involvement of both the upper and lower palpebral conjunctiva of either eye. It was treated successfully by excision and cryotherapy.

Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

PubMed

Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

2018-04-13

The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as moderate responsiveness in patients with upper extremity conditions.

Motivating Inquiry in Statistics and Probability in the Primary Classroom

ERIC Educational Resources Information Center

Leavy, Aisling; Hourigan, Mairéad

2015-01-01

We describe how the use of a games environment combined with technology supports upper primary children in engaging with a concept traditionally considered too advanced for the primary classes: "The Law of Large Numbers."

RELAP5 Analyses of OECD/NEA ROSA-2 Project Experiments on Intermediate-Break LOCAs at Hot Leg or Cold Leg

NASA Astrophysics Data System (ADS)

Takeda, Takeshi; Maruyama, Yu; Watanabe, Tadashi; Nakamura, Hideo

Experiments simulating PWR intermediate-break loss-of-coolant accidents (IBLOCAs) with 17% break at hot leg or cold leg were conducted in OECD/NEA ROSA-2 Project using the Large Scale Test Facility (LSTF). In the hot leg IBLOCA test, core uncovery started simultaneously with liquid level drop in crossover leg downflow-side before loop seal clearing (LSC) induced by steam condensation on accumulator coolant injected into cold leg. Water remained on upper core plate in upper plenum due to counter-current flow limiting (CCFL) because of significant upward steam flow from the core. In the cold leg IBLOCA test, core dryout took place due to rapid liquid level drop in the core before LSC. Liquid was accumulated in upper plenum, steam generator (SG) U-tube upflow-side and SG inlet plenum before the LSC due to CCFL by high velocity vapor flow, causing enhanced decrease in the core liquid level. The RELAP5/MOD3.2.1.2 post-test analyses of the two LSTF experiments were performed employing critical flow model in the code with a discharge coefficient of 1.0. In the hot leg IBLOCA case, cladding surface temperature of simulated fuel rods was underpredicted due to overprediction of core liquid level after the core uncovery. In the cold leg IBLOCA case, the cladding surface temperature was underpredicted too due to later core uncovery than in the experiment. These may suggest that the code has remaining problems in proper prediction of primary coolant distribution.

Documentation for the USAF School of Aerospace Medicine Altitude Decompression Sickness Research Database

DTIC Science & Technology

2010-05-01

following investigators have been listed on protocols where DCS and/or VGE were the primary data gathered (omits PRK and LASIK ): Jimmy D. Adams, PhD...there was a difference in the level of upper vs . lower-body joint pain which was evident statistically when many non-ambulatory vs . ambulatory studies...5,000 fpm vs . 80,000 fpm ascents to 40,000 ft (90-min prebreathe, 90-min exposure), there were a few more neurologic and respiratory symptoms

Hydrogeology and preliminary assessment of regional flow in the upper Cretaceous and adjacent aquifers in the northern Mississippi embayment

USGS Publications Warehouse

Brahana, J.V.; Mesko, T.O.

1988-01-01

On a regional scale, the groundwater system of the northern Mississippi embayment is composed of a series of nonindurated clastic sediments that overlie a thick sequence of Paleozoic carbonate, sandstones, and shales. The units that comprise the geohydrologic framework of this study are the alluvium-lower Wilcox Aquifer the Midway confining unit, the Upper Cretaceous aquifer, the Cretaceous-Paleozoic confining unit, and the Ozark-St. Francois aquifer. The Upper Cretaceous aquifer of Late Cretaceous age is the primary focus of this investigation; the study is part of the Gulf Coast Regional Aquifer-System Analysis. A four layer finite-difference groundwater flow model enabled testing of alternative boundary concepts and provide a refined definition of the hydrologic budget of the deep aquifers. The alluvium-lower Wilcox aquifer, the Upper Cretaceous aquifer, and the Ozark-St. Francois aquifer form layers 2 through 4, respectively. Layer 1 is an inactive layer of constant heads representing shallow water levels, which are a major control on recharge to and discharge from the regional system. A matrix of leakance values simulates each confining unit, allowing vertical interchange of water between different aquifers. The model was calibrated to 1980 conditions by using the assumption that 1980 was near steady-state conditions; it was calibrated to simulate observed heads were found to be most sensitive to pumping, and least sensitive to the leakance. By using all available water quality and water level data, alternative boundary conditions were tested by comparing model simulated heads to observed heads. The results of the early modeling effort also contribute to a better understanding of the regional hydrologic budget, indicating that: upward leakage from the Ozark-St. Francois aquifer to the Upper Cretaceous aquifer is about 43 cu ft/sec; upward recharge of about 68 cu ft/sec occurs to the lower Wilcox-alluvium aquifer from the Upper Cretaceous aquifer; and the Midway is an effective regional confining unit. (Author 's abstract)

Poleward Tropical Moisture Transport and its Link to Four Sequential Extreme Weather Events over North America in October 2007

NASA Astrophysics Data System (ADS)

Bosart, L. F.; Cordeira, J. M.; Archambault, H. M.; Moore, B. J.

2014-12-01

A case of four sequentially linked extreme weather events (EWEs) during 22 - 31 October 2007 which included wildfires in southern California, cold surges in northern and eastern Mexico, widespread heavy rain in the eastern United Sates, and heavy rains in southern Mexico is presented. These EWEs were preceded by a rapid dynamically driven rapid amplification of the upper-level flow across the North Pacific and North America associated with the formation of a large-amplitude Rossby wave train (RWT) through downstream baroclinic development involving multiple tropical and polar disturbance interactions with the North Pacific jet stream. The primary contributors to the formation of the large-amplitude RWT were two sequential upper-level polar disturbances, a diabatic Rossby vortex, western North Pacific TC Kajiki, and migratory extratropical cyclones (ECs). Deep subtropical and tropical moisture plumes resembling "atmospheric rivers" drawn poleward along warm conveyor belts into the warm sectors of these ECs played a critical role in further amplifying the downstream upper-level ridges based on an Eulerian analysis of negative potential vorticity advection by the irrotational wind and a Lagrangian trajectory analysis of tropical and subtropical moisture sources. In particular, these atmospheric rivers extending poleward from TC Kajiki and from the subtropical eastern North Pacific into the warm sectors of polar disturbance-generated ECs over the western and eastern North Pacific, respectively, bolstered latent heat release and ridge building and contributed to additional upper-level flow amplification. The EWEs occurred subsequent to anticyclonic wave breaking over western North America and the concomitant downstream formation of a meridionally elongated potential vorticity streamer over the central United States. The resulting high-amplitude flow pattern over North America favored the formation of the aforementioned EWEs by promoting an extensive meridional exchange of air masses from high and low latitudes.

OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE ...

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

OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE BIN, LOOKING NORTHEAST. REMAINS OF A BLACKSMITH'S FORGE AND WORK CAN BE SEEN JUST BELOW THE ORE BIN (SEE CA-291-32 FOR DETAIL). ROCK FOUNDATIONS LOCATED JUST ABOVE THE ORE BIN AND ALONG THE FIRST RIDGELINE ARE TENT PADS. SEE CA-291-24 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE ...

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

OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE BIN, LOOKING NORTHEAST. REMAINS OF A BLACKSMITH'S FORGE AND WORK CAN BE SEEN JUST BELOW THE ORE BIN (SEE CA-291-32 FOR DETAIL). ROCK FOUNDATIONS LOCATED JUST ABOVE THE ORE BIN AND ALONG THE FIRST RIDGELINE ARE TENT PADS. SEE CA-291-49 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

Knowledge, attitudes and practices towards antibiotic use in upper respiratory tract infections among patients seeking primary health care in Singapore.

PubMed

Pan, Darius Shaw Teng; Huang, Joyce Huixin; Lee, Magdalene Hui Min; Yu, Yue; Chen, Mark I-Cheng; Goh, Ee Hui; Jiang, Lili; Chong, Joash Wen Chen; Leo, Yee Sin; Lee, Tau Hong; Wong, Chia Siong; Loh, Victor Weng Keong; Poh, Adrian Zhongxian; Tham, Tat Yean; Wong, Wei Mon; Lim, Fong Seng

2016-11-03

Patients' expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients visiting primary healthcare services in Singapore. Data was collected through a cross-sectional interviewer-assisted survey of patients aged ≥21 years waiting to see primary healthcare practitioners for one or more symptoms suggestive of URTI (cough, sore throat, runny nose or blocked nose) for 7 days or less, covering the demographics, presenting symptoms, knowledge, attitudes, beliefs and practices of URTI and associated antibiotic use. Univariate and multivariate logistic regression was used to assess independent factors associated with patients' expectations for antibiotics. Nine hundred fourteen out of 987 eligible patients consulting 35 doctors were recruited from 24 private sector primary care clinics in Singapore. A third (307/907) expected antibiotics, of which a substantial proportion would ask the doctor for antibiotics (121/304, 40 %) and/or see another doctor (31/304, 10 %) if antibiotics were not prescribed. The majority agreed "antibiotics are effective against viruses" (715/914, 78 %) and that "antibiotics cure URTI faster" (594/912, 65 %). Inappropriate antibiotic practices include "keeping antibiotics stock at home" (125/913, 12 %), "taking leftover antibiotics" (114/913, 14 %) and giving antibiotics to family members (62/913, 7 %). On multivariate regression, the following factors were independently associated with wanting antibiotics (odds ratio; 95 % confidence interval): Malay ethnicity (1.67; 1.00-2.79), living in private housing (1.69; 1.13-2.51), presence of sore throat (1.50; 1.07-2.10) or fever (1.46; 1.01-2.12), perception that illness is serious (1.70; 1.27-2.27), belief that antibiotics cure URTI faster (5.35; 3.76-7.62) and not knowing URTI resolves on its own (2.18; 1.08-2.06), while post-secondary education (0.67; 0.48-0.94) was inversely associated. Those with lower educational levels were significantly more likely to have multiple misconceptions about antibiotics. Majority of patients seeking primary health care in Singapore are misinformed about the role of antibiotics in URTI. Agreeing with the statement that antibiotics cure URTI faster was most strongly associated with wanting antibiotics. Those with higher educational levels were less likely to want antibiotics, while those with lower educational levels more likely to have incorrect knowledge.

40 CFR 131.34 - Kansas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Contact Recreation Basin: Solomon Subbasin: Upper North Fork Solomon Ash Creek 10260011 24 Primary Contact... Recreation Subbasin: Lower North Fork Solomon Beaver Creek 10260012 10 Primary Contact Recreation...

40 CFR 131.34 - Kansas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Contact Recreation Basin: Solomon Subbasin: Upper North Fork Solomon Ash Creek 10260011 24 Primary Contact... Recreation Subbasin: Lower North Fork Solomon Beaver Creek 10260012 10 Primary Contact Recreation...

40 CFR 131.34 - Kansas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Contact Recreation Basin: Solomon Subbasin: Upper North Fork Solomon Ash Creek 10260011 24 Primary Contact... Recreation Subbasin: Lower North Fork Solomon Beaver Creek 10260012 10 Primary Contact Recreation...

40 CFR 131.34 - Kansas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Contact Recreation Basin: Solomon Subbasin: Upper North Fork Solomon Ash Creek 10260011 24 Primary Contact... Recreation Subbasin: Lower North Fork Solomon Beaver Creek 10260012 10 Primary Contact Recreation...

Groundwater quality of southeastern Wyoming

USGS Publications Warehouse

Eddy-Miller, Cheryl A.; Blain, Liberty

2011-01-01

Groundwater is an important resource for domestic, municipal, stock, and irrigation uses in southeastern Wyoming. Thirty-seven percent of water used in the tri-County area, which includes Laramie, Platte, and Goshen Counties, is from groundwater. Most groundwater use in the tri-County area is withdrawn from three primary aquifer groups: Quaternary-age unconsolidated-deposit aquifers, Tertiary-age units of the High Plains aquifer system, and Upper Cretaceous bedrock aquifers (Lance Formation and Fox Hills Sandstone). Authors include selected physical properties and chemicals found in water samples, describe sources and importance, and report maximum levels established by the U.S. Environmental Protection Agency. They also show concentration ranges for selected physical properties and chemicals in samples collected from the three primary aquifer groups in the tri-County area.

A retrospective observational analysis of post-pandemic influenza-related outcomes in the United Kingdom, 2010-2014.

PubMed

Rajaram, Sankarasubramanian; Wiecek, Witold; Lawson, Richard; Blak, Betina; Zhao, Yanli; Hackett, Judith; Brody, Robert; Salimi, Tehseen; Amzal, Billy; Patel, Vishal

2018-02-01

This study set out to evaluate influenza- and respiratory-related illnesses recorded during primary care physician consultations in England following the H1N1 pandemic in 2009 and to enable the development of a dynamic disease model. Data were obtained from the Clinical Practice Research Datalink of primary care records over four influenza seasons (2010-2014). The primary outcome of the study was incidence of influenza- and respiratory-related diagnoses, calculated per practice and by season and age group. Upper respiratory tract infection diagnoses were most frequently recorded (mean seasonal practice level incidence; 3,762 consultations per 100,000 [SD = 1,989]), and influenza-related diagnoses were least frequently recorded across all seasons, except one. Incidence rates for the under 18 population were higher than those for the general population, in particular for upper respiratory tract infection (range of 8,024-9,950 versus 3,228-4,120, respectively) and otitis media diagnoses (2,668-3,652 versus 782-1,057, respectively). For influenza-related diagnoses, the 65+ age group, the 0 to <2 and 2 to <4 groups had a higher risk (risk ratio = 1.33, 1.12 and 1.16, respectively) than other age groups. This study provides valuable insight into the incidence of influenza- and respiratory-related diagnoses in the primary care setting in England, and suggests a higher burden of disease in young children and the elderly. The study also indicates that some influenza illness is likely to be reported under respiratory-related diagnoses, given the low incidence of influenza-related diagnoses in the study.

40 CFR 131.34 - Kansas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Contact Recreation Basin: Solomon Subbasin: Upper North Fork Solomon Ash Creek 10260011 24 Primary Contact... Recreation Subbasin: Lower North Fork Solomon Beaver Creek 10260012 10 Primary Contact Recreation Beaver...

High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis.

PubMed

Cosottini, M; Donatelli, G; Costagli, M; Caldarazzo Ienco, E; Frosini, D; Pesaresi, I; Biagi, L; Siciliano, G; Tosetti, M

2016-03-01

Amyotrophic lateral sclerosis is a progressive motor neuron disorder that involves degeneration of both upper and lower motor neurons. In patients with amyotrophic lateral sclerosis, pathologic studies and ex vivo high-resolution MR imaging at ultra-high field strength revealed the co-localization of iron and activated microglia distributed in the deep layers of the primary motor cortex. The aims of the study were to measure the cortical thickness and evaluate the distribution of iron-related signal changes in the primary motor cortex of patients with amyotrophic lateral sclerosis as possible in vivo biomarkers of upper motor neuron impairment. Twenty-two patients with definite amyotrophic lateral sclerosis and 14 healthy subjects underwent a high-resolution 2D multiecho gradient-recalled sequence targeted on the primary motor cortex by using a 7T scanner. Image analysis consisted of the visual evaluation and quantitative measurement of signal intensity and cortical thickness of the primary motor cortex in patients and controls. Qualitative and quantitative MR imaging parameters were correlated with electrophysiologic and laboratory data and with clinical scores. Ultra-high field MR imaging revealed atrophy and signal hypointensity in the deep layers of the primary motor cortex of patients with amyotrophic lateral sclerosis with a diagnostic accuracy of 71%. Signal hypointensity of the deep layers of the primary motor cortex correlated with upper motor neuron impairment (r = -0.47; P < .001) and with disease progression rate (r = -0.60; P = .009). The combined high spatial resolution and sensitivity to paramagnetic substances of 7T MR imaging demonstrate in vivo signal changes of the cerebral motor cortex that resemble the distribution of activated microglia within the cortex of patients with amyotrophic lateral sclerosis. Cortical thinning and signal hypointensity of the deep layers of the primary motor cortex could constitute a marker of upper motor neuron impairment in patients with amyotrophic lateral sclerosis. © 2016 by American Journal of Neuroradiology.

Pelvic inflammatory disease: a clinical syndrome with social causes.

PubMed

Brabin, L; Raleigh, V S; Dumella, S

1992-08-01

Prevalence of pelvic inflammatory disease (PID) reflects community and individual risk factors. Cultural and behavioural factors influence community prevalence of sexually transmitted disease (STD), illegal abortion, puerperal sepsis and contraceptive usage--all of which influence risk of PID. The relative importance of these factors will vary by region. Individual risk factors for the ascent of a lower genital tract infection are still poorly understood but are thought to be behavioural and immunological. Prevention of PID must be undertaken at several levels. At primary level, it requires a reduction in community risk. At secondary level, individual risk can be modified by ensuring diagnosis and treatment of STD before damage of the upper genital tract occurs. More attention to cultural factors should increase the potential for prevention at both levels.

Difference in Voice Problems and Noise Reports Between Teachers of Public and Private Schools in Upper Egypt.

PubMed

Abo-Hasseba, Ahmed; Waaramaa, Teija; Alku, Paavo; Geneid, Ahmed

2017-07-01

This study aimed to assess teachers' voice symptoms and noise in schools in Upper Egypt and to study possible differences between teachers in public and private schools. A cross-sectional analysis via questionnaire was carried out. Four schools were chosen randomly to represent primary and preparatory schools as well as public and private ones. In these schools, a total of 140 teachers participated in the study. They answered a questionnaire on vocal and throat symptoms and their effects on working and social activities, as well as levels and effects of experienced noise. Of all teachers, 47.9% reported moderate or severe dysphonia within the last 6 months, and 21.4% reported daily dysphonia. All teachers reported frequent feelings of being in noise, with 82.2% feeling it sometimes or always during the working day, resulting in a need to raise their voice. Teachers in public schools experienced more noise from nearby classes. The working conditions and vocal health of teachers in Upper Egypt, especially in public schools, are alarming. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper

PubMed Central

2010-01-01

Background Use of Botulinum toxin-A (BoNT-A) for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. There is now high-level evidence that upper limb BoNT-A injection, in combination with occupational therapy, improves outcomes in children with cerebral palsy at both the body function/structure and activity level domains of the International Classification of Functioning, Disability and Health. Investigation is now required to establish what amount and specific type of occupational therapy will further enhance functional outcomes and prolong the beneficial effects of BoNT-A. Methods/Design A randomised, controlled, evaluator blinded, prospective parallel-group trial. Eligible participants were children aged 18 months to 6 years, diagnosed with spastic hemiplegic cerebral palsy and who were able to demonstrate selective motor control of the affected upper limb. Both groups received upper limb injections of BoNT-A. Children were randomised to either the modified constraint-induced movement therapy group (experimental) or bimanual occupational therapy group (control). Outcome assessments were undertaken at pre-injection and 1, 3 and 6 months following injection of BoNT-A. The primary outcome measure was the Assisting Hand Assessment. Secondary outcomes included: the Quality of Upper Extremity Skills Test; Pediatric Evaluation of Disability Inventory; Canadian Occupational Performance Measure; Goal Attainment Scaling; Pediatric Motor Activity Log; modified Ashworth Scale and; the modified Tardieu Scale. Discussion The aim of this paper is to describe the methodology of a randomised controlled trial comparing the effects of modified constraint-induced movement therapy (a uni-manual therapy) versus bimanual occupational therapy (a bimanual therapy) on improving bimanual upper limb performance of children with hemiplegic cerebral palsy following upper limb injection of BoNT-A. The paper outlines the background to the study, the study hypotheses, outcome measures and trial methodology. It also provides a comprehensive description of the interventions provided. Trial Registration ACTRN12605000002684 PMID:20602795

Hydrogeology and quality of ground water in the upper Arkansas River basin from Buena Vista to Salida, Colorado, 2000-2003

USGS Publications Warehouse

Watts, Kenneth R.

2005-01-01

The upper Arkansas River Basin between Buena Vista and Salida, Colorado, is a downfaulted basin, the Buena Vista-Salida structural basin, located between the Sawatch and Mosquito Ranges. The primary aquifers in the Buena Vista-Salida structural basin consist of poorly consolidated to unconsolidated Quaternary-age alluvial and glacial deposits and Tertiary-age basin-fill deposits. Maximum thickness of the alluvial, glacial, and basin-fill deposits is about 5,000 feet, but 95 percent of the water-supply wells in Chaffee County are no more than 300 feet deep. Hydrologic conditions in the 149-square mile study area are described on the basis of hydrologic and geologic data compiled and collected during September 2000 through September 2003. The principal aquifers described in this report are the alluvial-outwash and basin-fill aquifers. An estimated 3,443 wells pumped about 690 to 1,240 acre-feet for domestic and household use in Chaffee County during 2003. By 2030, projected increases in the population of Chaffee County, Colorado, may require use of an additional 4,000 to 5,000 wells to supply an additional 800 to 1,800 acre-feet per year of ground water for domestic and household supply. The estimated specific yield of the upper 300 feet of the alluvial-outwash and basin-fill aquifers ranged from about 0.02 to 0.2. Current (2003) and projected (2030) ground-water withdrawals by domestic and household wells are less than 1 percent of the estimated 472,000 acre-feet of drainable ground water in the upper 300 feet of the subsurface. Locally, little water is available in the upper 300 feet. In densely populated areas, well interference could result in decreased water levels and well yields, which may require deepening or replacement of wells. Infiltration of surface water diverted for irrigation and from losing streams is the primary source of ground-water recharge in the semiarid basin. Ground-water levels in the alluvial-outwash and basin-fill aquifers vary seasonally with maximum water levels occurring in the early summer after snowmelt runoff peaks. Because of the drought during 2002, relatively large declines in ground-water levels occurred in about one-half of the monitored wells. Differences in water-level altitudes in shallow and deep wells indicate the potential for downward flow in upland areas and support results of preliminary cross-sectional models of ground-water flow. The apparent mean age of ground-water recharge ranged from about 1 to more than 48 years before 2001. The older (pre-1953) water was from wells that were located in ground-water discharge areas. Ground-water flow in the Buena Vista-Salida structural basin drains eastward toward the Arkansas River and, locally, toward the South Arkansas River. Ground water in the alluvial-outwash and basin-fill aquifers generally is calcium-bicarbonate water type with less than 250 milligrams per liter dissolved solids. Nitrate concentrations generally were less than 1 to 2 milligrams per liter and do not indicate widespread contamination of ground water from surface sources.

Analytical investigation of the dynamics of tethered constellations in earth orbit

NASA Technical Reports Server (NTRS)

Lorenzini, Enrico C.; Gullahorn, Gordon E.; Estes, Robert D.

1988-01-01

This Quarterly Report on Tethering in Earth Orbit deals with three topics: (1) Investigation of the propagation of longitudinal and transverse waves along the upper tether. Specifically, the upper tether is modeled as three massive platforms connected by two perfectly elastic continua (tether segments). The tether attachment point to the station is assumed to vibrate both longitudinally and transversely at a given frequency. Longitudinal and transverse waves propagate along the tethers affecting the acceleration levels at the elevator and at the upper platform. The displacement and acceleration frequency-response functions at the elevator and at the upper platform are computed for both longitudinal and transverse waves. An analysis to optimize the damping time of the longitudinal dampers is also carried out in order to select optimal parameters. The analytical evaluation of the performance of tuned vs. detuned longitudinal dampers is also part of this analysis. (2) The use of the Shuttle primary Reaction Control System (RCS) thrusters for blowing away a recoiling broken tether is discussed. A microcomputer system was set up to support this operation. (3) Most of the effort in the tether plasma physics study was devoted to software development. A particle simulation code has been integrated into the Macintosh II computer system and will be utilized for studying the physics of hollow cathodes.

[Clinical significance of four quadrant localization in the diagnosis and treatment of metastatic carcinoma of the neck with unknown primary].

PubMed

Gao, Y Y; Chen, X H

2017-06-05

Objective: The aim of this study is to investigate the clinical significance of four quadrant localization in the diagnosis and treatment of unknown primary cervical metastases. Method: The clinical data with unknown primary cervical metastases, were analyzed retrospectively. All the patients have not been found the original site in the initial treatment. There are four quadrants in the neck, the neck line as the longitudinal axis, and edge of cricoid cartilage as the horizontal axis. When cervical metastasis occurred in the left and right upper quadrant, the primary tumor site and radiotherapy from the skull base to the root of the neck; when appear in left and right lower quadrant, the primary investigation site and radiotherapy from neck to thoracic mediastinum, left lower abdomen also includes following primary search. At the same time, bilateral cervical metastasis cancers, focusing on the central line near the primary focus. Specific treatment strategies include ipsilateral total neck dissection and radical radiotherapy of the above radiotherapy site. Result: Left upper neck in 4 cases, right upper neck in 5 cases, left lower neck in 7 cases, lower right neck in 8 cases and mixed area in 6 cases. Only 10 of 30 patients (33.3%) with primary sites were found in the follow up period. In accordance with the four quadrant localization, the median time was 6 months. Conclusion: Four quadrant localization to locate the primary site is accurate, and individualized comprehensive treatment is the key to improve the curative effect. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Upper Washita River experimental watersheds: Sediment Database

USDA-ARS?s Scientific Manuscript database

Improving the scientific understanding of the effectiveness of watershed conservation practices and floodwater-retardation structures to control floods and soil erosion is one of the primary objectives for sediment studies in the upper Washita River Experimental Watersheds. This paper summarizes se...

Follow-Up Care for Older Women With Breast Cancer

DTIC Science & Technology

1999-08-01

range of patient outcomes, including primary tumor therapy and mortality, self -reported upper body function, and overall physical function. Methods...mor therapy, all cause mortality, self -reported function and overall physical function than upper body function, and overall physical was the interview...Major Analytic Variables mor therapy and all cause mortality, as well as self -reported upper body and overall physical Dependent Variables. Our first

The annual cycle of primary productivity in a tropical estuary: the inner regions of the Golfo de Nicoya, Costa Rica.

PubMed

Gocke, K; Cortés, J; Murillo, M M

2001-12-01

A one year cycle of primary productivity (PP) was studied using the "light and dark bottle" technique in the Golfo de Nicoya, located at 10 degrees N and 85 degrees W at the Pacific coast of Costa Rica. Samples were always incubated at 0, 1, 2, 3 and 4 m depth for 5 hrs from 8:30 till 13:30. The measurements were performed twice per month, first around high tide and one week later at low tide to account for tidal influences. This routine study was supplemented by special measurements about regional and short-term variations of primary productivity using the 14C-method, which mainly served to account for the shortcomings of the routinely employed incubation technique. The upper Golfo de Nicoya is an extremely productive, phytoplankton dominated estuarine system with an annual gross PP of 1037, a net PP of 610 and a community respiration of 427 g C m(-2) a(-1). Highest monthly PP values occurred during the dry season and at the beginning of the rainy season. Peaks in primary productivity coincided with massive blooms of red tide forming algae. Internal biological dynamics, estuarine circulation and land run-off are the most important nutrient sources. High water turbidity reduces the euphotic layer to 4-5 m depth, making the underwater light regime the rate limiting factor. On an annual basis, 41% of the organic carbon produced in the system is already consumed in the euphotic layer. Considering the entire water column (mean depth at mean tidal water level is around 7.7 m) 79% is consumed in the pelagial. Taking into account the organic material consumed and stored in the sediments the carbon budget of the upper gulf is probably balanced. Since, however, the system receives a considerable amount of organic material from its terrestrial surroundings (especially from the mangrove forests), a surplus of organic carbon is exported from the upper Golfo de Nicoya, which enhances the overall water productivity of the lower gulf and the adjacent area.

Ares I Crew Launch Vehicle Upper Stage Element Overview

NASA Technical Reports Server (NTRS)

McArthur, J. Craig

2008-01-01

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

Socioeconomic status and obesity in Abia State, South East Nigeria.

PubMed

Chukwuonye, Innocent Ijezie; Chuku, Abali; Okpechi, Ikechi Gareth; Onyeonoro, Ugochukwu Uchenna; Madukwe, Okechukwu Ojoemelam; Okafor, Godwin Oguejiofor Chukwuebuka; Ogah, Okechukwu Samuel

2013-01-01

Obesity is a major risk factor for cardiovascular disease in developed and emerging economies. There is a paucity of data from Nigeria on the association between socioeconomic status and obesity. The aim of this study is to highlight that association in Abia State, South East Nigeria. This was a cross-sectional survey in South East Nigeria. Participating subjects were recruited from the three senatorial zones of Abia state. A total of 2,487 adults took part in the study. The subjects were classified based on their monthly income and level of educational attainment (determinants of obesity). Monthly income was classified into three groups: low, middle, and upper income, while educational level was classified into four groups: no formal education, primary, secondary, and tertiary education. Body mass index of subjects was determined and used for defining obesity. Data on blood pressure and other anthropometric measurements were also collected using a questionnaire, modified from the World Health Organization STEPwise Approach to Chronic Disease Risk Factor Surveillance. Overall, the prevalence of obesity in low, middle, and upper income groups was 12.2%, 16%, and 20%, respectively. The overall prevalence of obesity in individuals with no formal education, primary, secondary, and tertiary education was 6.3%, 14.9%, 10.5%, and 17.7%, respectively. Educational status was found to be significantly associated with obesity in women, but not in men, or in the combined group. However, level of income was observed to be significantly associated with obesity in men, women, and in the combined group. Sociodemographic and socioeconomic factors are important determinants of obesity in our study population, and therefore may be indirectly linked to the prevalence and the outcomes of cardiovascular disease in Nigeria.

Socioeconomic status and obesity in Abia State, South East Nigeria

PubMed Central

Chukwuonye, Innocent Ijezie; Chuku, Abali; Okpechi, Ikechi Gareth; Onyeonoro, Ugochukwu Uchenna; Madukwe, Okechukwu Ojoemelam; Okafor, Godwin Oguejiofor Chukwuebuka; Ogah, Okechukwu Samuel

2013-01-01

Background and objectives Obesity is a major risk factor for cardiovascular disease in developed and emerging economies. There is a paucity of data from Nigeria on the association between socioeconomic status and obesity. The aim of this study is to highlight that association in Abia State, South East Nigeria. Material and methods This was a cross-sectional survey in South East Nigeria. Participating subjects were recruited from the three senatorial zones of Abia state. A total of 2,487 adults took part in the study. The subjects were classified based on their monthly income and level of educational attainment (determinants of obesity). Monthly income was classified into three groups: low, middle, and upper income, while educational level was classified into four groups: no formal education, primary, secondary, and tertiary education. Body mass index of subjects was determined and used for defining obesity. Data on blood pressure and other anthropometric measurements were also collected using a questionnaire, modified from the World Health Organization STEPwise Approach to Chronic Disease Risk Factor Surveillance. Results Overall, the prevalence of obesity in low, middle, and upper income groups was 12.2%, 16%, and 20%, respectively. The overall prevalence of obesity in individuals with no formal education, primary, secondary, and tertiary education was 6.3%, 14.9%, 10.5%, and 17.7%, respectively. Educational status was found to be significantly associated with obesity in women, but not in men, or in the combined group. However, level of income was observed to be significantly associated with obesity in men, women, and in the combined group. Conclusion Sociodemographic and socioeconomic factors are important determinants of obesity in our study population, and therefore may be indirectly linked to the prevalence and the outcomes of cardiovascular disease in Nigeria. PMID:24204167

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

PubMed Central

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

2016-01-01

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

Paleoecology of a Northern Michigan Lake and the relationship among climate, vegetation, and Great Lakes water levels

USGS Publications Warehouse

Booth, R.K.; Jackson, S.T.; Thompson, T.A.

2002-01-01

We reconstructed Holocene water-level and vegetation dynamics based on pollen and plant macrofossils from a coastal lake in Upper Michigan. Our primary objective was to test the hypothesis that major fluctuations in Great Lakes water levels resulted in part from climatic changes. We also used our data to provide temporal constraints to the mid-Holocene dry period in Upper Michigan. From 9600 to 8600 cal yr B.P. a shallow, lacustrine environment characterized the Mud Lake basin. A Sphagnum-dominated wetland occupied the basin during the mid-Holocene dry period (???8600 to 6600 cal yr B.P.). The basin flooded at 6600 cal yr B.P. as a result of rising water levels associated with the onset of the Nipissing I phase of ancestral Lake Superior. This flooding event occured contemporaneously with a well-documented regional expansion of Tsuga. Betula pollen increased during the Nipissing II phase (4500 cal yr B.P.). Macrofossil evidence from Mud Lake suggests that Betula alleghaniensis expansion was primarily responsible for the rising Betula pollen percentages. Major regional and local vegetational changes were associated with all the major Holocene highstands of the western Great Lakes (Nipissing I, Nipissing II, and Algoma). Traditional interpretations of Great Lakes water-level history should be revised to include a major role of climate. ?? 2002 University of Washington.

Mass-spectrometric identification of primary biological particle markers: indication for low abundance of primary biological material in the pristine submicron aerosol of Amazonia

NASA Astrophysics Data System (ADS)

Schneider, J.; Freutel, F.; Zorn, S. R.; Chen, Q.; Farmer, D. K.; Jimenez, J. L.; Martin, S. T.; Artaxo, P.; Wiedensohler, A.; Borrmann, S.

2011-07-01

The abundance of marker compounds for primary biological particles in submicron aerosol was investigated by means of aerosol mass spectrometry. Mass spectra of amino acids, carbohydrates, small peptides, and proteins, all of which are key building blocks of biological particles, were recorded in laboratory experiments. Several characteristic marker peaks were identified. The identified marker peaks were compared with mass spectra recorded during AMAZE-08, a field campaign conducted in the pristine rainforest of the Central Amazon Basin, Brazil, during the wet season of February and March 2008. The low abundance of identified marker peaks places upper limits of 7.5 % for amino acids and 5.6 % for carbohydrates on the contribution of primary biological aerosol particles (PBAPs) to the submicron organic aerosol mass concentration during this time period. Upper limits for the absolute submicron concentrations for both compound classes range from 0.01 to 0.1 μg m-3. Carbohydrates and protein amino acids make up for about two thirds of the dry mass of a biological cell. Thus, our findings suggest an upper limit for the PBAPs mass fraction of about 20 % to the submicron organic aerosol.

Serum Thyroid-Stimulating Hormone Levels and Body Mass Index Percentiles in Children with Primary Hypothyroidism on Levothyroxine Replacement.

PubMed

Shaoba, Asma; Basu, Sanjib; Mantis, Stelios; Minutti, Carla

2017-12-15

To determine the association, if any, between thyroid-stimulating hormone (TSH) levels and body mass index (BMI) percentiles in children with primary hypothyroidism who are chemically euthyroid and on treatment with levothyroxine. This retrospective cross-sectional study consisted of a review of medical records from RUSH Medical Center and Stroger Hospital, Chicago, USA of children with primary hypothyroidism who were seen in the clinic from 2008 to 2014 and who were chemically euthyroid and on treatment with levothyroxine for at least 6 months. The patients were divided into two groups based on their TSH levels (0.34-<2.5 mIU/L and ≥2.5-5.6 mIU/L). The data were analyzed by Spearman rank correlation, linear regression, cross tabulation and chi-square, Mann-Whitney U test, and Kruskal-Wallis test. One hundred and forty-six children were included, of which 26% were obese (BMI ≥95%), 21.9% overweight (BMI ≥85-<95%), and 52.1% of a healthy weight (BMI ≥5-<85%). There was a significant positive correlation between TSH and BMI percentiles (r=0.274, p=0.001) and a significant negative correlation between TSH and serum free T4 (r=-0.259, p=0.002). In the lower TSH group, 68.4% of the children had a healthy weight, while the percentage of obese children was 60.5% in the upper TSH group (p=0.012). In children diagnosed with primary hypothyroidism who are chemically euthyroid on treatment with levothyroxine, there is a positive association between higher TSH levels and higher BMI percentiles. However, it is difficult to establish if the higher TSH levels are a direct cause or a consequence of the obesity. Further studies are needed to establish causation beyond significant association.

When is prior ureteral stent placement necessary to access the upper urinary tract in prepubertal children?

PubMed

Corcoran, Anthony T; Smaldone, Marc C; Mally, Dev; Ost, Michael C; Bellinger, Mark F; Schneck, Francis X; Docimo, Steven G; Wu, Hsi-Yang

2008-10-01

We studied the possibility that age, height, weight and body mass index could be used to predict the likelihood of successful ureteroscopic access to the upper urinary tract without previous stent placement in prepubertal children. We retrospectively reviewed all ureteroscopic procedures for upper tract calculi in prepubertal children from 2003 to 2007. We compared age, height, weight and body mass index in patients who underwent successful primary flexible ureteroscopic access and in those who required initial stent placement to perform ureteroscopy. Successful primary ureteroscopic access to the upper tract was achieved in 18 of 30 patients (60%). There was no difference in mean age (9.9 vs 9.5 years, p = 0.8), height (132 vs 128 cm, p = 0.6), weight (37 vs 36 kg, p = 0.86) or body mass index (19.3 vs 20.5 kg/m(2), p = 0.55) between patients with successful vs unsuccessful upper tract access. Locations that prevented access to the upper urinary tract were evenly distributed among the ureteral orifice, iliac vessels and ureteropelvic junction. Age, height, weight and body mass index could not predict the likelihood of successful ureteroscopic access to the upper tract. Placement of a ureteral stent for passive ureteral dilation is not necessary for successful ureteroscopic access to the renal pelvis in prepubertal children. An initial attempt at ureteroscopy, with placement of a ureteral stent if upper tract access is unsuccessful, decreases the number of procedures while maintaining a low complication rate.

PROPOSAL OF A CLINICAL CARE PATHWAY FOR THE MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING.

PubMed

Franco, Matheus Cavalcante; Nakao, Frank Shigueo; Rodrigues, Rodrigo; Maluf-Filho, Fauze; Paulo, Gustavo Andrade de; Libera, Ermelindo Della

2015-12-01

Upper gastrointestinal bleeding implies significant clinical and economic repercussions. The correct establishment of the latest therapies for the upper gastrointestinal bleeding is associated with reduced in-hospital mortality. The use of clinical pathways for the upper gastrointestinal bleeding is associated with shorter hospital stay and lower hospital costs. The primary objective is the development of a clinical care pathway for the management of patients with upper gastrointestinal bleeding, to be used in tertiary hospital. It was conducted an extensive literature review on the management of upper gastrointestinal bleeding, contained in the primary and secondary information sources. The result is a clinical care pathway for the upper gastrointestinal bleeding in patients with evidence of recent bleeding, diagnosed by melena or hematemesis in the last 12 hours, who are admitted in the emergency rooms and intensive care units of tertiary hospitals. In this compact and understandable pathway, it is well demonstrated the management since the admission, with definition of the inclusion and exclusion criteria, passing through the initial clinical treatment, posterior guidance for endoscopic therapy, and referral to rescue therapies in cases of persistent or rebleeding. It was also included the care that must be taken before hospital discharge for all patients who recover from an episode of bleeding. The introduction of a clinical care pathway for patients with upper gastrointestinal bleeding may contribute to standardization of medical practices, decrease in waiting time for medications and services, length of hospital stay and costs.

Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients.

PubMed

Cacchio, Angelo; De Blasis, Elisabetta; De Blasis, Vincenzo; Santilli, Valter; Spacca, Giorgio

2009-10-01

Complex regional pain syndrome type 1 (CRPSt1) of the upper limb is a painful and debilitating condition, frequent after stroke, and interferes with the rehabilitative process and outcome. However, treatments used for CRPSt1 of the upper limb are limited. . This randomized controlled study was conducted to compare the effectiveness on pain and upper limb function of mirror therapy on CRPSt1 of upper limb in patients with acute stroke. . Of 208 patients with first episode of unilateral stroke admitted to the authors' rehabilitation center, 48 patients with CRPSt1 of the affected upper limb were enrolled in a randomized controlled study, with a 6-month follow-up, and assigned to either a mirror therapy group or placebo control group. The primary end points were a reduction in the visual analogue scale score of pain at rest, on movement, and brush-induced tactile allodynia. The secondary end points were improvement in motor function as assessed by the Wolf Motor Function Test and Motor Activity Log. . The mean scores of both the primary and secondary end points significantly improved in the mirror group (P < .001). No statistically significant improvement was observed in any of the control group values (P > .001). Moreover, statistically significant differences after treatment (P < .001) and at the 6-month follow-up were found between the 2 groups. . The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.

Hydrogeologic framework and selected components of the groundwater budget for the upper Umatilla River Basin, Oregon

USGS Publications Warehouse

Herrera, Nora B.; Ely, Kate; Mehta, Smita; Stonewall, Adam J.; Risley, John C.; Hinkle, Stephen R.; Conlon, Terrence D.

2017-05-31

Executive SummaryThis report presents a summary of the hydrogeology of the upper Umatilla River Basin, Oregon, based on characterization of the hydrogeologic framework, horizontal and vertical directions of groundwater flow, trends in groundwater levels, and components of the groundwater budget. The conceptual model of the groundwater flow system integrates available data and information on the groundwater resources of the upper Umatilla River Basin and provides insights regarding key hydrologic processes, such as the interaction between the groundwater and surface water systems and the hydrologic budget.The conceptual groundwater model developed for the study area divides the groundwater flow system into five hydrogeologic units: a sedimentary unit, three Columbia River basalt units, and a basement rock unit. The sedimentary unit, which is not widely used as a source of groundwater in the upper basin, is present primarily in the lowlands and consists of conglomerate, loess, silt and sand deposits, and recent alluvium. The Columbia River Basalt Group is a series of Miocene flood basalts that are present throughout the study area. The basalt is uplifted in the southeastern half of the study area, and either underlies the sedimentary unit, or is exposed at the surface. The interflow zones of the flood basalts are the primary aquifers in the study area. Beneath the flood basalts are basement rocks composed of Paleogene to Pre-Tertiary sedimentary, volcanic, igneous, and metamorphic rocks that are not used as a source of groundwater in the upper Umatilla River Basin.The major components of the groundwater budget in the upper Umatilla River Basin are (1) groundwater recharge, (2) groundwater discharge to surface water and wells, (3) subsurface flow into and out of the basin, and (4) changes in groundwater storage.Recharge from precipitation occurs primarily in the upland areas of the Blue Mountains. Mean annual recharge from infiltration of precipitation for the upper Umatilla River Basin during 1951–2010 is about 9.6 inches per year (in/yr). Annual recharge from precipitation for water year 2010 ranged from 3 in. in the lowland area to about 30 in. in the Blue Mountains. Using Kahle and others (2011) data and methods from the Columbia Plateau regional model, average annual recharge from irrigation is estimated to be about 2.2 in/yr for the 13 square miles of irrigated land in the upper Umatilla River Basin.Groundwater discharges to streams throughout the year and is a large component of annual streamflow in the upper Umatilla River Basin. Upward vertical hydraulic gradients near the Umatilla River indicate the potential for groundwater discharge. Groundwater discharge to the Umatilla River generally occurs in the upper part of the basin, upstream from the main stem.Groundwater development in the upper Umatilla River Basin began sometime after 1950 (Davies-Smith and others, 1988; Gonthier and Bolke, 1991). By water year 2010, groundwater use in the upper Umatilla River Basin was approximately 11,214 acre-feet (acre-ft). Total groundwater withdrawals for the study area were estimated at 7,575 acre-ft for irrigation, 3,173 acre-ft for municipal use, and 466 acre-ft for domestic use.Total groundwater flow into or from the study area depends locally on geology and hydraulic head distribution. Estimates of subsurface flow were calculated using the U.S. Geological Survey Columbia Plateau regional groundwater flow model. Net flux values range from 25,000 to 27,700 acre-ft per year and indicate that groundwater is moving out of the upper Umatilla River Basin into the lower Umatilla River Basin.Water level changes depend on storage changes within an aquifer, and storage changes depend on the storage properties of the aquifer, as well as recharge to or discharge from the aquifer. Groundwater level data in the upper Umatilla River Basin are mostly available from wells in Columbia River basalt units, which indicate areas of long-term water level declines in the Grande Ronde basalt unit near Pendleton and Athena, Oregon. Groundwater levels in the Wanapum basalt unit do not show long-term declines in the upper Umatilla River Basin. Because of pumping, some areas in the upper Umatilla River Basin have shown a decrease, or reversal, in the upward vertical head gradient.Key data needs are improvement of the spatial and temporal distribution of water-level data collection and continued monitoring of streamflow gaging sites. Additionally, refinement of recharge estimates would enhance understanding of the processes that provide the groundwater resources in the upper Umatilla River Basin.

Observations Of General Learning Patterns In An Upper-Level Thermal Physics Course

NASA Astrophysics Data System (ADS)

Meltzer, David E.

2009-11-01

I discuss some observations from using interactive-engagement instructional methods in an upper-level thermal physics course over a two-year period. From the standpoint of the subject matter knowledge of the upper-level students, there was a striking persistence of common learning difficulties previously observed in students enrolled in the introductory course, accompanied, however, by some notable contrasts between the groups. More broadly, I comment on comparisons and contrasts regarding general pedagogical issues among different student sub-populations, for example: differences in the receptivity of lower- and upper-level students to diagrammatic representations; varying receptivity to tutorial-style instructional approach within the upper-level population; and contrasting approaches to learning among physics and engineering sub-populations in the upper-level course with regard to use of symbolic notation, mathematical equations, and readiness to employ verbal explanations.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L.; Gilbert, Ronald W.

2007-10-23

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

System and method for inventorying multiple remote objects

DOEpatents

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

2009-12-29

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

Synthesis of regional crust and upper-mantle structure from seismic and gravity data

NASA Technical Reports Server (NTRS)

Alexander, S. S.; Lavin, P. M.

1979-01-01

Available seismic and ground based gravity data are combined to infer the three dimensional crust and upper mantle structure in selected regions. This synthesis and interpretation proceeds from large-scale average models suitable for early comparison with high-altitude satellite potential field data to more detailed delineation of structural boundaries and other variations that may be significant in natural resource assessment. Seismic and ground based gravity data are the primary focal point, but other relevant information (e.g. magnetic field, heat flow, Landsat imagery, geodetic leveling, and natural resources maps) is used to constrain the structure inferred and to assist in defining structural domains and boundaries. The seismic data consists of regional refraction lines, limited reflection coverage, surface wave dispersion, teleseismic P and S wave delay times, anelastic absorption, and regional seismicity patterns. The gravity data base consists of available point gravity determinations for the areas considered.

Defining upper gastrointestinal bleeding from linked primary and secondary care data and the effect on occurrence and 28 day mortality.

PubMed

Crooks, Colin John; Card, Timothy Richard; West, Joe

2012-11-13

Primary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary care data has augmented this data but the timing and coding of concurrent events, and how the definition of events in linked data effects occurrence and 28 day mortality is not known. We used the recently linked English Hospital Episodes Statistics and General Practice Research Database, 1997-2010, to define events by; a specific upper gastrointestinal bleed code in either dataset, a specific bleed code in both datasets, or a less specific but plausible code from the linked dataset. This approach resulted in 81% of secondary care defined bleeds having a corresponding plausible code within 2 months in primary care. However only 62% of primary care defined bleeds had a corresponding plausible HES admission within 2 months. The more restrictive and specific case definitions excluded severe events and almost halved the 28 day case fatality when compared to broader and more sensitive definitions. Restrictive definitions of gastrointestinal bleeding in linked datasets fail to capture the full heterogeneity in coding possible following complex clinical events. Conversely too broad a definition in primary care introduces events not severe enough to warrant hospital admission. Ignoring these issues may unwittingly introduce selection bias into a study's results.

The Effects of Video Feedback Coaching for Teachers on Scientific Knowledge of Primary Students

NASA Astrophysics Data System (ADS)

van Vondel, Sabine; Steenbeek, Henderien; van Dijk, Marijn; van Geert, Paul

2017-04-01

The present study was aimed at investigating the effects of a video feedback coaching intervention for upper-grade primary school teachers on students' cognitive gains in scientific knowledge. This teaching intervention was designed with the use of inquiry-based learning principles for teachers, such as the empirical cycle and the posing of thought-provoking questions. The intervention was put into practice in 10 upper-grade classrooms. The trajectory comprised four lessons, complemented with two premeasures and two postmeasures. The control condition consisted of 11 upper-grade teachers and their students. The success of the intervention was tested using an established standardized achievement test and situated measures. In this way, by means of premeasure and postmeasure questionnaires and video data, an assessment could be made of the change in students' scientific knowledge before, during, and after the intervention. In this study, we primarily focused on the dynamics of students' real-time expressions of scientific knowledge in the classroom. Important indicators of the effect of the intervention were found. Through focusing on the number of explanations and predictions, a significant increase could be seen in the proportion of students' utterances displaying scientific understanding in the intervention condition. In addition, students in the intervention condition more often reasoned on higher complexity levels than students in the control condition. No effect was found for students' scientific knowledge as measured with a standardized achievement test. Implications for future studies are stressed, as well as the importance of enriching the evaluation of intervention studies by focusing on dynamics in the classroom.

Hand Function in Children with an Upper Brachial Plexus Birth Injury: Results of the Nine-Hole Peg Test

ERIC Educational Resources Information Center

Immerman, Igor; Alfonso, Daniel T.; Ramos, Lorna E.; Grossman, Leslie A.; Alfonso, Israel; Ditaranto, Patricia; Grossman, John A. I.

2012-01-01

Aim: The aim of this study was to evaluate hand function in children with Erb upper brachial plexus palsy. Method: Hand function was evaluated in 25 children (eight males; 17 females) with a diagnosed upper (C5/C6) brachial plexus birth injury. Of these children, 22 had undergone primary nerve reconstruction and 13 of the 25 had undergone…

Dimensional changes of upper airway after rapid maxillary expansion: a prospective cone-beam computed tomography study.

PubMed

Chang, Yoon; Koenig, Lisa J; Pruszynski, Jessica E; Bradley, Thomas G; Bosio, Jose A; Liu, Dawei

2013-04-01

The aim of this prospective study was to use cone-beam computed tomography to assess the dimensional changes of the upper airway in orthodontic patients with maxillary constriction treated by rapid maxillary expansion. Fourteen orthodontic patients (mean age, 12.9 years; range, 9.7-16 years) were recruited. The patients with posterior crossbite and constricted maxilla were treated with rapid maxillary expansion as the initial part of their comprehensive orthodontic treatments. Before and after rapid maxillary expansion cone-beam computed tomography scans were taken to measure the retropalatal and retroglossal airway changes in terms of volume, and sagittal and cross-sectional areas. The transverse expansions by rapid maxillary expansion were assessed between the midlingual alveolar bone plates at the maxillary first molar and first premolar levels. The measurements of the before and after rapid maxillary expansion scans were compared by using paired t tests with the Bonferroni adjustment for multiple comparisons. After rapid maxillary expansion, significant and equal amounts of 4.8 mm of expansion were observed at the first molar (P = 0.0000) and the first premolar (P = 0.0000) levels. The width increase at the first premolar level (20.0%) was significantly greater than that at the first molar level (15.0%) (P = 0.035). As the primary outcome variable, the cross-sectional airway measured from the posterior nasal spine to basion level was the only parameter showing a significant increase of 99.4 mm(2) (59.6%) after rapid maxillary expansion (P = 0.0004). These results confirm the findings of previous studies of the effect of rapid maxillary expansion on the maxilla. Additionally, we found that only the cross-sectional area of the upper airway at the posterior nasal spine to basion level significantly gains a moderate increase after rapid maxillary expansion. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Assessment of the levels of serum Hsp 70 and ghrelin in children with simple febrile convulsions.

PubMed

Kilic, Mehmet; Gündüzalp, Mehmet; Taskin, Erdal; Aydin, Süleyman; Serin, Hepsen M

2016-04-01

In this study we aimed to evaluate the serum levels of Heat-shock protein (Hsp) 70 and acylated and desacylated ghrelin in patients suffering from a simple febrile convulsion. This cross-sectional study included patients who were diagnosed with a simple febrile convulsion, afebrile tonic-clonic epileptic seizure and upper respiratory tract infection when admitted to our hospital. All patients were aged between six months and 60 months. Patients enrolled in this study were divided into five groups. Group I: patients with a simple febrile convulsion and body temperature of 38º C to 39° C; group II: patients with a simple febrile convulsion and body temperature of 39.1° C to 41° C; group III: patients with primary generalised tonic-clonic seizure and normal body temperature; group IV: patients with upper respiratory infection without convulsion and a body temperature of 38° C to 39° C; and group V: patients with upper respiratory infection without convulsion and a body temperature of 39.1° C to 41° C. The control group included healthy children who were followed up in the healthy children polyclinic. Serum levels of Hsp70 and acylated and des-acylated ghrelin were studied from the blood samples collected from the patients and control group. Serum levels of Hsp70 were higher in the febrile convulsion (groups I, II) and epileptic convulsion and infection (groups IV, V) groups than in the controls (P<0.0001). Moreover, serum levels of acylated and desacylated ghrelin were higher in the simple febrile convulsion (groups I and II) and epileptic convulsion and infection (groups IV and V) groups than in the control (P<0.05). We demonstrated that serum levels of Hsp70 and acylated and desacylated ghrelin increased in patients with a simple febrile convulsion.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed

Usman, Juliana; McIntosh, Andrew Stuart

2013-04-01

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

Macronutrient supply, uptake and recycling in the coastal ocean of the west Antarctic Peninsula

NASA Astrophysics Data System (ADS)

Henley, Sian F.; Tuerena, Robyn E.; Annett, Amber L.; Fallick, Anthony E.; Meredith, Michael P.; Venables, Hugh J.; Clarke, Andrew; Ganeshram, Raja S.

2017-05-01

Nutrient supply, uptake and cycling underpin high primary productivity over the continental shelf of the west Antarctic Peninsula (WAP). Here we use a suite of biogeochemical and isotopic data collected over five years in northern Marguerite Bay to examine these macronutrient dynamics and their controlling biological and physical processes in the WAP coastal ocean. We show pronounced nutrient drawdown over the summer months by primary production which drives a net seasonal nitrate uptake of 1.83 mol N m-2 yr-1, equivalent to net carbon uptake of 146 g C m-2 yr-1. High primary production fuelled primarily by deep-sourced macronutrients is diatom-dominated, but non-siliceous phytoplankton also play a role. Strong nutrient drawdown in the uppermost surface ocean has the potential to cause transient nitrogen limitation before nutrient resupply and/or regeneration. Interannual variability in nutrient utilisation corresponds to winter sea ice duration and the degree of upper ocean mixing, implying susceptibility to physical climate change. The nitrogen isotope composition of nitrate (δ15NNO3) shows a utilisation signal during the growing seasons with a community-level net isotope effect of 4.19 ± 0.29‰. We also observe significant deviation of our data from modelled and observed utilisation trends, and argue that this is driven primarily by water column nitrification and meltwater dilution of surface nitrate. This study is important because it provides a detailed description of the nutrient biogeochemistry underlying high primary productivity at the WAP, and shows that surface ocean nutrient inventories in the Antarctic sea ice zone can be affected by intense recycling in the water column, meltwater dilution and sea ice processes, in addition to utilisation in the upper ocean.

Mechanisms controlling primary and new production in a global ecosystem model - Part I: Validation of the biological simulation

NASA Astrophysics Data System (ADS)

Popova, E. E.; Coward, A. C.; Nurser, G. A.; de Cuevas, B.; Fasham, M. J. R.; Anderson, T. R.

2006-12-01

A global general circulation model coupled to a simple six-compartment ecosystem model is used to study the extent to which global variability in primary and export production can be realistically predicted on the basis of advanced parameterizations of upper mixed layer physics, without recourse to introducing extra complexity in model biology. The "K profile parameterization" (KPP) scheme employed, combined with 6-hourly external forcing, is able to capture short-term periodic and episodic events such as diurnal cycling and storm-induced deepening. The model realistically reproduces various features of global ecosystem dynamics that have been problematic in previous global modelling studies, using a single generic parameter set. The realistic simulation of deep convection in the North Atlantic, and lack of it in the North Pacific and Southern Oceans, leads to good predictions of chlorophyll and primary production in these contrasting areas. Realistic levels of primary production are predicted in the oligotrophic gyres due to high frequency external forcing of the upper mixed layer (accompanying paper Popova et al., 2006) and novel parameterizations of zooplankton excretion. Good agreement is shown between model and observations at various JGOFS time series sites: BATS, KERFIX, Papa and HOT. One exception is the northern North Atlantic where lower grazing rates are needed, perhaps related to the dominance of mesozooplankton there. The model is therefore not globally robust in the sense that additional parameterizations are needed to realistically simulate ecosystem dynamics in the North Atlantic. Nevertheless, the work emphasises the need to pay particular attention to the parameterization of mixed layer physics in global ocean ecosystem modelling as a prerequisite to increasing the complexity of ecosystem models.

Video-game based therapy performed by children with cerebral palsy: a cross-over randomized controlled trial and a cross-sectional quantitative measure of physical activity.

PubMed

Zoccolillo, L; Morelli, D; Cincotti, F; Muzzioli, L; Gobbetti, T; Paolucci, S; Iosa, M

2015-12-01

Previous studies reported controversial results about the efficacy of video-game based therapy (VGT) in improving neurorehabilitation outcomes in children with cerebral palsy (CP). Primary aim was to investigate the effectiveness of VGT with respect to conventional therapy (CT) in improving upper limb motor outcomes in a group of children with CP. Secondary aim was to quantify if VGT leads children to perform a higher number of movements. A cross-over randomized controlled trial (RCT) for investigating the primary aim and a cross-sectional study for investigating the secondary aim of this study. Outpatients. clinical diagnosis of CP, age between 4 and 14 years, level of GMFC between I and IV. QI<35, severe comorbidities, incapacity to stand even with an external support. Twenty-two children with CP (6.89±1.91-year old) were enrolled in a cross-over RCT with 16 sessions of VGT (using Xbox with Kinect device) and then 16 of CT or vice versa. Upper limb functioning was assessed using the Quality of Upper Extremities Skills Test (QUEST) and hand abilities using Abilhand-kids score. According to the secondary aim of this study a secondary cross-sectional study has been performed. Eight children with CP (6.50±1.60-year old) were enrolled into a trial in which five wireless triaxial accelerometers were positioned on their forearms, legs and trunk for quantifying the physical activity during VGT vs. CT. QUEST scores significantly improved only after VGT (P=0.003), and not after CT (P=0.056). The reverse occurred for Abilhand-kids scores (P=0.165 vs. P=0.013, respectively). Quantity of performed movements was three times higher in VGT than in CT (+198%, P=0.027). VGT resulted effective in improving the motor functions of upper limb extremities in children with CP, conceivably for the increased quantity of limb movements, but failed in improving the manual abilities for performing activities of daily living which benefited more from CT. VGT performed using the X-Box with Kinect device could enhance the number of upper limb movements in children with CP during rehabilitation and in turn improving upper limb motor skills, but CT remained superior for improving performances in manual activities of daily living.

Closely Reading Informational Texts in the Primary Grades

ERIC Educational Resources Information Center

Fisher, Douglas; Frey, Nancy

2014-01-01

In this article we discuss the differences between close reading in the primary grades and upper elementary grades. We focus on text selection, initial reading. repeated reading, annotation, text-based discussions, and responding to texts.

Predator protection versus rapid growth in a montane leaf beetle.

PubMed

Smiley, John T; Rank, Nathan E

1986-08-01

Adults and larvae of Chrysomela aenicollis (Coleoptera: Chrysomelidae) feed on foliage of Salix species (Salicaceae) between 2,400-3,400 m above sea level in the eastcentral Sierra Nevada mountains of California. We predicted that (1) cold climatic conditions would be a more frequent source of mortality at higher elevations, (2) mildweather agents of mortality such as predation should be more severe at lower elevations, and (3) populations of C. aenicollis would be adapted to the local selective regime at each elevation. We tested these predictions in 1984 and 1985 by transferring over 6,000 eggs and larvae within and between two sites at 2,810 and 3,240 m elevation above sea level. During mild summer weather at both sites, survivorship on Salix branches isolated by a barrier of sticky resin was similar to that on control branches, and we concluded that aerial predators were the primary cause of mortality. At least one major predator, a solitary wasp (Symmorphus sp., Hymenoptera: Eumenidae), was specifically associated with C. aenicollis at the lower site, where beetle mortality was highest. At both sites in 1984 and 1985, larvae originating from the lower site remained in aggregations and survived more frequently than larvae from the upper site, suggesting that they are better defended against predators. During a storm with cold weather late in the 1984 season, larvae and pupae died more frequently at the upper site, and there was a marginally significant trend (P<0.1) for the lower site individuals to die more frequently than upper site larvae during the cold storm. Upper site larvae grew approximately 10% faster than lower site larvae at the lower site and under controlled conditions in the laboratory. These findings indicate that upper and lower site populations were adapted to the local selective regime, which suggest how populations of montane phytopagous insects may adapt to changing elevations.

Long term effects of intensity of upper and lower limb training after stroke: a randomised trial

PubMed Central

Kwakkel, G; Kollen, B; Wagenaar, R

2002-01-01

Objective: To assess long term effects at 1 year after stroke in patients who participated in an upper and lower limb intensity training programme in the acute and subacute rehabilitation phases. Design: A three group randomised controlled trial with repeated measures was used. Method: One hundred and one patients with a primary middle cerebral artery stroke were randomly allocated to one of three groups for a 20 week rehabilitation programme with an emphasis on (1) upper limb function, (2) lower limb function or (3) immobilisation with an inflatable pressure splint (control group). Follow up assessments within and between groups were compared at 6, 9, and 12 months after stroke. Results: No statistically significant effects were found for treatment assignment from 6 months onwards. At a group level, the significant differences in efficacy demonstrated at 20 weeks after stroke in favour of the lower limb remained. However, no significant differences in functional recovery between groups were found for Barthel index (BI), functional ambulation categories (FAC),action research arm test (ARAT), comfortable and maximal walking speed, Nottingham health profile part 1(NHP-part 1), sickness impact profile-68 (SIP-68), and Frenchay activities index (FAI) from 6 months onwards. At an individual subject level a substantial number of patients showed improvement or deterioration in upper limb function (n=8 and 5, respectively) and lower limb function (n=19 and 9, respectively). Activities of daily living (ADL) scores showed that five patients deteriorated and four improved beyond the error threshold from 6 months onwards. In particular, patients with some but incomplete functional recovery at 6 months are likely to continue to improve or regress from 6 months onwards. Conclusions: On average patients maintained their functional gains for up to 1 year after stroke after receiving a 20 week upper or lower limb function training programme. However, a significant number of patients with incomplete recovery showed improvements or deterioration in dexterity, walking ability, and ADL beyond the error threshold. PMID:11909906

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

NASA Technical Reports Server (NTRS)

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

1985-01-01

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

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

PubMed

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

2012-11-01

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

Terminator assembly for a floating structure

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

Chiu, H.; Hall, J.E.

1987-10-20

A terminator assembly is described for use in mooring a floating surface to the floor of a body of water. The floating structure has has an upper support and a lower support, comprising: a hawsepipe extending downwardly from adjacent the upper support and supported by the lower support, a tension member extending downwardly from adjacent the upper support through the hawsepipe and the lower support. The tension member has a lower end adapted for connection to the floor of the body of water. Locking means connected to an upper portion of the tension member for maintaining the tension member inmore » tension by acting upon an upper portion of the hawsepipe without transferring primary tension load forces to the upper support.« less

Median-lower normal levels of serum thyroxine are associated with low triiodothyronine levels and body temperature in patients with central hypothyroidism.

PubMed

Hirata, Yu; Fukuoka, Hidenori; Iguchi, Genzo; Iwahashi, Yasuyuki; Fujita, Yasunori; Hari, Yusuke; Iga, Makiko; Nakajima, Shinsuke; Nishimoto, Yuki; Mukai, Miki; Hirota, Yushi; Sakaguchi, Kazuhiko; Ogawa, Wataru; Takahashi, Yutaka

2015-08-01

Although it has been recommended that serum free thyroxine (FT4) levels should be targeted to middle-upper normal levels during levothyroxine (l-T4) replacement therapy in patients with central hypothyroidism (CeH), the rationale has not been clarified. A retrospective single-center study enrolled 116 patients with hypothyroidism (CeH, n=32; total thyroidectomy (Tx), n=22; primary hypothyroidism (PH), n=33; and control benign thyroid nodule (C), n=29). The patients had received L-T4 therapy at the Kobe University Hospital between 2003 and 2013. They were stratified according to serum FT4 level (≥ 1.10 or <1.10 ng/dl), and body temperature (BT), serum free triiodothyronine (FT3) levels, FT3/FT4 ratio, and lipid profiles were compared. The effect of GH replacement therapy on thyroid function was also analyzed. FT3 levels and FT3/FT4 ratios were significantly lower in patients with CeH than in patients with PH (P<0.05) or C (P<0.05). In patients with FT4 <1.10 ng/dl, BT was significantly lower in patients with CeH (P=0.002) and Tx (P=0.005) than in patients with PH, whereas no differences were found in patients with FT4 ≥ 1.10 ng/dl. In patients with CeH, FT3 levels were higher in those with GH replacement therapy (P=0.018). In CeH, patients with median-lower normal levels of serum FT4 exhibited lower serum FT3 levels and lower BT. These results support the target levels of serum FT4 as middle-upper normal levels during l-T4 replacement therapy in patients with CeH. © 2015 European Society of Endocrinology.

Resource Utilization in Ambulatory Primary Care at Darnall Army Community Hospital, Fort Hood, Texas

DTIC Science & Technology

1991-07-23

population: gastroenteritis (GI), otitis media (OM), and upper respiratory infection (URI). These resources will be thc- dependent variables of the study...1991. The children ranged in age from 3 to 5 years old and were diagnosed with otitis media , upper respiratory tract infection, and gastroenteritis. A...x-rays wer-e rarely ordered to confirm the diagnoses of otitis media , gastroeinteritis. and upper respiratory tract infection. Only eight, laboratory

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Prediction of stemless humeral implant micromotion during upper limb activities.

PubMed

Favre, Philippe; Henderson, Adam D

2016-07-01

Adequate primary stability is essential for the long term success of uncemented stemless shoulder implants. The goal of this study was to evaluate the micromotion of a stemless humeral implant during various upper limb activities. A finite element model was validated by reproducing experimental primary stability testing. Loading from an instrumented prosthesis representing a set of 29 upper limb activities were applied within the validated FE model. Peak micromotion and percentage area for different micromotion thresholds were considered. In all simulated activities, at least 99% of the implant surface experienced micromotion below 150μm. Micromotion depended strongly on loading with large discrepancies between upper limb activities. Carrying no external weight and keeping the arm at lower angles induced lower micromotion. Activities representative of demanding manual labor generally led to higher micromotion. Axilla crutches led to lower micromotion than forearm crutches. Micromotion increased when a wheelchair was used on slopes above 2% inclination. Micromotions below the 150μm threshold below which bone ingrowth occurs were measured over at least 99% of the implant surface for all simulated activities. Peak micromotion dependence on activity type demonstrates the need to consider physiologic in vivo loading and the full contact interface in primary stability evaluations. Focusing on activities with no hand weight and low arm motions during the rehabilitation period may enhance primary stability. For patients unable to walk without aids, axilla crutches and motorized wheelchairs might be more beneficial than forearm crutches and manual drive wheelchairs respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

Partial weight support of the arm affects corticomotor selectivity of biceps brachii.

PubMed

Runnalls, Keith D; Anson, Greg; Byblow, Winston D

2015-10-26

Weight support of the arm (WS) can be used in stroke rehabilitation to facilitate upper limb therapy, but the neurophysiological effects of this technique are not well understood. While an overall reduction in muscle activity is expected, the mechanism by which WS may alter the expression of muscle synergies has not been examined until now. We explored the neurophysiological effect of WS on the selectivity of biceps brachii (BB) activation in healthy adults. Thirteen participants completed counterbalanced movement tasks in a repeated measures design. Three levels of WS (0, 45, and 90 % of full support) were provided to the arm using a commercial device (Saebo Mobile Arm Support). At each level of WS, participants maintained a flexed shoulder posture while performing rhythmic isometric elbow flexion (BB agonist) or forearm pronation (BB antagonist). Single-pulse transcranial magnetic stimulation of primary motor cortex was used to elicit motor-evoked potentials (MEPs) in BB 100-300 ms before muscle contraction. Baseline muscle activity and MEP amplitude were the primary dependent measures. Effects of movement TASK and SUPPORT LEVEL were statistically analyzed using linear mixed effects models. As expected, with increased support tonic activity was reduced across all muscles. This effect was greatest in the anti-gravity muscle anterior deltoid, and evident in biceps brachii and pronator teres as well. For BB MEP amplitude, TASK and SUPPORT LEVEL, interacted such that for elbow flexion, MEP amplitudes were smaller with incrementally greater WS whereas, for forearm pronation MEP amplitudes were smaller only at high WS. Weight support of the arm influences corticomotor selectivity of biceps brachii. WS may impact coordination independently of a global reduction in muscle activity. The amount of supportive force applied to the arm influences the neuromechanical control profile for the limb. These findings may inform the application of WS in upper limb stroke rehabilitation.

"FIND Technology": investigating the feasibility, efficacy and safety of controller-free interactive digital rehabilitation technology in an inpatient stroke population: study protocol for a randomized controlled trial.

PubMed

Bird, M L; Cannell, J; Callisaya, M L; Moles, E; Rathjen, A; Lane, K; Tyson, A; Smith, S

2016-04-16

Stroke results in significant disability, which can be reduced by physical rehabilitation. High levels of repetition and activity are required in rehabilitation, but patients are typically sedentary. Using clinically relevant and fun computer games may be one way to achieve increased activity in rehabilitation. A single-blind randomized controlled trial will be conducted to evaluate the feasibility, efficacy and safety of novel stroke-specific rehabilitation software. This software uses controller-free client interaction and inertial motion sensors. Elements of feasibility include recruitment into the trial, ongoing participation (adherence and dropout), perceived benefit, enjoyment and ease of use of the games. Efficacy will be determined by measuring activity and using upper-limb tasks as well as measures of balance and mobility. The hypothesis that the intervention group will have increased levels of physical activity within rehabilitation and improved physical outcomes compared with the control group will be tested. Results from this study will provide a basis for discussion of feasibility of this interactive video technological solution in an inpatient situation. Differences in activity levels between groups will be the primary measure of efficacy. It will also provide data on measures of upper-limb function, balance and mobility. ACTRN12614000427673 . Prospectively registered 17 April 2014.

Virus activation and immune function during intense training in rugby football players.

PubMed

Yamauchi, R; Shimizu, K; Kimura, F; Takemura, M; Suzuki, K; Akama, T; Kono, I; Akimoto, T

2011-05-01

Epidemiological studies suggest that highly trained athletes are more susceptible to upper respiratory tract infections (URTI) compared with the general population. Upper respiratory symptoms (URS) often appear as either primary invasion of pathogenic organisms and/or reactivation of latent viruses such as Epstein-Barr virus (EBV). The purpose of this study was to examine the relationship between EBV reactivation and the appearance of URS during intensive training in collegiate rugby football players. We evaluated EBV-DNA expression in saliva and examined the relationship between onset of URS and daily changes in EBV-DNA as well as secretory immunoglobulin A (SIgA) levels among 32 male collegiate rugby football players during a 1-month training camp. The EBV-DNA expression tended to be higher in subjects who exhibited sore throat (p=0.07) and cough (p=0.18) than that of those who had no symptoms, although their differences were not significant. The SIgA level was significantly lower 1 day before the EBV-DNA expression (p<0.05). The number of URS increased along with the EBV-DNA expression and decrease of SIgA levels. These results suggest that the appearance of URS is associated with reactivation of EBV and reduction of SIgA during training. © Georg Thieme Verlag KG Stuttgart · New York.

An elevated serum alkaline phosphatase level in hepatic metastases of grade 1 and 2 gastrointestinal neuroendocrine tumors is unusual and of prognostic value

PubMed Central

Andriantsoa, Maeva; Hoibian, Solene; Autret, Aurelie; Gilabert, Marine; Sarran, Anthony; Niccoli, Patricia

2017-01-01

Background In our clinical practice we have observed that despite a high hepatic metastatic tumor burden, serum alkaline phosphatase (AP) levels are frequently normal in cases of metastatic neuroendocrine tumor (NET). Patients and methods We retrospectively reviewed the records of patients with grade 1 and 2 NETs with liver metastases but without bone metastases seen at our institution in 2013. In total, 49 patients were included (22 female), with a median age of 60 years (range: 28 to 84 years). The primary tumors were located in the duodenum/pancreas (n = 29), small bowel (n = 17) or colon/rectum (n = 3); 10 cases were grade 1 and 39 grade 2. Hepatic involvement was bulky, with more than 10 lesions in 23 patients and a tumor burden above 10% of the liver volume in 26 patients. Results Serum AP levels were elevated (≥ upper limit of normal (ULN)) in 16 patients. In multiparametric analysis, elevated serum AP levels were not associated with the primary site, grade, or number or volume of metastases. In multiparametric analysis, progression-free survival was only correlated with grade (p = 0.010) and AP level (p = 0.017). Conclusions Serum AP levels are frequently normal in liver metastases from NET, even in the event of a major tumor burden, and the serum AP level can be of prognostic value. PMID:28562682

An elevated serum alkaline phosphatase level in hepatic metastases of grade 1 and 2 gastrointestinal neuroendocrine tumors is unusual and of prognostic value.

PubMed

Andriantsoa, Maeva; Hoibian, Solene; Autret, Aurelie; Gilabert, Marine; Sarran, Anthony; Niccoli, Patricia; Raoul, Jean-Luc

2017-01-01

In our clinical practice we have observed that despite a high hepatic metastatic tumor burden, serum alkaline phosphatase (AP) levels are frequently normal in cases of metastatic neuroendocrine tumor (NET). We retrospectively reviewed the records of patients with grade 1 and 2 NETs with liver metastases but without bone metastases seen at our institution in 2013. In total, 49 patients were included (22 female), with a median age of 60 years (range: 28 to 84 years). The primary tumors were located in the duodenum/pancreas (n = 29), small bowel (n = 17) or colon/rectum (n = 3); 10 cases were grade 1 and 39 grade 2. Hepatic involvement was bulky, with more than 10 lesions in 23 patients and a tumor burden above 10% of the liver volume in 26 patients. Serum AP levels were elevated (≥ upper limit of normal (ULN)) in 16 patients. In multiparametric analysis, elevated serum AP levels were not associated with the primary site, grade, or number or volume of metastases. In multiparametric analysis, progression-free survival was only correlated with grade (p = 0.010) and AP level (p = 0.017). Serum AP levels are frequently normal in liver metastases from NET, even in the event of a major tumor burden, and the serum AP level can be of prognostic value.

Optimizing treatment of hypothyroidism.

PubMed

Clarke, Nick; Kabadi, Udaya M

2004-01-01

Several thyroid hormone preparations are currently available, including levothyroxine sodium (thyroxine), liothyronine (triiodothyronine), and desiccated thyroid extract, as well as a combination of levothyroxine sodium and liothyronine. Levothyroxine sodium monotherapy at an appropriate daily dose provides uniform levels of both thyroxine and triiodothyronine in the circulation without diurnal variation. Therefore, it is the preparation of choice in most patients with hypothyroidism of both the primary and central types. A normal thyrotropin (TSH) level of 1-2 mU/L is considered the determinant of optimal daily levothyroxine sodium dose in patients with primary hypothyroidism, whereas normal thyroxine and triiodothyronine levels in the mid or upper normal range may denote optimal replacement in patients with central hypothyroidism. Optimal daily levothyroxine sodium dose may be determined according to serum TSH level at the time of diagnosis of primary hypothyroidism. Initial administration of close to the full calculated dose of levothyroxine sodium is appropriate for younger patients, reducing the need for follow-up visits and repeated laboratory testing for dose titration. In the elderly and in patients with a history of coronary artery disease (CAD), the well established approach of starting with a low dose and gradually titrating to the full calculated dose is always the best option. Levothyroxine sodium can and should be continued in patients receiving treatment for CAD. Even minor over-replacement during initial titration of levothyroxine sodium should be avoided, because of the risk of cardiac events. Chronic over-replacement may induce osteoporosis, particularly in postmenopausal women, and should also be avoided.

A Trophic Model of a Sandy Barrier Lagoon at Chiku in Southwestern Taiwan

NASA Astrophysics Data System (ADS)

Lin, H.-J.; Shao, K.-T.; Kuo, S.-R.; Hsieh, H.-L.; Wong, S.-L.; Chen, I.-M.; Lo, W.-T.; Hung, J.-J.

1999-05-01

Using the ECOPATH 3.0 software system, a balanced trophic model of a sandy barrier lagoon with intensive fishery activities at Chiku in tropical Taiwan was constructed. The lagoon model comprised 13 compartments. Trophic levels of the compartments varied from 1·0 for primary producers and detritus to 3·6 for piscivorous fish. Hanging-cultured oysters accounted for 39% of the harvestable fishery biomass and were the most important fishery species. The most prominent group in terms of biomass and energy flow in the lagoon was herbivorous zooplankton. Manipulations of the biomass of herbivorous zooplankton would have a marked impact on most compartments. Both total system throughput and fishery yield per unit area were high when compared to other reported marine ecosystems. This appears mainly due to high planktonic primary production, which is probably promoted by enriched river discharges draining mangroves and aquaculture ponds. Consequently, more than half of the total system throughput originates from primary producers in the lagoon. Although half of the primary production was not immediately used by upper trophic levels and flowed into the detrital pool, most of the detritus was directly consumed, passed up the food web and was exported to the fishery. Thus only a small proportion of energy was recycled through detritus pathways. This mechanism produces short pathways with high trophic efficiencies at higher trophic levels. The high fishery yield in the lagoon is due to high primary production and short pathways. This is the first model of a tropical sandy barrier lagoon with intensive fishery activities and thus may serve as a basis for future comparisons and ecosystem management.

Petroleum geology of Carter sandstone (upper Mississippian), Black Warrior Basin, Alabama

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

Bearden, B.L.; Mancini, E.A.

1985-03-01

The presence of combination petroleum traps makes the Black Warrior basin of northwestern Alabama an attractive area for continued hydrocarbon exploration. More than 1,500 wells have been drilled, and more than 90 separate petroleum pools have been discovered. The primary hydrocarbon reservoirs are Upper Mississippian sandstones. The Carter sandstone is the most productive petroleum reservoir in the basin. Productivity of the Carter sandstone is directly related to its environment of deposition. The Carter accumulated within a high constructive elongate to lobate delta, which prograded into the basin from the northwest to the southeast. Carter bar-finger and distal-bar lithofacies constitute themore » primary hydrocarbon reservoirs. Primary porosity in the Carter sandstone has been reduced by quartz overgrowths and calcite cementation. Petroleum traps in the Carter sandstone in central Fayette and Lamar Counties, Alabama, are primarily stratigraphic and combination (structural-stratigraphic) traps. The potential is excellent for future development of hydrocarbon reservoirs in the Upper Mississippian Carter sandstone. Frontier regions south and east of the known productive limits of the Black Warrior basin are ideal areas for continued exploration.« less

Evidence-based Value of Prophylactic Drainage in Gastrointestinal Surgery

PubMed Central

Petrowsky, Henrik; Demartines, Nicolas; Rousson, Valentin; Clavien, Pierre-Alain

2004-01-01

Objective: To determine the evidence-based value of prophylactic drainage in gastrointestinal (GI) surgery. Methods: An electronic search of the Medline database from 1966 to 2004 was performed to identify articles comparing prophylactic drainage with no drainage in GI surgery. The studies were reviewed and classified according to their quality of evidence using the grading system proposed by the Oxford Centre for Evidence-based Medicine. Seventeen randomized controlled trials (RCTs) were found for hepato-pancreatico-biliary surgery, none for upper GI tract, and 13 for lower GI tract surgery. If sufficient RCTs were identified, we performed a meta-analysis to characterize the drain effect using the random-effects model. Results: There is evidence of level 1a that drains do not reduce complications after hepatic, colonic, or rectal resection with primary anastomosis and appendectomy for any stage of appendicitis. Drains were even harmful after hepatic resection in chronic liver disease and appendectomy. In the absence of RCTs, there is a consensus (evidence level 5) about the necessity of prophylactic drainage after esophageal resection and total gastrectomy due to the potential fatal outcome in case of anastomotic and gastric leakage. Conclusion: Many GI operations can be performed safely without prophylactic drainage. Drains should be omitted after hepatic, colonic, or rectal resection with primary anastomosis and appendectomy for any stage of appendicitis (recommendation grade A), whereas prophylactic drainage remains indicated after esophageal resection and total gastrectomy (recommendation grade D). For many other GI procedures, especially involving the upper GI tract, there is a further demand for well-designed RCTs to clarify the value of prophylactic drainage. PMID:15570212

50 CFR 14.142 - Primary enclosures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Wild Mammals and Birds to the United States Specifications for Elephants and Ungulates § 14.142 Primary... shall be located on the upper one-half of the primary enclosure. (b) No more than one elephant or... case of land or sea transport, a pair of juvenile elephants or ungulates or other pairs that have been...

50 CFR 14.142 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wild Mammals and Birds to the United States Specifications for Elephants and Ungulates § 14.142 Primary... shall be located on the upper one-half of the primary enclosure. (b) No more than one elephant or... case of land or sea transport, a pair of juvenile elephants or ungulates or other pairs that have been...

50 CFR 14.142 - Primary enclosures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wild Mammals and Birds to the United States Specifications for Elephants and Ungulates § 14.142 Primary... shall be located on the upper one-half of the primary enclosure. (b) No more than one elephant or... case of land or sea transport, a pair of juvenile elephants or ungulates or other pairs that have been...

50 CFR 14.142 - Primary enclosures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Wild Mammals and Birds to the United States Specifications for Elephants and Ungulates § 14.142 Primary... shall be located on the upper one-half of the primary enclosure. (b) No more than one elephant or... case of land or sea transport, a pair of juvenile elephants or ungulates or other pairs that have been...

50 CFR 14.142 - Primary enclosures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Wild Mammals and Birds to the United States Specifications for Elephants and Ungulates § 14.142 Primary... shall be located on the upper one-half of the primary enclosure. (b) No more than one elephant or... case of land or sea transport, a pair of juvenile elephants or ungulates or other pairs that have been...

TOP VIEW OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND ...

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

TOP VIEW OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND ORE CHUTE,LOOKING SOUTHWEST. TRAM MACHINERY AND GEARS ARE AT LOWER CENTER. A SMALL ELECTRIC MOTOR AT THE REAR LEFT OF THE TERMINAL PROBABLY WAS ADDED AFTER THE ORIGINAL CONSTRUCTION. THE MOVING CABLE OF THE TRAM WAS DRIVEN BY THESE GEARS AND THE LARGE WHEEL UNDERNEATH (SEE CA-291-31 FOR DETAIL). EMPTY TRAM BUCKETS CAME IN FROM THE LEFT, SWINGING AROUND TO THE CHUTES FROM THE ORE BIN TO BE LOADED FOR THE TRIP DOWN TO THE MILL (SEE CA-291-35 FOR DETAIL). THE BREAK OVER TOWER CAN BE SEEN IN THE DISTANCE AT TOP LEFT. THE SUPPORT TOWER BETWEEN THE UPPER TERMINAL AND THE BREAK OVER TOWER IS COLLAPSED. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

A Composite Diagnosis of Synoptic-Scale Extratropical Cyclone Development over the United States

NASA Technical Reports Server (NTRS)

Rolfson, Donald M.; Smith, Phillip J.

1996-01-01

This paper presents a composite diagnosis of synoptic-scale forcing mechanisms associated with extratropical cyclone evolution. Drawn from 12 cyclone cases that occurred over the continental United States during the cool season months, the diagnosis provides a 'climatology' of development mechanisms for difference categories of cyclone evolution ranging from cyclone weakening through three stages of cyclone intensification. Computational results were obtained using an 'extended' form of the Zwack-Okossi equation applied to routine upper-air and surface data analyzed on a 230 km x 230 km grid. Results show that cyclonic vorticity advection, which maximizes in the upper troposphere, was the primary contributor to cyclone development regardless of the stage of development. A second consistent contributor to development was latent heat release. Horizontal temperature advection, often acknowledged as a development mechanism, was found to contribute to development only during more intense stages. During weakening and weaker development stages, temperature advection opposed development, as the warm-air advection invariably found at upper levels was dominated by cold air advection in the lower half of the troposphere. In the more intense stages, development was moderated by dry-adiabatic cooling associated with the ascending vertical motions.

Tethered satellite control mechanism

NASA Technical Reports Server (NTRS)

Kyrias, G. M.

1983-01-01

The tethered satellite control mechanisms consist of four major subsystems. The reel drive mechanism stores the tether. It is motor driven and includes a level wind to uniformly feed the tether to the reel. The lower boom mechanism serves two primary functions: (1) it measures tether length and velocity as the tether runs through the mechanism, and (2) it reads the tether tension at the reel. It also provides change the direction for the tether from the reel to the upper boom mechanism. The deployment boom positions the upper boom mechanism with satellite out of the cargo bay. The deployment function places the 500-kg satellite 20 m away from the Space Shuttle (producing a small natural gravity gradient force), impacts an initial velocity to the satellite for deployment, and allows for satellite docking at a safe distance from the body of the Space Shuttle. The upper boom mechanism (UBM) services three functions: (1) it provides tether control to the satellite as the satellite swings in and out of plane; (2) it reads tether tension in the low range during the early deployment and final retrieval parts of the mission; and (3) it produces additional tether tension at the reel when tether tension to the satellite is in the low range.

Defining upper gastrointestinal bleeding from linked primary and secondary care data and the effect on occurrence and 28 day mortality

PubMed Central

2012-01-01

Background Primary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary care data has augmented this data but the timing and coding of concurrent events, and how the definition of events in linked data effects occurrence and 28 day mortality is not known. Methods We used the recently linked English Hospital Episodes Statistics and General Practice Research Database, 1997–2010, to define events by; a specific upper gastrointestinal bleed code in either dataset, a specific bleed code in both datasets, or a less specific but plausible code from the linked dataset. Results This approach resulted in 81% of secondary care defined bleeds having a corresponding plausible code within 2 months in primary care. However only 62% of primary care defined bleeds had a corresponding plausible HES admission within 2 months. The more restrictive and specific case definitions excluded severe events and almost halved the 28 day case fatality when compared to broader and more sensitive definitions. Conclusions Restrictive definitions of gastrointestinal bleeding in linked datasets fail to capture the full heterogeneity in coding possible following complex clinical events. Conversely too broad a definition in primary care introduces events not severe enough to warrant hospital admission. Ignoring these issues may unwittingly introduce selection bias into a study’s results. PMID:23148590

A limit on the diffuse gamma-rays measured with KASCADE-Grande

NASA Astrophysics Data System (ADS)

Kang, D.; Apel, W. D.; Arteaga-Velázquez, J. C.; Bekk, K.; Bertaina, M.; Blümer, J.; Bozdog, H.; Brancus, I. M.; Cantoni, E.; Chiavassa, A.; Cossavella, F.; Daumiller, K.; de Souza, V.; Di Pierro, F.; Doll, P.; Engel, R.; Feng, Z.; Fuhrmann, D.; Gherghel-Lascu, A.; Gils, H. J.; Glasstetter, R.; Grupen, C.; Haungs, A.; Heck, D.; Hörandel, J. R.; Huber, D.; Huege, T.; Kampert, K. H.; Klages, H. O.; Link, K.; Łuczak, P.; Mathes, H. J.; Mayer, H. J.; Milke, J.; Mitrica, B.; Morello, C.; Oehlschläger, J.; Ostapchenko, S.; Palmieri, N.; Petcu, M.; Pierog, T.; Rebel, H.; Roth, M.; Schieler, H.; Schoo, S.; Schröder, F.; Sima, O.; Toma, G.; Trinchero, G. C.; Ulrich, H.; Weindl, A.; Wochele, J.; Zabierowski, J.

2015-08-01

Using data measured by the KASCADE-Grande air shower array, an upper limit to the flux of ultra-high energy gamma-rays in the primary cosmic-ray flux is determined. KASCADE-Grande measures the electromagnetic and muonic components for individual air showers in the energy range from 10 PeV up to 1 EeV. The analysis is performed by selecting air showers with low muon contents. A preliminary result on the 90% C.L. upper limit to the relative intensity of gamma-ray with respect to cosmic ray primaries is presented and compared with limits reported by other measurements.

Primary Lateral Sclerosis.

PubMed

Statland, Jeffrey M; Barohn, Richard J; Dimachkie, Mazen M; Floeter, Mary Kay; Mitsumoto, Hiroshi

2015-11-01

Primary lateral sclerosis is characterized by insidious onset of progressive upper motor neuron dysfunction in the absence of clinical signs of lower motor neuron involvement. Patients experience stiffness; decreased balance and coordination; mild weakness; and, if the bulbar region is affected, difficulty speaking and swallowing, and emotional lability. The diagnosis is made based on clinical history, typical examination findings, and diagnostic testing negative for other causes of upper motor neuron dysfunction. Electromyogram is normal, or only shows mild neurogenic findings in a few muscles, not meeting El Escorial criteria. Treatment is largely supportive. Copyright © 2015 Elsevier Inc. All rights reserved.

Global Ocean Phytoplankton

NASA Technical Reports Server (NTRS)

Franz, B. A.; Behrenfeld, M. J.; Siegel, D. A.; Werdell, P. J.

2013-01-01

Phytoplankton are free-floating algae that grow in the euphotic zone of the upper ocean, converting carbon dioxide, sunlight, and available nutrients into organic carbon through photosynthesis. Despite their microscopic size, these photoautotrophs are responsible for roughly half the net primary production on Earth (NPP; gross primary production minus respiration), fixing atmospheric CO2 into food that fuels our global ocean ecosystems. Phytoplankton thus play a critical role in the global carbon cycle, and their growth patterns are highly sensitive to environmental changes such as increased ocean temperatures that stratify the water column and prohibit the transfer of cold, nutrient richwaters to the upper ocean euphotic zone.

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

NASA Astrophysics Data System (ADS)

Rivest, Chantal; Farrell, Brian F.

1992-11-01

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

Responses of East Asian Summer Monsoon to Natural and Anthropogenic Forcings in the 17 Latest CMIP5 Models

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

Song, Fengfei; Zhou, Tianjun; Qian, Yun

2014-01-31

In this study, we examined the responses of East Asian Summer Monsoon (EASM) to natural (solar variability and volcanic aerosols) and anthropogenic (greenhouse gasses and aerosols) forcings simulated in the 17 latest Coupled Model Intercomparison Program phase 5 (CMIP5) models with 105 realizations. The observed weakening trend of low-level EASM circulation during 1958-2001 is partly reproduced under all-forcing runs. A comparison of separate forcing experiments reveals that the aerosol-forcing plays a primary role in driving the weakened low-level monsoon circulation. The preferential cooling over continental East Asia caused by aerosol affects the monsoon circulation through reducing the land-sea thermal contrastmore » and results in higher sea level pressure over northern China. In the upper-level, both natural-forcing and aerosol-forcing contribute to the observed southward shift of East Asian subtropical jet through changing the meridional temperature gradient.« less

A VLA radio-continuum survey of a sample of confirmed and marginal barium stars

NASA Technical Reports Server (NTRS)

Drake, Stephen A.; Simon, Theodore; Linsky, Jeffrey L.

1987-01-01

Results are reported from a 6-cm VLA survey of five confirmed Ba II stars and eight mild Ba II stars, undertaken to search for evidence of gyrosynchrotron emission or thermal emission from the primary star's wind that is enhanced or photoionized by a white dwarf companion. Of these 13 stars, only Beta UMi was detected as a possible radio source at a flux level of 0.11 mJy (3sigma). The 6-cm radio luminosities (L6) of the other stars are as small as log L6 less than or equal to 14.0 and are an order of magnitude or more lower than the average levels found in RS CVn systems, but are consistent with the L6 upper limits previously found for stars of spectral type similar to the Ba II stars and normal elemental abundances. The upper limit to the radio luminosity for the possible mild Ba II star 56 Peg, when combined with its previously known X-ray luminosity, may provide useful constraints on the various models that have been proposed for this interesting object, once its orbital period is known.

Determination of polychlorinated biphenyls, selected persistent organochlorine pesticides, and polybrominated flame retardants in fillets of fishes from the 2007 Missouri Department of Conservation Monitoring Program

USGS Publications Warehouse

Gale, Robert W.; Orazio, Carl E.; McKee, Michael J.

2009-01-01

This report presents the results of a study to determine polychlorinated biphenyl, organochlorine pesticide, and polybrominated diphenylether flame retardant concentrations in selected fishes from lakes and streams across Missouri. Fillets were collected from each fish sample and after homogenization, compositing, and preparation, analyte concentrations were determined with dual column capillary gas chromatography-electron-capture detection. Total concentrations of polychlorinated biphenyls in samples ranged from background levels of about 50 to 300 nanograms per gram. In samples with elevated contaminant concentrations, chlordanes, DDT-related chemicals, and dieldrin constituted the primary classes of pesticides present, and ranged from 5 to 75 nanograms per gram. Total concentrations of polybrominated diphenyl ethers in samples ranged from background levels of 5 to 86 nanograms per gram. Channel catfish from the upper and lower Blue River and lake sturgeon from the Mississippi River at Saverton exhibited different polybrominated diphenyl ethers ratios. Concentrations of polychlorinated biphenyls, chlordanes, DDT-related compounds, and polybrominated diphenyl ethers all were greatest in samples of channel catfish from the upper and lower Blue River, and in samples of lake sturgeon from the Mississippi River at Saverton.

Teaching information literacy skills to sophomore-level biology majors.

PubMed

Thompson, Leigh; Blankinship, Lisa Ann

2015-05-01

Many undergraduate students lack a sound understanding of information literacy. The skills that comprise information literacy are particularly important when combined with scientific writing for biology majors as they are the foundation skills necessary to complete upper-division biology course assignments, better train students for research projects, and prepare students for graduate and professional education. To help undergraduate biology students develop and practice information literacy and scientific writing skills, a series of three one-hour hands-on library sessions, discussions, and homework assignments were developed for Biological Literature, a one-credit, one-hour-per-week, required sophomore-level course. The embedded course librarian developed a learning exercise that reviewed how to conduct database and web searches, the difference between primary and secondary sources, source credibility, and how to access articles through the university's databases. Students used the skills gained in the library training sessions for later writing assignments including a formal lab report and annotated bibliography. By focusing on improving information literacy skills as well as providing practice in scientific writing, Biological Literature students are better able to meet the rigors of upper-division biology courses and communicate research findings in a more professional manner.

Teaching Information Literacy Skills to Sophomore-Level Biology Majors

PubMed Central

Thompson, Leigh; Blankinship, Lisa Ann

2015-01-01

Many undergraduate students lack a sound understanding of information literacy. The skills that comprise information literacy are particularly important when combined with scientific writing for biology majors as they are the foundation skills necessary to complete upper-division biology course assignments, better train students for research projects, and prepare students for graduate and professional education. To help undergraduate biology students develop and practice information literacy and scientific writing skills, a series of three one-hour hands-on library sessions, discussions, and homework assignments were developed for Biological Literature, a one-credit, one-hour-per-week, required sophomore-level course. The embedded course librarian developed a learning exercise that reviewed how to conduct database and web searches, the difference between primary and secondary sources, source credibility, and how to access articles through the university’s databases. Students used the skills gained in the library training sessions for later writing assignments including a formal lab report and annotated bibliography. By focusing on improving information literacy skills as well as providing practice in scientific writing, Biological Literature students are better able to meet the rigors of upper-division biology courses and communicate research findings in a more professional manner. PMID:25949754

AExaCTT - Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study.

PubMed

Valkenborghs, Sarah R; Visser, Milanka M; Dunn, Ashlee; Erickson, Kirk I; Nilsson, Michael; Callister, Robin; van Vliet, Paulette

2017-09-01

Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70-85%HR max ) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.

Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

ERIC Educational Resources Information Center

Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

2007-01-01

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

Practice Makes Pretty Good: Assessment of Primary Literature Reading Abilities across Multiple Large-Enrollment Biology Laboratory Courses

ERIC Educational Resources Information Center

Sato, Brian K.; Kadandale, Pavan; He, Wenliang; Murata, Paige M. N.; Latif, Yama; Warschauer, Mark

2014-01-01

Primary literature is essential for scientific communication and is commonly utilized in undergraduate biology education. Despite this, there is often little time spent "training" our students how to critically analyze a paper. To address this, we introduced a primary literature module in multiple upper-division laboratory courses. In…

Moving across Physical and Online Spaces: A Case Study in a Blended Primary Classroom

ERIC Educational Resources Information Center

Thibaut, Patricia; Curwood, Jen Scott; Carvalho, Lucila; Simpson, Alyson

2015-01-01

With the introduction of digital tools and online connectivity in primary schools, the shape of teaching and learning is shifting beyond the physical classroom. Drawing on the architecture of productive learning networks framework, we examine the affordances and limitations of an upper primary learning network and focus on how the digital and…

Time allocated to mathematics in post-primary schools in Ireland: are we in double trouble?

NASA Astrophysics Data System (ADS)

O'Meara, Niamh; Prendergast, Mark

2018-05-01

Mathematics educators and legislators worldwide have begun placing a greater emphasis on teaching mathematics for understanding and through the use of real-life applications. Revised curricula have led to the time allocated to mathematics in effected countries being scrutinised. This has resulted in policy-makers and educationalists worldwide calling for the inclusion of double class periods on the mathematics timetable. Research from the United States suggests that the introduction of double or block periods allow for the objectives of revised curricula to be realized. The aim of this study, which is set in the school context, is first to ascertain if schools in Ireland are scheduling double periods for mathematics at both lower post-primary level (Junior Cycle) and upper post-primary level (Senior Cycle). It also seeks to determine if there is a link between teachers' levels of satisfaction with the time allocated to mathematics and the provision of double periods and to get insights from teachers in relation to their opinions on what can be achieved through the introduction of such classes. Questionnaires were sent to 400 post-primary schools (approximately 1600 teachers) which were selected using stratified sampling techniques. It was found that 8.7% of mathematics teachers reported the provision of double periods at Junior Cycle while 55% reported that double periods were included on their timetable at Senior Cycle. The study also identified a link between teachers' levels of satisfaction with the time allocated to mathematics and the provision of double periods. Finally, teachers felt that double periods allowed for new teaching methodologies, which were promoted by the revised curricula, to be implemented and teaching for understanding was also more feasible. In essence, it was found that double periods have an influence on the mathematical experience of post-primary students as well as the teaching approaches employed.

[Impact of air pollution in paediatric consultations in Primary Health Care: Ecological study].

PubMed

Martín Martín, Raquel; Sánchez Bayle, Marciano

2017-08-09

To study the correlation between the levels of environmental pollutants and the number of paediatric consultations related to respiratory disease in Primary Health Care. An ecological study is performed, in which the dependent variable analysed was the number of paediatric consultations in an urban Primary Health Care centre in Madrid over a 3 year period (2013-2015), and specifically the consultations related to bronchiolitis, recurrent bronchospasm, and upper respiratory diseases. The independent variables analysed were the levels of environmental pollutants. Coefficients of correlation and multiple lineal regressions were calculated. An analysis has been carried out comparing the average of paediatric consultations when the levels of nitrogen dioxide (NO 2 ) were higher and lower than 40μg/m 3. RESULTS: During the period of the study, there were a total of 52,322 paediatric consultations in the health centre, of which 6,473 (12.37%) were related to respiratory diseases. A positive correlation was found between SO 2 , CO, NOx and NO 2 and benzene levels and paediatric consultations related to respiratory diseases, and a negative correlation with temperature. The number of consultations was significantly higher when NO 2 levels exceeded 40μg/m 3 . In the multiple lineal regression (P=.0001), the correlation was only positive between consultations and NO 2 levels (3.630, 95% CI: 0.691-6.570), and negative with temperature (-5,957, 95% CI: -8.665 to -3.248). NO 2 environmental pollution is related to an increase in respiratory diseases in children. Paediatricians should contribute to promote an improvement in urban air quality as a significant preventive measure. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Costs and clinical outcomes of primary prophylaxis of variceal bleeding in patients with hepatic cirrhosis: a decision analytic model.

PubMed

Saab, Sammy; DeRosa, Vincent; Nieto, Jose; Durazo, Francisco; Han, Steven; Roth, Bennett

2003-04-01

Current guidelines recommend upper endoscopic screening for patients with hepatic cirrhosis and primary prophylaxis with a nonselective beta-blocker for those with large varices. However, only 25% of cirrhotics develop large varices. Thus, the aim of this study is to evaluate the most cost-effective approach for primary prophylaxis of variceal hemorrhage. Using a Markov model, we compared the costs and clinical outcomes of three strategies for primary prophylaxis of variceal bleeding. In the first strategy, patients were given a beta-blocker without undergoing upper endoscopy. In the second strategy, patients underwent upper endoscopic screening; those found to have large varices were treated with a beta-blocker. In the third strategy, no prophylaxis was used. Selected sensitivity analyses were performed to validate outcomes. Our results show screening prophylaxis was associated with a cost of $37,300 and 5.72 quality-adjusted life yr (QALYs). Universal prophylaxis was associated with a cost of $34,100 and 6.65 QALYs. The no prophylaxis strategy was associated with a cost of $36,600 and 4.84 QALYs. The incremental cost-effectiveness ratio was $800/QALY for the endoscopic strategy relative to the no prophylaxis strategy. Screening endoscopy was cost saving when the compliance, bleed risk without beta-blocker, and variceal bleed costs were increased, and when the discount rate, bleed risk on beta-blockers, and cost of upper endoscopy were decreased. In contrast, the universal prophylaxis strategy was persistently cost saving relative to the no prophylaxis strategy. In comparing the strategies, sensitivity analysis on the death rates from variceal hemorrhage did not alter outcomes. Our results provide economic and clinical support for primary prophylaxis of esophageal variceal bleeding in patients with hepatic cirrhosis. Universal prophylaxis with beta-blocker is preferred because it is consistently associated with the lowest costs and highest QALYs.

Preparing for ICESat-2: Simulated Geolocated Photon Data for Cryospheric Data Products

NASA Astrophysics Data System (ADS)

Harbeck, K.; Neumann, T.; Lee, J.; Hancock, D.; Brenner, A. C.; Markus, T.

2017-12-01

ICESat-2 will carry NASA's next-generation laser altimeter, ATLAS (Advanced Topographic Laser Altimeter System), which is designed to measure changes in ice sheet height, sea ice freeboard, and vegetation canopy height. There is a critical need for data that simulate what certain ICESat-2 science data products will "look like" post-launch in order to aid the data product development process. There are several sources for simulated photon-counting lidar data, including data from NASA's MABEL (Multiple Altimeter Beam Experimental Lidar) instrument, and M-ATLAS (MABEL data that has been scaled geometrically and radiometrically to be more similar to that expected from ATLAS). From these sources, we are able to develop simulated granules of the geolocated photon cloud product; also referred to as ATL03. These simulated ATL03 granules can be further processed into the upper-level data products that report ice sheet height, sea ice freeboard, and vegetation canopy height. For ice sheet height (ATL06) and sea ice height (ATL07) simulations, both MABEL and M-ATLAS data products are used. M-ATLAS data use ATLAS engineering design cases for signal and background noise rates over certain surface types, and also provides large vertical windows of data for more accurate calculations of atmospheric background rates. MABEL data give a more accurate representation of background noise rates over areas of water (i.e., melt ponds, crevasses or sea ice leads) versus land or solid ice. Through a variety of data manipulation procedures, we provide a product that mimics the appearance and parameter characterization of ATL03 data granules. There are three primary goals for generating this simulated ATL03 dataset: (1) allowing end users to become familiar with using the large photon cloud datasets that will be the primary science data product from ICESat-2, (2) the process ensures that ATL03 data can flow seamlessly through upper-level science data product algorithms, and (3) the process ensures parameter traceability through ATL03 and upper-level data products. We will present a summary of how simulated data products are generated, the cryospheric data product applications for this simulated data (specifically ice sheet height and sea ice freeboard), and where these simulated datasets are available to the ICESat-2 data user community.

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

NASA Astrophysics Data System (ADS)

Treacy, Páraic Thomas

2018-04-01

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

An upper limit of muon flux of energies above 100 TeV determined from horizontal air showers observed at Akeno

NASA Technical Reports Server (NTRS)

Nagano, M.; Yoshii, H.; Hara, T.; Kamata, K.; Kawaguchi, S.; Kifune, T.

1985-01-01

Muon energy spectrum above 100 TeV was determined by observing the extensive air showers (EAS) from the horizontal direction (HAS). No definite muon originated shower of sizes above 100,000 and zenith angles above 60 deg was observed. The upper limits of HAS intensity is 5x10/12 m/2 s/1 sn/1 above 100,000. It is indicated that the upper limit of muon flux above 100 TeV is about 1.3x10/8 m/2 s/1 sr/1 and is in agreement with that expected from the primary spectrum with a knee assuming scaling in the fragmentation region and 40% protons in the primary beam. The critical energy at which muon flux from prompt processes take over that from the conventional process is higher than 100 Tev at horizontal direction.

Differential diagnosis and cancer staging of a unique case with multiple nodules in the lung - lung adenocarcinoma, metastasis of colon adenocarcinoma, and colon adenocarcinoma metastasizing to lung adenocarcinoma.

PubMed

Bai, Yun; Qiu, Jianxing; Shang, Xueqian; Liu, Ping; Zhang, Ying; Wang, Ying; Xiong, Yan; Li, Ting

2015-05-01

Lung cancer is the most common cancer in the world. Despite this, there have been few cases of simultaneous primary and metastatic cancers in the lung reported, let alone coexisting with tumor-to-tumor metastasis. Herein, we describe an extremely unusual case. A 61-year-old man with a history of colon adenocarcinoma was revealed as having three nodules in the lung 11 months after colectomy. The nodule in the left upper lobe was primary lung adenocarcinoma, the larger one in the right upper lobe was a metastasis of colon adenocarcinoma, and the smaller one in the right upper lobe was colon adenocarcinoma metastasizing to lung adenocarcinoma. Our paper focused on the differential diagnosis and cancer staging of this unique case, and discussed the uncommon phenomenon of the lung acting as a recipient in tumor-to-tumor metastasis.

Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial.

PubMed

Kim, TaeHoon; Kim, SeongSik; Lee, ByoungHee

2016-03-01

The purpose of this study was to investigate whether action observational training (AOT) plus brain-computer interface-based functional electrical stimulation (BCI-FES) has a positive influence on motor recovery of paretic upper extremity in patients with stroke. This was a hospital-based, randomized controlled trial with a blinded assessor. Thirty patients with a first-time stroke were randomly allocated to one of two groups: the BCI-FES group (n = 15) and the control group (n = 15). The BCI-FES group administered to AOT plus BCI-FES on the paretic upper extremity five times per week during 4 weeks while both groups received conventional therapy. The primary outcomes were the Fugl-Meyer Assessment of the Upper Extremity, Motor Activity Log (MAL), Modified Barthel Index and range of motion of paretic arm. A blinded assessor evaluated the outcomes at baseline and 4 weeks. All baseline outcomes did not differ significantly between the two groups. After 4 weeks, the Fugl-Meyer Assessment of the Upper Extremity sub-items (total, shoulder and wrist), MAL (MAL-Activity of Use and Quality of Movement), Modified Barthel Index and wrist flexion range of motion were significantly higher in the BCI-FES group (p < 0.05). AOT plus BCI-based FES is effective in paretic arm rehabilitation by improving the upper extremity performance. The motor improvements suggest that AOT plus BCI-based FES can be used as a therapeutic tool for stroke rehabilitation. The limitations of the study are that subjects had a certain limited level of upper arm function, and the sample size was comparatively small; hence, it is recommended that future large-scale trials should consider stratified and lager populations according to upper arm function. Copyright © 2015 John Wiley & Sons, Ltd.

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

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2012-01-01

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

Teacher's Perceptions of Class Control in the Upper Primary School.

ERIC Educational Resources Information Center

Roberts, Alasdair

1984-01-01

Reports that 73% of 66 elementary school (primary) teachers interviewed in the Aberdeen, Scotland, area operated using moderate policies of class control, rather than the permissive policies commonly found in small rural schools or the more traditional restrictive policies. (SB)

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

Treesearch

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

2008-01-01

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

An infrastructure for data-intensive seismology using ADMIRE: laying the bricks for a new data highway

NASA Astrophysics Data System (ADS)

Trani, L.; Spinuso, A.; Galea, M.; Atkinson, M.; Van Eck, T.; Vilotte, J.

2011-12-01

The data bonanza generated by today's digital revolution is forcing scientists to rethink their methodologies and working practices. Traditional approaches to knowledge discovery are pushed to their limit and struggle to keep apace with the data flows produced by modern systems. This work shows how the ADMIRE data-intensive architecture supports seismologists by enabling them to focus on their scientific goals and questions, abstracting away the underlying technology platform that enacts their data integration and analysis tasks. ADMIRE accomplishes this partly by recognizing 3 different types of experts that require clearly defined interfaces between their interaction: the domain expert who is the application specialist, the data-analysis expert who is a specialist in extracting information from data, and the data-intensive engineer who develops the infrastructure for data-intensive computation. In order to provide a context in which each category of expert may flourish, ADMIRE uses a 3-level architecture: the upper - tool - level supports the work of both domain and data-analysis experts, housing an extensive and evolving set of portals, tools and development environments; the lower - enactment - level houses a large and dynamic community of providers delivering data and data-intensive enactment environments as an evolving infrastructure that supports all of the work underway in the upper layer. Most data-intensive engineers work here; the crucial innovation lies in the middle level, a gateway that is a tightly defined and stable interface through which the two diverse and dynamic upper and lower layers communicate. This is a minimal and simple protocol and language (DISPEL), ultimately to be controlled by standards, so that the upper and lower communities may invest, secure in the knowledge that changes in this interface will be carefully managed. We implemented a well-established procedure for processing seismic ambient noise on the prototype architecture. The primary goal was to evaluate its capabilities for large-scale integration and analysis of distributed data. A secondary goal was to gauge its potential and the added value that it might bring to the seismological community. Though still in its infant state, the architecture met the demands of our use case and promises to cater for our future requirements. We shall continue to develop its capabilities as part of an EU funded project VERCE - Virtual Earthquake and Seismology Research Community for Europe. VERCE aims to significantly advance our understanding of the Earth in order to aid society in its management of natural resources and hazards. Its strategy is to enable seismologists to fully exploit the under-utilized wealth of seismic data, and key to this is a data-intensive computation framework adapted to the scale and diversity of the community. This is a first step in building a data-intensive highway for geoscientists, smoothing their travel from the primary sources of data to new insights and rapid delivery of actionable information.

The quality of our Nation's waters: water quality in the Upper Floridan aquifer and overlying surficial aquifers, southeastern United States, 1993-2010

USGS Publications Warehouse

Berndt, Marian P.; Katz, Brian G.; Kingsbury, James A.; Crandall, Christy A.

2015-01-01

About 10 million people rely on groundwater from the Upper Floridan and surficial aquifers for drinking water. The Upper Floridan aquifer also is of primary importance to the region as a source of water for irrigation and as a source of crystal clear water that discharges to springs and streams providing recreational and tourist destinations and unique aquatic habitats. The reliance of the region on the Upper Floridan aquifer for drinking water and for the tourism and agricultural economies highlights the importance of long-term management to sustain the availability and quality of these resources.

Mass-spectrometric identification of primary biological particle markers and application to pristine submicron aerosol measurements in Amazonia

NASA Astrophysics Data System (ADS)

Schneider, J.; Freutel, F.; Zorn, S. R.; Chen, Q.; Farmer, D. K.; Jimenez, J. L.; Martin, S. T.; Artaxo, P.; Wiedensohler, A.; Borrmann, S.

2011-11-01

The detection of primary biological material in submicron aerosol by means of thermal desorption/electron impact ionization aerosol mass spectrometry was investigated. Mass spectra of amino acids, carbohydrates, small peptides, and proteins, all of which are key building blocks of biological particles, were recorded in laboratory experiments. Several characteristic marker fragments were identified. The intensity of the marker signals relative to the total organic mass spectrum allows for an estimation of the content of primary biological material in ambient organic aerosol. The developed method was applied to mass spectra recorded during AMAZE-08, a field campaign conducted in the pristine rainforest of the central Amazon Basin, Brazil, during the wet season of February and March 2008. The low abundance of identified marker fragments places upper limits of 7.5% for amino acids and 5.6% for carbohydrates on the contribution of primary biological aerosol particles (PBAP) to the submicron organic aerosol mass concentration during this time period. Upper limits for the absolute submicron concentrations for both compound classes range from 0.01 to 0.1 μg m-3. Carbohydrates and proteins (composed of amino acids) make up for about two thirds of the dry mass of a biological cell. Thus, our findings suggest an upper limit for the PBAP mass fraction of about 20% to the submicron organic aerosol measured in Amazonia during AMAZE-08.

Hyponatremia due to Secondary Adrenal Insufficiency Successfully Treated by Dexamethasone with Sodium Chloride.

PubMed

Kazama, Itsuro; Tamada, Tsutomu; Nakajima, Toshiyuki

2015-08-28

Patients who were surgically treated for Cushing's syndrome postoperatively surrender to "primary" adrenal insufficiency. However, the preoperative over-secretion of cortisol or the postoperative administration of excessive glucocorticoids can cause "secondary" adrenal insufficiency, in which the prevalence of hyponatremia is usually lower than that of primary adrenal insufficiency. A 60-year-old woman with a past medical history of Cushing's syndrome developed hyponatremia with symptoms of acute glucocorticoid deficiency, such as prolonged general fatigue and anorexia, after upper respiratory tract infection. A decrease in the serum cortisol level and the lack of increase in the ACTH level, despite the increased demand for cortisol, enabled a diagnosis of "secondary" adrenal insufficiency. Although the initial fluid replacement therapy was not effective, co-administration of dexamethasone and sodium chloride quickly resolved her symptoms and ameliorated the refractory hyponatremia. In this case, the hypothalamic-pituitary axis of the patient was thought to have become suppressed long after the surgical treatment for Cushing's syndrome. This case suggested a mechanism of refractory hyponatremia caused by secondary adrenal insufficiency, for which the administration of dexamethasone and sodium chloride exerted additional therapeutic efficacy.

Developments in Motivation and Achievement during Primary School: A Longitudinal Study on Group-Specific Differences

ERIC Educational Resources Information Center

Hornstra, Lisette; van der Veen, Ineke; Peetsma, Thea; Volman, Monique

2013-01-01

To gain insight in developmental trajectories of motivation during upper primary school, the present study focused on how different aspects of students' motivation, i.e., task-orientation, self-efficacy, and school investment develop from grade three to six of primary school and how these developments differ for boys and girls, and students with…

Learning to teach upper primary school algebra: changes to teachers' mathematical knowledge for teaching functional thinking

NASA Astrophysics Data System (ADS)

Wilkie, Karina J.

2016-06-01

A key aspect of learning algebra in the middle years of schooling is exploring the functional relationship between two variables: noticing and generalising the relationship, and expressing it mathematically. This article describes research on the professional learning of upper primary school teachers for developing their students' functional thinking through pattern generalisation. This aspect of algebra learning has been explicitly brought to the attention of upper primary teachers in the recently introduced Australian curriculum. Ten practising teachers participated over 1 year in a design-based research project involving a sequence of geometric pattern generalisation lessons with their classes. Initial and final survey responses and teachers' interactions in regular meetings and lessons were analysed from cognitive and situated perspectives on professional learning, using a theoretical model for the different types of knowledge needed for teaching mathematics. The teachers demonstrated an increase in certain aspects of their mathematical knowledge for teaching algebra as well as some residual issues. Implications for the professional learning of practising and pre-service teachers to develop their mathematics knowledge for teaching functional thinking, and challenges with operationalising knowledge categories for field-based research are presented.

Measurements Methods for the analysis of Nuclear Reactors Thermal Hydraulic in Water Scaled Facilities

NASA Astrophysics Data System (ADS)

Spaccapaniccia, C.; Planquart, P.; Buchlin, J. M. AB(; ), AC(; )

2018-01-01

The Belgian nuclear research institute (SCK•CEN) is developing MYRRHA. MYRRHA is a flexible fast spectrum research reactor, conceived as an accelerator driven system (ADS). The configuration of the primary loop is pool-type: the primary coolant and all the primary system components (core and heat exchangers) are contained within the reactor vessel, while the secondary fluid is circulating in the heat exchangers. The primary coolant is Lead Bismuth Eutectic (LBE). The recent nuclear accident of Fukushima in 2011 changed the requirements for the design of new reactors, which should include the possibility to remove the residual decay heat through passive primary and secondary systems, i.e. natural convection (NC). After the reactor shut down, in the unlucky event of propeller failures, the primary and secondary loops should be able to remove the decay heat in passive way (Natural Convection). The present study analyses the flow and the temperature distribution in the upper plenum by applying laser imaging techniques in a laboratory scaled water model. A parametric study is proposed to study stratification mitigation strategies by varying the geometry of the buffer tank simulating the upper plenum.

Isolation and characterization of beta-glucan synthase: A potential biochemical regulator of gravistimulated differential cell wall loosening

NASA Technical Reports Server (NTRS)

Kuzmanoff, K. M.

1984-01-01

In plants, gravity stimulates differential growth in the upper and lower halves of horizontally oriented organs. Auxin regulation of cell wall loosening and elongation is the basis for most models of this phenomenon. Auxin treatment of pea stem tissue rapidly increases the activity of Golgi-localized Beta-1,4-glucan synthase, an enzyme involved in biosynthesis of wall xyloglucan which apparently constitutes the substrate for the wall loosening process. The primary objective is to determine if auxin induces de novo formation of Golgi glucan synthase and increases the level of this glucan synthase mRNA. This shall be accomplished by (a) preparation of a monoclonal antibody to the synthase, (b) isolation, and characterization of the glucan synthase, and (c) examination for cross reactivity between the antibody and translation products of auxin induced mRNAs in pea tissue. The antibody will also be used to localize the glucan synthase in upper and lower halves of pea stem tissue before, during and after the response to gravity.

Theoretical studies of solar-pumped lasers

NASA Technical Reports Server (NTRS)

Harries, W. L.

1983-01-01

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

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

ERIC Educational Resources Information Center

Irving, Paul W.; Sayre, Eleanor C.

2013-01-01

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

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

ERIC Educational Resources Information Center

Finn, Kevin; FitzPatrick, Kathleen; Yan, Zi

2017-01-01

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

Serum Thyroid-Stimulating Hormone Levels and Body Mass Index Percentiles in Children with Primary Hypothyroidism on Levothyroxine Replacement

PubMed Central

Shaoba, Asma; Basu, Sanjib; Mantis, Stelios; Minutti, Carla

2017-01-01

Objective: To determine the association, if any, between thyroid-stimulating hormone (TSH) levels and body mass index (BMI) percentiles in children with primary hypothyroidism who are chemically euthyroid and on treatment with levothyroxine. Methods: This retrospective cross-sectional study consisted of a review of medical records from RUSH Medical Center and Stroger Hospital, Chicago, USA of children with primary hypothyroidism who were seen in the clinic from 2008 to 2014 and who were chemically euthyroid and on treatment with levothyroxine for at least 6 months. The patients were divided into two groups based on their TSH levels (0.34-<2.5 mIU/L and ≥2.5-5.6 mIU/L). The data were analyzed by Spearman rank correlation, linear regression, cross tabulation and chi-square, Mann-Whitney U test, and Kruskal-Wallis test. Results: One hundred and forty-six children were included, of which 26% were obese (BMI ≥95%), 21.9% overweight (BMI ≥85-<95%), and 52.1% of a healthy weight (BMI ≥5-<85%). There was a significant positive correlation between TSH and BMI percentiles (r=0.274, p=0.001) and a significant negative correlation between TSH and serum free T4 (r=-0.259, p=0.002). In the lower TSH group, 68.4% of the children had a healthy weight, while the percentage of obese children was 60.5% in the upper TSH group (p=0.012). Conclusion: In children diagnosed with primary hypothyroidism who are chemically euthyroid on treatment with levothyroxine, there is a positive association between higher TSH levels and higher BMI percentiles. However, it is difficult to establish if the higher TSH levels are a direct cause or a consequence of the obesity. Further studies are needed to establish causation beyond significant association. PMID:28766504

Excitation of photosystem I by 760 nm femtosecond laser pulses: transient absorption spectra and intermediates

NASA Astrophysics Data System (ADS)

Cherepanov, Dmitry A.; Shelaev, Ivan V.; Gostev, Fedor E.; Mamedov, Mahir D.; Petrova, Anastasia A.; Aybush, Arseniy V.; Shuvalov, Vladimir A.; Semenov, Alexey Yu; Nadtochenko, Victor A.

2017-09-01

Excitation of photosystem I (PS I) by a femtosecond 760 nm pump leads to one- and two-photon absorption. The one-photon excitation produces intermediates with transient absorption spectra similar to the spectra of the primary [{{{P}}700}+{{{A}}0}-{{A}}1] and secondary [{{{P}}700}+{{A}}0{{{A}}1}-] ion-radical pairs in the PS I reaction center. The two-photon absorption generates the upper level excited states of chlorophyll (Chl) and carotenoid molecules in the antenna. These excited states are converted into the long-lived intermediates and can be tentatively attributed to the excited and charge-transfer ion-radical states of Chl molecules and to the excited states of carotenoids in the antenna. The transient spectra of intermediates generated by two-photon excitation differ from the transient one-photon spectra of the primary and secondary ion-radical pairs.

50 CFR 14.151 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING... Wild Mammals and Birds to the United States Specifications for Sloths, Bats, and Flying Lemurs... located on the upper one-half of the primary enclosure. (b) No more than one sloth, bat, or flying lemur...

[Soft tissue sarcoma of the upper extremities. Analysis of factors relevant for prognosis in 160 patients].

PubMed

Lehnhardt, M; Hirche, C; Daigeler, A; Goertz, O; Ring, A; Hirsch, T; Drücke, D; Hauser, J; Steinau, H U

2012-02-01

Soft tissue sarcomas (STS) are a rare entity with reduced prognosis due to their aggressive biology. For an optimal treatment of STS identification of independent prognostic factors is crucial in order to reduce tumor-related mortality and recurrence rates. The surgical oncological concept includes wide excisions with resection safety margins >1 cm which enables acceptable functional results and reduced rates of amputation of the lower extremities. In contrast, individual anatomy of the upper extremities, in particular of the hand, leads to an intentional reduction of resection margins in order to preserve the extremity and its function with the main intention of tumor-free resection margins. In this study, the oncological safety and outcome as well as functional results were validated by a retrospective analysis of survival rate, recurrence rate and potential prognostic factors. A total of 160 patients who had been treated for STS of the upper extremities were retrospectively included. Independent prognostic factors were analyzed (primary versus recurrent tumor, tumor size, resection status, grade of malignancy, additional therapy, localization in the upper extremity). Kaplan-Meier analyses for survival rate and local control were calculated. Further outcome measures were functional results validated by the DASH score and rate of amputation. In 130 patients (81%) wide tumor excision (R0) was performed and in 19 patients (12%) an amputation was necessary. The 5-year overall survival rate was 70% and the 5-year survival rate in primary tumors was 81% whereas in recurrences 55% relapsed locally. The 10-year overall survival rate was 45% and the 5-year recurrence rate was 18% for primary STS and 43% for recurrent STS. Variance analysis revealed primary versus recurrent tumor, tumor size, resection status and grade of malignancy as independent prognostic factors. Analysis of functional results showed a median DASH score of 37 (0-100; 0=contralateral extremity). The 5-year survival and local recurrence rates are comparable to STS wide resections with safety margins >1 cm for the lower extremities and the trunk. Analysis of prognostic factors revealed resection status and the tumor-free resection margins to be the main goals in STS resection of upper extremity.

Marcus Gunn jaw-winking synkinesis: clinical features and management.

PubMed

Demirci, Hakan; Frueh, Bartley R; Nelson, Christine C

2010-07-01

To evaluate the clinical features including eyelid excursion and management of Marcus Gunn jaw-winking synkinesis (MGJWS). Observational case series. Forty-eight consecutive patients with MGJWS. Clinical features and management of 48 patients with MGJWS were reviewed retrospectively. Upper eyelid excursion was measured and graded. Complications of surgical intervention were evaluated. Resolution of MGJWS and symmetry of upper eyelids in primary position. Excursion of the ptotic eyelid with jaw movement in MGJWS was graded as mild (<2 mm) in 16% of patients, moderate (2-4 mm) in 76% of patients, and severe (> or = 5 mm) in 8% of patients. Thirty patients with moderate or severe MGJWS underwent disabling of the involved levator muscle and bilateral or unilateral frontalis suspension and had more than 6 months of follow-up. After a mean follow-up of 62 months, MGJWS resolved in 29 (97%) patients and improved from 6 mm to 2 mm in 1 (3%) patient. Relative upper eyelid height was within 1 mm in 87% of patients in primary position and within 1 mm in 80% of patients in downgaze. Twenty-six patients had bilateral frontalis suspension with disabling of unilateral levator muscle on the involved side. Relative upper eyelid height was within 1 mm in 88% of patients in the primary position and within 1 mm in 88% of patients in downgaze. Four non-amblyopic patients had unilateral frontalis suspension with levator muscle disabling. Relative upper eyelid height was symmetrical in 75% of the patients in primary position and in 25% of patients in downgaze. Complications included eyelash ptosis in 10% of the patients, loss of eyelid crease in 10%, and entropion in 3%. Most of the patients with MGJWS exhibited moderate eyelid excursion. Disabling of the involved levator muscle and bilateral frontalis suspension and, in selected cases, disabling of the involved levator muscle and unilateral frontalis suspension were effective in the treatment of MGJWS. Eyelash ptosis and loss of eyelid crease were the most common complications, each occurring in 10% of the patients. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Vertical Structures of Anvil Clouds of Tropical Mesoscale Convective Systems Observed by CloudSat

NASA Technical Reports Server (NTRS)

Hence, Deanna A.; Houze, Robert A.

2011-01-01

A global study of the vertical structures of the clouds of tropical mesoscale convective systems (MCSs) has been carried out with data from the CloudSat Cloud Profiling Radar. Tropical MCSs are found to be dominated by cloud-top heights greater than 10 km. Secondary cloud layers sometimes occur in MCSs, but outside their primary raining cores. The secondary layers have tops at 6 8 and 1 3 km. High-topped clouds extend outward from raining cores of MCSs to form anvil clouds. Closest to the raining cores, the anvils tend to have broader distributions of reflectivity at all levels, with the modal values at higher reflectivity in their lower levels. Portions of anvil clouds far away from the raining core are thin and have narrow frequency distributions of reflectivity at all levels with overall weaker values. This difference likely reflects ice particle fallout and therefore cloud age. Reflectivity histograms of MCS anvil clouds vary little across the tropics, except that (i) in continental MCS anvils, broader distributions of reflectivity occur at the uppermost levels in the portions closest to active raining areas; (ii) the frequency of occurrence of stronger reflectivity in the upper part of anvils decreases faster with increasing distance in continental MCSs; and (iii) narrower-peaked ridges are prominent in reflectivity histograms of thick anvil clouds close to the raining areas of connected MCSs (superclusters). These global results are consistent with observations at ground sites and aircraft data. They present a comprehensive test dataset for models aiming to simulate process-based upper-level cloud structure around the tropics.

Vertical Structures of Anvil Clouds of Tropical Mesoscale Convective Systems Observed by CloudSat

NASA Technical Reports Server (NTRS)

Yuan, J.; Houze, R. A., Jr.; Heymsfield, A.

2011-01-01

A global study of the vertical structures of the clouds of tropical mesoscale convective systems (MCSs) has been carried out with data from the CloudSat Cloud Profiling Radar. Tropical MCSs are found to be dominated by cloud-top heights greater than 10 km. Secondary cloud layers sometimes occur in MCSs, but outside their primary raining cores. The secondary layers have tops at 6--8 and 1--3 km. High-topped clouds extend outward from raining cores of MCSs to form anvil clouds. Closest to the raining cores, the anvils tend to have broader distributions of reflectivity at all levels, with the modal values at higher reflectivity in their lower levels. Portions of anvil clouds far away from the raining core are thin and have narrow frequency distributions of reflectivity at all levels with overall weaker values. This difference likely reflects ice particle fallout and therefore cloud age. Reflectivity histograms of MCS anvil clouds vary little across the tropics, except that (i) in continental MCS anvils, broader distributions of reflectivity occur at the uppermost levels in the portions closest to active raining areas; (ii) the frequency of occurrence of stronger reflectivity in the upper part of anvils decreases faster with increasing distance in continental MCSs; and (iii) narrower-peaked ridges are prominent in reflectivity histograms of thick anvil clouds close to the raining areas of connected MCSs (superclusters). These global results are consistent with observations at ground sites and aircraft data. They present a comprehensive test dataset for models aiming to simulate process-based upper-level cloud structure around the tropics.

The utility of the KJOC score in professional baseball in the United States.

PubMed

Franz, Justin O; McCulloch, Patrick C; Kneip, Chris J; Noble, Philip C; Lintner, David M

2013-09-01

The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire has been shown by previous studies to be more sensitive than other validated subjective measurement tools in the detection of upper extremity dysfunction in overhead-throwing athletes. The primary objective was to establish normative data for KJOC scores in professional baseball players in the United States. The secondary objectives were to evaluate the effect of player age, playing position, professional competition level, history of injury, history of surgery, and time point of administration on the KJOC score. Cross-sectional study; Level of evidence, 3. From 2011 to 2012, a total of 203 major league and minor league baseball players within the Houston Astros professional baseball organization completed the KJOC questionnaire. The questionnaire was administered at 3 time points: spring training 2011, end of season 2011, and spring training 2012. The KJOC scores were analyzed for significant differences based on player age, injury history, surgery history, fielding position, competition level, self-reported playing status, and time point of KJOC administration. The average KJOC score among healthy players with no history of injury was 97.1 for major league players and 96.8 for minor league players. The time point of administration did not significantly affect the final KJOC score (P = .224), and KJOC outcomes did not vary with player age (r = -0.012; P = .867). Significantly lower average KJOC scores were reported by players with a history of upper extremity injury (86.7; P < .001) and upper extremity surgery (75.4; P < .0001). The KJOC results did vary with playing position (P = .0313), with the lowest average scores being reported by pitchers (90.9) and infielders (91.3). This study establishes a quantitative baseline for the future evaluation of professional baseball players with the KJOC score. Age and time of administration had no significant effect on the outcome of the KJOC score. Missed practices or games within the previous year because of injury were the most significant demographic predictors of lower KJOC scores. The KJOC score was shown to be a sensitive measurement tool for detecting subtle changes in the upper extremity performance of the professional baseball population studied.

Pathways between primary production and fisheries yields of large marine ecosystems.

PubMed

Friedland, Kevin D; Stock, Charles; Drinkwater, Kenneth F; Link, Jason S; Leaf, Robert T; Shank, Burton V; Rose, Julie M; Pilskaln, Cynthia H; Fogarty, Michael J

2012-01-01

The shift in marine resource management from a compartmentalized approach of dealing with resources on a species basis to an approach based on management of spatially defined ecosystems requires an accurate accounting of energy flow. The flow of energy from primary production through the food web will ultimately limit upper trophic-level fishery yields. In this work, we examine the relationship between yield and several metrics including net primary production, chlorophyll concentration, particle-export ratio, and the ratio of secondary to primary production. We also evaluate the relationship between yield and two additional rate measures that describe the export of energy from the pelagic food web, particle export flux and mesozooplankton productivity. We found primary production is a poor predictor of global fishery yields for a sample of 52 large marine ecosystems. However, chlorophyll concentration, particle-export ratio, and the ratio of secondary to primary production were positively associated with yields. The latter two measures provide greater mechanistic insight into factors controlling fishery production than chlorophyll concentration alone. Particle export flux and mesozooplankton productivity were also significantly related to yield on a global basis. Collectively, our analyses suggest that factors related to the export of energy from pelagic food webs are critical to defining patterns of fishery yields. Such trophic patterns are associated with temperature and latitude and hence greater yields are associated with colder, high latitude ecosystems.

Pathways between Primary Production and Fisheries Yields of Large Marine Ecosystems

PubMed Central

Friedland, Kevin D.; Stock, Charles; Drinkwater, Kenneth F.; Link, Jason S.; Leaf, Robert T.; Shank, Burton V.; Rose, Julie M.; Pilskaln, Cynthia H.; Fogarty, Michael J.

2012-01-01

The shift in marine resource management from a compartmentalized approach of dealing with resources on a species basis to an approach based on management of spatially defined ecosystems requires an accurate accounting of energy flow. The flow of energy from primary production through the food web will ultimately limit upper trophic-level fishery yields. In this work, we examine the relationship between yield and several metrics including net primary production, chlorophyll concentration, particle-export ratio, and the ratio of secondary to primary production. We also evaluate the relationship between yield and two additional rate measures that describe the export of energy from the pelagic food web, particle export flux and mesozooplankton productivity. We found primary production is a poor predictor of global fishery yields for a sample of 52 large marine ecosystems. However, chlorophyll concentration, particle-export ratio, and the ratio of secondary to primary production were positively associated with yields. The latter two measures provide greater mechanistic insight into factors controlling fishery production than chlorophyll concentration alone. Particle export flux and mesozooplankton productivity were also significantly related to yield on a global basis. Collectively, our analyses suggest that factors related to the export of energy from pelagic food webs are critical to defining patterns of fishery yields. Such trophic patterns are associated with temperature and latitude and hence greater yields are associated with colder, high latitude ecosystems. PMID:22276100

NASA Ares I Crew Launch Vehicle Upper Stage Overview

NASA Technical Reports Server (NTRS)

Davusm Daniel J.; McArthur, J. Craig

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system.

NASA Ares I Crew Launch Vehicle Upper State Overview

NASA Technical Reports Server (NTRS)

Davis, Daniel J.

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA s Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program s transportation system.

String scattering amplitudes and deformed cubic string field theory

NASA Astrophysics Data System (ADS)

Lai, Sheng-Hong; Lee, Jen-Chi; Lee, Taejin; Yang, Yi

2018-01-01

We study string scattering amplitudes by using the deformed cubic string field theory which is equivalent to the string field theory in the proper-time gauge. The four-string scattering amplitudes with three tachyons and an arbitrary string state are calculated. The string field theory yields the string scattering amplitudes evaluated on the world sheet of string scattering whereas the conventional method, based on the first quantized theory brings us the string scattering amplitudes defined on the upper half plane. For the highest spin states, generated by the primary operators, both calculations are in perfect agreement. In this case, the string scattering amplitudes are invariant under the conformal transformation, which maps the string world sheet onto the upper half plane. If the external string states are general massive states, generated by non-primary field operators, we need to take into account carefully the conformal transformation between the world sheet and the upper half plane. We show by an explicit calculation that the string scattering amplitudes calculated by using the deformed cubic string field theory transform into those of the first quantized theory on the upper half plane by the conformal transformation, generated by the Schwarz-Christoffel mapping.

Improved Mars Upper Atmosphere Climatology

NASA Technical Reports Server (NTRS)

Bougher, S. W.

2004-01-01

The detailed characterization of the Mars upper atmosphere is important for future Mars aerobraking activities. Solar cycle, seasonal, and dust trends (climate) as well as planetary wave activity (weather) are crucial to quantify in order to improve our ability to reasonably depict the state of the Mars upper atmosphere over time. To date, our best information is found in the Mars Global Surveyor (MGS) Accelerometer (ACC) database collected during Phase 1 (Ls = 184 - 300; F10.7 = 70 - 90) and Phase 2 (Ls = 30 - 90; F10.7 = 90 - 150) of aerobraking. This database (100 - 170 km) consists of thermospheric densities, temperatures, and scale heights, providing our best constraints for exercising the coupled Mars General Circulation Model (MGCM) and the Mars Thermospheric General Circulation Model (MTGCM). The Planetary Data System (PDS) contains level 0 and 2 MGS Accelerometer data, corresponding to atmospheric densities along the orbit track. Level 3 products (densities, temperatures, and scale heights at constant altitudes) are also available in the PDS. These datasets provide the primary model constraints for the new MGCM-MTGCM simulations summarized in this report. Our strategy for improving the characterization of the Mars upper atmospheres using these models has been three-fold : (a) to conduct data-model comparisons using the latest MGS data covering limited climatic and weather conditions at Mars, (b) to upgrade the 15-micron cooling and near-IR heating rates in the MGCM and MTGCM codes for ad- dressing climatic variations (solar cycle and seasonal) important in linking the lower and upper atmospheres (including migrating tides), and (c) to exercise the detailed coupled MGCM and MTGCM codes to capture and diagnose the planetary wave (migrating plus non-migrating tidal) features throughout the Mars year. Products from this new suite of MGCM-MTGCM coupled simulations are being used to improve our predictions of the structure of the Mars upper atmosphere for the upcoming MRO aerobraking exercises in 2006. A Michigan website, containing MTGCM output fields from previous climate simulations, is being expanded to include new MGCM-MTGCM simulations addressing planetary wave influences upon thermospheric aerobraking fields (densities and temperatures). In addition, similar MTGCM output fields have been supplied to the MSFC MARSGRAM - 200X empirical model, which will be used in mission operations for conducting aerobraking maneuvers.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors.

PubMed

Pérez-Cruzado, David; Merchán-Baeza, Jose Antonio; González-Sánchez, Manuel; Cuesta-Vargas, Antonio I

2017-04-01

Stroke is a leading cause of disability in developed countries. One of the most widespread techniques in clinical practice is mirror therapy (MT). To determine the effectiveness of MT over other methods of intervention in the recovery of upper limb function in people who have had a stroke. A systematic review was conducted. The search string was established based on the last systematic review about MT that dated from 2009: "upper extremity" OR "upper limb "AND "mirror therapy" AND stroke. For this search Pubmed, Scopus and SciELO databases were used. Fifteen studies were included in the systematic review. Recovery of the upper limb, upper limb function and gross manual dexterity were frequently measured in these studies. In the primary variables in promoting recovery, MT alone showed better results in acute and chronic stroke patients in upper limb functioning than either conventional rehabilitation (CR) or CR plus MT. PROSPERO registration number: CRD42015026869. © 2016 Occupational Therapy Australia.

Geothermal implications of a refined composition-age geologic map for the volcanic terrains of southeast Oregon, northeast California, and southwest Idaho, USA

USGS Publications Warehouse

Burns, Erick; Gannett, Marshall W.; Sherrod, David R.; Keith, Mackenzie K.; Curtis, Jennifer A.; Bartolino, James R.; Engott, John A.; Scandella, Benjamin P.; Stern, Michelle A.; Flint, Alan L.

2017-01-01

Sufficient temperatures to generate steam likely exist under most of the dominantly volcanic terrains of southeast Oregon, northeast California, and southeast Idaho, USA, but finding sufficient permeability to allow efficient advective heat exchange is an outstanding challenge. A new thematic interpretation of existing state-level geologic maps provides an updated and refined distribution of the composition and age of geologic units for the purposes of assessing the implications for measurement and development of geothermal resources. This interpretation has been developed to better understand geothermal and hydrologic resources of the region. Comparison of the new geologic categories with available hydrologic data shows that younger volcanogenic terrains tend to have higher primary permeability than older terrains. Decrease in primary permeability with age is attributable to weathering and hydrothermal alteration of volcanogenic deposits to pore-filling clays and deposition of secondary deposits (e.g., zeolites). Spring density as a function of geology and precipitation can be used to infer groundwater flow path length within the upper aquifers. Beneath the upper aquifers, we postulate that, due to accelerated hydrothermal alteration at temperatures ~>30 °C, primary permeability at depths of geothermal interest will be limited, and that secondary permeability is a more viable target for hydrothermal fluid withdrawal. Because open fractures resulting from tensile stresses will affect all geologic layers, regions with a significant amount of groundwater flow through shallow, structurally controlled secondary permeability may overlay zones of deep secondary permeability. Regardless of whether the shallow permeability is connected with the deep permeability, shallow groundwater flow can mask the presence of deep hydrothermal flow, resulting in blind geothermal systems. Ideally, hydraulic connectivity between shallow and deep secondary permeability is limited, so that shallow groundwater does not cool potential geothermal reservoirs.

Sarcoidosis of the lacrimal gland as a first manifestation.

PubMed

Peralta-Gómez, M Y; Ávila-Ocampo, K A; Huerta-Velázquez, S; Rivera-Salgado, M I

2018-04-01

The first manifestation of sarcoidosis is usually at the pulmonary level. The case is described of a 40-year-old female patient, who presented with an increased volume of the lacrimal gland and mechanical ptosis of upper left eyelid as the first expression of this disease. The diagnosis of systemic sarcoidosis with primary presentation of the lacrimal gland was made after performing several immunological studies with negative results, imaging studies, and taking of glandular and lymph node biopsies. A favourable response was achieved with oral methotrexate treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Hydrogeologic framework, hydrology, and refined conceptual model of groundwater flow for Coastal Plain aquifers at the Standard Chlorine of Delaware, Inc. Superfund Site, New Castle County, Delaware, 2005-12

USGS Publications Warehouse

Brayton, Michael J.; Cruz, Roberto M.; Myers, Luke; Degnan, James R.; Raffensperger, Jeff P.

2015-01-01

The regional hydrogeologic framework indicates that the site is underlain by Coastal Plain sediments of the Columbia, Merchantville, and Potomac Formations. Two primary aquifers underlying the site, the Columbia and the upper Potomac, are separated by the Merchantville Formation confining unit. Local groundwater flow in the surficial (Columbia) aquifer is controlled by topography and generally flows northward and discharges to nearby surface water. Regional flow within the Potomac aquifer is towards the southeast, and is strongly influenced by major water withdrawals locally. Previous investigations at the site indicated that contaminants, primarily benzene and chlorinated benzene compounds, were present in the Columbia aquifer in most locations; however, there were only limited detections in the upper Potomac aquifer as of 2004. From 2005 through 2012, the USGS designed a monitoring network, assisted with exploratory drilling, collected data at monitoring wells, conducted geophysical surveys, evaluated water-level responses in wells during pumping of a production well, and evaluated major aquifer withdrawals. Data collected through these efforts were used to refine the local conceptual flow system. The refined conceptual flow system for the site includes: (a) identification of gaps in confining units in the study area, (b) identification and correlation of multiple water-bearing sand intervals within the upper Potomac Formation, (c) connections between groundwater and surface water, (d) connections between shallow and deeper groundwater, (e) new water-level (or potentiometric surface) maps and inferred flow directions, and (f) identification of major local pumping well influences. The implications of the revised conceptual flow system on the occurrence and movement of site contaminants are that the resulting detection of contaminants in the upper Potomac aquifer at specific well locations can be attributed primarily to either advective lateral transport, direct vertical contaminant transport, or a combination of vertical and lateral movement resulting from changes in water withdrawal rates over time.

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

NASA Technical Reports Server (NTRS)

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

1985-01-01

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

Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

PubMed

Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, Johan Hviid

2013-10-01

Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.

Ecological contingency in the effects of climatic warming on forest herb communities.

PubMed

Harrison, Susan; Damschen, Ellen I; Grace, James B

2010-11-09

Downscaling from the predictions of general climate models is critical to current strategies for mitigating species loss caused by climate change. A key impediment to this downscaling is that we lack a fully developed understanding of how variation in physical, biological, or land-use characteristics mediates the effects of climate change on ecological communities within regions. We analyzed change in understory herb communities over a 60-y period (1949/1951-2007/2009) in a complex montane landscape (the Siskiyou Mountains, Oregon) where mean temperatures have increased 2 °C since 1948, similar to projections for other terrestrial communities. Our 185 sites included primary and secondary-growth lower montane forests (500-1.200 m above sea level) and primary upper montane to subalpine forests (1,500-2,100 m above sea level). In lower montane forests, regardless of land-use history, we found multiple herb-community changes consistent with an effectively drier climate, including lower mean specific leaf area, lower relative cover by species of northern biogeographic affinity, and greater compositional resemblance to communities in southerly topographic positions. At higher elevations we found qualitatively different and more modest changes, including increases in herbs of northern biogeographic affinity and in forest canopy cover. Our results provide community-level validation of predicted nonlinearities in climate change effects.

Ecological contingency in the effects of climatic warming on forest herb communities

USGS Publications Warehouse

Harrison, Susan; Damschen, Ellen Ingman; Grace, James B.

2010-01-01

Downscaling from the predictions of general climate models is critical to current strategies for mitigating species loss caused by climate change. A key impediment to this downscaling is that we lack a fully developed understanding of how variation in physical, biological, or land-use characteristics mediates the effects of climate change on ecological communities within regions. We analyzed change in understory herb communities over a 60-y period (1949/1951–2007/2009) in a complex montane landscape (the Siskiyou Mountains, Oregon) where mean temperatures have increased 2 °C since 1948, similar to projections for other terrestrial communities. Our 185 sites included primary and secondary-growth lower montane forests (500–1.200 m above sea level) and primary upper montane to subalpine forests (1,500–2,100 m above sea level). In lower montane forests, regardless of land-use history, we found multiple herb-community changes consistent with an effectively drier climate, including lower mean specific leaf area, lower relative cover by species of northern biogeographic affinity, and greater compositional resemblance to communities in southerly topographic positions. At higher elevations we found qualitatively different and more modest changes, including increases in herbs of northern biogeographic affinity and in forest canopy cover. Our results provide community-level validation of predicted nonlinearities in climate change effects.

Red and far-red fluorescent dyes for the characterization of head and neck cancer at the cellular level.

PubMed

Abbaci, Muriel; Casiraghi, Odile; Temam, Stephane; Ferchiou, Malek; Bosq, Jacques; Dartigues, Peggy; De Leeuw, Frederic; Breuskin, Ingrid; Laplace-Builhé, Corinne

2015-11-01

Primary upper aerodigestive tract malignancy remains a cancer having a poor prognosis, despite current progress in treatment, due to a generally late diagnosis. We conducted a preliminary assessment of five dyes approved for human use for the imaging of head and neck tissues at the cellular level, which could be considered for clinical examination. We investigated fluorescence endomicroscopic images on fresh samples obtained from head and neck surgeries after staining with hypericin, methylene blue, toluidine blue, patent blue or indocyanine green to provide a preliminary consideration as to whether these images contain enough information for identification of non-pathologic and pathologic tissues. The distribution pattern of dye has been examined using probe-based confocal laser endomicroscopy (pCLE) in ex vivo specimens and compared with corresponding histology. In most samples, the image quality provided by pCLE with both dyes allowed pathologists to recognize histological characteristics to identify the tissues. The combination of pCLE imaging with these dyes provides interpretable images close to conventional histology; a promising clinical tool to assist physicians in examination of upper aerodigestive tract, as long as depth imaging issues can be overcome. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative gastrointestinal safety of weekly oral bisphosphonates

PubMed Central

Katz, J. N.; Brookhart, M. A.; Stürmer, T.; Stedman, M. R.; Levin, R.; Solomon, D. H.

2012-01-01

Summary Weekly bisphosphonates are the primary agents used to treat osteoporosis. Although these agents are generally well tolerated, serious gastrointestinal adverse events, including hospitalization for gastrointestinal bleed, may arise. We compared the gastrointestinal safety between weekly alendronate and weekly risedronate and found no important difference between new users of these agents. Introduction Weekly bisphosphonates are the primary agents prescribed for osteoporosis. We examined the comparative gastrointestinal safety between weekly bisphosphonates. Methods We studied new users of weekly alendronate and weekly risedronate from June 2002 to August 2005 among enrollees in a state-wide pharmaceutical benefit program for seniors. Our primary outcome was hospitalization for upper gastrointestinal bleed. Secondary outcomes included outpatient diagnoses for upper gastrointestinal disease, symptoms, endoscopic procedures, use of gastroprotective agents, and switching between therapies. We used Cox proportional hazard models to compare outcomes between agents within 120 days of treatment initiation, adjusting for propensity score quintiles. We also examined composite safety outcomes and stratified results by age and prior gastrointestinal history. Results A total of 10,420 new users were studied, mean age=79 years (SD, 6.9), and 95% women. We observed 31 hospitalizations for upper gastrointestinal bleed (0.91 per 100 person-years) within 120 days of treatment initiation. Adjusting for covariates, there was no difference in hospitalization for upper gastrointestinal bleed among those treated with risedronate compared with alendronate (HR, 1.12; 95%CI, 0.55 to 2.28). Risedronate switching rates were lower; otherwise, no differences were observed for secondary or composite outcomes. Conclusions We found no important difference in gastrointestinal safety between weekly oral bisphosphonates. PMID:19266138

Amniotic Constriction Bands: Secondary Deformities and Their Treatments.

PubMed

Drury, Benjamin T; Rayan, Ghazi M

2018-01-01

The purpose of this study was to report the surgical treatment experience of patients with amniotic constriction bands (ACB) over a 35-year interval and detail consequential limb deformities with emphasis on hands and upper extremities, along with the nature and frequency of their surgical treatment methods. Fifty-one patients were identified; 26 were males and 25 females. The total number of deformities was listed. The total number of operations, individual procedures, and operations plus procedures that were done for each patient and their frequency were recorded. The total number of operations was 117, and total number of procedures was 341. More procedures were performed on the upper extremity (85%) than the lower extremity (15%). Including the primary deformity ACB, 16 different hand deformities secondary to ACB were encountered. Sixteen different surgical methods for the upper extremity were utilized; a primary procedure for ACB and secondary reconstructions for all secondary deformities. Average age at the time of the first procedure was 9.3 months. The most common procedures performed, in order of frequency, were excision of ACB plus Z-plasty, release of partial syndactyly, release of fenestrated syndactyly, full-thickness skin grafts, resection of digital bony overgrowth from amputation stumps, and deepening of first and other digital web spaces. Many hand and upper extremity deformities secondary to ACB are encountered. Children with ACB may require more than one operation including multiple procedures. Numerous surgical methods of reconstruction for these children's secondary deformities are necessary in addition to the customary primary procedure of excision of ACB and Z-plasty.

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

ERIC Educational Resources Information Center

Markussen, Eifred

2017-01-01

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

Therapeutic-diagnostic Evaluation of Chronic Cough Amongst Adults: Causes, Symptoms and Management at the Primary Care Level, Malaysia.

PubMed

Nantha, Yogarabindranath Swarna

2014-07-01

Patients presenting with chronic cough pose a common diagnostic dilemma during routine consultations at public primary care clinics in Malaysia. To date, there has been little attempt at designing a standardized model or algorithm to facilitate an accurate diagnosis of chronic cough. This study proposes a clinical method to detect the causes of chronic cough in a primary care setting in Malaysia. A total of 117 patients aged above 18 at an urban primary care clinic were tracked over a span of 5 months to diagnose the cause of chronic cough. A therapeutic-diagnostic method was employed to help identify the causes of chronic cough. Subsequently, the demographic details of patients, the prevalence of the different causes of chronic cough and the relationship between history and diagnosis were analyzed statistically. Chronic cough had a slightly higher male preponderance (51.3% vs. 48.7%). Patients within the 'above 60' age category had the highest frequency of chronic cough. The most common cause of chronic cough was post-infectious cough (n = 42, 35.9%), followed closely by angiotensin-converting enzyme-inhibitor related cough (n = 14, 12%). Majority of patients had the symptom of phlegm production (n = 41, 54%). 33 patients (29.2%) had recent upper respiratory tract infection (<2 weeks ago) prior to the diagnosis of chronic cough. There were poor association between symptoms and the various entities comprising chronic cough. The exceptions were the following associations: (1) Bronchial asthma and itchiness of throat (P = 0021), (2) gastroesophageal reflux disease and heartburn (P < 0.001), (3) upper airway cough syndrome and running nose (P = 0.016) and (4) pulmonary tuberculosis and absence of weight loss (P = 0.004). This study demonstrates that the effectiveness of a therapeutic-diagnostic technique in the diagnosis of chronic cough. Consistent with previous studies, there was poor association between most symptoms and the causes of chronic cough. A study involving a larger primary care population is required to confirm the findings found in this analysis.

What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.

PubMed

Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

2017-09-07

To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality's perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Orion: Design of a system for assured low-cost human access to space

NASA Technical Reports Server (NTRS)

Elvander, Josh; Heifetz, Andy; Hunt, Teresa; Zhu, Martin

1994-01-01

In recent years, Congress and the American people have begun to seriously question the role and importance of future manned spaceflight. This is mainly due to two factors: a decline in technical competition caused by the collapse of communism, and the high costs associated with the Space Shuttle transportation system. With these factors in mind, the ORION system was designed to enable manned spaceflight at a low cost, while maintaining the ability to carry out diverse missions, each with a high degree of flexibility. It is capable of performing satellite servicing missions, supporting a space station via crew rotation and resupply, and delivering satellites into geosynchronous orbit. The components of the system are a primary launch module, an upper stage, and a manned spacecraft capable of dynamic reentry. For satellite servicing and space station resupply missions, the ORION system utilizes three primary modules, an upper stage, and the spacecraft, which is delivered to low earth orbit and used to rendezvous, transfer materials, and make repairs. For launching a geosynchronous satellite, one primary module and an upper stage are used to deliver the satellite, along with an apogee kick motor, into orbit. The system is designed with reusability and modularity in mind in an attempt to lower cost.

Upper Limit for Regional Sea Level Projections

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

The Estimation of the IRT Reliability Coefficient and Its Lower and Upper Bounds, with Comparisons to CTT Reliability Statistics

ERIC Educational Resources Information Center

Kim, Seonghoon; Feldt, Leonard S.

2010-01-01

The primary purpose of this study is to investigate the mathematical characteristics of the test reliability coefficient rho[subscript XX'] as a function of item response theory (IRT) parameters and present the lower and upper bounds of the coefficient. Another purpose is to examine relative performances of the IRT reliability statistics and two…

Upper-Level Waves of Synoptic Scale at Midlatitudes

NASA Astrophysics Data System (ADS)

Rivest, Chantal

1990-01-01

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

[Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital].

PubMed

Valdovinos-Oregón, D; Ramírez-Mayans, J; Cervantes-Bustamante, R; Toro-Monjaraz, E; Cázares-Méndez, M; Cadena-León, J; Zárate-Mondragón, F; Montijo-Barrios, E

2014-01-01

Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

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

ERIC Educational Resources Information Center

Fernandes, Brian E.

2017-01-01

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

Investigating Metacom's War: Analyzing Rowlandson's Primary Document in Upper-Elementary Classrooms

ERIC Educational Resources Information Center

Campbell, Susan E.

2011-01-01

Metacom's War, also known as King Phillip's War, sets a pattern of national expansion through displacement of native people that echoes throughout American history. Helping students further understand this war through the examination of Mary Rowlandson's primary document provides educators and students with an opportunity to delve deeper into the…

Imports and exports of roundwood in the upper Midwestern United States. Chapter 2.

Treesearch

Charles H. Perry; Mark D. Nelson; Ronald J. Piva

2010-01-01

Industrial roundwood is the raw material produced from harvested trees that is used to manufacture a wide range of wood products. Roundwood is harvested from the forest and is transported to primary manufacturing facilities to be processed into primary and secondary wood products. Roundwood includes sawlogs that are processed into...

Use of Angle Model to Understand Addition and Subtraction of Fractions

ERIC Educational Resources Information Center

Mukwambo, Muzwangowenyu; Ngcoza, Kenneth; Ramasike, Lineo Florence

2018-01-01

Learners in lower primary and even some in upper primary grades grapple to perform mathematical operations which involve fractions. Failure to solve these mathematical operations creates a gap in the teaching and learning processes of mathematics. We opine that this is attributed to use of traditional mathematical approaches of teaching and…

Motivation for Reading and Upper Primary School Students' Academic Achievement in Reading in Kenya

ERIC Educational Resources Information Center

Mucherah, Winnie; Herendeen, Abbey

2013-01-01

This study examined primary school students' reading motivation and performance on the standardized exam. Participants included 901 seventh and eighth grade students from Kenya. There were 468 females and 433 males. Contrary to previous studies, results showed reading challenge and aesthetics, but not efficacy, predicted reading achievement,…

Social Participation and Friendship Quality of Students with Special Educational Needs in Regular Greek Primary Schools

ERIC Educational Resources Information Center

Avramidis, Elias; Avgeri, Georgia; Strogilos, Vasilis

2018-01-01

The study addresses the social participation of integrated students with special educational needs (SEN) in upper primary regular classes in Greece alongside their perceptions of best friend quality. Social participation was defined as consisting of four key dimensions: students' acceptance by classmates, friendships, social self-perceptions, and…

The Contribution of Segmental and Suprasegmental Phonology to Reading Comprehension

ERIC Educational Resources Information Center

Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo

2016-01-01

The aim of the present study was to examine the relation between decoding and segmental and suprasegmental phonology, and their contribution to reading comprehension, in the upper primary grades. Following a longitudinal design, the performance of 99 Dutch primary school students on phonological awareness (segmental phonology) and text-reading…

Use of Switchgrass as the Primary Potting Component in Nursery Containers

USDA-ARS?s Scientific Manuscript database

Pine bark is the primary potting component for nursery containers in Ohio and other Upper Midwest states. Most pine bark comes from lumber or paper mills in southern states. Due to the recent energy crisis, availability of pine bark has declined while the cost to import pine bark from southern sta...

Infection rate after transoral approach for the upper cervical spine.

PubMed

Shousha, Mootaz; Mosafer, Azim; Boehm, Heinrich

2014-09-01

A retrospective review of prospectively collected databases of 139 consecutive patients who underwent transoral surgery for lesions of the upper cervical spine. To analyze the incidence and risk factors of local infection after transoral surgery for the craniocervical junction in a single institution and to compare the findings with the literature. One of the primary risks associated with transoral approach for lesions in the upper cervical spine is postoperative surgical wound infection. From April 1994 to December 2012, 139 consecutive transoral surgical procedures were performed at a single referral center. The mean age at presentation was 53.6 years (range: 5-87 yr), and more than half of the patients were males (58.3%). The majority of cases were experiencing rheumatic diseases (43.9%), whereas tumor destruction was the indication for surgery in 23.7% of the cases. A total of 23% had fracture of the upper cervical spine and primary infection was found in 7 patients (5%). The mean follow-up period was 4.5 years. Infection of the pharyngeal wound occurred in 5 patients (3.6%), solely in the rheumatic and tumor groups. The presentation was mostly in the first 4 months. A single patient with cage reconstruction after giant cell tumor C2 presented with a late infection 5 years postoperatively. Debridement and primary closure was possible in 2 patients, whereas flap coverage of the pharyngeal wall was necessary in 3 patients. The presence of implant did not have a statistically significant effect on the occurrence of infection. However, infection in the presence of titanium cage mostly necessitated flap coverage of the pharyngeal wall after removal of the cage. The transoral route has proved to be an invaluable method of approaching pathological lesions in the upper cervical spine. The infection rate in this work was 3.6%. Patients with rheumatic diseases and patients presenting with tumors were more susceptible to postoperative surgical wound infection. 4.

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

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

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

2013-01-31

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

The upper bound of Pier Scour defined by selected laboratory and field data

USGS Publications Warehouse

Benedict, Stephen; Caldwell, Andral W.

2015-01-01

The U.S. Geological Survey, in cooperation with the South Carolina Department of Transportation, conducted several field investigations of pier scour in South Carolina (Benedict and Caldwell, 2006; Benedict and Caldwell, 2009) and used that data to develop envelope curves defining the upper bound of pier scour. To expand upon this previous work, an additional cooperative investigation was initiated to combine the South Carolina data with pier-scour data from other sources and evaluate the upper bound of pier scour with this larger data set. To facilitate this analysis, a literature review was made to identify potential sources of published pier-scour data, and selected data were compiled into a digital spreadsheet consisting of approximately 570 laboratory and 1,880 field measurements. These data encompass a wide range of laboratory and field conditions and represent field data from 24 states within the United States and six other countries. This extensive database was used to define the upper bound of pier-scour depth with respect to pier width encompassing the laboratory and field data. Pier width is a primary variable that influences pier-scour depth (Laursen and Toch, 1956; Melville and Coleman, 2000; Mueller and Wagner, 2005, Ettema et al. 2011, Arneson et al. 2012) and therefore, was used as the primary explanatory variable in developing the upper-bound envelope curve. The envelope curve provides a simple but useful tool for assessing the potential maximum pier-scour depth for pier widths of about 30 feet or less.

Craniocervical chiropractic procedures – a précis of upper cervical chiropractic

PubMed Central

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

2015-01-01

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

Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study.

PubMed

Massironi, Sara; Cavalcoli, Federica; Rossi, Roberta Elisa; Conte, Dario; Spampatti, Matilde Pia; Ciafardini, Clorinda; Verga, Uberta; Beck-Peccoz, Paolo; Peracchi, Maddalena

2013-05-01

The coexistence of chronic autoimmune atrophic gastritis (CAAG) and primary hyperparathyroidism (PHPT) has been described previously, even if its extent and underlying mechanisms remain poorly understood. We therefore prospectively evaluated this association in two series of patients, one with CAAG and the other with sporadic PHPT. From January 2005 to March 2012, 107 histologically confirmed CAAG patients and 149 PHPT patients were consecutively enrolled. Routine laboratory assays included serum calcium, parathyroid hormone (PTH), plasma gastrin and chromogranin A (CgA). In CAAG patients with high PTH levels, ionized calcium and 25(OH)-vitamin D were evaluated. All CAAG and hypergastrinemic PHPT patients received an upper gastrointestinal endoscopy. Exclusion criteria were familial PHPT, MEN1 syndrome, treatment with proton pump inhibitor drugs, Helicobacter pylori infection and renal failure. Of the 107 CAAG patients, nine (8.4%) had PHPT and 13 (12.1%) had secondary hyperparathyroidism stemming from vitamin D deficiency. Among the 149 PHPT patients, 11 (7.4%) had CAAG. Gastrin and CgA levels were similar in the CAAG patients with vs those without hyperparathyroidism (either primary or secondary), and calcium and PTH levels were similar in the PHPT patients with vs those without CAAG. This study confirms a non-casual association between PHPT and CAAG. The prevalence of PHPT in CAAG patients is threefold that of the general population (8.4 vs 1-3%), and the prevalence of CAAG in PHPT patients is fourfold that of the general population (7.4 vs 2%). The mechanisms underlying this association remain unknown, but a potential role for autoimmunity is suggested.

Ecological contingency in the effects of climatic warming on forest herb communities

USGS Publications Warehouse

Harrison, S.; Damschen, E.I.; Grace, J.B.

2010-01-01

Downscalingfromthe predictions ofgeneral climatemodels is critical to current strategies for mitigating species loss caused by climate change. A key impediment to this downscaling is that we lack a fully developed understanding of howvariation in physical, biological, or land-use characteristics mediates the effects of climate change on ecological communities within regions. We analyzed change in understory herb communities over a 60-y period (1949/1951-2007/ 2009) in a complexmontane landscape (the SiskiyouMountains, Oregon) where mean temperatures have increased 2 ??C since 1948, similar to projections for other terrestrial communities. Our 185 sites included primary and secondary-growth lower montane forests (500-1.200 m above sea level) and primary upper montane to subalpine forests (1,500-2,100 m above sea level). In lower montane forests, regardless of land-use history, we found multiple herbcommunity changes consistent with an effectively drier climate, including lower mean specific leaf area, lower relative cover by species of northern biogeographic affinity, and greater compositional resemblance to communities in southerly topographic positions. At higher elevations we found qualitatively different andmoremodest changes, including increases in herbs of northern biogeographic affinity and in forest canopy cover. Our results provide communitylevel validation of predicted nonlinearities in climate change effects.

Predicting Hail Size Using Model Vertical Velocities

DTIC Science & Technology

2008-03-01

updrafts from a simple cloud model using forecasted soundings . The models used MM5 model data coinciding with severe hail events collected from the...updrafts from a simple cloud model using forecasted soundings . The models used MM5 model data coinciding with severe hail events collected from the...determine their accuracy. Plus they are based primary on observed upper air soundings . Obtaining upper air soundings in proximity to convective

Top studies relevant to primary care practice.

PubMed

Perry, Danielle; Kolber, Michael R; Korownyk, Christina; Lindblad, Adrienne J; Ramji, Jamil; Ton, Joey; Allan, G Michael

2018-04-01

To summarize 10 high-quality studies from 2017 that have strong relevance to primary care practice. Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching the American College of Physicians Journal Club. Topics of the 2017 articles include whether treating subclinical hypothyroidism improves outcomes or symptoms; whether evolocumab reduces cardiovascular disease as well as low-density lipoprotein levels; whether lifestyle interventions reduce medication use in patients with diabetes; whether vitamin D prevents cardiovascular disease, cancer, or upper respiratory tract infections; whether canagliflozin reduces clinical events in patients with diabetes; how corticosteroid injections affect knee osteoarthritis; whether drained abscesses benefit from antibiotic treatment; whether patients with diabetes benefit from bariatric surgery; whether exenatide reduces clinical events in patients with diabetes; and whether tympanostomy tubes affect outcomes in recurrent acute otitis media or chronic otitis media. We provide brief summaries, context where needed, and final recommendations for 10 studies with potential effects on primary care. We also briefly review 5 "runner-up" studies. Research from 2017 produced several high-quality studies in diabetes management. These have demonstrated benefit for alternative therapies and offered evidence not previously available. This year's selection of studies also provided information on a variety of conditions and therapies that are, or might become, more common in primary care settings. Copyright© the College of Family Physicians of Canada.

Climatology of the autumn Red Sea trough

NASA Astrophysics Data System (ADS)

Awad, Adel M.; Mashat, Abdul-Wahab S.

2018-03-01

In this study, the Sudan low and the associated Red Sea trough (RST) are objectively identified using the mean sea level pressure (SLP) data from the National Center for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis dataset covering the period 1955-2015. The Sudan low was detected in approximately 60.6% of the autumn periods, and approximately 83% of the detected low-pressure systems extended into RSTs, with most generated at night and during cold months. The distribution of the RSTs demonstrated that Sudan, South Sudan and Red Sea are the primary development areas of the RSTs, generating 97% of the RSTs in the study period. In addition, the outermost areas affected by RSTs, which include the southern, central and northern Red Sea areas, received approximately 91% of the RSTs originating from the primary generation areas. The synoptic features indicated that a Sudan low developed into an RST when the Sudan low deepened in the atmosphere, while the low pressures over the southern Arabian Peninsula are shallow and the anticyclonic systems are weakened over the northern Red Sea. Moreover, stabile areas over Africa and Arabian Peninsula form a high stability gradient around the Red Sea and the upper maximum winds weaken. The results of the case studies indicate that RSTs extend northward when the upper cyclonic and anticyclonic systems form a high geopotential gradient over Arabian Peninsula. Furthermore, the RST is oriented from the west to the east when the Azores high extends eastward and the Siberian high shrinks eastward or shifts northward.

The relationship between physical activity and work ability - A cross-sectional study of teachers.

PubMed

Grabara, Małgorzata; Nawrocka, Agnieszka; Powerska-Didkowska, Aneta

2018-01-01

To assess relationship between physical activity (PA) and perceived work ability amongst teachers from the Upper Silesia, Poland. The study involved 171 teachers (129 women, 42 men) of primary and secondary schools of the Upper Silesia, Poland. Physical education teachers were excluded from the study. The level of PA was estimated using the International Physical Activity Questionnaire short version, and perceived work ability was estimated using Work Ability Index (WAI). Male teachers had significantly higher levels of vigorous-intensity PA, moderateintensity PA, and total weekly PA than female teachers. The recommendations of the World Health Organization (WHO) met 46% of studied women and 74% of men. Work ability did not differ between male and female teachers. Work ability was related to age, body mass index (BMI), and PA (vigorous-intensity PA, moderate-intensity PA, total weekly PA). The female teachers with excellent or good WAI had significantly higher levels of vigorous-intensity PA, moderate-intensity PA and total weekly PA than female teachers with moderate or poor WAI. The teachers involving in high or moderate intensity PA could improve their work ability. Further studies should focus on relation between physical activity and work ability among teachers of various age and seniority, from both, urban and rural schools. Int J Occup Med Environ Health 2018;31(1):1-9. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Evaluation of the validity of a rapid method for measuring high and low haemoglobin levels in whole blood donors.

PubMed

Shahshahani, Hayedeh J; Meraat, Nahid; Mansouri, Fatemeh

2013-07-01

Haemoglobin screening methods need to be highly sensitive to detect both low and high haemoglobin levels and avoid unnecessary rejection of potential blood donors. The aim of this study was to evaluate the accuracy of measurements by HemoCue in blood donors. Three hundred and fourteen randomly selected, prospective blood donors were studied. Single fingerstick blood samples were obtained to determine the donors' haemoglobin levels by HemoCue, while venous blood samples were drawn for measurement of the haemoglobin level by both HemoCue and an automated haematology analyser as the reference method. The sensitivity, specificity, predictive values and correlation between the reference method and HemoCue were assessed. Cases with a haemoglobin concentration in the range of 12.5-17.9 g/dL were accepted for blood donation. Analysis of paired results showed that haemoglobin levels measured by HemoCue were higher than those measured by the reference method. There was a significant correlation between the reference method and HemoCue for haemoglobin levels less than 12.5 g/dL. The correlation was less strong for increasing haemoglobin levels. Linear correlation was poor for haemoglobin levels over 18 g/dL. Thirteen percent of donors, who had haemoglobin levels close to the upper limit, were unnecessarily rejected. HemoCue is suitable for screening for anaemia in blood donors. Most donors at Yazd are males and a significant percentage of them have haemoglobin values close to the upper limit for acceptance as a blood donor; since these subjects could be unnecessarily rejected on the basis of HemoCue results and testing with this method is expensive, it is recommended that qualitative methods are used for primary screening and accurate quantitative methods used in clinically suspicious cases or when qualitative methods fail.

Assessing Upper-Level Winds on Day-of-Launch

NASA Technical Reports Server (NTRS)

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

2012-01-01

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

Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursodeoxycholic acid.

PubMed

Hirschfield, Gideon M; Mason, Andrew; Luketic, Velimir; Lindor, Keith; Gordon, Stuart C; Mayo, Marlyn; Kowdley, Kris V; Vincent, Catherine; Bodhenheimer, Henry C; Parés, Albert; Trauner, Michael; Marschall, Hanns-Ulrich; Adorini, Luciano; Sciacca, Cathi; Beecher-Jones, Tessa; Castelloe, Erin; Böhm, Olaf; Shapiro, David

2015-04-01

We evaluated the efficacy and safety of obeticholic acid (OCA, α-ethylchenodeoxycholic acid) in a randomized controlled trial of patients with primary biliary cirrhosis who had an inadequate response to ursodeoxycholic acid therapy. We performed a double-blind study of 165 patients with primary biliary cirrhosis (95% women) and levels of alkaline phosphatase (ALP) 1.5- to 10-fold the upper limit of normal. Patients were randomly assigned to groups given 10 mg, 25 mg, or 50 mg doses of OCA or placebo, once daily for 3 months. Patients maintained their existing dose of ursodeoxycholic acid throughout the study. The primary outcome was change in level of ALP from baseline (day 0) until the end of the study (day 85 or early termination). We also performed an open-label extension of the trial in which 78 patients were enrolled and 61 completed the first year. OCA was superior to placebo in achieving the primary end point. Subjects given OCA had statistically significant relative reductions in mean ALP from baseline to the end of the study (P < .0001 all OCA groups vs placebo). Levels of ALP decreased 21%-25% on average from baseline in the OCA groups and 3% in the placebo group. Sixty-nine percent (68 of 99) of patients given OCA had at least a 20% reduction in ALP compared with 8% (3 of 37) of patients given placebo (P < .0003). Among secondary end points, levels of γ-glutamyl transpeptidase decreased 48%-63%, on average, among subjects given OCA, vs a 7% decrease in the group given placebo; levels of alanine aminotransferase decreased 21%-35% on average among subjects given OCA vs none of the patients given placebo. Pruritus was the principal adverse event; incidence values in the OCA 10 mg, 25 mg, and 50 mg groups were 47% (not significantly different), 87% (P < .0003), and 80% (P < .006), respectively, vs 50% in the placebo group. In the extension study, levels of ALP continued to decrease to a mean level of 202 ± 11 U/L after 12 months vs 285 ± 15 U/L at baseline. Daily doses of OCA, ranging from 10 to 50 mg, significantly reduced levels of ALP, γ-glutamyl transpeptidase, and alanine aminotransferase, compared with placebo, in patients with primary biliary cirrhosis who had inadequate responses to ursodeoxycholic acid. The incidence and severity of pruritus were lowest among patients who received 10 mg/d OCA. Biochemical responses to OCA were maintained in a 12-month open-label extension trial. ClinicalTrials.gov ID: NCT00550862. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Mitigation and enhancement techniques for the Upper Mississippi River system and other large river systems

USGS Publications Warehouse

Schnick, Rosalie A.; Morton, John M.; Mochalski, Jeffrey C.; Beall, Jonathan T.

1982-01-01

Extensive information is provided on techniques that can reduce or eliminate the negative impact of man's activities (particularly those related to navigation) on large river systems, with special reference to the Upper Mississippi River. These techniques should help resource managers who are concerned with such river systems to establish sound environmental programs. Discussion of each technique or group of techniques include (1) situation to be mitigated or enhanced; (2) description of technique; (3) impacts on the environment; (4) costs; and (5) evaluation for use on the Upper Mississippi River Systems. The techniques are divided into four primary categories: Bank Stabilization Techniques, Dredging and Disposal of Dredged Material, Fishery Management Techniques, and Wildlife Management Techniques. Because techniques have been grouped by function, rather than by structure, some structures are discussed in several contexts. For example, gabions are discussed for use in revetments, river training structures, and breakwaters. The measures covered under Bank Stabilization Techniques include the use of riprap revetments, other revetments, bulkheads, river training structures, breakwater structures, chemical soil stabilizers, erosion-control mattings, and filter fabrics; the planting of vegetation; the creation of islands; the creation of berms or enrichment of beaches; and the control of water level and boat traffic. The discussions of Dredging and the Disposal of Dredged Material consider dredges, dredging methods, and disposal of dredged material. The following subjects are considered under Fishery Management Techniques: fish attractors; spawning structures; nursery ponds, coves, and marshes; fish screens and barriers; fish passage; water control structures; management of water levels and flows; wing dam modification; side channel modification; aeration techniques; control of nuisance aquatic plants; and manipulated of fish populations. Wildlife Management Techniques include treatments of artificial nest structures, island creation or development, marsh creation or development, greentree reservoirs and mast management, vegetation control, water level control, and revegetation.

The GestureTek virtual reality system in rehabilitation: a scoping review.

PubMed

Glegg, Stephanie M N; Tatla, Sandy K; Holsti, Liisa

2014-03-01

To identify, to map out and to appraise research examining GestureTek virtual reality (VR) use for physical and cognitive rehabilitation and to highlight areas for future research. Scoping review methodology was used to systematically and comprehensively search the academic and grey literature for GestureTek-specific research. Consensus was achieved following two reviewers' independent inclusion screening, data extraction and appraisal. Forty-four studies evaluated the utility and efficacy of the IREX, GX, VMall and Meal Maker software for rehabilitation across a range of populations, with few adverse events reported. Stroke and cerebral palsy research dominated, while geriatrics was largely overlooked. Efficacy research provided support for balance, mobility, upper extremity, cognitive, fitness and daily living skills outcomes for specific populations with effect sizes ranging from 0.19 to 3.34. Nevertheless, few strong quality or high-level studies are available, and no clear guidelines on optimal treatment characteristics exist. Outcomes of primary interest were at ICF body function and activity levels; evaluation of transfer of training across ICF levels is needed. This literature provides preliminary evidence for the technology's efficacy for rehabilitation. Identified research gaps relate to study quality and design, treatment characteristics, populations and outcomes of interest, including transfer across ICF levels. There is limited high-level evidence to support the use of the GestureTek virtual reality system for rehabilitation. Moderate to strong quality evidence exists primarily for the stroke and cerebral palsy populations, and primarily for balance, mobility and upper extremity outcomes. A lack of consistent outcome measures in this body of literature has created "silos" of research that cannot be quantitatively combined using a meta-analytic strategy.

Activities of the National Water-Quality Assessment Program in the upper Snake River Basin, Idaho and western Wyoming, 1991-2001

USGS Publications Warehouse

Low, Walton H.

1997-01-01

In 1991, the U.S. Geological Survey (USGS) began a full-scale National Water-Quality Assessment (NAWQA) Program. The long-term goals of the NAWQA Program are to describe the status and trends in the water quality of a large part of the Nation's rivers and aquifers and to improve understanding of the primary natural and human factors that affect water-quality conditions. In meeting these goals, the program will produce water-quality, ecological, and geographic information that will be useful to policy makers and managers at the national, State, and local levels. A major component of the program is study-unit investigations, upon which national-level assessment activities are based. The program's 60 study-unit investigations are associated with principal river basins and aquifer systems throughout the Nation. Study units encompass areas from 1,200 to more than 65,000 mi2 (square miles) and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the upper Snake River Basin was among the first 20 NAWQA study units selected for implementation. From 1991 to 1995, a high-intensity data-collection phase of the upper Snake River Basin study unit (fig. 1) was implemented and completed. Components of this phase are described in a report by Gilliom and others (1995). In 1997, a low-intensity phase of data collection began, and work continued on data analysis, report writing, and data documentation and archiving activities that began in 1996. Principal data-collection activities during the low-intensity phase will include monitoring of surface-water and ground-water quality, assessment of aquatic biological conditions, and continued compilation of environmental setting information.

Budd-Chiari syndrome with upper gastrointestinal hemorrhage: Characteristic and long-term outcomes of endovascular treatment.

PubMed

Zhou, Peng-Li; Wu, Gang; Han, Xin-Wei; Yan, Lei; Zhang, Wen-Guang

2017-12-01

Purpose To identify the characteristics and evaluate the long-term outcomes of endovascular treatment of Budd-Chiari syndrome with upper gastrointestinal hemorrhage. Methods Forty-seven consecutive Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage were referred for the treatment with percutaneous transluminal balloon angioplasty, and subsequently underwent follow-up. Data were retrospectively collected and follow-up observations were performed at 1, 2, 2-5, and 5-8 years postoperatively. Results Cirrhosis was presented in 16 patients, and splenoportography reviewed obvious varices in 18 patients. Percutaneous transluminal balloon angioplasty was technically successful in all patients. Major procedure-related complications occurred in 3 of the 47 patients (6.38%). The cumulative 1, 2, 2-5, and 5-8 year primary patency rates were 100% (46/46), 93.2% (41/44), 90.9% (40/44), and 86.4% (19/22), respectively. The cumulative 1, 2, 2-5, and 5-8 year secondary patency rates were 100% (47/47), 100% (44/44), 100% (44/44), and 95.5% (21/22), respectively. Mean and median duration of primary patency was 65.17 ± 3.78 and 69.0 ± 5.69 months, respectively. No upper gastrointestinal hemorrhage recurred during follow-ups. The mean survival time was 66.97 ± 3.61 months and the median survival time was 69.0 ± 4.10 months. Conclusion PTBA was an effective treatment that can prevent recurrence of the life-threatening complications and ensured long-term satisfactory clinical outcomes for Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage. Percutaneous transhepatic variceal embolization was not recommended for all Budd-Chiari syndrome patients with upper gastrointestinal hemorrhage.

Type-2 diabetes mellitus reduces cortical thickness and decreases oxidative metabolism in sensorimotor regions after stroke.

PubMed

Ferris, Jennifer K; Peters, Sue; Brown, Katlyn E; Tourigny, Katherine; Boyd, Lara A

2018-05-01

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with stroke and diabetes had lower cortical thickness bilaterally in the primary somatosensory cortex, and primary and secondary motor cortices. Individuals with stroke and diabetes also showed reduced creatine levels bilaterally in the sensorimotor cortex. Contralesional primary and secondary motor cortex thicknesses were negatively related to sensorimotor outcomes in the paretic upper-limb in the stroke and diabetes group such that those with thinner primary and secondary motor cortices had better motor function. These data suggest that type-2 diabetes alters cerebral energy metabolism, and is associated with thinning of sensorimotor cortex after stroke. These factors may influence motor outcomes after stroke.

Site, gender and age variation in normal skin colour on the back and the forearm: tristimulus colorimeter measurements.

PubMed

Fullerton, A; Serup, J

1997-02-01

To study whether anatomical location and age and gender of subjects had any influence on the objective skin colour measurements. Baseline colour in prone position was measured with the Minolta ChromaMeter® in the upper, middle and lower level of the upper back and on the forearm of 168 volunteers. These two sites are commonly used in skin testing. Higher basal a* and lower basal L* levels were found on the upper scapular region compared to the lower scapular region and the subscapular region. The basal b* level showed no variation relative to site. The basal a* and the basal b* levels were lower on the forearm compared to the upper back while the basal L* level was higher. Females above 65 years showed a less coloured skin with lower values as compared to those of younger age. Females were found to have a generally lower basal a* level than males both on the upper back and forearm skin. These relatively major differences and sources of variation have to be considered when planning irritancy studies where colour differences between erythema and normal skin is used.

Molecular Testing in Multiple Synchronous Lung Adenocarcinomas: Case Report and Literature Review.

PubMed

Rafael, Oana C; Lazzaro, Richard; Hasanovic, Adnan

2016-02-01

Discovery of driver mutations in pulmonary adenocarcinoma has revolutionized the field of thoracic oncology with major impact on therapy and diagnosis. Testing for EGFR, ALK, and KRAS mutations has become part of everyday practice. We report a case with multiple synchronous primary pulmonary adenocarcinomas in a 72-year-old female with previous history of smoking. The patient presented with cough and bilateral lung ground glass opacities. A positron emission tomography/computed tomography scan showed no activity in mediastinal lymph nodes. She underwent a left upper lobe biopsy and a right upper lobe wedge resection. Pathology revealed 4 morphologically distinct adenocarcinoma foci, suggestive of synchronous primary lung tumors. Molecular testing demonstrated no mutation in the left tumor. Three different driver mutations were present in the right lung tumors: KRAS codon 12 G12D and G12V and EGFR exon 21 L858R mutation, confirming the initial histologic impression. Subsequently, left upper lobe lobectomy showed 3 additional foci of adenocarcinoma with different morphologies, suggestive of synchronous primaries as well. No additional molecular testing was performed. Synchronous pulmonary adenocarcinomas are not uncommon; however, 4 or more synchronous tumors are rare. Distinguishing multiple primary tumors from intrapulmonary metastases is a common problem in thoracic oncology with major implications for staging, prognosis, and treatment. Lung adenocarcinoma subclassification based on predominant and coexisting histologic patterns can greatly facilitate differentiation between intrapulmonary metastases and multiple synchronous tumors. Use of molecular profiling is recommended since it further increases confidence in the diagnostic workup of multiple pulmonary adenocarcinomas and helps guiding therapy. © The Author(s) 2015.

Heart Rates in Hospitalized Children by Age and Body Temperature

PubMed Central

Bonafide, Christopher P.; Brady, Patrick W.

2015-01-01

BACKGROUND AND OBJECTIVES: Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient’s severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings. METHODS: Vital sign data were extracted from electronic health records of inpatients <18 years of age at 2 large freestanding children’s hospitals from July 2011 to June 2012. We selected up to 10 HR-temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings. RESULTS: We used 60 863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher. CONCLUSIONS: We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia. PMID:25917984

Heart rates in hospitalized children by age and body temperature.

PubMed

Daymont, Carrie; Bonafide, Christopher P; Brady, Patrick W

2015-05-01

Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient's severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings. Vital sign data were extracted from electronic health records of inpatients <18 years of age at 2 large freestanding children's hospitals from July 2011 to June 2012. We selected up to 10 HR-temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings. We used 60,863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼ 10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher. We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia. Copyright © 2015 by the American Academy of Pediatrics.

Development and Lab-Scale Testing of a Gas Generator Hybrid Fuel in Support of the Hydrogen Peroxide Hybrid Upper Stage Program

NASA Technical Reports Server (NTRS)

Lund, Gary K.; Starrett, William David; Jensen, Kent C.; McNeal, Curtis (Technical Monitor)

2001-01-01

As part of a NASA funded contract to develop and demonstrate a gas generator cycle hybrid rocket motor for upper stage space motor applications, the development and demonstration of a low sensitivity, high performance fuel composition was undertaken. The ultimate goal of the development program was to demonstrate successful hybrid operation (start, stop, throttling) of the fuel with high concentration (90+%) hydrogen peroxide. The formulation development and lab-scale testing of a simple DOT Class 1.4c gas generator propellant is described. Both forward injected center perforated and aft injected end burner hybrid combustion behavior were evaluated with gaseous oxygen and catalytically decomposed 90% hydrogen peroxide. Cross flow and static environments were found to yield profoundly different combustion behaviors, which were further governed by binder type, oxidizer level and, significantly, oxidizer particle size. Primary extinguishment was accomplished via manipulation of PDL behavior and oxidizer turndown, which is enhanced with the hydrogen peroxide system. Laboratory scale combustor results compared very well with 11-inch and 24-inch sub-scale test results with 90% hydrogen peroxide.

Analysing the Relationship between the Problem-Solving-Related Beliefs, Competence and Teaching of Three Cypriot Primary Teachers

ERIC Educational Resources Information Center

Andrews, Paul; Xenofontos, Constantinos

2015-01-01

In this article, we analyse the problem-solving-related beliefs, competence and classroom practice of three Cypriot upper-primary teachers. Data derived from semi-structured interviews focused on teachers' beliefs about the nature of mathematical problems, problem-solving, and their competence as both problem-solvers and teachers of…

Primary Teachers' Beliefs about Scientific Creativity in the Classroom Context

ERIC Educational Resources Information Center

Liu, Shu-Chiu; Lin, Huann-shyang

2014-01-01

While a number of studies have investigated people's perceptions or conceptions of creativity, there is a lack of studies looking into science teachers' views. The study aimed to explore the meanings of scientific creativity in the classroom context as perceived by a selective group of upper primary (Grades 3-6; student ages 8-12) science teachers…

Teaching Children to Organise and Represent Large Data Sets in a Histogram

ERIC Educational Resources Information Center

Nisbet, Steven; Putt, Ian

2004-01-01

Although some bright students in primary school are able to organise numerical data into classes, most attend to the characteristics of individuals rather than the group, and "see the trees rather than the forest". How can teachers in upper primary and early high school teach students to organise large sets of data with widely varying…

75 FR 19277 - PLMR Licensing; Frequency Coordination and Eligibility Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

... band (1427-1429.5 MHz), and non-medical telemetry in the upper half of the band (1429.5-1432 MHz). Non... secondary basis on those portions of the 1427-1432 MHz shared band where non-medical telemetry is primary...-medical telemetry has primary status. Some WMTS operations in the portions of the 1427-1432 MHz band where...

The Effects of Video Feedback Coaching for Teachers on Scientific Knowledge of Primary Students

ERIC Educational Resources Information Center

van Vondel, Sabine; Steenbeek, Henderien; van Dijk, Marijn; van Geert, Paul

2018-01-01

The present study was aimed at investigating the effects of a video feedback coaching intervention for upper-grade primary school teachers on students' cognitive gains in scientific knowledge. This teaching intervention was designed with the use of inquiry-based learning principles for teachers, such as the empirical cycle and the posing of…

Exploring the Cognitive Demand and Features of Problem Solving Tasks in Primary Mathematics Classrooms

ERIC Educational Resources Information Center

McCormick, Melody

2016-01-01

Student learning is greatest in classrooms where students engage in problem solving tasks that are cognitively demanding. However, there are growing concerns that many Australian students are given limited opportunities to engage in these types of tasks. 108 upper primary school teachers were surveyed to examine task features and cognitive demand…

Movement-Dependent Stroke Recovery: A Systematic Review and Meta-Analysis of TMS and fMRI Evidence

ERIC Educational Resources Information Center

Richards, Lorie G.; Stewart, Kim C.; Woodbury, Michelle L.; Senesac, Claudia; Cauraugh, James H.

2008-01-01

Evidence indicates that experience-dependent cortical plasticity underlies post-stroke motor recovery of the impaired upper extremity. Motor skill learning in neurologically intact individuals is thought to involve the primary motor cortex, and the majority of studies in the animal literature have studied changes in the primary sensorimotor cortex…

Antibiotic prescribing for upper respiratory-tract infections in primary care.

PubMed

Patterson, Craig A; Mackson, Judith M; Weekes, Lynn M

2003-01-01

The use and overuse of antibiotics in humans is a major contributor to the selection of antibiotic resistance organisms. Recent evidence has shown that primary care prescribing selects for resistances of clinical importance. The National Prescribing Service runs both educational and audit activities. The latter provide some insight into general practice attitudes toward antibiotic prescribing.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Integrated Molecular Profiling in Advanced Cancers Trial

ClinicalTrials.gov

2018-02-26

Breast Cancer; Non-small Cell Lung Cancer; Colorectal Cancer; Genitourinary Cancer; Pancreatobiliary Gastrointestinal Cancer; Upper Aerodigestive Tract Cancer; Gynecological Cancers; Melanoma Cancers; Rare Cancers; Unknown Primary Cancers

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

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

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

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

Initializing a Mesoscale Boundary-Layer Model with Radiosonde Observations

NASA Astrophysics Data System (ADS)

Berri, Guillermo J.; Bertossa, Germán

2018-01-01

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

Single-specialty management and reconstruction of necrotizing fasciitis of the upper extremities: clinical and economic benefits from a case series.

PubMed

Mattison, Gennaya; Leis, Amber R; Gupta, Subhas C

2014-05-01

Patients with necrotizing fasciitis are managed with multiple prompt, radical surgical debridements and critical care support. Debridement and reconstruction are often provided by different surgical teams. Anecdotally, single-specialty management seemed to be a more efficient management strategy. This study aimed to investigate and compare the outcomes of management by plastic surgery versus multiple disciplines through a retrospective economic and clinical analysis of patients with necrotizing fasciitis treated over 8 years. We also present 3 index cases for which our service functioned as the primary management team. Necrotizing fasciitis cases evaluated and treated by our department, covering both Level I and Level II Trauma Centers, were reviewed for total charges, length of hospital stay, length of intensive care unit (ICU) stay, and number of procedures. The admission Acute Physiology and Chronic Health Evaluation II score was calculated for each patient. Three comparative index cases of upper extremity necrotizing fasciitis managed primarily by the plastic surgery team are presented in greater detail. Patients managed primarily by the plastic surgery service had equivalent Acute Physiology and Chronic Health Evaluation II scores to patients managed by multiple services for their necrotizing fasciitis, with the average score higher for patients managed by plastic surgery alone. In a case-matched series of upper extremity necrotizing fasciitis, the patients admitted directly to plastic surgery had shorter average lengths of hospital and ICU stays as well as decreased total number of procedures, resulting in decreased average total hospital charges. There were no amputations among the cases treated primarily by the plastic surgery. The patients also required smaller areas of reconstruction with skin grafting despite large initial areas of debridement compared to those whose reconstructive teams differed from the team performing the debridement. Improved economic and clinical outcomes-as indicated by the reduced lengths of overall and ICU stay, the reduced number of procedures, none of the cases requiring amputation, and the reduced need for skin grafting-may be attainable when the surgeon eventually performing the reconstruction is involved early in management. We propose that, in the interest of improving patient care, a closer collaboration should be established between the reconstructive and primary managing teams.

[Should morphology of the upper pole in renal duplication with preserved function and associated ureterocele be taken into account during treatment planning?].

PubMed

Materny, Jacek; Chojnacka, Hanna; Urasińska, Elzbieta; Gawrych, Elzbieta

2011-01-01

The aim of this study was to assess structural changes of the upper pole in renal duplication with coexisting ureterocele with regard to primary and/or secondary lesions. These changes might be of importance in treatment planning. The material of this study consisted of clinical documentation and results of histopathology of 23 upper poles removed due to renal duplication with coexisting ureterocele. The qualification criterion was preserved function of the upper pole seen with 99mTc-DTPA (99mTechnetium diethylenetriaminepentaacetic acid)/99mTc-DMSA (99mTechnetium dimercaptosuccinic acid). Resection of the upper pole was indicated in patients with recurrent urinary tract infections and/or persistent vesicoureteral reflux to the lower pole following endoscopic surgery of the ureterocele and/or low function of the upper pole. Morphological lesions were classified as primary (dysplasia) or secondary lesions. The patients were operated at the Department of Pediatric and Oncologic Surgery, PMU, in 1990-2008. The study group consisted of 17 girls and 6 boys aged from 4 months to 9 years (mean 40 months). Recurrent urinary tract infections noted in 16 (70%) children were the most frequent indication for surgery. The preoperative mean function of the renal poles assessed with DTPA/DMSA represented 6% of the differential renal function. Dysplasia was identified in eight resected renal poles (34%) with coexisting secondary lesions in three of them. Secondary lesions only were seen in 15 poles (66%). There was no correlation between age and incidence of dysplasia during follow-up (Pearson's correlation coefficient r = 0.031). Secondary lesions are a quite frequent finding in resected upper poles. As 66% of the renal poles studied with histopathology revealed secondary lesions only, we believe that renal sparing treatment is justified in cases of urinary duplication with coexisting ureterocele.

Cortical disconnection of the ipsilesional primary motor cortex is associated with gait speed and upper extremity motor impairment in chronic left hemispheric stroke.

PubMed

Peters, Denise M; Fridriksson, Julius; Stewart, Jill C; Richardson, Jessica D; Rorden, Chris; Bonilha, Leonardo; Middleton, Addie; Gleichgerrcht, Ezequiel; Fritz, Stacy L

2018-01-01

Advances in neuroimaging have enabled the mapping of white matter connections across the entire brain, allowing for a more thorough examination of the extent of white matter disconnection after stroke. To assess how cortical disconnection contributes to motor impairments, we examined the relationship between structural brain connectivity and upper and lower extremity motor function in individuals with chronic stroke. Forty-three participants [mean age: 59.7 (±11.2) years; time poststroke: 64.4 (±58.8) months] underwent clinical motor assessments and MRI scanning. Nonparametric correlation analyses were performed to examine the relationship between structural connectivity amid a subsection of the motor network and upper/lower extremity motor function. Standard multiple linear regression analyses were performed to examine the relationship between cortical necrosis and disconnection of three main cortical areas of motor control [primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA)] and motor function. Anatomical connectivity between ipsilesional M1/SMA and the (1) cerebral peduncle, (2) thalamus, and (3) red nucleus were significantly correlated with upper and lower extremity motor performance (P ≤ 0.003). M1-M1 interhemispheric connectivity was also significantly correlated with gross manual dexterity of the affected upper extremity (P = 0.001). Regression models with M1 lesion load and M1 disconnection (adjusted for time poststroke) explained a significant amount of variance in upper extremity motor performance (R 2  = 0.36-0.46) and gait speed (R 2  = 0.46), with M1 disconnection an independent predictor of motor performance. Cortical disconnection, especially of ipsilesional M1, could significantly contribute to variability seen in locomotor and upper extremity motor function and recovery in chronic stroke. Hum Brain Mapp 39:120-132, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

ORNL-TNS/PEPR overall heating requirements

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

Peng, Y. K.M.; Rome, J. A.

1977-01-01

The ORNL TNS/PEPR studies have the objectives of (1) leading to a system that demonstrates the fusion reactor core in the mid-to-late 1980's and extrapolates to an economic tokamak power reactor, and (2) providing a near-term focus for the scientific and technological programs toward the power reactor. This discussion of the overall heating requirements for the ORNL TNS/PEPR is concerned with the neutral beams as the primary heating method, the electron-cyclotron resonance (ECR) heating at a lower power level for profile control, and the upper hybrid resonance (UHR) initiation and preheating of currentless plasmas to reduce current start-up loop voltagemore » (V/sub l/) requirements.« less

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

ERIC Educational Resources Information Center

DeKorver, Brittland K.; Towns, Marcy H.

2016-01-01

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

Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus.

PubMed

Verit, Ayhan; Savas, Murat; Ciftci, Halil; Unal, Dogan; Yeni, Ercan; Kaya, Mete

2006-02-01

Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

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

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

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

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

PubMed

Walker-Bone, K; Cooper, C

2005-08-01

Pain in the neck and upper limb is common and contributes greatly to absence due to sickness. Evidence is accumulating that factors such as prolonged abnormal posture and repetition contribute to these conditions. Psychosocial factors may also play a part and the relative importance of these is not yet known. Primary and secondary prevention trials are needed.

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

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

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

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

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

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

The effect of middle-age body weight and physical activity on the risk of early revision hip arthroplasty: a cohort study of 1,535 individuals.

PubMed

Flugsrud, Gunnar B; Nordsletten, Lars; Espehaug, Birgitte; Havelin, Leif I; Meyer, Haakon E

2007-02-01

Overweight and a high level of physical activity are known risk factors for loosening of a total hip arthroplasty (THA) due to primary osteoarthritis. We wanted to investigate how these factors, together with age and sex, affect the risk of revision surgery. We matched data from the Norwegian Arthroplasty Register with information on risk factors collected at a cardiovascular screening. We identified 1,535 primary THAs in the screened cohort (930 cemented implants using well-documented cement). Of the participants included, 969 were female. Mean age at screening was 49 years, at primary THA 63 years, and 69 years at the end of follow-up. We used Cox regression analysis to estimate relative risks (RRs). Event was defined as implant revision due to aseptic loosening of cup, stem or both. Follow-up was time from primary THA to event or censoring. Men were at greater risk than women of loosening of the femoral stem (RR 2.0, 95% CI 1.3-3.2). Both men and women with upper-quartile body weight were at increased risk of revision due to loosening of the stem (RR 2.5 and 2.7, respectively). Men with a high level of physical activity during leisure time were at increased risk of revision due to loosening of the cup (RR 4.8, 95% CI 1.3-18). In the multivariate model with adjustment for activity, there was little association between age at primary THA and risk of revision due to loosening. We found that body weight and physical activity recorded long before THA affected the survival of total hip arthroplasties. Controlling for these variables weakened the association between age at primary surgery and aseptic loosening. Men had an increased risk of loosening of the femoral stem, also after controlling for lifestyle factors.

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

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

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

Primary gastric mucosa associated lymphoid tissue lymphoma: Clinical data predicted treatment outcome

PubMed Central

Todorovic, Milena; Balint, Bela; Jevtic, Miodrag; Suvajdzic, Nada; Ceric, Amela; Stamatovic, Dragana; Markovic, Olivera; Perunicic, Maja; Marjanovic, Slobodan; Krstic, Miodrag

2008-01-01

AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy. METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MALT) lymphoma (Ann Arbor stages I to IV) were enrolled. All had upper gastric endoscopy, abdominal ultrasonography, CT and H pylori status assessment (histology and serology). After anti-H pylori treatment and initial chemotherapy, patients were re-examined every 4 mo. RESULTS: Histological regression of the lymphoma was complete in 22/34 (64.7%) and partial in 9 (26.5%) patients. Median follow up time for these 31 responders was 60 mo (range 48-120). No regression was noted in 3 patients. Among the 25 (73.5%) H pylori positive patients, the eradication rate was 100%. CONCLUSION: Using univariate analysis, predictive factors for overall survival were international prognostic index (IPI) score, hemoglobin level, erythrocyte sedimentation rate (ESR), and platelet numbers (P < 0.005). In addition to this, Cox proportion hazard model differentiate IPI score, ESR, and platelets as predictors of survival. PMID:18416467

Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE): a randomized controlled trial protocol.

PubMed

Winstein, Carolee J; Wolf, Steven L; Dromerick, Alexander W; Lane, Christianne J; Nelsen, Monica A; Lewthwaite, Rebecca; Blanton, Sarah; Scott, Charro; Reiss, Aimee; Cen, Steven Yong; Holley, Rahsaan; Azen, Stanley P

2013-01-11

Residual disability after stroke is substantial; 65% of patients at 6 months are unable to incorporate the impaired upper extremity into daily activities. Task-oriented training programs are rapidly being adopted into clinical practice. In the absence of any consensus on the essential elements or dose of task-specific training, an urgent need exists for a well-designed trial to determine the effectiveness of a specific multidimensional task-based program governed by a comprehensive set of evidence-based principles. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Stroke Initiative is a parallel group, three-arm, single blind, superiority randomized controlled trial of a theoretically-defensible, upper extremity rehabilitation program provided in the outpatient setting.The primary objective of ICARE is to determine if there is a greater improvement in arm and hand recovery one year after randomization in participants receiving a structured training program termed Accelerated Skill Acquisition Program (ASAP), compared to participants receiving usual and customary therapy of an equivalent dose (DEUCC). Two secondary objectives are to compare ASAP to a true (active monitoring only) usual and customary (UCC) therapy group and to compare DEUCC and UCC. Following baseline assessment, participants are randomized by site, stratified for stroke duration and motor severity. 360 adults will be randomized, 14 to 106 days following ischemic or hemorrhagic stroke onset, with mild to moderate upper extremity impairment, recruited at sites in Atlanta, Los Angeles and Washington, D.C. The Wolf Motor Function Test (WMFT) time score is the primary outcome at 1 year post-randomization. The Stroke Impact Scale (SIS) hand domain is a secondary outcome measure.The design includes concealed allocation during recruitment, screening and baseline, blinded outcome assessment and intention to treat analyses. Our primary hypothesis is that the improvement in log-transformed WMFT time will be greater for the ASAP than the DEUCC group. This pre-planned hypothesis will be tested at a significance level of 0.05. ICARE will test whether ASAP is superior to the same number of hours of usual therapy. Pre-specified secondary analyses will test whether 30 hours of usual therapy is superior to current usual and customary therapy not controlled for dose. www.ClinicalTrials.gov Identifier: NCT00871715

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

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

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

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

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

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

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

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

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

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

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

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

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

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2013-01-01

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

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

PubMed

Davidson, Judith

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

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

PubMed

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

2010-03-01

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

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

PubMed Central

2014-01-01

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

Climate-driven shifts in quantity and seasonality of river discharge over the past 1000 years from the hydrographic apex of North America

NASA Astrophysics Data System (ADS)

Wolfe, Brent B.; Hall, Roland I.; Edwards, Thomas W. D.; Jarvis, Suzanne R.; Sinnatamby, R. Niloshini; Yi, Yi; Johnston, John W.

2008-12-01

Runoff generated from high elevations is the primary source of freshwater for western North America, yet this critical resource is managed on the basis of short instrumental records that capture an insufficient range of climatic conditions. Here we probe the effects of climate change over the past ~1000 years on river discharge in the upper Mackenzie River system based on paleoenvironmental information from the Peace-Athabasca Delta. The delta landscape responds to hydroclimatic changes with marked variability, while Lake Athabasca level appears to directly monitor overall water availability. The latter fluctuated systematically over the past millennium, with the highest levels occurring in concert with maximum glacier extent during the Little Ice Age, and the lowest during the 11th century, prior to medieval glacier expansion. Recent climate-driven hydrological change appears to be on a trajectory to even lower levels as high-elevation snow and glacier meltwater contributions both continue to decline.

Does Classroom Composition Make a Difference: Effects on Developments in Motivation, Sense of Classroom Belonging, and Achievement in Upper Primary School

ERIC Educational Resources Information Center

Hornstra, Lisette; van der Veen, Ineke; Peetsma, Thea; Volman, Monique

2015-01-01

The present study investigated the effects of socioeconomic and ethnic classroom composition on developments in students' motivation, sense of classroom belonging, and achievement. A sample of 722 primary school students completed questionnaires from 3rd to 6th grade. Latent growth curve analyses revealed that the reading comprehension scores of…

Fostering Writing in Upper Primary Grades: A Study into the Distinct and Combined Impact of Explicit Instruction and Peer Assistance

ERIC Educational Resources Information Center

De Smedt, Fien; Van Keer, Hilde

2018-01-01

As writing is a complex and resource demanding task, high-quality writing instruction is indispensable from primary grades on to support beginning writers in developing effective writing skills. Writing research should therefore provide teachers and schools with evidence-based guidelines for teaching writing in daily practice. In this respect, the…

A Longitudinal Study of the Role of Reading Motivation in Primary Students' Reading Comprehension: Implications for a Less Simple View of Reading

ERIC Educational Resources Information Center

Cartwright, Kelly B.; Marshall, Timothy R.; Wray, Erica

2016-01-01

Although substantial research indicates motivation contributes significant variance to reading comprehension in upper elementary students, research with students in primary grades has focused, instead, on the relation of motivation to word reading. Assessment of reading motivation in 68 first and second graders indicated word and nonword reading…

A Task Analysis of a Sport Education Physical Education Season for Fourth Grade Students

ERIC Educational Resources Information Center

Layne, Todd; Hastie, Peter

2015-01-01

Background: Previous research on Sport Education in which the participants were in the primary grades has focused on perceptions of fun and enjoyment as well as other components of motivation. To date, no study in Sport Education has examined the accomplishment of the various instructional and managerial tasks by upper primary school children,…

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

ERIC Educational Resources Information Center

Treacy, Páraic Thomas

2018-01-01

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

Radical and sparing surgical treatment of patients with upper urinary tract transitional cell carcinomas (UUT -TCC) - preliminary results.

PubMed

Jabłonowski, Zbigniew; Kędzierski, Robert; Sosnowski, Marek

2011-01-01

Tumors originating from transitional epithelium of the renal pelvis and ureter are infrequent. Their course is asymptomatic at early stages of the disease, and diagnosis and institution of appropriate treatment delayed. The aim of the study is to assess the results of treatment in patients with upper urinary tract transitional cell carcinomas (UUT-TCC). Fifteen patients treated in 2005-2010 for UUT-TCC were qualified for the retrospective study. Clinical symptoms, diagnostic methods, tumor location, clinical stage and histopathological characteristics of the tumors were assessed. Then, the instituted treatment and its results were analyzed. The average follow-up period was 51 month (range 6-65), UUT-TCC accounted for 6.7% of renal tumors treated. Concurrent treated vesical tumors were observed in 4 (26.7%) patients. Primary UUT-TCC was diagnosed in 10 (66.7%) patients. Radical surgery was performed in 10 (66.7%) patients, whereas 5 (33.3%) underwent sparing operations. Macroscopic hematuria was the predominant clinical symptom. In most cases T2-T3 clinical stage (60.0%) and high-grade (66.7%) were observed. Development of an upper urinary tract tumor after treatment of a vesical tumor was noted in 4 (26.7%) patients. During the follow-up period, urinary bladder carcinomas were diagnosed in 5 (33.3%) patients with primary upper urinary tract tumors. Nephroureterectomy remains the standard treatment for UUT-TCC. Organ-sparing surgery is possible in selected patients with low clinical stage and low grade tumors. Patients treated for urinary bladder carcinomas require regular monitoring of the upper urinary tract.

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

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

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

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

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

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

Anapole dark matter annihilation into photons

NASA Astrophysics Data System (ADS)

Latimer, David C.

2017-05-01

In models of anapole dark matter (DM), the DM candidate is a Majorana fermion whose primary interaction with standard model (SM) particles is through an anapole coupling to off-shell photons. As such, at tree-level, anapole DM undergoes p-wave annihilation into SM charged fermions via a virtual photon. But, generally, Majorana fermions are polarizable, coupling to two real photons. This fact admits the possibility that anapole DM can annihilate into two photons in an s-wave process. Using an explicit model, we compute both the tree-level and diphoton contributions to the anapole DM annihilation cross section. Depending on model parameters, the s-wave process can either rival or be dwarfed by the p-wave contribution to the total annihilation cross section. Subjecting the model to astrophysical upper bounds on the s-wave annihilation mode, we rule out the model with large s-wave annihilation.

NO(x) Concentrations in the Upper Troposphere as a Result of Lightning

NASA Technical Reports Server (NTRS)

Penner, Joyce E.

1998-01-01

Upper tropospheric NO(x) controls, in part, the distribution of ozone in this greenhouse-sensitive region of the atmosphere. Many factors control NO(x) in this region. As a result it is difficult to assess uncertainties in anthropogenic perturbations to NO from aircraft, for example, without understanding the role of the other major NO(x) sources in the upper troposphere. These include in situ sources (lightning, aircraft), convection from the surface (biomass burning, fossil fuels, soils), stratospheric intrusions, and photochemical recycling from HNO3. This work examines the separate contribution to upper tropospheric "primary" NO(x) from each source category and uses two different chemical transport models (CTMS) to represent a range of possible atmospheric transport. Because aircraft emissions are tied to particular pressure altitudes, it is important to understand whether those emissions are placed in the model stratosphere or troposphere and to assess whether the models can adequately differentiate stratospheric air from tropospheric air. We examine these issues by defining a point-by-point "tracer tropopause" in order to differentiate stratosphere from troposphere in terms of NO(x) perturbations. Both models predict similar zonal average peak enhancements of primary NO(x) due to aircraft (approx. = 10-20 parts per trillion by volume (pptv) in both January and July); however, the placement of this peak is primarily in a region of large stratospheric influence in one model and centered near the level evaluated as the tracer tropopause in the second. Below the tracer tropopause, both models show negligible NO(x) derived directly from the stratospheric source. Also, they predict a typically low background of 1 - 20 pptv NO(x) when tropospheric HNO3 is constrained to be 100 pptv of HNO3. The two models calculate large differences in the total background NO(x) (defined as the source of NO(x) from lightning + stratosphere + surface + HNO3) when using identical loss frequencies for NO(x). This difference is primarily due to differing treatments of vertical transport. An improved diagnosis of this transport that is relevant to NO(x) requires either measurements of a surface-based tracer with a substantially shorter lifetime than Rn-222 or diagnosis and mapping of tracer correlations with different source signatures. Because of differences in transport by the two models we cannot constrain the source of NO(x) from lightning through comparison of average model concentrations with observations of NO(x).

Sedimentology of the upper Karoo fluvial strata in the Tuli Basin, South Africa

NASA Astrophysics Data System (ADS)

Bordy, Emese M.; Catuneanu, Octavian

2001-08-01

The sedimentary rocks of the Karoo Supergroup in the Tuli Basin (South Africa) may be grouped in four stratigraphic units: the basal, middle and upper units, and the Clarens Formation. This paper presents the findings of the sedimentological investigation of the fluvial terrigenous clastic and chemical deposits of the upper unit. Evidence provided by primary sedimentary structures, palaeontological record, borehole data, palaeo-flow measurements and stratigraphic relations resulted in the palaeo-environmental reconstruction of the upper unit. The dominant facies assemblages are represented by sandstones and finer-grained sediments, which both can be interbedded with subordinate intraformational coarser facies. The facies assemblages of the upper unit are interpreted as deposits of a low-sinuosity, ephemeral stream system with calcretes and silcretes in the dinosaur-inhabited overbank area. During the deposition of the upper unit, the climate was semi-arid with sparse precipitation resulting in high-magnitude, low-frequency devastating flash floods. The current indicators of the palaeo-drainage system suggest flow direction from northwest to southeast, in a dominantly extensional tectonic setting. Based on sedimentologic and biostratigraphic evidence, the upper unit of the Tuli Basin correlates to the Elliot Formation in the main Karoo Basin to the south.

Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: a randomised controlled trial protocol.

PubMed

Johnson, Liam; Bird, Marie-Louise; Muthalib, Makii; Teo, Wei-Peng

2018-01-09

The STRoke Interactive Virtual thErapy (STRIVE) intervention provides community-dwelling stroke survivors access to individualised, remotely supervised progressive exercise training via an online platform. This trial aims to determine the clinical efficacy of the STRIVE intervention and its effect on brain activity in community-dwelling stroke survivors. In a multisite, assessor-blinded randomised controlled trial, 60 stroke survivors >3 months poststroke with mild-to-moderate upper extremity impairment will be recruited and equally randomised by location (Melbourne, Victoria or Launceston, Tasmania) to receive 8 weeks of virtual therapy (VT) at a local exercise training facility or usual care. Participants allocated to VT will perform 3-5 upper limb exercises individualised to their impairment severity and preference, while participants allocated to usual care will be asked to maintain their usual daily activities. The primary outcome measures will be upper limb motor function and impairment, which will be assessed using the Action Research Arm Test and Upper Extremity Fugl-Meyer, respectively. Secondary outcome measures include upper extremity function and spasticity, as measured by the box and block test and Modified AshworthScale, respectively, and task-related changes in bilateral sensorimotor cortex haemodynamics during hand reaching and wrist extension movements as measured by functional near-infrared spectroscopy. Quality of life will be measured using the Euro-Quality of Life-5 Dimension-5 Level Scale, and the Motor Activity Log-28 will be used to measure use of the hemiparetic arm. All measures will be assessed at baseline and immediately postintervention. The study was approved by the Deakin University Human Research Ethics Committee in May 2017 (No. 2017-087). The results will be disseminated in peer-reviewed journals and presented at major international stroke meetings. ACTRN12617000745347; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: a randomised controlled trial protocol

PubMed Central

Bird, Marie-Louise; Muthalib, Makii

2018-01-01

Introduction The STRoke Interactive Virtual thErapy (STRIVE) intervention provides community-dwelling stroke survivors access to individualised, remotely supervised progressive exercise training via an online platform. This trial aims to determine the clinical efficacy of the STRIVE intervention and its effect on brain activity in community-dwelling stroke survivors. Methods and analysis In a multisite, assessor-blinded randomised controlled trial, 60 stroke survivors >3 months poststroke with mild-to-moderate upper extremity impairment will be recruited and equally randomised by location (Melbourne, Victoria or Launceston, Tasmania) to receive 8 weeks of virtual therapy (VT) at a local exercise training facility or usual care. Participants allocated to VT will perform 3–5 upper limb exercises individualised to their impairment severity and preference, while participants allocated to usual care will be asked to maintain their usual daily activities. The primary outcome measures will be upper limb motor function and impairment, which will be assessed using the Action Research Arm Test and Upper Extremity Fugl-Meyer, respectively. Secondary outcome measures include upper extremity function and spasticity, as measured by the box and block test and Modified AshworthScale, respectively, and task-related changes in bilateral sensorimotor cortex haemodynamics during hand reaching and wrist extension movements as measured by functional near-infrared spectroscopy. Quality of life will be measured using the Euro-Quality of Life-5 Dimension-5 Level Scale, and the Motor Activity Log-28 will be used to measure use of the hemiparetic arm. All measures will be assessed at baseline and immediately postintervention. Ethics and dissemination The study was approved by the Deakin University Human Research Ethics Committee in May 2017 (No. 2017–087). The results will be disseminated in peer-reviewed journals and presented at major international stroke meetings. Trial registration number ACTRN12617000745347; Pre-results. PMID:29317414

The Effects of Upper-Secondary Education and Training Systems on Skills Inequality. A Quasi-Cohort Analysis Using PISA 2000 and the OECD Survey of Adult Skills

ERIC Educational Resources Information Center

Green, Andy; Pensiero, Nicola

2016-01-01

Research tells us much about the effects of primary and lower-secondary schooling on skills inequality, but we know less about the impact of the next stage of education. This article uses a differences-in-differences analysis of data on literacy and numeracy skills in PISA 2000 and SAS 2011/12 to assess the contribution of upper-secondary…

[Comparison of SIB-IMRT treatment plans for upper esophageal carcinoma].

PubMed

Fu, Wei-hua; Wang, Lv-hua; Zhou, Zong-mei; Dai, Jian-rong; Hu, Yi-min

2003-06-01

To implement simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT) plans for upper esophageal carcinoma and investigate the dose profiles of tumor and electively treated region and the dose to organs at risk (OARs). SIB-IMRT plans were designed for two patients with upper esophageal carcinoma. Two target volumes were predefined: PTV1, the target volume of the primary lesion, which was given to 67.2 Gy, and PTV2, the target volume of electively treated region, which was given to 50.4 Gy. With the same dose-volume constraints, but different beams arrangements (3, 5, 7, or 9 equispaced coplanar beams), four plans were generated. Indices, including dose distribution, dose volume histogram (DVH) and conformity index, were used for comparison of these plans. The plan with three intensity-modulated beams could produce good dose distribution for the two target volumes. The dose conformity to targets and the dose to OARs were improved as the beam number increased. The dose distributions in targets changed little when the beam number increased from 7 to 9. Five to seven intensity-modulated beams can produce desirable dose distributions for simultaneous integrated boost (SIB) treatment for upper esophageal carcinoma. The primary tumor can get higher equivalent dose by SIB treatments. It is easier and more efficient to design plans with equispaced coplanar beams. The efficacy of SIB-IMRT remains to be determined by the clinical outcome.

Carbon isotopic shift and its cause at the Wuchiapingian-Changhsingian boundary in the Upper Permian at the Zhaojiaba section, South China: Evidences from multiple geochemical proxies

NASA Astrophysics Data System (ADS)

Wei, Hengye; Yu, Hao; Wang, Jianguo; Qiu, Zhen; Xiang, Lei; Shi, Guo

2015-06-01

The Late Permian environmental change, connecting the Guadalupian-Lopingian (G-L) (Middle-Upper Permian) boundary mass extinction and the Permain-Triassic (P-Tr) boundary mass extinction, has attracted more and more attentions. A significant negative shift for carbon isotope had been found at the Wuchiapingian-Changhsingian (W-C) boundary in the Upper Permian recently. However, the cause(s) of this negative excursion is still unknown. To resolve this problem, we analyzed the bulk organic carbon isotope, total organic carbon (TOC) content, pyritic sulfur (Spy) content, major element concentrations, and molecular organic biomarkers in the Wujiaping and Dalong formations in the Upper Permian from the Zhaojiaba section in western Hubei province, South China. Our results show that (1) there was a significant negative excursion in organic carbon isotopes at the W-C boundary and again a negative excursion at the top of Changhsingian stage; (2) the significant negative excursion at the W-C boundary was probably a global signal and mainly caused by the low primary productivity; and (3) the negative carbon isotope excursion at the top of Changhsingian was probably caused by the Siberian Traps eruptions. A decline in oceanic primary productivity at the W-C boundary probably represents a disturbance of the marine food web, leading to a vulnerable ecosystem prior to the P-Tr boundary mass extinction.

Spatial and socio-demographic determinants of contraceptive use in the Upper East region of Ghana.

PubMed

Achana, Fabian Sebastian; Bawah, Ayaga A; Jackson, Elizabeth F; Welaga, Paul; Awine, Timothy; Asuo-Mante, Eric; Oduro, Abraham; Awoonor-Williams, John Koku; Phillips, James F

2015-04-02

This paper presents results of baseline data on the determinants of contraceptive use in 7 districts in northern Ghana where there is an ongoing integrated primary health care systems strengthening projectknown as the Ghana Essential Health Intervention Project (GEHIP). We used a household survey data conducted within 66 randomly sampled census enumeration areas in seven rural districts of the Upper East Region of northern Ghana where health systems strengthening interventions are currently ongoing in three of the districts with four of the districts serving as comparison districts. This survey was conducted prior to the introduction of interventions. Data was collected on various indices included geographic information systems (GIS) and contraceptive use. The data was analyzed using survey design techniques that accounts for correct variance estimation. Categorical variables were summarized as proportions and associations between these variables and contraceptive use tested using Chi-square test. Uni-variable and multivariable logistic regression techniques were used to assess the effects of the selected covariates on contraceptive use. All tests were deemed to be statistically significant at 5% level statistical significance. Results show that contraceptive use is generally low (about 13 per cent) and use is nearly evenly for spacing and stopping purposes. Factors associated with the use of contraceptives include exposure to integrated primary healthcare services, the level of education, and socioeconomic status, couple fertility preference, marital status, and parity. For instance, the odds of contraceptive use among 15-45 year old women who live 2 km or more from a CHPS compound is 0.74 compared to women who live less than 2 km from a CHPS compound (p-value = 0.035). The findings suggest that rapid scale up of the Community based Health Planning and Services (CHPS) program accompanied with improved door-to-door health services would kindle uptake of modern contraceptive use, reduce unwanted pregnancies and hasten the attainment of MDG 4 & 5 in Ghana.

Annual Tropical Cyclone Report, 1983.

DTIC Science & Technology

1983-01-01

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

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

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

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

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

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

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

Surface wind mixing in the Regional Ocean Modeling System (ROMS)

NASA Astrophysics Data System (ADS)

Robertson, Robin; Hartlipp, Paul

2017-12-01

Mixing at the ocean surface is key for atmosphere-ocean interactions and the distribution of heat, energy, and gases in the upper ocean. Winds are the primary force for surface mixing. To properly simulate upper ocean dynamics and the flux of these quantities within the upper ocean, models must reproduce mixing in the upper ocean. To evaluate the performance of the Regional Ocean Modeling System (ROMS) in replicating the surface mixing, the results of four different vertical mixing parameterizations were compared against observations, using the surface mixed layer depth, the temperature fields, and observed diffusivities for comparisons. The vertical mixing parameterizations investigated were Mellor- Yamada 2.5 level turbulent closure (MY), Large- McWilliams- Doney Kpp (LMD), Nakanishi- Niino (NN), and the generic length scale (GLS) schemes. This was done for one temperate site in deep water in the Eastern Pacific and three shallow water sites in the Baltic Sea. The model reproduced the surface mixed layer depth reasonably well for all sites; however, the temperature fields were reproduced well for the deep site, but not for the shallow Baltic Sea sites. In the Baltic Sea, the models overmixed the water column after a few days. Vertical temperature diffusivities were higher than those observed and did not show the temporal fluctuations present in the observations. The best performance was by NN and MY; however, MY became unstable in two of the shallow simulations with high winds. The performance of GLS nearly as good as NN and MY. LMD had the poorest performance as it generated temperature diffusivities that were too high and induced too much mixing. Further observational comparisons are needed to evaluate the effects of different stratification and wind conditions and the limitations on the vertical mixing parameterizations.

Effect of Upper-Cycle Temperature on the Load-Biased, Strain-Temperature Response of NiTi

NASA Technical Reports Server (NTRS)

Padula, Santo, II; Vaidyanathan, Raj; Gaydosh, Darrell; Noebe, Ronald; Bigelow, Glen; Garg, Anita

2008-01-01

Over the past decade, interest in shape memory alloy based actuators has increased as the primary benefits of these solid-state devices have become more apparent. However, much is still unknown about the characteristic behavior of these materials when used in actuator applications. Recently we have shown that the maximum temperature reached during thermal cycling under isobaric conditions could significantly affect the observed mechanical response of NiTi (55 wt% Ni), especially the amount of transformation strain available for actuation and thus work output. This investigation extends that original work to ascertain whether further increases in the upper-cycle temperature would produce additional improvement in the work output of the material, which has a stress-free Af of 113 oC, and to determine the optimum cyclic conditions. Thus, isobaric, thermal-cycle experiments were conducted in the aforementioned alloy at various stress levels from 50-300 MPa using upper-cycle temperatures of 165, 200, 230, 260, 290, 320 and 350 oC. The data indicated that the amount of applied stress influenced the transformation strain available in the system, as would be expected. However, the maximum temperature reached during the thermal excursion also plays a role in determining the transformation strain, with the maximum transformation strain being developed by thermal cycling to 290 oC. In situ, neutron diffraction showed that the differences in transformation strain were related to differences in martensite texture within the microstructure when cycling to different upper-cycle temperatures. Hence, understanding this effect is important to optimizing the operation of SMA-based actuators and could lead to new methods for processing and training shape memory alloys for optimal performance.

Fallopian tube cancer. The Roswell Park experience.

PubMed

Rose, P G; Piver, M S; Tsukada, Y

1990-12-15

Sixty-four patients with primary fallopian tube cancer treated at Roswell Park Memorial Institute from 1964 to 1987 underwent retrospective clinicopathologic review. In 40 patients fallopian tube cancer was the only primary, but in 24 patients primary fallopian tube cancer was part of a multifocal upper genital tract malignancy. Of the 40 patients with unifocal fallopian disease, the median survival was 28 months. Only 15% of patients were alive and disease free with follow-up ranging from 22 to 141 months (median, 90.5 months). Survival was not associated with stage of disease, tumor histology, grade, or depth of invasion in this series. Fourteen patients who received cisplatin-based chemotherapy were evaluable for response. Three patients (21%) responded; two complete and one partial. Twelve patients without clinical evidence of disease underwent second-look procedures, ten laparotomy and two laparoscopy. Four of ten second-look laparotomies were negative. Secondary debulking was done in three of four patients with gross disease, one of which had a negative third-look laparotomy. Negative laparotomy, second-look or third-look, was associated with improved survival (P = 0.016). One of the two laparoscopies was negative, but the patient recurred. In the remaining 24 patients cancer of the fallopian tube was part of a multifocal upper genital tract malignancy. In 12 patients tubal disease was invasive, and in 12, it was in situ. Separate primaries occurred in the ovaries (n = 20); uterus (n = 7); and cervix (n = 2). This represents 1.3% of ovarian malignancies treated at Roswell Park Memorial Institute during the study period. Fallopian tube cancer seems as virulent as ovarian cancer with few long-term survivors. It is frequently associated with other sites of upper genital tract malignancy. Second-look laparotomy is an important predictor of survival. Second-look laparoscopy may be useful if positive.

Integrated Solar Upper Stage Technical Support

NASA Technical Reports Server (NTRS)

Jaworske, Donald A.

1998-01-01

NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test article, leading to a potential ISUS flight test in 2002.

Transposed brachial-basilic arteriovenous fistulas versus prosthetic upper limb grafts: a meta-analysis.

PubMed

Lazarides, M K; Georgiadis, G S; Papasideris, C P; Trellopoulos, G; Tzilalis, V D

2008-11-01

Controversy exists regarding the best type of arteriovenous (AV) fistula to be formed in secondary and tertiary access procedures when primary fistulas have failed. This meta-analysis aimed to compare transposed brachial-basilic AV fistulas (BBAVFs) with upper limb AV prosthetic grafts. A literature search of the MEDLINE and SCOPUS databases was performed to identify comparative studies reporting outcomes for both BBAVFs with upper limb AV prosthetic grafts. Meta-analysis techniques were applied to identify differences in outcomes between the two groups regarding primary and secondary 1-year failure rates. Eleven relevant studies, involving 1509 patients, met the inclusion criteria and were incorporated in the final analysis; however, only one was randomised controlled trial. The pooled odds' ratio (OR) estimate for the primary and secondary failure rates at 1 year was 0.67 (CI 0.41-1.09) and 0.88 (CI 0.69-1.12), respectively, showing no difference in the outcome between the two groups. The re-intervention rate was higher for prosthetic grafts (0.54 per BBAVF versus 1.32 per graft). In a small subgroup of two studies comparing BBAVFs with forearm grafts the pooled estimate for 1-year primary failure rate was in favour of the BBAVF group (OR 0.3, CI 0.15-0.58, p=0.0004) suggesting that forearm grafts were inferior having a 3-fold risk of failure at 1 year. This analysis supports the use of BBAVF early in difficult access cases prior to the use of prosthetic grafts. However, the latter conclusion is debatable due to heterogeneity, small size and non-randomised design of the included studies.

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

NASA Technical Reports Server (NTRS)

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

2014-01-01

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

Upper Extremity Function in Multiple Sclerosis Patients With Advanced Disability Treated With Ocrevus

ClinicalTrials.gov

2018-06-18

Multiple Sclerosis; Pathologic Processes; Demyelinating Diseases; Demyelinating Autoimmune Diseases; Nervous System Diseases; Autoimmune Diseases; Immune System Diseases; Primary Progressive Multiple Sclerosis; Relapsing Remitting Multiple Sclerosis

Use of thoracic spine thrust manipulation for neck pain and headache in a patient following multiple-level anterior cervical discectomy and fusion: a case report.

PubMed

Salvatori, Renata; Rowe, Robert H; Osborne, Raine; Beneciuk, Jason M

2014-06-01

Case report. Thoracic spine thrust manipulation has been shown to be an effective intervention for individuals experiencing mechanical neck pain. The patient was a 46-year-old woman referred to outpatient physical therapy 2 months following multiple-level anterior cervical discectomy and fusion. At initial evaluation, primary symptoms consisted of frequent headaches, neck pain, intermittent referred right elbow pain, and muscle fatigue localized to the right cervical and upper thoracic spine regions. Initial examination findings included decreased passive joint mobility of the thoracic spine, limited cervical range of motion, and limited right shoulder strength. Outcome measures consisted of the numeric pain rating scale, the Neck Disability Index, and the global rating of change scale. Treatment consisted of a combination of manual therapy techniques aimed at the thoracic spine, therapeutic exercises for the upper quarter, and patient education, including a home exercise program, over a 6-week episode of care. Immediate reductions in cervical-region pain (mean ± SD, 2.0 ± 1.1) and headache (2.0 ± 1.3) intensity were reported every treatment session immediately following thoracic spine thrust manipulation. At discharge, the patient reported 0/10 cervical pain and headache symptoms during all work-related activities. From initial assessment to discharge, Neck Disability Index scores improved from 46% to 16%, with an associated global rating of change scale score of +7 ("a very great deal better"). This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain and headache following anterior cervical discectomy and fusion surgical intervention. Clinical rationale and patient preference aided the decision to incorporate thoracic spine thrust manipulation as a treatment for this patient. Level of Evidence Therapy, level 4.

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

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

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

Rural and urban Ugandan primary school children's alternative ideas about animals

NASA Astrophysics Data System (ADS)

Otaala, Justine

This study examined rural and urban Ugandan primary children's alternative ideas about animals through the use of qualitative research methods. Thirty-six children were selected from lower, middle, and upper primary grades in two primary schools (rural and urban). Data were collected using interview-about-instance technique. Children were shown 18 color photographs of instances and non-instances of familiar animals and asked to say if the photographed objects were animals or not. They were then asked to give reasons to justify their answers. The interviews were audiotaped and transcribed. The results indicate that children tended to apply the label "animal" to large mammals, usually found at home, on the farm, in the zoo, and in the wild. Humans were not categorized as animals, particularly by children in the lower grades. Although the children in upper grades correctly identified humans as animals, they used reasons that were irrelevant to animal attributes and improperly derived from the biological concept of evolution. Many attributes children used to categorize instances of animals were scientifically unacceptable and included superficial features, such as body outline, anatomical features (body parts), external features (visual cues), presence or absence and number of appendages. Movement and eating (nutrition) were the most popular attributes children used to identify instances of animals. The main differences in children's ideas emanated from the reasons used to identify animals. Older rural children drew upon their cultural and traditional practices more often than urban children. Anthropomorphic thinking was predominant among younger children in both settings, but diminished with progression in children's grade levels. Some of the implications of this study are: (1) teachers, teacher educators and curriculum developers should consider learners' ideas in planning and developing teaching materials and interventions. (2) Teachers should relate humans to other animals during instruction. (3) Textbooks and teaching materials need careful scrutiny to insure they include humans and other small animals as part of the animal kingdom. (4) Teaching interventions should begin with the basic attributes of animals and insure children understand the relationship between the attributes and concepts. (5) Encourage the use of examples and non-examples of the concept "animal" during instruction.

A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery.

PubMed

Sebbag, Ilana; Massey, Simon R; Albert, Arianne Y K; Dube, Alison; Gunka, Vit; Douglas, M Joanne

2015-09-01

Shivering is common during cesarean delivery (CD) under neuraxial anesthesia and may disrupt the measurement of noninvasive blood pressure (BP). BP measured at the wrist may be less affected by shivering. There have been no studies comparing trends in BP measured on the upper arm and wrist. We hypothesized that wrist systolic blood pressure (sBP) would accurately trend with upper arm sBP measurements (agree within a limit of ±10%) in parturients undergoing elective CD under spinal anesthesia or combined spinal-epidural anesthesia. After initiation of spinal anesthesia, BP measurements were obtained simultaneously from the upper arm and wrist on opposite arms. The interval between measurements was 1 to 2 minutes, and data were collected for 20 minutes or until delivery. The primary outcome was agreement in dynamic changes in sBP measurements between the upper arm and the wrist. Bland-Altman plots indicating the levels of agreement between the methods were drawn for baseline measurements, over multiple measurements, and over multiple measurements on percentage change from baseline. Forty-nine patients were recruited and completed the study. The wrist sBP tended to overestimate the upper sBP for both baseline data (sBP bias = 13.4 mm Hg; 95% confidence interval = +10.4 to +16.4 mm Hg) and data obtained over multiple measurements (sBP bias = 12.8 mm Hg; 95% confidence interval = +9.3 to +16.3 mm Hg). For change in sBP from baseline over multiple measurements, the mean difference between the wrist and the arm sBP was -0.2 percentage points (99% limits of agreement -25 to +25 percentage points). The wrist measurement overestimated the reading relative to the upper arm measurement for multiple measurements over time. However, when the time series for each subject was examined for percentage change from baseline, the 2 methods mirrored each other in most cases. Nevertheless, our hypothesis was rejected as the limits of agreement were higher than ±10%. This finding suggests that wrist BP may not be an accurate method of detecting hypotension or hypertension during spinal or combined spinal-epidural anesthesia for CD.

High Spectral Resolution Lidar and MPLNET Micro Pulse Lidar Aerosol Optical Property Retrieval Intercomparison During the 2012 7-SEAS Field Campaign at Singapore

NASA Technical Reports Server (NTRS)

Lolli, Simone; Welton, Ellsworth J.; Campbell, James R.; Eloranta, Edwin; Holben, Brent N.; Chew, Boon Ning; Salinas, Santo V.

2014-01-01

From August 2012 to February 2013 a High Resolution Spectral Lidar (HSRL; 532 nm) was deployed at that National University of Singapore near a NASA Micro Pulse Lidar NETwork (MPLNET; 527 nm) site. A primary objective of the MPLNET lidar project is the production and dissemination of reliable Level 1 measurements and Level 2 retrieval products. This paper characterizes and quantifies error in Level 2 aerosol optical property retrievals conducted through inversion techniques that derive backscattering and extinction coefficients from MPLNET elastic single-wavelength datasets. MPLNET Level 2 retrievals for aerosol optical depth and extinction/backscatter coefficient profiles are compared with corresponding HSRL datasets, for which the instrument collects direct measurements of each using a unique optical configuration that segregates aerosol and cloud backscattered signal from molecular signal. The intercomparison is performed, and error matrices reported, for lower (0-5km) and the upper (>5km) troposphere, respectively, to distinguish uncertainties observed within and above the MPLNET instrument optical overlap regime.

Comparison of upper arm and forearm blood pressure.

PubMed

Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

2008-11-01

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

Arrow Lakes Reservoir Fertilization Experiment, Technical Report 1999-2004.

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

Schindler, E.

2007-02-01

The Arrow Lakes food web has been influenced by several anthropogenic stressors during the past 45 years. These include the introduction of mysid shrimp (Mysis relicta) in 1968 and 1974 and the construction of large hydroelectric impoundments in 1969, 1973 and 1983. The construction of the impoundments affected the fish stocks in Upper and Lower Arrow lakes in several ways. The construction of Hugh Keenleyside Dam (1969) resulted in flooding that eliminated an estimated 30% of the available kokanee spawning habitat in Lower Arrow tributaries and at least 20% of spawning habitat in Upper Arrow tributaries. The Mica Dam (1973)more » contributed to water level fluctuations and blocked upstream migration of all fish species including kokanee. The Revelstoke Dam (1983) flooded 150 km of the mainstem Columbia River and 80 km of tributary streams which were used by kokanee, bull trout, rainbow trout and other species. The construction of upstream dams also resulted in nutrient retention which ultimately reduced reservoir productivity. In Arrow Lakes Reservoir (ALR), nutrients settled out in the Revelstoke and Mica reservoirs, resulting in decreased productivity, a process known as oligotrophication. Kokanee are typically the first species to respond to oligotrophication resulting from aging impoundments. To address the ultra-oligotrophic status of ALR, a bottom-up approach was taken with the addition of nutrients (nitrogen and phosphorus in the form of liquid fertilizer from 1999 to 2004). Two of the main objectives of the experiment were to replace lost nutrients as a result of upstream impoundments and restore productivity in Upper Arrow and to restore kokanee and other sport fish abundance in the reservoir. The bottom-up approach to restoring kokanee in ALR has been successful by replacing nutrients lost as a result of upstream impoundments and has successfully restored the productivity of Upper Arrow. Primary production rates increased, the phytoplankton community responded with a shift in species and zooplankton biomass was more favorable for kokanee. With more productive lower trophic levels, the kokanee population increased in abundance and biomass, resulting in improved conditions for bull trout, one of ALR's piscivorous species.« less

Usability of Videogame-Based Dexterity Training in the Early Rehabilitation Phase of Stroke Patients: A Pilot Study.

PubMed

Vanbellingen, Tim; Filius, Suzanne J; Nyffeler, Thomas; van Wegen, Erwin E H

2017-01-01

Approximately 70-80% of stroke survivors have limited activities of daily living, mainly due to dexterous problems. Videogame-based training (VBT) along with virtual reality seems to be beneficial to train upper limb function. To evaluate the usability of VBT using the Leap Motion Controller (LMC) to train fine manual dexterity in the early rehabilitation phase of stroke patients as an add-on to conventional therapy. Additionally, this study aimed to estimate the feasibility and potential efficacy of the VBT. During 3 months, 64 stroke patients were screened for eligibility, 13 stroke patients were included (4 women and 9 men; age range: 24-91 years; mean time post stroke: 28.2 days). Nine sessions of 30 min VBT, three times per week as an add-on to conventional therapy with stroke inpatients. Primary outcome was the usability of the system measured with the System Usability Scale. Secondary outcomes concerning feasibility were the compliance rate calculated from the total time spent on the intervention (TT) compared to planned time, the opinion of participants via open-end questions, and the level of active participation measured with the Pittsburgh Rehabilitation Participation Scale. Regarding the potential efficacy secondary outcomes were: functional dexterity measured with the Nine Hole Peg Test (NHPT), subjective dexterity measured with the Dexterity Questionnaire 24, grip strength measured with the Jamar dynamometer, and motor impairment of the upper limb measured with the Fugl-Meyer Upper Extremity (FM-UE) scale. Primarily, the usability of the system was good to excellent. The patient's perception of usability remained stable over a mean period of 3 weeks of VBT. Secondly, the compliance rate was good, and the level of active participation varied between good and very good. The opinion of the participants revealed that despite individual differences, the overall impression of the therapy and device was good. Patients showed significant improvements in hand dexterity. No changes were found in motor impairment of the upper limb (FM-UE) during intervention. VBT using LMC is a usable rehabilitation tool to train dexterity in the early rehabilitation phase of stroke inpatients.

Periodic gastroenterology and hepatology meetings with primary care. Reasons for consultation.

PubMed

Mata-Román, Laura; del Olmo-Martínez, Lourdes; Briso-Montiano, Raquel; García-Pascual, Agustina; Catón-Valdés, Manuela; Jiménez-Rodríguez-Vila, Manuel; Castellanos-Alonso, Maria Jose; Laso, Lucinio; Gómez-Gómez, Pilar; Otero, Antonio; Pinilla-Gimeno, Jose Ignacio; del-Río-Hortega, Juan; Pradera-Leonardo, Juan; Vallelado, Rosario; Villuela-González, Fernando; Ibañes-Jalón, Elisa; Sañudo, Soledad; Mayo, Agustin; Caro-Patón, Agustin; Almaraz-Gómez, Ana

2013-10-01

care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects. to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology. a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period. most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45 %), as well as in rural setting (45.24 %). common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.

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

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

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

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

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

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

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

PubMed

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

2018-03-06

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

International Classification of Primary Care-2 coding of primary care data at the general out-patients' clinic of General Hospital, Lagos, Nigeria.

PubMed

Olagundoye, Olawunmi Abimbola; van Boven, Kees; van Weel, Chris

2016-01-01

Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC) may be a solution to this problem at the primary care level. To apply ICPC-2 for secondary coding of reasons for encounter (RfE), problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain/cramps general. The top five diagnoses were: Malaria, hypertension uncomplicated, visual disturbance other, peptic ulcer, and upper respiratory infection. From the determination of the posterior probability given the top five RfE, malaria, hypertension, upper respiratory infection, refractive error, and conjuctivitis were the five most frequent diagnoses that resulted from a complaint of a headache. The study demonstrated that ICPC-2 can be applied to primary care data in the Nigerian context to generate information about morbidity and services provided. It also provided an empirical basis to support diagnosis and prognostication in a primary care setting. In developing countries where the transition to electronic health records is still evolving and fraught with limitations, more reliable data collection can be achieved from paper records through the application of the ICPC-2.

The "I Knew It All Along" Phenomenon: Second-Order False Belief Understanding and the Curse of Knowledge in Primary School Children

ERIC Educational Resources Information Center

Massaro, Davide; Castelli, Ilaria; Sanvito, Laura; Marchetti, Antonella

2014-01-01

This study investigated two different expressions of the so-called curse of knowledge in primary school children: hindsight bias and outcome bias. Further, it explored the possible predictive function of false belief understanding in reducing these biases. Ninety-one children aged 7, 9, and 11 years (middle- to upper-middle class) were…

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

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

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

Endurance and fatigue characteristics in the neck muscles during sub-maximal isometric test in patients with cervical radiculopathy.

PubMed

Halvorsen, Marie; Abbott, Allan; Peolsson, Anneli; Dedering, Åsa

2014-03-01

The aim of the study was to compare myoelectric manifestation in neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance test in patients with cervical radiculopathy and asymptomatic subjects. An additional aim was to explore associations between primary neck muscle endurance, myoelectric fatigability, and self-rated levels of fatigue, pain and subjective health measurements in patients with cervical radiculopathy. Muscle fatigue in the ventral and dorsal neck muscles was assessed in patients with cervical radiculopathy and in an asymptomatic group during an isometric neck muscle endurance test in prone and supine. 46 patients and 34 asymptomatic subjects participated. Surface electromyography signals were recorded from the sternocleidomastoid, cervical paraspinal muscles and upper and middle trapezius bilaterally during the endurance test. Subjective health measurements were assessed with questionnaires. The results showed altered neck muscle endurance in several of the muscles investigated with greater negative median frequency slope, greater variability, side imbalance, lower endurance time and higher experience of fatigue among the cervical radiculopathy patients compared with healthy subjects. Endurance times were significantly lower in both prone and in supine positions between the patients compared to asymptomatic subjects. During the neck muscle endurance test, fatigues in the upper trapezius muscles during the prone test and in the sternocleidomastoid muscles during the supine test were of more importance than self-perceived pain, fatigue, disability and kinesiophobia in predicting neck muscle endurance (NME). NME testing in the primary neck muscles seems to be an important factor to take into consideration in rehabilitation.

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

PubMed

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

2017-01-01

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

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

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

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

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

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

Upper GI and small bowel series

MedlinePlus

... the stomach may indicate the following problems: Gastric cancer Gastric ulcer - benign Gastritis Polyps (a tumor that is usually noncancerous and grows on the mucus membrane ) Pyloric stenosis ... ring Primary or idiopathic intestinal pseudo-obstruction

Assessment and comparison of student engagement in a variety of physiology courses.

PubMed

Hopper, Mari K

2016-03-01

Calls for reform in science education have promoted active learning as a means to improve student engagement (SENG). SENG is generally acknowledged to have a positive effect on student learning, satisfaction, and retention. A validated 14-question survey was used to assess SENG in a variety of upper- and lower-level physiology courses, including 100-level Anatomy and Physiology 1, 300-level Animal Physiology, 400-level Advanced Physiology, and 500-level Medical Physiology courses. The results indicated that SENG did not vary consistently by course level, format, or curriculum. The highest levels of SENG were found in the Advanced Physiology course, which included SENG as a primary objective of the course. Physiology student SENG scores were compared with National Survey of Student Engagement (NSSE) scores. The results demonstrated that physiology students enrolled in the Anatomy and Physiology 1 course reported lower levels of SENG than first-year students that completed the NSSE. Students enrolled in the Advanced Physiology course reported higher levels of SENG than fourth-year students that completed the NSSE. Assessment of SENG offers insights as to how engaged students are, identifies where efforts may best be applied to enhance SENG, and provides a baseline measure for future comparisons after targeted course modifications. Copyright © 2016 The American Physiological Society.

Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study.

PubMed

Kaminski, Juliana; Miasaki, Fabíola Yukiko; Paz-Filho, Gilberto; Graf, Hans; Carvalho, Gisah Amaral de

2016-01-01

To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16. Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged. The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.

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

PubMed

Mozaffari, Brian

2014-01-01

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

Interrater reliability of the cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain.

PubMed

Burns, Scott A; Cleland, Joshua A; Carpenter, Kristin; Mintken, Paul E

2016-03-01

Examine the interrater reliability of cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain. Single-group repeated-measures design for interrater reliability. Orthopaedic physical therapy clinics. Twenty-one patients with a primary complaint of shoulder pain underwent a standardized examination by a physical therapist (PT). A PT conducted the first examination and one of two additional PTs conducted the 2nd examination. The Cohen κ and weighted κ were used to calculate the interrater reliability of ordinal level data. Intraclass correlation coefficients model 2,1 (ICC2,1) and the 95% confidence intervals were calculated to determine the interrater reliability. The kappa coefficients ranged from -.24 to .83 for the mobility assessment of the glenohumeral, acromioclavicular and sternoclavicular joints. The kappa coefficients ranged from -.20 to .58 for joint mobility assessment of the cervical and thoracic spine. The kappa coefficients ranged from .23 to 1.0 for special tests of the shoulder and cervical spine. The present study reported the reliability of a comprehensive upper quarter physical examination for a group of patients with a primary report of shoulder pain. The reliability varied considerably for the cervical and shoulder examination and was significantly higher for the examination of muscle length and cervical range of motion. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design, fabrication and test of the RL10 derivative II chamber/primary nozzle

NASA Technical Reports Server (NTRS)

Marable, R. W.

1989-01-01

The design, fabrication and test of the RL10-II chamber/primary nozzle was accomplished as part of the RL10 Product Improvement Program (PIP). The overall goal of the RL10 PIP was to gain the knowledge and experience necessary to develop new cryogenic upper stage engines to fulfill future NASA requirements. The goal would be reached by producing an RL10 engine designed to be reusable, operate at several thrust levels, and have increased performance. The goals for the chamber/primary nozzle task were: (1) to design a reusable assembly capable of operation at increased mixture ratio and low thrust; (2) to fabricate three assemblies using new or updated techniques where possible; and (3) to test one assembly to verify the design and construction. The design and fabrication phases produced an assembly having improved features such as single piece reinforcing band segments (i.e., Mae West segments) and relocated tube exit braze joints (i.e., hooked tube exit). In addition, a computer program was developed to design the chamber tubes to meet both performance and heat transfer requirements. The test phase showed the specific impulse of the test bed engine system to be as predicted. These results, along with the heat transfer data obtained, sufficiently proved the overall design of the RL10-II recontoured and shortened chamber/primary nozzle assembly.

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

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

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

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

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

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

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

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

T. K. Haarmann; P. R. Fresquez

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

Determination of fracture toughness of human permanent and primary enamel using an indentation microfracture method.

PubMed

Hayashi-Sakai, Sachiko; Sakai, Jun; Sakamoto, Makoto; Endo, Hideaki

2012-09-01

The purpose of the present study was to examine the fracture toughness and Vickers microhardness number of permanent and primary human enamel using the indentation microfracture method. Crack resistance and a parameter indirectly related to fracture toughness were measured in 48 enamel specimens from 16 permanent teeth and 12 enamel specimens obtained from six primary teeth. The Vickers microhardness number of the middle portion was greater than the upper portion in primary enamel. The fracture toughness was highest in the middle portion of permanent enamel, because fracture toughness greatly depends upon microstructure. These findings suggest that primary teeth are not miniature permanent teeth but have specific and characteristic mechanical properties.

CT measurement of glenoid erosion in arthritis.

PubMed

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

1994-05-01

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

Investigating and Improving Student Understanding of Key Ideas in Quantum Mechanics throughout Instruction

NASA Astrophysics Data System (ADS)

Emigh, Paul Jeffrey

This dissertation describes research on student understanding of quantum mechanics across multiple levels of instruction. The primary focus has been to identify patterns in student reasoning related to key concepts in quantum mechanics. The specific topics include quantum measurements, time dependence, vector spaces, and angular momentum. The research has spanned a variety of different quantum courses intended for introductory physics students, upper-division physics majors, and graduate students in physics. The results of this research have been used to develop a set of curriculum, Tutorials in Physics: Quantum Mechanics, for addressing the most persistent student difficulties. We document both the development of this curriculum and how it has impacted and improved student understanding of quantum mechanics.

The Seasat commercial demonstration program

NASA Technical Reports Server (NTRS)

Mccandless, S. W.; Miller, B. P.; Montgomery, D. R.

1981-01-01

The background and development of the Seasat commercial demonstration program are reviewed and the Seasat spacecraft and its sensors (altimeter, wind field scatterometer, synthetic aperture radar, and scanning multichannel microwave radiometer) are described. The satellite data distribution system allows for selected sets of data, reformatted or tailored to specific needs and geographical regions, to be available to commercial users. Products include sea level and upper atmospheric pressure, sea surface temperature, marine winds, significant wave heights, primary wave direction and period, and spectral wave data. The results of a set of retrospective case studies performed for the commercial demonstration program are described. These are in areas of application such as marine weather and ocean condition forecasting, offshore resource exploration and development, commercial fishing, and marine transportation.

Clinico-Radiological Diagnosis of Isolated Congenital Esophageal Stenosis in a Preterm Neonate

PubMed Central

Sham, Minakshi

2013-01-01

A 2-day-old preterm female neonate weighing 1.6 kg and having excessive frothing from mouth was investigated for suspected esophageal atresia and tracheoesophageal fistula. X-ray findings of an unusually low-ending upper pouch (up to T8 level) and the absence of gas in abdomen lead to suspicion of an unusual variety of esophageal atresia. Hence unlike the usual management of pure esophageal atresia, in terms of esophagostomy and gastrostomy in neonatal period, right thoracotomy was performed allowing successful primary anastomosis. A high index of suspicion on the basis of radiological picture led to early diagnosis of a rare anomaly like congenital esophageal stenosis and successful management of this low birth weight baby. PMID:25755945

Use of thyroid-stimulating hormone tests for identifying primary hypothyroidism in family medicine patients.

PubMed

Birk-Urovitz, Elizabeth; Elisabeth Del Giudice, M; Meaney, Christopher; Grewal, Karan

2017-09-01

To assess the use of thyroid-stimulating hormone (TSH) tests for identifying primary hypothyroidism in 2 academic family medicine settings. Descriptive study involving a retrospective electronic chart review of family medicine patients who underwent TSH testing. Two academic family practice sites: one site is within a tertiary hospital in Toronto, Ont, and the other is within a community hospital in Newmarket, Ont. A random sample of 205 adult family medicine patients who had 1 or more TSH tests for identifying potential primary hypothyroidism between July 1, 2009, and September 15, 2013. Exclusion criteria included a previous diagnosis of any thyroid condition or abnormality, as well as pregnancy or recent pregnancy within the year preceding the study period. The proportion of normal TSH test results and the proportion of TSH tests that did not conform to test-ordering guidelines. Of the 205 TSH test results, 200 (97.6%, 95% CI 94.4% to 99.2%) showed TSH levels within the normal range. All 5 patients with abnormal TSH test results had TSH levels above the upper reference limits. Nearly one-quarter (22.4%, 95% CI 16.9% to 28.8%) of tests did not conform to test-ordering guidelines. All TSH tests classified as not conforming to test-ordering guidelines showed TSH levels within normal limits. There was a significant difference ( P < .001) between the proportions of nonconforming TSH tests at the tertiary site (14.3%, 95% CI 8.2% to 22.5%) and the community site (31.0%, 95% CI 22.1% to 41.0%). Preliminary analyses examining which variables might be associated with abnormal TSH levels showed that only muscle cramps or myalgia ( P = .0286) and a history of an autoimmune disorder ( P = .0623) met or approached statistical significance. In this study, the proportion of normal TSH test results in the context of primary hypothyroidism case finding and screening was high, and the overall proportion of TSH tests that did not conform to test-ordering guidelines was relatively high as well. These results highlight a need for more consistent TSH test-ordering guidelines for primary hypothyroidism and perhaps some educational interventions to help curtail the overuse of TSH tests in the family medicine setting. Copyright© the College of Family Physicians of Canada.

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

PubMed

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

2011-01-01

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

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

PubMed

Hamilton, Clayon B; Chesworth, Bert M

2013-11-01

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

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

PubMed Central

Chesworth, Bert M.

2013-01-01

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

Euphausia mucronata: A keystone herbivore and prey of the Humboldt Current System

NASA Astrophysics Data System (ADS)

Antezana, Tarsicio

2010-04-01

Euphausiids are important components of many ecosystems, especially in productive regions of temperate and high latitudes. The present paper makes the case that E. mucronata plays a keystone role in the food web of the Humboldt Current System (HCS) based on a synthesis of new and published data supporting its potential role as a primary grazer, as well as a principal prey for upper trophic level fish. E. mucronata is an endemic species, concentrated in the coastal upwelling belt of the HCS, with morpho-physiological adaptations to vertically migrate into the Oxygen Minimum Zone (OMZ). Within the 100-km coastal belt of the HCS it accounts for ca. 50% of the meso zooplankton wet weight in winter. In the mixed layer, it is a herbivore with high night ingestion rates (612.2 ng Chl eq ind -1 h -1 or 1013.9 μg C ind -1 d -1, in winter), and accounted for a 19.3% impact on primary production in winter, at an intermediate population abundance (3.8 ind m -3). At higher abundances (50 ind m -3) equivalent to swarms, impact on primary production could reach 254%. Additionally E. mucronata is a common prey of numerous upper trophic level predators. The diet of jack mackerel ( Trachurus murphyi) off central Chile (34-39°S) indicates a striking dependence on E. mucronata prey (average of 75% of stomach content in weight). The fishing season off central Chile extended from austral fall (March-April) and continued at least until the end of austral winter (September). The average daily ration of jack mackerel was 17.4 g, which is equivalent to 2.3% of fish body weight per day. The total E. mucronata consumed in 1991 by the landed population of fish (3.7 million tons yr -1) amounted to 23.2 million tons yr -1. The total estimated population of jack mackerel that year (17.6 million tons) would have consumed ca. 110.2 million tons of E. mucronata. Based on stomach contents, consumption of E. mucronata by other nektonic predators off Chile and off Peru is also outstanding. Four different food web scenarios are offered for the northern and southern sectors of the HCS, according to regime shifts of small pelagics such as anchovy and jack mackerel, under the assumption that E. mucronata is a keystone link.

Theta burst stimulation over the primary motor cortex does not induce cortical plasticity in Parkinson's disease.

PubMed

Eggers, Carsten; Fink, Gereon R; Nowak, Dennis A

2010-10-01

The purpose of this study was to investigate whether a period of continuous theta burst stimulation (cTBS) induces cortical plasticity and thus improves bradykinesia of the upper limb in Parkinson's disease. In eight patients with Parkinson's disease (two females; mean age: 68.5 ± 5 years; disease duration: 4 ± 3 years) electrophysiological (motor evoked potentials, contralateral and ipsilateral silent period) and behavioural (Purdue pegboard test, UPDRS motor subscore) parameters were evaluated before (baseline condition) and after a 40-s period of (1) real or (2) sham continuous theta burst stimulation over the primary motor cortex contralateral to the more affected body side off dopaminergic drugs. Compared to baseline, cTBS did change neither measures of cortical excitability nor behavioural measures. cTBS over the primary motor cortex does not impact on cortical excitability or motor function of the upper limb in Parkinson's disease. We interpret these data to reflect impaired cortical plasticity in Parkinson's disease. This study is an important contribution to the knowledge about impaired plasticity in Parkinson's disease.

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

PubMed Central

2016-01-01

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

Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial.

PubMed

Dunning, James R; Butts, Raymond; Mourad, Firas; Young, Ian; Fernandez-de-Las Peñas, Cesar; Hagins, Marshall; Stanislawski, Thomas; Donley, Jonathan; Buck, Dustin; Hooks, Todd R; Cleland, Joshua A

2016-02-06

Although commonly utilized interventions, no studies have directly compared the effectiveness of cervical and thoracic manipulation to mobilization and exercise in individuals with cervicogenic headache (CH). The purpose of this study was to compare the effects of manipulation to mobilization and exercise in individuals with CH. One hundred and ten participants (n = 110) with CH were randomized to receive both cervical and thoracic manipulation (n = 58) or mobilization and exercise (n = 52). The primary outcome was headache intensity as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included headache frequency, headache duration, disability as measured by the Neck Disability Index (NDI), medication intake, and the Global Rating of Change (GRC). The treatment period was 4 weeks with follow-up assessment at 1 week, 4 weeks, and 3 months after initial treatment session. The primary aim was examined with a 2-way mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization and exercise) as the between subjects variable and time (baseline, 1 week, 4 weeks and 3 months) as the within subjects variable. The 2X4 ANOVA demonstrated that individuals with CH who received both cervical and thoracic manipulation experienced significantly greater reductions in headache intensity (p < 0.001) and disability (p < 0.001) than those who received mobilization and exercise at a 3-month follow-up. Individuals in the upper cervical and upper thoracic manipulation group also experienced less frequent headaches and shorter duration of headaches at each follow-up period (p < 0.001 for all). Additionally, patient perceived improvement was significantly greater at 1 and 4-week follow-up periods in favor of the manipulation group (p < 0.001). Six to eight sessions of upper cervical and upper thoracic manipulation were shown to be more effective than mobilization and exercise in patients with CH, and the effects were maintained at 3 months. NCT01580280 April 16, 2012.

[Treatment of eyelid retraction in Grave's disease by recession of the levator complex].

PubMed

Fichter, N; Schittkowski, M; Guthoff, R F

2004-11-01

The chronic stage in Grave's orbitopathy is characterised by fibrotic changes within the orbital soft tissues, especially the extraocular muscles. Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modified Harvey's technique for the correction of upper eyelid retraction which includes a complete recession of the Muller's muscle/levator complex from the tarsal plate without the interposition of a spacer. Finally only the skin and the superficial orbicularis muscle are sutured. We also report about our results with this procedure. 8 patients (1 male, 7 female) with lid retraction in Grave's ophthalmopathy were recorded who had undergone the modified lengthening technique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant under-correction, necessitating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre- and postoperatively. Within a follow-up period of at least 3 months we recorded an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the two eyelid apertures in primary position improved from 2.2 mm preoperatively to 1.0 mm postoperatively. Only 1 patient needed reoperation because of a significant under-correction. There were no late over-corrections observed. The modified Harvey's technique to lengthen the upper eyelid is a safe and effective method to reduce upper eyelid retraction in Grave's disease. An eventually required orbital decompression or extraocular muscle surgery has to be done before the lid surgery.

Matched pair analysis of ureteroscopy vs. shock wave lithotripsy for the treatment of upper ureteric calculi.

PubMed

Stewart, G D; Bariol, S V; Moussa, S A; Smith, G; Tolley, D A

2007-05-01

There is controversy over whether shock wave lithotripsy (SWL) or ureteroscopy (URS) is the best management of ureteric calculi, especially for stones located in the upper ureter. This study compares URS and SWL management of upper ureteric stones directly for the first time using a different analysis tool, the matched pair analysis study design. This method enables meaningful comparisons to be made on a small number of matched patients, using precise like-for-like matching. Adult patients undergoing primary treatment of solitary radiopaque proximal ureteric stones were identified. Patients with stents, nephrostomies or stones at the pelvi-ureteric junction were excluded. Patients had a minimum of 3 months follow-up. Patients treated by primary URS were matched using four parameters (sex, laterality, stone size and location) to patients treated on a Dornier Compact Delta Lithotriptor. A total of 1479 patients had URS or SWL from which 27 upper ureteric stone matched pairs were identified. Three-month stone free rates were 82% for URS and 89% for SWL (McNemar's test, p=0.625). Re-treatment was required in 11% and 26% following URS and SWL respectively (p=0.219). Forty-one per cent of URS patients required an ancillary treatment, such as stent removal, compared with only 22% of SWL patients (p=0.227). Introduction of a holmium:YAG laser for use with URS improved the stone free rate for URS to 100%. Using a robust like-for-like comparison of similar patients with very similar upper ureteric stones the outcomes following SWL and URS were comparable. Choice of treatment should therefore be based on parameters such as availability of equipment, waiting times and patient preference.

Effects of low-frequency repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation on upper extremity motor recovery in the early period after stroke: a preliminary study.

PubMed

Tosun, Aliye; Türe, Sabiha; Askin, Ayhan; Yardimci, Engin Ugur; Demirdal, Secil Umit; Kurt Incesu, Tülay; Tosun, Ozgur; Kocyigit, Hikmet; Akhan, Galip; Gelal, Fazıl Mustafa

2017-07-01

To assess the efficacy of inhibitory repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on upper extremity motor function in patients with acute/subacute ischemic stroke. Twenty-five ischemic acute/subacute stroke subjects were enrolled in this randomized controlled trial. Experimental group 1 received low frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT) including activities to improve strength, flexibility, transfers, posture, balance, coordination, and activities of daily living, mainly focusing on upper limb movements; experimental group 2 received the same protocol combined with NMES to hand extensor muscles; and the control group received only PT. Functional magnetic resonance imaging (fMRI) scan was used to evaluate the activation or inhibition of the affected and unaffected primary motor cortex. No adverse effect was reported. Most of the clinical outcome scores improved significantly in all groups, however no statistically significant difference was found between groups due to the small sample sizes. The highest percent improvement scores were observed in TMS + NMES group (varying between 48 and 99.3%) and the lowest scores in control group (varying between 13.1 and 28.1%). Hand motor recovery was significant in both experimental groups while it did not change in control group. Some motor cortex excitability changes were also observed in fMRI. LF-rTMS with or without NMES seems to facilitate the motor recovery in the paretic hand of patients with acute/subacute ischemic stroke. TMS or the combination of TMS + NMES may be a promising additional therapy in upper limb motor training. Further studies with larger numbers of patients are needed to establish their effectiveness in upper limb motor rehabilitation of stroke.

Performance analysis for the cryogenic etalon spectrometer on the Upper Atmospheric Research Satellite

NASA Technical Reports Server (NTRS)

Roche, A. E.; Forney, P. B.; Kumer, J. B.; Naes, L. G.; Nast, T. C.

1983-01-01

The Upper Atmospheric Research Satellite (UARS) program has the objective of providing an 18-month to 2-year platform for observations of the upper atmosphere, giving particular attention to the stratosphere, mesosphere, and lower thermosphere. The primary aims of the mission are related to the measurement of the solar energy input between 120 and 500 km, the acquisition of global maps of the vertical and horizontal distribution of a series of critical trace and minor species, and the investigation of the dynamics of the upper atmosphere. One of several instruments designed to perform neutral species measurements on board the satellite is the Cryogenic Limb Array Etalon Spectrometer (CLAES). The CLAES experiment is concerned with measurements of concentrations of species of interest to the ozone layer balance. Attention is given to the performance requirements of the instrument and the effects of these requirements on the cryogenic design.

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

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

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

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

PubMed

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

2015-01-01

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

Internal performance characteristics of vectored axisymmetric ejector nozzles

NASA Technical Reports Server (NTRS)

Lamb, Milton

1993-01-01

A series of vectoring axisymmetric ejector nozzles were designed and experimentally tested for internal performance and pumping characteristics at NASA-Langley Research Center. These ejector nozzles used convergent-divergent nozzles as the primary nozzles. The model geometric variables investigated were primary nozzle throat area, primary nozzle expansion ratio, effective ejector expansion ratio (ratio of shroud exit area to primary nozzle throat area), ratio of minimum ejector area to primary nozzle throat area, ratio of ejector upper slot height to lower slot height (measured on the vertical centerline), and thrust vector angle. The primary nozzle pressure ratio was varied from 2.0 to 10.0 depending upon primary nozzle throat area. The corrected ejector-to-primary nozzle weight-flow ratio was varied from 0 (no secondary flow) to approximately 0.21 (21 percent of primary weight-flow rate) depending on ejector nozzle configuration. In addition to the internal performance and pumping characteristics, static pressures were obtained on the shroud walls.

Compensating Level-Dependent Frequency Representation in Auditory Cortex by Synaptic Integration of Corticocortical Input

PubMed Central

Happel, Max F. K.; Ohl, Frank W.

2017-01-01

Robust perception of auditory objects over a large range of sound intensities is a fundamental feature of the auditory system. However, firing characteristics of single neurons across the entire auditory system, like the frequency tuning, can change significantly with stimulus intensity. Physiological correlates of level-constancy of auditory representations hence should be manifested on the level of larger neuronal assemblies or population patterns. In this study we have investigated how information of frequency and sound level is integrated on the circuit-level in the primary auditory cortex (AI) of the Mongolian gerbil. We used a combination of pharmacological silencing of corticocortically relayed activity and laminar current source density (CSD) analysis. Our data demonstrate that with increasing stimulus intensities progressively lower frequencies lead to the maximal impulse response within cortical input layers at a given cortical site inherited from thalamocortical synaptic inputs. We further identified a temporally precise intercolumnar synaptic convergence of early thalamocortical and horizontal corticocortical inputs. Later tone-evoked activity in upper layers showed a preservation of broad tonotopic tuning across sound levels without shifts towards lower frequencies. Synaptic integration within corticocortical circuits may hence contribute to a level-robust representation of auditory information on a neuronal population level in the auditory cortex. PMID:28046062

Utility of blind forceps biopsy of the main carina and upper-lobe carina in patients with non-small cell lung cancer.

PubMed

Gunen, H; Kizkin, O; Tahaoglu, C; Aktas, O

2001-02-01

Preoperative detection of non-small cell lung cancer (NSCLC) metastasis to the main carina and upper-lobe carina can alter the operative approach, preclude further staging procedures, and save many patients from thoracotomy. This study assessed whether bronchoscopic forceps biopsy of the normal-appearing main carina and upper-lobe carina (blind biopsy) ipsilateral to the primary NSCLC lesion improved the accuracy of cancer staging and helped guide the management of these patients. A prospective study of 52 patients was carried out at the SSK Süreyyapasa Center for Chest Disease and Cardiothoracic Surgery. Over a 6-month period, we bronchoscopically evaluated 52 consecutive NSCLC patients who were radiologically classified as operable. At least five blind forceps biopsy specimens were obtained from the main carina and/or upper-lobe carina during each patient's initial fiberoptic bronchoscopic examination. Biopsy specimens were collected from the main carina and upper-lobe carina in 51 and 17 patients, respectively. Initially, all patients were staged and evaluated for operability in standard fashion, without histologic assessment of the blind biopsy specimens. We then restaged the disease and reassessed the patients' operability in light of the biopsy findings. Metastasis was histologically diagnosed in seven patients (13.7%) who underwent main carina biopsy and in four patients (23.5%) who underwent upper-lobe carina biopsy. Cancer-positive blind biopsy results changed the status of 25% (6 of 24) of patients from operable to inoperable, and changed the surgical approach in 11.1% (2 of 18) of patients who ultimately did undergo surgery. We found no statistical relationship between metastasis to either carina and tumor type, stage of disease, visibility of the tumor on fiberoptic bronchoscopy, primary tumor location, T status, or N status (p > 0.05). A blind forceps biopsy of the main carina and upper-lobe carina ipsilateral to the lesion site should be done routinely at initial bronchoscopic examination of all radiologically operable patients with suspected lung cancer. This type of screening can save a significant number of NSCLC patients from inappropriate or unnecessary thoracotomy and further staging procedures with their associated morbidity and risk.

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

NASA Technical Reports Server (NTRS)

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

1982-01-01

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

Rare Case of Primary Gastric Burkitt Lymphoma in a Child.

PubMed

Kim, Soon Chul; Hwang, Jung Won; Lee, Min Kyung; Hwang, Pyoung Han

2016-08-25

Primary gastric tumors are very rare in children. Burkitt lymphoma is a common type of non-Hodgkin's lymphoma, and gastric Burkitt lymphoma usually occurs in the aged. When involving the gastrointestinal tract, primary gastric Burkitt lymphoma is very rare in younger childhood. Many gastric lymphomas including mucosa-associated lymphoid tissue lymphoma are associated with Helicobacter pylori infection or acute bleeding symptom. We report a seven-year-old boy who presented with only some vomiting and postprandial pain. His upper gastrointestinal endoscopy and biopsy revealed a large primary Burkitt lymphoma with no acute bleeding and no evidence of H. pylori infection. After chemotherapy, he remains in remission.

Preoperative normal level of parathyroid hormone signifies an early and mild form of primary hyperparathyroidism.

PubMed

Bergenfelz, Anders; Lindblom, Pia; Lindergård, Birger; Valdemarsson, Stig; Westerdahl, Johan

2003-04-01

Contemporary patients are often diagnosed with mild or intermittent hypercalcemia. In addition, most studies demonstrate patients with parathyroid (PTH) levels in the upper normal range. The aim of the present investigation was to define subgroups of patients with mild primary hyperparathyroidism (pHPT), which could be of importance in the decision for or against surgical treatment. Two-hundred and eleven patients, operated for pHPT were investigated with biochemical variables known to reflect PTH activity, renal function, and bone mineral content. The preoperative diagnosis of pHPT was based on the presence of hypercalcemia combined with an inappropriate serum concentration of PTH. The mean age of the patients was 64 +/- 14 years and the mean serum level of calcium was 2.78 +/- 0.19 mmol/L. One hundred and sixty-two patients (77%) had raised levels of calcium and PTH the day before surgery (overt pHPT), 25 patients (12%) had a normal level of calcium and a raised PTH level (normal calcium group), and 20 patients (9%) had a raised level of calcium and a normal level of PTH (normal PTH group). In four patients the level of calcium and PTH was normal. Between-group analysis demonstrated no major difference in symptom and signs of pHPT. Except for lower adenoma weight, patients in the normal calcium group did not essentially differ from the patients in the overt pHPT group. However, patients in the normal PTH group were a decade younger, and had better renal function, lower bone turnover, and a preserved bone density compared with patients in the overt pHPT group. In conclusion, the data from the present investigation show that pHPT patients with a preoperative normal PTH level have an early and mild form of the disease. Furthermore, the serum calcium concentration does not reflect disease severity in pHPT.

Groundwater levels for selected wells in Upper Kittitas County, Washington

USGS Publications Warehouse

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

2011-01-01

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

Development of conceptual ecological models linking management of the Missouri River to pallid sturgeon population dynamics

USGS Publications Warehouse

Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

2015-01-01

This report documents the process of developing and refining conceptual ecological models (CEMs) for linking river management to pallid sturgeon (Scaphirhynchus albus) population dynamics in the Missouri River. The refined CEMs are being used in the Missouri River Pallid Sturgeon Effects Analysis to organize, document, and formalize an understanding of pallid sturgeon population responses to past and future management alternatives. The general form of the CEMs, represented by a population-level model and component life-stage models, was determined in workshops held in the summer of 2013. Subsequently, the Missouri River Pallid Sturgeon Effects Analysis team designed a general hierarchical structure for the component models, refined the graphical structure, and reconciled variation among the components and between models developed for the upper river (Upper Missouri & Yellowstone Rivers) and the lower river (Missouri River downstream from Gavins Point Dam). Importance scores attributed to the relations between primary biotic characteristics and survival were used to define a candidate set of working dominant hypotheses about pallid sturgeon population dynamics. These CEMs are intended to guide research and adaptive-management actions to benefit pallid sturgeon populations in the Missouri River.

Prevention and management of infections associated with combat-related extremity injuries.

PubMed

Murray, Clinton K; Hsu, Joseph R; Solomkin, Joseph S; Keeling, John J; Andersen, Romney C; Ficke, James R; Calhoun, Jason H

2008-03-01

Orthopedic injuries suffered by casualties during combat constitute approximately 65% of the total percentage of injuries and are evenly distributed between upper and lower extremities. The high-energy explosive injuries, environmental contamination, varying evacuation procedures, and progressive levels of medical care make managing combat-related injuries challenging. The goals of orthopedic injury management are to prevent infection, promote fracture healing, and restore function. It appears that 2% to 15% of combat-related extremity injuries develop osteomyelitis, although lower extremity injuries are at higher risk of infections than upper extremity. Management strategies of combat-related injuries primarily focus on early surgical debridement and stabilization, antibiotic administration, and delayed primary closure. Herein, we provide evidence-based recommendations from military and civilian data to the management of combat-related injuries of the extremity. Areas of emphasis include the utility of bacterial cultures, antimicrobial therapy, irrigation fluids and techniques, timing of surgical care, fixation, antibiotic impregnated beads, wound closure, and wound coverage with negative pressure wound therapy. Most of the recommendations are not supported by randomized controlled trials or adequate cohorts studies in a military population and further efforts are needed to answer best treatment strategies.

Finnish Primary and Secondary School Students' Interest in Music and Mathematics Relating to Enjoyment of the Subject and Perception of the Importance and Usefulness of the Subject

ERIC Educational Resources Information Center

Tossavainen, Timo; Juvonen, Antti

2015-01-01

Based on an expectancy-value theoretical framework and data (n = 1654) collected in 29 Finnish municipalities using a structured questionnaire, this study examines primary (grades 5-6), lower secondary (grades 7-9) and upper secondary (grades 10-12) students' motivation in music and mathematics. It explores in detail the students' interest in…

Prosthesis rejection in acquired major upper-limb amputees: a population-based survey.

PubMed

Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

2012-07-01

To estimate the rates of primary and secondary prosthesis rejection in acquired major upper-limb amputees (ULAs), to describe the most frequently reported reasons for rejection and to estimate the influence of background factors on the risk of rejection. Cross-sectional study analysing population-based questionnaire data (n = 224). Effects were analysed by logistic regression analyses and Cox regression analyses. Primary prosthesis rejection was found in 4.5% whereas 13.4% had discontinued prosthesis use. The main reasons reported for primary non-wear were a perceived lack of need and discrepancies between perceived need and the prostheses available. The main reasons reported for secondary prosthesis rejection were dissatisfaction with prosthetic comfort, function and control. Primary prosthesis rejection was more likely in ULAs amputated at high age and in ULAs with proximal amputations. Secondary prosthesis rejection was more likely in proximal ULAs and in women. Clinicians should be aware of the increased risk of rejection in proximal ULAs, elderly ULAs and in women. Emphasising individual needs will probably facilitate successful prosthetic fitting. Improved prosthesis quality and individualised prosthetic training may increase long-term prosthesis use. Further studies of the effect of prosthetic training and of the reasons for rejection of different prosthetic types are suggested.

The potential use of primary human upper urinary tract urothelial cell carcinoma (UUT-UCC) cultured cells for prognostic indicators and chemosensitivity test.

PubMed

Hsieh, Teng-Fu; Chen, Chi-Cheng; Chang, Chao-Hsiang; Yu, Ai-Lin; Ma, Wen-Lung; Shyr, Chih-Rong

2013-07-01

Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a rare yet aggressive urologic tumor with a high rate of recurrence and metastasis, resulting in high mortality. Chemotherapy has been used to prevent recurrence and treat metastatic UUT-UCCs. Although UUT-UCC is sensitive to chemotherapy, the patients' responses to therapy vary and the therapy outcome is unpredictable. Therefore, the identification of patients who are at high risk of failure in chemotherapy is important for accurate prognostication, patient counseling, and better therapy. We have obtained cells from UUT-UCC tumor tissues after surgery and established individual primary cultured cell lines, which were used to evaluate E-cadherin and Ki-67 proliferation marker expression and their chemosensitivity to chemotherapeutic drugs. Differential Ki-67 expression and chemosensitivity were observed in these primary cultured cell lines, suggesting these types of UUT-UCC cell lines could provide a platform for determining prognostic makers and evaluating the efficacy of chemotherapy. In conclusion, primary cultured cell lines from individual patients will be a great tool for evaluating and determining each individual's personalized chemotherapy course and for testing and screening new chemotherapeutic agents against UUT-UCCs. Copyright © 2012 Elsevier GmbH. All rights reserved.

Rationale and design of the ARCUS: Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function.

PubMed

Zwaan, Eva M; IJsselmuiden, Alexander J J; van Rosmalen, Joost; van Geuns, Robert-Jan M; Amoroso, Giovanni; Moerman, Esther; Ritt, Marco J P F; Schreuders, Ton A R; Kofflard, Marcel J M; Holtzer, Carlo A J

2016-12-01

The aim of this study is to provide a complete insight in the access-site morbidity and upper extremity function after Transradial Percutaneous Coronary Intervention (TR-PCI). In percutaneous coronary intervention the Transradial Approach (TRA) is gaining popularity as a default technique. It is a very promising technique with respect to post-procedure complications, but the exact effects of TRA on upper extremity function are unknown. The effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function (ARCUS) trial is a multicenter prospective cohort study that will be conducted in all patients admitted for TR-PCI. Clinical outcomes will be monitored during a follow-up of 6 months, with its primary endpoint at two weeks of follow-up. To investigate the complete upper extremity function, a combination of physical examinations and validated questionnaires will be used to provide information on anatomical integrity, strength, range of motion (ROM), coordination, sensibility, pain, and functioning in everyday life. Procedural and material specifications will be registered in order to include all possible aspects influencing upper extremity function. Results from this study will elucidate the effect of TR-PCI on upper extremity function. This creates the opportunity to further optimize TR-PCI, to make improvements in functional outcome and to prevent morbidity regarding full upper extremity function. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

DIGITAL Q METER

DOEpatents

Briscoe, W.L.

1962-02-13

A digital Q meter is described for measuring the Q of mechanical or electrical devices. The meter comprises in combination a transducer coupled to an input amplifier, and an upper and lower level discriminator coupled to the amplifier and having their outputs coupled to an anticoincidence gate. The output of the gate is connected to a scaler. The lower level discriminator is adjusted to a threshold level of 36.8 percent of the operating threshold level of the upper level discriminator. (AEC)

Brain cancer and pesticide relationship in orchard farmers of Kashmir.

PubMed

Bhat, Abdul Rashid; Wani, Muhammed Afzal; Kirmani, A R

2010-09-01

The increasing trend in the incidence of primary malignant brain tumors in orchard farmers and their families in Kashmir. To determine the relationship between the patients of primary malignant brain tumors and their occupation. Retrospectively, case files along with death certificates of 432 patients of primary malignant brain tumors and 457 controls (non-tumor neurologic diseases), admitted for treatment simultaneously over a period of 4 years from January 2005 to December 2008, to the Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Kashmir, were studied. Follow-up and family interaction was established. Analysis revealed that 90.04% (389 out of 432) patients were orchard farm workers, orchard residents and orchard playing children exposed to the high levels of multiple types of neurotoxic and carcinogenic (chlorpyriphos, dimethoate, mancozeb and captan) chemicals for more than 10 years [relative risk (RR) = 10.6; odds ratio (OR) = >10; 95% confidence interval (CI) = >25-40]. The 9.96% (43 out of 432) patients were not exposed to pesticides. On the other hand, only 19 patients out of 457 controls had recorded history of pesticide exposure and 438 were unrelated to pesticides. Out of 389 patients, 71.7% (279 out of 389) were males and 28.3% (110 out of 389), including six members of three families, were females (one male child). All orchard-related 389 patients had high-grade tumors as compared to the non-pesticide tumors. Mortality in pesticide-exposed tumors was 12%. The higher or upper-normal levels of serum cholinesterase (AChE) were observed in 54.7% (213 out of 389) patients and decreased levels were found in only 45.3% (176 out of 389) orchard-related patients (RR = 19.4; OR = >5; 95% CI = >1-10). Although serum AChE levels were a routine investigation in malignant brain tumors, this was not a routine in other neurological conditions (hospitalized controls). The familial gliomas have shown an emerging trend in the orchard residents of valley of Kashmir.

Interior, north end, upper level, looking south towards door to ...

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

Interior, north end, upper level, looking south towards door to one of the building's refrigeration rooms. Photograph taken just south of CO-172-AQ-4. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Interior, north end, upper level, looking west. This photograph taken ...

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

Interior, north end, upper level, looking west. This photograph taken inside the refrigeration room whose door is in the background of CO-172-AQ-5. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Skylab

NASA Image and Video Library

1972-01-01

This photograph, with callouts, depicts the experiment area of the forward compartment at the upper level of the Orbital Workshop. The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

Service Learning in Domestic and International Settings

ERIC Educational Resources Information Center

Miller, Kari Knutson; Gonzalez, Amber M.

2009-01-01

This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. One group of upper-division undergraduate level pre service teachers participated in supervised experiences in domestic settings. A second group of upper-division undergraduate level pre-service teachers participated in…

The analysis and kinetic energy balance of an upper-level wind maximum during intense convection

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.; Jedlovec, G. J.

1982-01-01

The purpose of this paper is to analyze the formation and maintenance of the upper-level wind maximum which formed between 1800 and 2100 GMT, April 10, 1979, during the AVE-SESAME I period, when intense storms and tornadoes were experienced (the Red River Valley tornado outbreak). Radiosonde stations participating in AVE-SESAME I are plotted (centered on Oklahoma). National Meteorological Center radar summaries near the times of maximum convective activity are mapped, and height and isotach plots are given, where the formation of an upper-level wind maximum over Oklahoma is the most significant feature at 300 mb. The energy balance of the storm region is seen to change dramatically as the wind maximum forms. During much of its lifetime, the upper-level wind maximum is maintained by ageostrophic flow that produces cross-contour generation of kinetic energy and by the upward transport of midtropospheric energy. Two possible mechanisms for the ageostrophic flow are considered.

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

A generalized public goods game with coupling of individual ability and project benefit

NASA Astrophysics Data System (ADS)

Zhong, Li-Xin; Xu, Wen-Juan; He, Yun-Xin; Zhong, Chen-Yang; Chen, Rong-Da; Qiu, Tian; Shi, Yong-Dong; Ren, Fei

2017-08-01

Facing a heavy task, any single person can only make a limited contribution and team cooperation is needed. As one enjoys the benefit of the public goods, the potential benefits of the project are not always maximized and may be partly wasted. By incorporating individual ability and project benefit into the original public goods game, we study the coupling effect of the four parameters, the upper limit of individual contribution, the upper limit of individual benefit, the needed project cost and the upper limit of project benefit on the evolution of cooperation. Coevolving with the individual-level group size preferences, an increase in the upper limit of individual benefit promotes cooperation while an increase in the upper limit of individual contribution inhibits cooperation. The coupling of the upper limit of individual contribution and the needed project cost determines the critical point of the upper limit of project benefit, where the equilibrium frequency of cooperators reaches its highest level. Above the critical point, an increase in the upper limit of project benefit inhibits cooperation. The evolution of cooperation is closely related to the preferred group-size distribution. A functional relation between the frequency of cooperators and the dominant group size is found.

The fate of production in the central Arctic Ocean - top-down regulation by zooplankton expatriates?

NASA Astrophysics Data System (ADS)

Olli, Kalle; Wassmann, Paul; Reigstad, Marit; Ratkova, Tatjana N.; Arashkevich, Elena; Pasternak, Anna; Matrai, Patricia A.; Knulst, Johan; Tranvik, Lars; Klais, Riina; Jacobsen, A.

2007-01-01

We estimated primary and bacterial production, mineral nutrients, suspended chlorophyll a (Chl), particulate organic carbon (POC) and nitrogen (PON), abundance of planktonic organisms, mesozooplankton fecal pellet production, and the vertical flux of organic particles of the central Arctic Ocean (Amundsen basin, 89-88° N) during a 3 week quasi-Lagrangian ice drift experiment at the peak of the productive season (August 2001). A visual estimate of ≈15% ice-free surface, plus numerous melt ponds on ice sheets, supported a planktonic particulate primary production of 50-150 mg C m -2 d -1 (mean 93 mg C m -2 d -1, n = 7), mostly confined to the upper 10 m of the nutrient replete water column. The surface mixed layer was separated from the rest of the water column by a strong halocline at 20 m depth. Phototrophic biomass was low, generally 0.03-0.3 mg Chl m -3 in the upper 20 m and <0.02 mg Chl m -3 below, dominated by various flagellates, dinoflagellates and diatoms. Bacterial abundance (typically 3.7-5.3 × 10 5, mean 4.1 × 10 5 cells ml -1 in the upper 20 m and 1.3-3.7 × 10 5, mean 1.9 × 10 5 cells ml -1 below) and Chl concentrations were closely correlated ( r = 0.75). Mineral nutrients (3 μmol NO 3 l -1, 0.45 μmol PO 4 l -1, 4-5 μmol SiO 4 l -1) were probably not limiting the primary production in the upper layer. Suspended POC concentration was ∼30-105 (mean 53) mg C m -3 and PON ∼5.4-14.9 (mean 8.2) mg N m -3 with no clear vertical trend. The vertical flux of POC in the upper 30-100 m water column was ∼37-92 (mean 55) mg C m -2 d -1 without clear decrease with depth, and was quite similar at the six investigated stations. The mesozooplankton biomass (≈2 g DW m -2, mostly in the upper 50 m water column) was dominated by adult females of the large calanoid copepods Calanus hyperboreus and Calanus glacialis (≈1.6 g DW m -2). The grazing of these copepods (estimated via fecal pellet production rates) was ≈15 mg C m -2 d -1, being on the order of 3% and 20% of the expected food-saturated ingestion rates of C. hyperboreus and C. glacialis, respectively. The stage structure of these copepods, dominated by adult females, and their unsatisfied grazing capacity during peak productive period suggest allochthonous origin of these species from productive shelf areas, supported by their long life span and the prevailing surface currents in the Arctic Ocean. We propose that the grazing capacity of the expatriated mesozooplankton population would match the potential seasonal increase of primary production in the future decreased ice perspective, diminishing the likelihood of algal blooms.

The Oncology of Discrimination and the Disparate Impact Therapy: Title VII and Upper Level Professional and Managerial Jobs.

ERIC Educational Resources Information Center

Sanders, Wayne

An examination was made of the evidentiary problems that exist in using a disparate impact theory to challenge the subjective criteria many organizations use to hire, promote, or dismiss upper-level professional and managerial employees. Although subjective criteria occur at all levels of employment, they are especially prevalent when dealing with…

Sequence stratigraphy and a revised sea-level curve for the Middle Devonian of eastern North America

USGS Publications Warehouse

Brett, Carlton E.; Baird, G.C.; Bartholomew, A.J.; DeSantis, M.K.; Ver Straeten, C.A.

2011-01-01

The well-exposed Middle Devonian rocks of the Appalachian foreland basin (Onondaga Formation; Hamilton Group, Tully Formation, and the Genesee Group of New York State) preserve one of the most detailed records of high-order sea-level oscillation cycles for this time period in the world. Detailed examination of coeval units in distal areas of the Appalachian Basin, as well as portions of the Michigan and Illinois basins, has revealed that the pattern of high-order sea-level oscillations documented in the New York-Pennsylvania section can be positively identified in all areas of eastern North America where coeval units are preserved. The persistence of the pattern of high-order sea-level cycles across such a wide geographic area suggests that these cycles are allocyclic in nature with primary control on deposition being eustatic sea-level oscillation, as opposed to autocylic controls, such as sediment supply, which would be more local in their manifestation. There is strong evidence from studies of cyclicity and spectral analysis that these cycles are also related to Milankovitch orbital variations, with the short and long-term eccentricity cycles (100. kyr and 405. kyr) being the dominant oscillations in many settings. Relative sea-level oscillations of tens of meters are likely and raise considerable issues about the driving mechanism, given that the Middle Devonian appears to record a greenhouse phase of Phanerozoic history. These new correlations lend strong support to a revised high-resolution sea-level oscillation curve for the Middle Devonian for the eastern portion of North America. Recognized third-order sequences are: Eif-1 lower Onondaga Formation, Eif-2: upper Onondaga and Union Springs formations; Eif-Giv: Oatka Creek Formation; Giv-1: Skaneateles, Giv-2: Ludlowville, Giv-3: lower Moscow, Giv-4: upper Moscow-lower Tully, and Giv-5: middle Tully-Geneseo formations. Thus, in contrast with the widely cited eustatic curve of Johnson et al. (1985), which recognizes just one major transgressive-regressive (T-R) cycle in the early-mid Givetian (If) prior to the major late Givetian Taghanic unconformity (IIa, upper Tully-Geneseo Shale), we recognize four T-R cycles: If (restricted), Ig, Ih, and Ii. We surmise that third-order sequences record eustatic sea-level fluctuations of tens of meters with periodicities of 0.8-2. myr, while their medial-scale (fourth-order) subdivisions record lesser variations primarily of 405. kyr duration (long-term eccentricity). This high-resolution record of sea-level change provides strong evidence for high-order eustatic cycles with probable Milankovitch periodicities, despite the fact that no direct evidence for Middle Devonian glacial sediments has been found to date. ?? 2010.

Foraminiferal, lithic, and isotopic changes across four major unconformities at Deep Sea Drilling Project Site 548, Goban Spur: Chapter 14 in Initial reports of the Deep Sea Drilling Project

USGS Publications Warehouse

Poag, C. Wylie; Reynolds, Leslie A.; Mazzullo, James M.; Keigwin, Loyd D.

1985-01-01

Sediment samples taken at close intervals across four major unconformities (middle Miocene/upper Miocene, lower Oligocene/upper Oligocene, lower Eocene/upper Eocene, lower Paleocene/upper Paleocene) at DSDP-IPOD Site 548, Goban Spur, reveal that coeval biostratigraphic gaps, sediment discontinuities, and seismic unconformities coincide with postulated low stands of sea level. Foraminiferal, lithic, and isotopic analyses demonstrate that environments began to shift prior to periods of marine erosion, and that sedimentation resumed in the form of turbidites derived from nearby upper-slope sources. The unconformities appear to have developed where a water-mass boundary intersected the continental slope, rhythmically crossing the drill site in concert with sea-level rise and fall.

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

PubMed Central

Mozaffari, Brian

2014-01-01

Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)—located deep in the hierarchy—serves as a bridge connecting supra- to infra—MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL “bridge” allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these “bridge” predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation. PMID:25426036

24. Pump Room interiordewatering pump motor on upper level. Note ...

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

24. Pump Room interior-dewatering pump motor on upper level. Note the removable roof hatch (steel frame) directly above motor. Dewatering pumps motor control center at left - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

41. Upper level, electronic racks, left to rightprogrammer group, status ...

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

41. Upper level, electronic racks, left to right--programmer group, status command message processing group, UHF radio, impss rack security - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

43. Upper level, left to rightground missile guidance system liquid ...

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

43. Upper level, left to right--ground missile guidance system liquid cooling equipment, guidance and control coupler rack, programmer group - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Skylab

NASA Image and Video Library

1972-01-01

This image, with callouts, depicts the storage area of the forward compartment at the upper level of the Orbital Workshop (OWS). The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

The structure of salt marsh soil mesofauna food webs – The prevalence of disturbance

PubMed Central

Kiggen, Mirijam; Klarner, Bernhard; Maraun, Mark; Scheu, Stefan

2017-01-01

Mesofauna taxa fill key trophic positions in soil food webs, even in terrestrial–marine boundary habitats characterized by frequent natural disturbances. Salt marshes represent such boundary habitats, characterized by frequent inundations increasing from the terrestrial upper to the marine pioneer zone. Despite the high abundance of soil mesofauna in salt marshes and their important function by facilitating energy and carbon flows, the structure, trophic ecology and habitat-related diet shifts of mesofauna species in natural salt marsh habitats is virtually unknown. Therefore, we investigated the effects of natural disturbance (inundation frequency) on community structure, food web complexity and resource use of soil mesofauna using stable isotope analysis (15N, 13C) in three salt marsh zones. In this intertidal habitat, the pioneer zone is exposed to inundations twice a day, but lower and upper salt marshes are less frequently inundated based on shore height. The mesofauna comprised 86 species / taxa dominated by Collembola, Oribatida and Mesostigmata. Shifts in environmental disturbances influenced the structure of food webs, diversity and density declined strongly from the land to the sea pointing to the importance of increasing levels of inundation frequency. Accordingly, the reduced diversity and density was associated by a simplification of the food web in the pioneer zone as compared to the less inundated lower and upper salt marsh with a higher number of trophic levels. Strong variations in δ15N signatures demonstrated that mesofauna species are feeding at multiple trophic levels. Primary decomposers were low and most mesofauna species functioned as secondary decomposers or predators including second order predators or scavengers. The results document that major decomposer taxa, such as Collembola and Oribatida, are more diverse than previously assumed and predominantly dwell on autochthonous resources of the respective salt marsh zone. The results further suggest that Mesostigmata mostly adopt an intraguild predation lifestyle. The high trophic position of a large number of predators suggests that intraguild predation is of significant importance in salt marsh food webs. Presumably, intraguild predation contributes to stabilizing the salt marsh food web against disturbances. PMID:29240806

Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system.

PubMed

Kim, Pyeong Hwa; Song, Ho-Young; Park, Jung-Hoon; Zhou, Wei-Zhong; Na, Han Kyu; Cho, Young Chul; Jun, Eun Jung; Kim, Jun Ki; Kim, Guk Bae

2017-03-01

To evaluate clinical outcomes of fluoroscopic removal of retrievable self-expandable metal stents (SEMSs) for malignant oesophageal strictures, to compare clinical outcomes of three different removal techniques, and to identify predictive factors of successful removal by the standard technique (primary technical success). A total of 137 stents were removed from 128 patients with malignant oesophageal strictures. Primary overall technical success and removal-related complications were evaluated. Logistic regression models were constructed to identify predictive factors of primary technical success. Primary technical success rate was 78.8 % (108/137). Complications occurred in six (4.4 %) cases. Stent location in the upper oesophagus (P=0.004), stricture length over 8 cm (P=0.030), and proximal granulation tissue (P<0.001) were negative predictive factors of primary technical success. If granulation tissue was present at the proximal end, eversion technique was more frequently required (P=0.002). Fluoroscopic removal of retrievable SEMSs for malignant oesophageal strictures using three different removal techniques appeared to be safe and easy. The standard technique is safe and effective in the majority of patients. The presence of proximal granulation tissue, stent location in the upper oesophagus, and stricture length over 8 cm were negative predictive factors for primary technical success by standard extraction and may require a modified removal technique. • Fluoroscopic retrievable SEMS removal is safe and effective. • Standard removal technique by traction is effective in the majority of patients. • Three negative predictive factors of primary technical success were identified. • Caution should be exercised during the removal in those situations. • Eversion technique is effective in cases of proximal granulation tissue.

Comparison of Sirtuin 3 Levels in ALS and Huntington’s Disease—Differential Effects in Human Tissue Samples vs. Transgenic Mouse Models

PubMed Central

Buck, Eva; Bayer, Hanna; Lindenberg, Katrin S.; Hanselmann, Johannes; Pasquarelli, Noemi; Ludolph, Albert C.; Weydt, Patrick; Witting, Anke

2017-01-01

Neurodegenerative diseases are characterized by distinct patterns of neuronal loss. In amyotrophic lateral sclerosis (ALS) upper and lower motoneurons degenerate whereas in Huntington’s disease (HD) medium spiny neurons in the striatum are preferentially affected. Despite these differences the pathophysiological mechanisms and risk factors are remarkably similar. In addition, non-neuronal features, such as weight loss implicate a dysregulation in energy metabolism. Mammalian sirtuins, especially the mitochondrial NAD+ dependent sirtuin 3 (SIRT3), regulate mitochondrial function and aging processes. SIRT3 expression depends on the activity of the metabolic master regulator peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), a modifier of ALS and HD in patients and model organisms. This prompted us to systematically probe Sirt3 mRNA and protein levels in mouse models of ALS and HD and to correlate these with patient tissue levels. We found a selective reduction of Sirt3 mRNA levels and function in the cervical spinal cord of end-stage ALS mice (superoxide dismutase 1, SOD1G93A). In sharp contrast, a tendency to increased Sirt3 mRNA levels was found in the striatum in HD mice (R6/2). Cultured primary neurons express the highest levels of Sirt3 mRNA. In primary cells from PGC-1α knock-out (KO) mice the Sirt3 mRNA levels were highest in astrocytes. In human post mortem tissue increased mRNA and protein levels of Sirt3 were found in the spinal cord in ALS, while Sirt3 levels were unchanged in the human HD striatum. Based on these findings we conclude that SIRT3 mediates the different effects of PGC-1α during the course of transgenic (tg) ALS and HD and in the human conditions only partial aspects Sirt3 dysregulation manifest. PMID:28603486

Sleep Apnea Crash Risk Study (Report)

DOT National Transportation Integrated Search

2004-09-01

Sleep apnea is a condition in which a narrowing or closure of the upper airway during sleep causes repeated sleep disturbances, and possible complete awakenings, leading to poor sleep quality and excessive daytime sleepiness. The primary objectives o...

TRUMP. Transient & S-State Temperature Distribution

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

Elrod, D.C.; Turner, W.D.

1992-03-03

TRUMP solves a general nonlinear parabolic partial differential equation describing flow in various kinds of potential fields, such as fields of temperature, pressure, or electricity and magnetism; simultaneously, it will solve two additional equations representing, in thermal problems, heat production by decomposition of two reactants having rate constants with a general Arrhenius temperature dependence. Steady-state and transient flow in one, two, or three dimensions are considered in geometrical configurations having simple or complex shapes and structures. Problem parameters may vary with spatial position, time, or primary dependent variables, temperature, pressure, or field strength. Initial conditions may vary with spatial position,more » and among the criteria that may be specified for ending a problem are upper and lower limits on the size of the primary dependent variable, upper limits on the problem time or on the number of time-steps or on the computer time, and attainment of steady state.« less

Primary Lateral Sclerosis

PubMed Central

Statland, Jeffrey M.; Barohn, Richard J.; Dimachkie, Mazen M.; Floeter, Mary Kay; Mitsumoto, Hiroshi

2015-01-01

Synopsis Primary lateral sclerosis (PLS) is characterized by insidious onset of progressive upper motor neuron dysfunction in the absence of clinical signs of lower motor neuron involvement. Patients experience stiffness, decreased balance and coordination, and mild weakness, and if the bulbar region is affected, difficulty speaking and swallowing, and emotional lability. The diagnosis is made based on clinical history, typical exam findings, and diagnostic testing negative for other causes of upper motor neuron dysfunction. EMG is normal, or only shows mild neurogenic findings in a few muscles, not meeting El Escorial criteria. Although no test is specific for PLS, some neurodiagnostic tests are supportive: including absent or delayed central motor conduction times; and changes in the precentral gyrus or corticospinal tracts on MRI, DTI or MR Spectroscopy. Treatment is largely supportive, and includes medications for spasticity, baclofen pump, and treatment for pseudobulbar affect. The prognosis in PLS is more benign than ALS, making this a useful diagnostic category. PMID:26515619

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

Elrod, D.C.; Turner, W.D.

TRUMP solves a general nonlinear parabolic partial differential equation describing flow in various kinds of potential fields, such as fields of temperature, pressure, or electricity and magnetism; simultaneously, it will solve two additional equations representing, in thermal problems, heat production by decomposition of two reactants having rate constants with a general Arrhenius temperature dependence. Steady-state and transient flow in one, two, or three dimensions are considered in geometrical configurations having simple or complex shapes and structures. Problem parameters may vary with spatial position, time, or primary dependent variables, temperature, pressure, or field strength. Initial conditions may vary with spatial position,more » and among the criteria that may be specified for ending a problem are upper and lower limits on the size of the primary dependent variable, upper limits on the problem time or on the number of time-steps or on the computer time, and attainment of steady state.« less

Potentiometric surface and water-level difference maps of selected confined aquifers in Southern Maryland and Maryland’s Eastern Shore, 1975-2015

USGS Publications Warehouse

Curtin, Stephen E.; Staley, Andrew W.; Andreasen, David C.

2016-01-01

Key Results This report presents potentiometric-surface maps of the Aquia and Magothy aquifers and the Upper Patapsco, Lower Patapsco, and Patuxent aquifer systems using water levels measured during September 2015. Water-level difference maps are also presented for these aquifers. The water-level differences in the Aquia aquifer are shown using groundwater-level data from 1982 and 2015, while the water-level differences are shown for the Magothy aquifer using data from 1975 and 2015. Water-level difference maps for both the Upper Patapsco and Lower Patapsco aquifer systems are shown using data from 1990 and 2015. The water-level differences in the Patuxent aquifer system are shown using groundwater-level data from 2007 and 2015. The potentiometric surface maps show water levels ranging from 53 feet above sea level to 164 feet below sea level in the Aquia aquifer, from 86 feet above sea level to 106 feet below sea level in the Magothy aquifer, from 115 feet above sea level to 115 feet below sea level in the Upper Patapsco aquifer system, from 106 feet above sea level to 194 feet below sea level in the Lower Patapsco aquifer system, and from 165 feet above sea level to 171 feet below sea level in the Patuxent aquifer system. Water levels have declined by as much as 116 feet in the Aquia aquifer since 1982, 99 feet in the Magothy aquifer since 1975, 66 and 83 feet in the Upper Patapsco and Lower Patapsco aquifer systems, respectively, since 1990, and 80 feet in the Patuxent aquifer system since 2007.

Potentiometric surface of the upper Floridan Aquifer in the St. Johns Water Management District and vicinity, Florida, May 1984

USGS Publications Warehouse

Schiner, George R.; Hayes, Eugene C.

1984-01-01

This map shows the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 1984. The Upper Floridan aquifer is the principal source of potable water in the area. Water-level measurements were made on approximately 1,000 wells and on several springs. The potentiometric surface is shown mostly by 5-foot contour intervals. In the Fernandina Beach area a 40-foot interval is used to show a deep cone of depression. The potentiometric surface ranged from 126 feet above sea level in Polk County to 84 feet below sea level in Nassau County. Water levels in key wells were mostly above, or less frequently, slightly below averages for May in response to diverse area rainfall patterns. Most levels in the district were about the same, or more commonly, 1 to 2 feet lower than May 1983 levels. (USGS)

Effect of level difference between left and right vocal folds on phonation: Physical experiment and theoretical study.

PubMed

Tokuda, Isao T; Shimamura, Ryo

2017-08-01

As an alternative factor to produce asymmetry between left and right vocal folds, the present study focuses on level difference, which is defined as the distance between the upper surfaces of the bilateral vocal folds in the inferior-superior direction. Physical models of the vocal folds were utilized to study the effect of the level difference on the phonation threshold pressure. A vocal tract model was also attached to the vocal fold model. For two types of different models, experiments revealed that the phonation threshold pressure tended to increase as the level difference was extended. Based upon a small amplitude approximation of the vocal fold oscillations, a theoretical formula was derived for the phonation threshold pressure. This theory agrees with the experiments, especially when the phase difference between the left and right vocal folds is not extensive. Furthermore, an asymmetric two-mass model was simulated with a level difference to validate the experiments as well as the theory. The primary conclusion is that the level difference has a potential effect on voice production especially for patients with an extended level of vertical difference in the vocal folds, which might be taken into account for the diagnosis of voice disorders.

Limited Interactions between Streptococcus Suis and Haemophilus Parasuis in In Vitro Co-Infection Studies

PubMed Central

Mathieu-Denoncourt, Annabelle; Letendre, Corinne; Auger, Jean-Philippe; Segura, Mariela; Aragon, Virginia; Lacouture, Sonia; Gottschalk, Marcelo

2018-01-01

Streptococcus suis and Haemophilus parasuis are normal inhabitants of the porcine upper respiratory tract but are also among the most frequent causes of disease in weaned piglets worldwide, causing inflammatory diseases such as septicemia, meningitis and pneumonia. Using an in vitro model of infection with tracheal epithelial cells or primary alveolar macrophages (PAMs), it was possible to determine the interaction between S. suis serotype 2 and H. parasuis strains with different level of virulence. Within H. parasuis strains, the low-virulence F9 strain showed higher adhesion levels to respiratory epithelial cells and greater association levels to PAMs than the high-virulence Nagasaki strain. Accordingly, the low-virulence F9 strain induced, in general, higher levels of pro-inflammatory cytokines than the virulent Nagasaki strain from both cell types. In general, S. suis adhesion levels to respiratory epithelial cells were similar to H. parasuis Nagasaki strain. Yet, S. suis strains induced a significantly lower level of pro-inflammatory cytokine expression from epithelial cells and PAMs than those observed with both H. parasuis strains. Finally, this study has shown that, overall and under the conditions used in the present study, S. suis and H. parasuis have limited in vitro interactions between them and use probably different host receptors, regardless to their level of virulence. PMID:29316613

Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

PubMed

Mai, Harry T; Burgmeier, Robert J; Mitchell, Sean M; Hecht, Andrew C; Maroon, Joseph C; Nuber, Gordon W; Hsu, Wellington K

2016-12-01

Retrospective cohort study. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper- (C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P = 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P = 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels. 4.

Malignant spinal cord compression in cancer patients may be mimicked by a primary spinal cord tumour.

PubMed

Mohammadianpanah, M; Vasei, M; Mosalaei, A; Omidvari, S; Ahmadloo, N

2006-12-01

Although it is quite rare, second primary neoplasms in cancer patients may present with the signs and symptoms of malignant spinal cord compression. Primary spinal cord tumours in the cancer patients may be deceptive and considered as the recurrent first cancer. Therefore, it should be precisely differentiated and appropriately managed. We report such a case of intramedullary ependymoma of the cervical spinal cord mimicking metatstatic recurrent lymphoma and causing cord compression. A 50-year-old man developed intramedullary ependymoma of the cervical spinal cord 1.5 years following chemoradiation for Waldeyer's ring lymphoma. He presented with a 2-month history of neck pain, progressive upper- and lower-extremity numbness and weakness, and bowel and bladder dysfunction. Magnetic resonance imaging revealed an intramedullary expansive lesion extending from C4 to C6 levels of the cervical spinal cord. The clinical and radiological findings were suggestive of malignant process. A comprehensive investigation failed to detect another site of disease. He underwent operation, and the tumour was subtotally resected. The patient's neurological deficits improved subsequently. The development of the intramedullary ependymoma following treating lymphoma has not been reported. We describe the clinical, radiological and pathological findings of this case and review the literature.

Feasibility of ultrasound-guided sacroiliac joint injection considering sonoanatomic landmarks at two different levels in cadavers and patients.

PubMed

Klauser, Andrea; De Zordo, Tobias; Feuchtner, Gudrun; Sögner, Peter; Schirmer, Michael; Gruber, Johann; Sepp, Norbert; Moriggl, Bernhard

2008-11-15

Sacroiliitis is often caused by rheumatic diseases, and besides other therapeutic options, treatment consists of intraarticular injection of corticosteroids. The purpose of this study was to assess the feasibility of ultrasound (US)-guided sacroiliac joint (SI joint) injection at 2 different puncture levels in cadavers and patients when defined sonoanatomic landmarks were considered. After defining sonoanatomic landmarks, US-guided needle insertion was performed in 10 human cadavers (20 SI joints) at 2 different puncture sites. Upper level was defined at the level of the posterior sacral foramen 1 and lower level at the level of the posterior sacral foramen 2. In 10 patients with unilateral sacroiliitis, injection at the most feasible level was attempted. Computed tomography confirmed correct intraarticular needle placement in cadavers by showing the tip of the needle in the joint and intraarticular diffusion of contrast media in 16 (80%) of 20 SI joints (upper level 7 [70%] of 10; lower level 9 [90%] of 10). In all 4 cases in which needle insertion failed, intraarticular SI joint injection at the other level was successful. In patients, 100% of US-guided injections were successful (8 lower level, 2 upper level), with a mean pain relief of 8.6 after 3 months. US guidance of needle insertion into SI joints was feasible at both levels when defined sonoanatomic landmarks were used. If SI joint alterations do not allow for direct visualization of the dorsal joint space of the lower level, which is easier to access, the upper level might offer an appropriate alternative.

Multiweek cell culture project for use in upper-level biology laboratories.

PubMed

Marion, Rebecca E; Gardner, Grant E; Parks, Lisa D

2012-06-01

This article describes a laboratory protocol for a multiweek project piloted in a new upper-level biology laboratory (BIO 426) using cell culture techniques. Human embryonic kidney-293 cells were used, and several culture media and supplements were identified for students to design their own experiments. Treatments included amino acids, EGF, caffeine, epinephrine, heavy metals, and FBS. Students researched primary literature to determine their experimental variables, made their own solutions, and treated their cells over a period of 2 wk. Before this, a sterile technique laboratory was developed to teach students how to work with the cells and minimize contamination. Students designed their experiments, mixed their solutions, seeded their cells, and treated them with their control and experimental media. Students had the choice of manipulating a number of variables, including incubation times, exposure to treatment media, and temperature. At the end of the experiment, students observed the effects of their treatment, harvested and dyed their cells, counted relative cell numbers in control and treatment flasks, and determined the ratio of living to dead cells using a hemocytometer. At the conclusion of the experiment, students presented their findings in a poster presentation. This laboratory can be expanded or adapted to include additional cell lines and treatments. The ability to design and implement their own experiments has been shown to increase student engagement in the biology-related laboratory activities as well as develop the critical thinking skills needed for independent research.

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

DOE PAGES

Edwards, Timothy S.

2014-10-29

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

Is larger scoliosis curve magnitude associated with increased perioperative health-care resource utilization?: a multicenter analysis of 325 adolescent idiopathic scoliosis curves.

PubMed

Miyanji, Firoz; Slobogean, Gerard P; Samdani, Amer F; Betz, Randal R; Reilly, Christopher W; Slobogean, Bronwyn L; Newton, Peter O

2012-05-02

The treatment of patients with large adolescent idiopathic scoliosis curves has been associated with increased surgical complexity. The purpose of this study was to determine whether surgical correction of larger adolescent idiopathic scoliosis curves increased the utilization of health-care resources and to identify potential predictors associated with increased perioperative health-care resource utilization. A nested cohort of patients with adolescent idiopathic scoliosis with Lenke type 1A and 1B curves were identified from a prospective longitudinal multicenter database. Four perioperative outcomes were selected as the primary health-care resource utilization outcomes of interest: operative time, number of vertebral levels instrumented, duration of hospitalization, and allogeneic blood transfusion. The effect of curve magnitude on these outcomes was assessed with use of univariate and multivariate regression. Three hundred and twenty-five patients with a mean age of 15 ± 2 years were included. The mean main thoracic curve was 54.4° ± 7.8°. Larger curves were associated with longer operative time (p = 0.03), a greater number of vertebral levels instrumented (p = 0.0005), and the need for blood transfusion (with every 10° increase associated with 1.5 times higher odds of receiving a transfusion). In addition to curve magnitude, surgical center, bone graft method, and upper and lower instrumented levels were strong predictors of operative time (R2 = 0.76). The duration of hospitalization was influenced by the surgical center and intraoperative blood loss (R2 < 0.4), whereas the number of levels instrumented was influenced by the curve magnitude, curve correction percentage, upper instrumented vertebra, and surgical center (R2 = 0.64). Correction of larger curves was associated with increased utilization of perioperative health-care resources, specifically longer operative time, a greater number of vertebral levels instrumented, and higher odds of receiving a blood transfusion.

40. Upper level, electronic racks, left to rightstatus command message ...

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

40. Upper level, electronic racks, left to right--status command message processing group, UHF radio, impss rack security, power supply group rack - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

42. Upper level, electronic racks, left to rightguidance and control ...

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

42. Upper level, electronic racks, left to right--guidance and control coupler rack, programmer group, status command message processing group, UHF radio - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Fostering Students' Preparation and Achievement in Upper Level Mathematics Courses

ERIC Educational Resources Information Center

Celik, Mehmet; Shaqlaih, Ali

2017-01-01

This study describes an intervention to address both motivation, student engagement and preparation in upper-level mathematics courses. The effect of the intervention regarding students' achievements is investigated via students' opinions and data analysis from students' assessments. The results of this study show the featured intervention…

Sample Size Limits for Estimating Upper Level Mediation Models Using Multilevel SEM

ERIC Educational Resources Information Center

Li, Xin; Beretvas, S. Natasha

2013-01-01

This simulation study investigated use of the multilevel structural equation model (MLSEM) for handling measurement error in both mediator and outcome variables ("M" and "Y") in an upper level multilevel mediation model. Mediation and outcome variable indicators were generated with measurement error. Parameter and standard…

EMG-based visual-haptic biofeedback: a tool to improve motor control in children with primary dystonia.

PubMed

Casellato, Claudia; Pedrocchi, Alessandra; Zorzi, Giovanna; Vernisse, Lea; Ferrigno, Giancarlo; Nardocci, Nardo

2013-05-01

New insights suggest that dystonic motor impairments could also involve a deficit of sensory processing. In this framework, biofeedback, making covert physiological processes more overt, could be useful. The present work proposes an innovative integrated setup which provides the user with an electromyogram (EMG)-based visual-haptic biofeedback during upper limb movements (spiral tracking tasks), to test if augmented sensory feedbacks can induce motor control improvement in patients with primary dystonia. The ad hoc developed real-time control algorithm synchronizes the haptic loop with the EMG reading; the brachioradialis EMG values were used to modify visual and haptic features of the interface: the higher was the EMG level, the higher was the virtual table friction and the background color proportionally moved from green to red. From recordings on dystonic and healthy subjects, statistical results showed that biofeedback has a significant impact, correlated with the local impairment, on the dystonic muscular control. These tests pointed out the effectiveness of biofeedback paradigms in gaining a better specific-muscle voluntary motor control. The flexible tool developed here shows promising prospects of clinical applications and sensorimotor rehabilitation.

CREATE cornerstone: introduction to scientific thinking, a new course for STEM-interested freshmen, demystifies scientific thinking through analysis of scientific literature.

PubMed

Gottesman, Alan J; Hoskins, Sally G

2013-01-01

The Consider, Read, Elucidate hypotheses, Analyze and interpret data, Think of the next Experiment (CREATE) strategy for teaching and learning uses intensive analysis of primary literature to improve students' critical-thinking and content integration abilities, as well as their self-rated science attitudes, understanding, and confidence. CREATE also supports maturation of undergraduates' epistemological beliefs about science. This approach, originally tested with upper-level students, has been adapted in Introduction to Scientific Thinking, a new course for freshmen. Results from this course's initial semesters indicate that freshmen in a one-semester introductory course that uses a narrowly focused set of readings to promote development of analytical skills made significant gains in critical-thinking and experimental design abilities. Students also reported significant gains in their ability to think scientifically and understand primary literature. Their perceptions and understanding of science improved, and multiple aspects of their epistemological beliefs about science gained sophistication. The course has no laboratory component, is relatively inexpensive to run, and could be adapted to any area of scientific study.

Geophysical data integration and conditional uncertainty analysis on hydraulic conductivity estimation

USGS Publications Warehouse

Rahman, A.; Tsai, F.T.-C.; White, C.D.; Carlson, D.A.; Willson, C.S.

2007-01-01

Integration of various geophysical data is essential to better understand aquifer heterogeneity. However, data integration is challenging because there are different levels of support between primary and secondary data needed to be correlated in various ways. This study proposes a geostatistical method to integrate the hydraulic conductivity measurements and electrical resistivity data to better estimate the hydraulic conductivity (K) distribution. The K measurements are obtained from the pumping tests and represent the primary data (hard data). The borehole electrical resistivity data from electrical logs are regarded as the secondary data (soft data). The electrical resistivity data is used to infer hydraulic conductivity values through the Archie law and Kozeny-Carman equation. A pseudo cross-semivariogram is developed to cope with the resistivity data non-collocation. Uncertainty in the auto-semivariograms and pseudo cross-semivariogram is quantified. The methodology is demonstrated by a real-world case study where the hydraulic conductivity is estimated in the Upper Chicot aquifer of Southwestern Louisiana. The groundwater responses by the cokriging and cosimulation of hydraulic conductivity are compared using analysis of variance (ANOVA). ?? 2007 ASCE.

Geophysical data integration, stochastic simulation and significance analysis of groundwater responses using ANOVA in the Chicot Aquifer system, Louisiana, USA

USGS Publications Warehouse

Rahman, A.; Tsai, F.T.-C.; White, C.D.; Carlson, D.A.; Willson, C.S.

2008-01-01

Data integration is challenging where there are different levels of support between primary and secondary data that need to be correlated in various ways. A geostatistical method is described, which integrates the hydraulic conductivity (K) measurements and electrical resistivity data to better estimate the K distribution in the Upper Chicot Aquifer of southwestern Louisiana, USA. The K measurements were obtained from pumping tests and represent the primary (hard) data. Borehole electrical resistivity data from electrical logs were regarded as the secondary (soft) data, and were used to infer K values through Archie's law and the Kozeny-Carman equation. A pseudo cross-semivariogram was developed to cope with the resistivity data non-collocation. Uncertainties in the auto-semivariograms and pseudo cross-semivariogram were quantified. The groundwater flow model responses by the regionalized and coregionalized models of K were compared using analysis of variance (ANOVA). The results indicate that non-collocated secondary data may improve estimates of K and affect groundwater flow responses of practical interest, including specific capacity and drawdown. ?? Springer-Verlag 2007.

CREATE Cornerstone: Introduction to Scientific Thinking, a New Course for STEM-Interested Freshmen, Demystifies Scientific Thinking through Analysis of Scientific Literature

PubMed Central

Gottesman, Alan J.; Hoskins, Sally G.

2013-01-01

The Consider, Read, Elucidate hypotheses, Analyze and interpret data, Think of the next Experiment (CREATE) strategy for teaching and learning uses intensive analysis of primary literature to improve students’ critical-thinking and content integration abilities, as well as their self-rated science attitudes, understanding, and confidence. CREATE also supports maturation of undergraduates’ epistemological beliefs about science. This approach, originally tested with upper-level students, has been adapted in Introduction to Scientific Thinking, a new course for freshmen. Results from this course's initial semesters indicate that freshmen in a one-semester introductory course that uses a narrowly focused set of readings to promote development of analytical skills made significant gains in critical-thinking and experimental design abilities. Students also reported significant gains in their ability to think scientifically and understand primary literature. Their perceptions and understanding of science improved, and multiple aspects of their epistemological beliefs about science gained sophistication. The course has no laboratory component, is relatively inexpensive to run, and could be adapted to any area of scientific study. PMID:23463229

More Precise Estimation of Lower-Level Interaction Effects in Multilevel Models.

PubMed

Loeys, Tom; Josephy, Haeike; Dewitte, Marieke

2018-01-01

In hierarchical data, the effect of a lower-level predictor on a lower-level outcome may often be confounded by an (un)measured upper-level factor. When such confounding is left unaddressed, the effect of the lower-level predictor is estimated with bias. Separating this effect into a within- and between-component removes such bias in a linear random intercept model under a specific set of assumptions for the confounder. When the effect of the lower-level predictor is additionally moderated by another lower-level predictor, an interaction between both lower-level predictors is included into the model. To address unmeasured upper-level confounding, this interaction term ought to be decomposed into a within- and between-component as well. This can be achieved by first multiplying both predictors and centering that product term next, or vice versa. We show that while both approaches, on average, yield the same estimates of the interaction effect in linear models, the former decomposition is much more precise and robust against misspecification of the effects of cross-level and upper-level terms, compared to the latter.

Primary site and regional lymph node involvement are independent prognostic factors for early-stage extranodal nasal-type natural killer/T cell lymphoma.

PubMed

Niu, Shao-Qing; Yang, Yong; Li, Yi-Yang; Wen, Ge; Wang, Liang; Li, Zhi-Ming; Wang, Han-Yu; Zhang, Lu-Lu; Xia, Yun-Fei; Zhang, Yu-Jing

2016-04-04

Nasal-type extranodal natural killer/T-cell lymphoma (ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract. However, it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement. The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL. To develop a nomogram, we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011. The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index (C-index) and calibration curve. The 5-year overall survival (OS) and progression-free survival (PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL (OS: 68.2% vs. 46.0%, P = 0.030; PFS: 53.4% vs. 26.6%, P = 0.010). The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage IIE ENKTCL (OS: 66.3% vs. 59.2%, P = 0.003; PFS: 51.4% vs. 40.3%, P = 0.009). Multivariate analysis showed that age >60 years, ECOG performance status score ≥2, elevated lactate dehydrogenase (LDH) level, extra-nasal primary site, and regional lymph node involvement were significantly associated with lower 5-year OS rate; age >60 years, elevated LDH level, extra-nasal primary site, and regional lymph node involvement were significantly associated with lower 5-year PFS rate. The nomogram included the primary site and regional lymph node involvement based on multivariate analysis. The calibration curve showed good agreement between the predicted and actual 5-year OS and PFS rates, and the C-indexes of the nomogram for the OS and PFS rates were 0.697 and 0.634, respectively. The primary site and regional lymph node involvement are independent prognostic factors for early-stage ENKTCL treated with chemotherapy followed by definitive radiotherapy.

An Analysis of Labwork Tasks Used in Science Teaching at Upper Secondary School and University Levels in Several European Countries.

ERIC Educational Resources Information Center

Tiberghien, Andree; Veillard, Laurent; Le Marechal, Jean-Francois; Buty, Christian; Millar, Robin

2001-01-01

Describes the results of a study on the similarities and differences in laboratory tasks used in science education at upper secondary school and university level in the three main science subjects in seven European countries. Some differences are noted between the science subjects and educational levels, but the dominant impression of the analysis…

Are stream stabilization projects reducing suspended sediment concentrations and turbidity in the New York City Water Supply Watershed?

NASA Astrophysics Data System (ADS)

McHale, M. R.; Siemion, J.; Davis, W. D.

2015-12-01

Turbidity and suspended sediment concentrations (SSCs) are primary water quality concerns in the upper Esopus Creek watershed, the main tributary to the Ashokan reservoir. The Ashokan reservoir is one of 6 surface water reservoirs that constitute about 90% of New York City's drinking water supply. This study quantified turbidity levels and SSCs at 10 locations throughout the upper Esopus Creek watershed for 3 years prior to the implementation of 2 stream stabilization projects and for 18 months after the projects were completed. More than 93 percent of the total-suspended sediment load occurred on days with flows greater than or equal to the 90th percentile of flows observed during the study period. Discharge, SSC, and turbidity were strongly related at the outlet of the upper Esopus Creek, but not at every monitoring site. In general, relations between discharge and SSC and turbidity were strongest at sites with high SSCs, with the exception of Stony Clove Creek, the largest tributary. Stony Clove Creek, consistently produced higher SSCs and turbidity than any of the other Esopus Creek tributaries. Nonetheless, there was not a strong relation between either turbidity or SSC and discharge because there was a series of eroding banks in contact with fine grained glacio-lacustrine deposits and associated hill slope failures within the Stony Clove Creek watershed that delivered elevated turbidity and SSCs to the stream during all flow conditions. Stream bank stabilization projects were completed at two of the largest bank failures. After the projects were completed there was decrease in stream SSC and turbidity however, flows during the 18 months following the projects were lower than before the projects. Nevertheless, a shift in the SSC and turbidity discharge rating curves suggests that the stream stabilization projects resulted in lower turbidity levels and SSCs for similar discharge conditions as compared to before the projects thereby reducing sediment yields within the watershed as a result of those projects.

The assessment of midface distraction osteogenesis in treatment of upper airway obstruction.

PubMed

Xu, Haisong; Yu, Zheyan; Mu, Xiongzheng

2009-09-01

Le Fort III osteotomy with midface distraction osteogenesis (Le Fort III DO) can improve the midface form and change the upper airway space. Some surgeons believe that midface advancement can improve respiratory outcome dramatically, but others think it does not predictably result in the cure of obstructive sleep apnea (OSA). In this study, we evaluated the structural and functional changes of the upper airway before and after Le Fort III DO; we hope these studies can improve future protocols for midface advancement. A retrospective study of 11 patients with severe midface retrusion who underwent Le Fort III osteotomy with midface external distractor system was undertaken. These patients had an average of 5.4 months of follow-up. Three-dimensional volumetric assessment of the upper airway was used before and after surgery. We also evaluated the two-dimensional cross-sectional area of the upper airway to show the changes in different airway levels. Two patients with preoperative evidence of OSA were evaluated both preoperatively and postoperatively by overnight polysomnography. The midface was distracted for an average of 20.27 +/- 8.04 mm. Comparison between preoperative and postoperative three-dimensional computed tomographic data showed an average 64.30% increase in upper airway volume, an improvement of 9.13 +/- 6.94 mL (P < 0.05). The two-dimensional measurement also showed that the cross-sectional area at the posterior nasal spine and uvula airway level increased (P < 0.05), but the cross-sectional area at the epiglottis level and the separation of airway and esophagus level did not increase (P > 0.05). Two patients with preoperative evidence of OSA had both preoperative and postoperative sleeping studies that showed improvement. Le Fort III DO can significantly improve the upper airway space in the cases of syndromic craniosynostosis. The upper airway space above the uvula level was significantly enlarged after Le Fort III DO according to two-dimensional and three-dimensional image measurements, and according to the polysomnography, the OSA was alleviated. Le Fort III DO is a promising procedure in the treatment of severe midface retrusion with OSA in young patients.

Seeing the Forest, Not the Trees: Essential Technologies for Literacy in the Primary-Grade and Upper Elementary-Grade Classroom

ERIC Educational Resources Information Center

Leu, Donald J.; Forzani, Elena; Timbrell, Nicole; Maykel, Cheryl

2015-01-01

While countless new technologies are appearing in our lives and in school classrooms, we argue that we need to keep in mind our goals in reading before we use any of them. We suggest that a primary goal is to develop the ability to read in order to learn with online information. Technologies that support this goal, especially the Internet, and…

Magmatic infiltration and melting in the lower crust and upper mantle beneath the Cima volcanic field, California

USGS Publications Warehouse

Wilshire, H.G.; McGuire, A.V.

1996-01-01

Xenoliths of lower crustal and upper mantle rocks from the Cima volcanic field (CVF) commonly contain glass pockets, veins, and planar trains of glass and/or fluid inclusions in primary minerals. Glass pockets occupy spaces formerly occupied by primary minerals of the host rocks, but there is a general lack of correspondence between the composition of the glass and that of the replaced primary minerals. The melting is considered to have been induced by infiltration of basaltic magma and differentiates of basaltic magma from complex conduits formed by hydraulic fracturing of the mantle and crustal rocks, and to have occurred during the episode of CVF magmatism between ???7.5 Ma and present. Variable compositions of quenched melts resulted from mixing of introduced melts and products of melting of primary minerals, reaction with primary minerals, partial crystallization, and fractionation resulting from melt and volatile expulsion upon entrainment of the xenoliths. High silica melts (> ??? 60% SiO2) may result by mixing introduced melts with siliceous melts produced by reaction of orthopyroxene. Other quenched melt compositions range from those comparable to the host basalts to those with intermediate Si compositions and elevated Al, alkalis, Ti, P, and S; groundmass compositions of CVF basalts are consistent with infiltration of fractionates of those basalts, but near-solidus melting may also contribute to formation of glass with intermediate silica contents with infiltration only of volatile constituents.

Total arsenic concentrations in Chinese children's urine by different geographic locations, ages, and genders.

PubMed

Zhang, Xuan; Wang, Beibei; Cui, Xiaoyong; Lin, Chunye; Liu, Xitao; Ma, Jin

2018-06-01

Little is known about the variation of Chinese children's exposure to arsenic by geography, age, gender, and other potential factors. The main objective of this study was to investigate the total arsenic concentration in Chinese children's urine by geographic locations, ages, and genders. In total, 259 24-h urine samples were collected from 210 2- to 12-year-old children in China and analyzed for total arsenic and creatinine concentrations. The results showed that the upper limit (upper limit of the 90% confidence interval for the 97.5 fractile) was 27.51 µg/L or 55.88 µg/g creatinine for Chinese children. The total urinary arsenic levels were significantly different for children in Guangdong, Hubei, and Gansu provinces (P < 0.05), where the upper limits were 24.29, 58.70, and 44.29 µg/g creatinine, respectively. In addition, the total urinary arsenic levels were higher for 2- to 7-year-old children than for 7- to 12-year-old children (P < 0.05; the upper limits were 59.06 and 44.29 µg/g creatinine, respectively) and higher for rural children than for urban children (P < 0.05; the upper limits were 59.06 and 50.44 µg/g creatinine, respectively). The total urinary arsenic levels for boys were not significantly different from those for girls (P > 0.05), although the level for boys (the upper limit was 59.30 µg/g) was slightly higher than that for girls (the upper limit was 58.64 µg/g creatinine). Because the total urinary arsenic concentrations are significantly different for general populations of children in different locations and age groups, the reference level of total urinary arsenic might be dependent on the geographic site and the child's age.

Diagnostic outcome of contrast videofluoroscopic swallowing studies in 216 dysphagic dogs.

PubMed

Pollard, Rachel E; Marks, Stanley L; Cheney, Diane M; Bonadio, Cecily M

2017-07-01

Determining the anatomic and functional origin for dysphagia is critical for development of an appropriate therapeutic plan and determination of the prognosis. The purpose of this retrospective study was to report the quantitative and qualitative outcome of contrast videofluoroscopic swallowing studies in a large cohort of dysphagic dogs presenting to a tertiary veterinary care hospital. The videofluoroscopic swallowing studies were reviewed to generate values for pharyngeal constriction ratio, timing of swallowing events (maximum pharyngeal contraction, opening of upper esophageal sphincter, closing of upper esophageal sphincter, and reopening of epiglottis), type of esophageal peristalsis generated, and esophageal transit time. One or more anatomic locations for origin of dysphagia were assigned (pharyngeal, cricopharyngeal, esophageal (primary motility disorder), other esophageal (stricture, vascular ring anomaly, mass), lower esophageal sphincter/hiatus. Sixty-one of 216 studies (28%) were deemed unremarkable. Twenty-seven of 216 dogs (13%) had pharyngeal dysphagia, 17/216 dogs (8%) had cricopharyngeal dysphagia, 98/216 dogs (45%) had dysphagia secondary to esophageal dysmotility, 19/216 dogs (9%) had dysphagia secondary to focal esophageal disorders, and 97/216 dogs (45%) had dysphagia of lower esophageal sphincter/hiatus origin. Multiple abnormalities were present in 82/216 (38%) dogs. Elevated pharyngeal constriction ratio was associated with pharyngeal, cricopharyngeal, and esophageal motility disorders, delayed upper esophageal sphincter opening was associated with cricopharyngeal disorders, a lower percentage of primary esophageal peristaltic waves was associated with cricopharyngeal, pharyngeal, or primary esophageal motility disorders. In conclusion, videofluoroscopic swallowing studies was pivotal in the diagnosis of dysphagia with 155/216 (72%) dogs receiving a final diagnosis. © 2017 American College of Veterinary Radiology.

Epstein-Barr virus negative primary hepatic leiomyoma: Case report and literature review

PubMed Central

Luo, Xian-Zhang; Ming, Chang-Sheng; Chen, Xiao-Ping; Gong, Nian-Qiao

2013-01-01

Primary hepatic leiomyoma is a neoplasm of mesenchymal origin and occurs only rarely. Secondary to benign smooth muscle proliferation, it is usually found in adult women and is associated with Epstein-Barr virus (EBV) infection. Here, we report the 29th case of primary hepatic leiomyoma with its unique features related to diagnosis, treatment and developmental biology. A 48-year-old man, with an immunocompromised status, complained of pain in the upper quadrant of the abdomen. Serological analysis indicated no presence of hepatitis virus, no human immunodeficiency virus, and no EBV infection. The levels of α-fetoprotein and carcinoembryonic antigen were normal. A mass was detected in segment III of the hepatic lobe by ultrasonography and an abdominal computed tomography scan. Endoscopy had negative findings. Exploratory laparotomy found no existing extrahepatic tumor and left lateral lobectomy was performed. Pathological examination showed the mass to be a typical leiomyoma. The cells were positive for α-smooth muscle actin and desmin, and negative for the makers of gastrointestinal stromal tumor (GIST), including CD117, CD34 and DOG1 (discovered on GIST1). In situ hybridization revealed negative status for EBV-encoded small RNA. After left lateral lobectomy, the patient was not given chemotherapy or radiotherapy. During a 2-year follow-up, no sign of local recurrence or distant metastasis was observed. In conclusion, we report a rare case of primary hepatic leiomyoma in a male patient without EBV infection. Hepatic resection was curative. This case presents data to expand our knowledge concerning the complex and heterogeneous nature of primary liver leiomyoma, indicating that EBV infection is important but neither necessary nor sufficient for the development of primary liver leiomyoma. PMID:23840159

Bottomland Hardwood Forests along the Upper Mississippi River

USGS Publications Warehouse

Yin, Y.; Nelson, J.C.; Lubinski, S.J.

1997-01-01

Bottomland hardwood forests along the United States' Upper Mississippi River have been drastically reduced in acreage and repeatedly logged during the nineteenth and twentieth centuries. Conversion to agricultural land, timber harvesting, and river modifications for flood prevention and for navigation were the primary factors that caused the changes. Navigation structures and flood-prevention levees have altered the fluvial geomorphic dynamics of the river and floodplain system. Restoration and maintenance of the diversity, productivity, and natural regeneration dynamics of the bottomland hardwood forests under the modified river environment represent a major management challenge.

MARSnet: Mission-aware Autonomous Radar Sensor Network for Future Combat Systems

DTIC Science & Technology

2008-07-31

Deviation Consider the case of a Gaussian primary MF having a fixed mean, ml, and an uncertain standard deviation that takes on values in [ai, 2]’ i.e...fuzzy set, so thatR k --* AXk (k = 1,... ,p), the upper and lower MFs of Pkk merge into one MF, AXk (Xk), in which case Theorem 1 simplifies to: Corollary...the upper and lower MFs of A k(Xk) merge into one crisp value, namely 1, in which case Theorem 1 simplifies further to: Corollary 2 In a favor weak

Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.

PubMed

Watson, Sheri; Aguas, Marita; Colegrove, Pat; Foisy, Nancy; Jondahl, Bonnie; Anastas, Zoe

2017-02-01

The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Impact of a Generalizable Reminder System on Colorectal Cancer Screening in Diverse Primary Care Practices

PubMed Central

Nease, Donald E.; Ruffin, Mack T.; Klinkman, Michael S.; Jimbo, Masahito; Braun, Thomas M.; Underwood, Jennifer M.

2015-01-01

Background Computerized reminder systems (CRS) show promise for increasing preventive services such as colorectal cancer (CRC) screening. However, prior research has not evaluated a generalizable CRS across diverse, community primary care practices. We evaluated whether a generalizable CRS, ClinfoTracker, could improve screening rates for CRC in diverse primary care practices. Methods The study was a prospective trial to evaluate ClinfoTracker using historical control data in 12 Great Lakes Research In Practice Network community-based, primary care practices distributed from Southeast to Upper Peninsula Michigan. Our outcome measures were pre- and post-study practice-level CRC screening rates among patients seen during the 9-month study period. Ability to maintain the CRS was measured by days of reminder printing. Field notes were used to examine each practice’s cohesion and technology capabilities. Results All but one practice increased their CRC screening rates, ranging from 3.3% to 16.8% improvement. t tests adjusted for within practice correlation showed improvement in screening rates across all 12 practices, from 41.7% to 50.9%, P = 0.002. Technology capabilities impacted printing days (74% for high technology vs. 45% for low technology practices, P = 0.01), and cohesion demonstrated an impact trend for screening (15.3% rate change for high cohesion vs. 7.9% for low cohesion practices). Conclusions Implementing a generalizable CRS in diverse primary care practices yielded significant improvements in CRC screening rates. Technology capabilities are important in maintaining the system, but practice cohesion may have a greater influence on screening rates. This work has important implications for practices implementing reminder systems. PMID:18725836

AW UMa observed with MOST satellite

NASA Astrophysics Data System (ADS)

Rucinski, S. M.; Matthews, J. M.; Cameron, C.; Guenther, D. B.; Kuschnig, R.; Moffat, A. F. J.; Rowe, J. F.; Sasselov, D.; Weiss, W. W.

2013-11-01

MOST observations were obtained to search for photometric non-radial oscillations; none was detected with an upper limit of 0.0001 in relative amplitude. A single, precise moment of the primary eclipse confirms the progressive shortening of the orbital period.

Defining the upper viscosity limit for mineral slurries used in drilled shaft construction.

DOT National Transportation Integrated Search

2014-02-01

Drilled shaft construction often requires the use of drill slurry to maintain borehole stability during : excavation and concreting. Florida Department of Transportation (FDOT) specifications require that the : mineral slurry used for all primary str...

Programmed Death-ligand 1 Expression in Upper Tract Urothelial Carcinoma.

PubMed

Skala, Stephanie L; Liu, Tzu-Ying; Udager, Aaron M; Weizer, Alon Z; Montgomery, Jeffrey S; Palapattu, Ganesh S; Siddiqui, Javed; Cao, Xuhong; Fields, Kristina; Abugharib, Ahmed E; Soliman, Moaaz; Hafez, Khaled S; Miller, David; Lee, Cheryl T; Alva, Ajjai; Chinnaiyan, Arul M; Morgan, Todd M; Spratt, Daniel E; Jiang, Hui; Mehra, Rohit

2017-10-01

Urothelial carcinoma (UC) is the most common malignancy of the urinary tract. Upper tract (renal pelvis and ureter) urothelial carcinomas (UTUC) account for approximately 5% of UCs but a significant subset are invasive and associated with poor clinical outcomes. To evaluate programmed death-ligand 1 (PD-L1) expression in UTUC. UTUC cases from 1997-2016 were retrospectively identified from the surgical pathology database at a single large academic institution. The cohort included 149 cases: 27 low-grade and 24 high-grade pathologic T (pT)a, 29 pT1, 23 pT2, 38 pT3, and eight pT4. PD-L1 immunohistochemistry (IHC) was performed on representative whole tumor sections using anti-PD-L1 primary antibody clone 5H1. PD-L1 expression was evaluated using a previously established cut-off for positivity (≥ 5% membranous staining). Association between PD-L1 IHC expression and clinicopathologic parameters was examined with Fisher's exact test; the effect of PD-L1 expression on cancer-specific mortality was assessed using the Cox proportional hazard model. Approximately one-third (32.7%) of invasive primary UTUC and 23.5% of all primary UTUC (invasive and noninvasive tumors) demonstrated positive PD-L1 expression. Positive PD-L1 expression was associated with high histologic grade, high pathologic stage, and angiolymphatic invasion. Cancer-specific survival was not significantly associated with positive PD-L1 expression using a 5% cut-off. Study limitations include the retrospective nature and the fact that PD-L1 expression by IHC is an imperfect surrogate for response to therapy. Positive PD-L1 expression in approximately one-third of primary invasive UTUC and association with high-risk clinicopathologic features provide a rational basis for further investigation of PD-L1-based immunotherapeutics in these patients. Upper tract urothelial carcinoma is often associated with poor clinical outcome. While current treatment options for advanced upper tract urothelial carcinoma are limited, programmed death-ligand 1 positivity in approximately one-third of invasive tumors provides a rational basis for further investigation of programmed death-ligand 1-based immunotherapeutics in these patients. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Measuring the space between vagina and rectum as it relates to rectocele

PubMed Central

Liu, Jin; Zhai, Li-Dong; Li, Yun-Sheng; Liu, Wan-Xiang; Wang, Rui-Hua

2009-01-01

AIM: To measure the normal space between the posterior wall of the vagina and the anterior wall of the respectively rectum using computed tomography (CT) and reveal its were relationship to rectocele. METHODS: A total of twenty female volunteers without rectocele were examined by CT scan. We performed a middle level continuous horizontal pelvic scan from the upper part to the lower part and collected the measurement data to analyze the results using t-test. RESULTS: Twenty volunteers were enrolled in the study. The space between the posterior wall of the vagina and the anterior wall of the rectum was measured at three levels (upper 1/3, middle, lower 1/3 level of vagina). The results showed that the space from the posterior wall of the vagina to the anterior wall of the rectum at the upper 1/3 level and the middle level was 3.896 ± 0.3617 mm and 4.6575 ± 0.3052 mm, respectively. When the two groups of data were compared, we found the space at the upper 1/3 level was shorter than at the middle level (P < 0.01). Moreover, at the lower 1/3 level the space measured was 10.058 ± 0.4534 mm. The results revealed that the space at the lower 1/3 level was longer than that at the middle level (P < 0.01). CONCLUSION: These measurement data may be helpful in assessing rectocele clinical diagnosis and functional outcomes of rectocele repair. PMID:19554660

Magnetic resonance spectroscopy of current hand amputees reveals evidence for neuronal-level changes in former sensorimotor cortex

PubMed Central

Choi, In-Young; Lee, Phil; Peng, Huiling; Kaufman, Christina L.; Frey, Scott H.

2017-01-01

Deafferentation is accompanied by large-scale functional reorganization of maps in the primary sensory and motor areas of the hemisphere contralateral to injury. Animal models of deafferentation suggest a variety of cellular-level changes including depression of neuronal metabolism and even neuronal death. Whether similar neuronal changes contribute to patterns of reorganization within the contralateral sensorimotor cortex of chronic human amputees is uncertain. We used functional MRI-guided proton magnetic resonance spectroscopy to test the hypothesis that unilateral deafferentation is associated with lower levels of N-acetylaspartate (NAA, a putative marker of neuronal integrity) in the sensorimotor hand territory located contralateral to the missing hand in chronic amputees (n = 19) compared with the analogous hand territory of age- and sex-matched healthy controls (n = 28). We also tested whether former amputees [i.e., recipients of replanted (n = 3) or transplanted (n = 2) hands] exhibit NAA levels that are indistinguishable from controls, possible evidence for reversal of the effects of deafferentation. As predicted, relative to controls, current amputees exhibited lower levels of NAA that were negatively and significantly correlated with the time after amputation. Contrary to our prediction, NAA levels in both replanted and transplanted patients fell within the range of the current amputees. We suggest that lower levels of NAA in current amputees reflects altered neuronal integrity consequent to chronic deafferentation. Thus local changes in NAA levels may provide a means of assessing neuroplastic changes in deafferented cortex. Results from former amputees suggest that these changes may not be readily reversible through reafferentation. NEW & NOTEWORTHY This study is the first to use functional magnetic resonance-guided magnetic resonance spectroscopy to examine neurochemical mechanisms underlying functional reorganization in the primary somatosensory and motor cortices consequent to upper extremity amputation and its potential reversal through hand replantation or transplantation. We provide evidence for selective alteration of cortical neuronal integrity associated with amputation-related deafferentation that may not be reversible. PMID:28179478

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

Edwards, Timothy S.

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

Supernumerary Teeth in Primary Dentition and Early Intervention: A Series of Case Reports

PubMed Central

Bahadure, Rakesh N.; Thosar, Nilima; Jain, Eesha S.; Kharabe, Vidhi; Gaikwad, Rahul

2012-01-01

Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stages. They are of great concern to the dentists and parents because of the eruption, occlusal, and esthetic problems they can cause. Supernumerary teeth occur more frequently in the permanent dentition but rarely in primary dentition. Mesiodens is the most common type of supernumerary teeth but rarely seen in lower arch. Early recognition and diagnosis of supernumerary teeth is important to prevent further complications in permanent dentition. Four cases of supernumerary teeth with mesiodens in upper and lower arch in primary dentition and their management have been discussed. PMID:22888456

Recurrence of primary extramedullary plasmacytoma in breast both simulating primary breast carcinoma

PubMed Central

Kaviani, Ahmad; Djamali-zavareie, Mansoor; Noparast, Maryam; Keyhani-Rofagha, Sedigheh

2004-01-01

Background Extramedullary myelomas (plasmacytoma) are malignant proliferations of plasma cells in the absence of bone involvement. When they occur in the soft tissue they usually involve the upper respiratory tract and oral cavity. Extramedullary plasmacytomas of breast are uncommon. Case presentation A 70 year-old woman with bilateral breast masses underwent excisional biopsy for suspected primary carcinoma that subsequently proved to be a recurrence from extramedullary plasmacytoma of the mediastinum. This was diagnosed and treated 5-years prior to appearance of breast lumps. Conclusion Though uncommon, considering the possibility of metastatic carcinoma and primary, secondary or recurrent lymphoproliferative disease presenting as a breast mass may avoid unnecessary surgeries. PMID:15339332

Persistent West Nile Virus Transmission and the Apparent Displacement St. Louis Encephalitis Virus in Southeastern California, 2003−2006

PubMed Central

REISEN, WILLIAM K.; LOTHROP, HUGH D.; WHEELER, SARAH S.; KENNSINGTON, MARC; GUTIERREZ, ARTURO; FANG, YING; GARCIA, SANDRA; LOTHROP, BRANKA

2008-01-01

West Nile virus (family Flaviviridae, genus Flavivirus, WNV) invaded the Colorado Desert biome of southern California during summer 2003 and seemed to displace previously endemic St. Louis encephalitis virus (family Flaviviridae, genus Flavivirus, SLEV, an antigenically similar Flavivirus in the Japanese encephalitis virus serocomplex). Western equine encephalomyelitis virus (family Togaviridae, genus Alphavirus, WEEV), an antigenically distinct Alphavirus, was detected during 2005 and 2006, indicating that conditions were suitable for encephalitis virus introduction and detection. Cross-protective “avian herd immunity” due to WNV infection possibly may have prevented SLEV reintroduction and/or amplification to detectable levels. During 2003−2006, WNV was consistently active at wetlands and agricultural habitats surrounding the Salton Sea where Culex tarsalis Coquillett served as the primary enzootic maintenance and amplification vector. Based on published laboratory infection studies and the current seroprevalence estimates, house sparrows, house finches, and several Ardeidae may have been important avian amplifying hosts in this region. Transmission efficiency may have been dampened by high infection rates in incompetent avian hosts, including Gamble's quail, mourning doves, common ground doves, and domestic pigeons. Early season WNV amplification and dispersal from North Shore in the southeastern portion of the Coachella Valley resulted in sporadic WNV incursions into the urbanized Upper Valley near Palm Springs, where Culex pipiens quinquefasciatus Say was the primary enzootic and bridge vector. Although relatively few human cases were detected during the 2003−2006 period, all were concentrated in the Upper Valley and were associated with high human population density and WNV infection in peridomestic populations of Cx. p. quinquefasciatus. Intensive early mosquito control during 2006 seemed to interrupt and delay transmission, perhaps setting the stage for the future reintroduction of SLEV. PMID:18533445

A Numerical Estimate of The Impact of The Saharan Dust On Medityerranean Trophic Web

NASA Astrophysics Data System (ADS)

Crise, A.; Crispi, G.

A first estimate of the importance of Saharan dust as input of macronutrients on the phytoplankton standing crop concentration and primary production at basin scale is here presented using a three-dimensional numerical model of the Mediterranean Sea. The numerical scheme adopted is a 1/4 degree resolution 31 levels MOM-based eco- hydrodynamical model with climatological ('perpetual year') forcings coupled on-line with a structure including multi-nutrient, size-fractionated phytoplankton functional groups, herbivores and a parametrized recycling detritus submodel, so to (explicitely or implicitely) include the major energy pathways of the upper layer mediterranean ecosystem. This model takes into account as potential limiting factors, among others, Nitrogen (in its oxidized and reduced forms) and Phosphorus. A gridded data setof (wet and dry) dust deposition over Mediterranean derived from SKIRON operational model is used to identify statistically the areas and the duration/intensity of the events. Starting from this averaging process, experiments are carried out to study the dust induced episodes of release of bioavailable phosphorus which is supposed to be the limiting factor in the oligotrophic waters of the surface layer in Med Sea. The metrics for the evaluation of the impact of deposition have been identified in phyto standing crop, primary and export production and switching in the food web functioning. These global parameters, even if cannot exaust the whealth of the informations provided by the model, can help discriminate the sensitivity of food web to the nutrient pulses induced by the deposition. First results of a scenario analysis of typical atmospheric input events, provide evidence of the response of the upper layer ecosystem to assess the sensitivity of the model predictions to the variability to integrated intensity of external input.

A biomechanical evaluation to optimize the configuration of a hinged external fixator for the primary treatment of severely displaced intraarticular calcaneus fractures with soft tissue damage.

PubMed

Besch, Lutz; Schmidt, Ina; Mueller, Michael; Daniels-Wredenhagen, Mark; Hilgert, Ralf-Eric; Varoga, Deike; Seekamp, Andreas

2008-01-01

The purpose of this investigation was to develop an optimized hinged external fixator for the primary treatment of dislocated, intra-articular calcaneus fractures with associated soft tissue damage. To this end, a calcaneus model was made out of a polyurethane block, and a steel cylinder served as the ankle joint and was connected to a synthetic model of the tibia via a metal clamp. A saw cut served as the fracture in the model. A Steinmann nail and Schanz screw were placed in defined positions in the model and connected medially and laterally with longitudinal support rods. The fixator allowed a total of 20 degrees of plantar- and dorsiflexion, with rotation in the virtual axis of the upper ankle joint. Changes in the model fracture were measured during cyclical strain, and at different screw positions in the model tibia and calcaneus. Miniature force sensors located on the longitudinal support rods, and a plantar tension spring, were used to measure pressure and tension. Reproducible values were determined and, with the optimal configuration, shifting within the osteotomy was minimal. In the experimental configuration, optimal tibial screw placement was 70 mm proximal to the rotation axis of the upper ankle joint, and optimal placement of the Steinmann nail was in the posterior surface of the calcaneus. These findings indicated that the hinged fixator allows 20 degrees of ankle movement without alteration of the rotation axis, and suggest that this type of external fixator can be used in all types of calcaneal fracture regardless of the soft tissue damage. ACFAS Level of Clinical Evidence: 5c.

An overview of monogenetic carbonatitic magmatism from Uganda, Italy, China and Spain: Volcanologic and geochemical features

NASA Astrophysics Data System (ADS)

Stoppa, Francesco; Schiazza, Mariangela

2013-01-01

We address general features of carbonatite monogenetic volcanic fields located in continental settings which are peculiar being associated with kamafugites or melilite-bearing leucitites. Instructive examples are the Toro Ankole in Uganda, West Qinling in China, and Campo de Calatrava in Spain and the Intra-mountain Ultra-alkaline Province (IUP) of Italy. Maars are the typical volcanic forms, occurring in isolation or in clusters along fault systems. Concentric-shelled juvenile lapilli and bombs, having a upper-mantle peridotite kernel, are unique to this type of volcanism. These pyroclasts are interpreted as the result of deep-seated fragmentation of magma having a high carbon dioxide-water (CO2/H2O) ratio. The presence of discrete, large peridotitic nodules implies a high-velocity propagation of magma, while the associated large CO2 emission suggests a high proportion of juvenile CO2. Magma fragmentation is inferred to occur as a consequence of explosive CO2 exsolution at the upper mantle level (diatresis) followed by immiscibility. Based on field evidence, carbonatitic maar formation could be due to violent CO2 expansion and does not require phreatomagmatic phenomena. Extrusive carbonatites and associated rocks represent very primitive melts having a distinct High Field Strength Elements (HFSE) distribution, the source of which is related to enriched mantle. Carbonated peridotite is a stable paragenesis at depths of 400-600 km; thus, primary carbonatitic silicate magma can be produced at these depths as a consequence of rising deeper melt/fluids that are trapped at the transition zone. In our opinion, carbonatitic carbon is linked to the primary process of deep-mantle differentiation and Earth's core degassing.

Predevelopment Water-Level Contours for Aquifers in the Rainier Mesa and Shoshone Mountain area of the Nevada Test Site, Nye County, Nevada

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

Joseph M. Fenelon; Randell J. Laczniak; and Keith J. Halford

2008-06-24

Contaminants introduced into the subsurface of the Nevada Test Site at Rainier Mesa and Shoshone Mountain by underground nuclear testing are of concern to the U.S. Department of Energy and regulators responsible for protecting human health and safety. Although contaminants were introduced into low-permeability rocks above the regional flow system, the potential for contaminant movement away from the underground test areas and into the accessible environment is greatest by ground-water transport. The primary hydrologic control on this transport is evaluated and examined through a series of contour maps developed to represent the water-level distribution within each of the major aquifersmore » underlying the area. Aquifers were identified and their extents delineated by merging and analyzing multiple hydrostratigraphic framework models developed by other investigators from existing geologic information. The contoured water-level distribution in each major aquifer was developed from a detailed evaluation and assessment of available water-level measurements. Multiple spreadsheets that accompany this report provide pertinent water-level and geologic data by well or drill hole. Aquifers are mapped, presented, and discussed in general terms as being one of three aquifer types—volcanic aquifer, upper carbonate aquifer, or lower carbonate aquifer. Each of these aquifer types was subdivided and mapped as independent continuous and isolated aquifers, based on the continuity of its component rock. Ground-water flow directions, as related to the transport of test-generated contaminants, were developed from water-level contours and are presented and discussed for each of the continuous aquifers. Contoured water-level altitudes vary across the study area and range from more than 5,000 feet in the volcanic aquifer beneath a recharge area in the northern part of the study area to less than 2,450 feet in the lower carbonate aquifer in the southern part of the study area. Variations in water-level altitudes within any single continuous aquifer range from a few hundred feet in a lower carbonate aquifer to just more than 1,100 feet in a volcanic aquifer. Flow directions throughout the study area are dominantly southward with minor eastward or westward deviations. Primary exceptions are westward flow in the northern part of the volcanic aquifer and eastward flow in the eastern part of the lower carbonate aquifer. Northward flow in the upper and lower carbonate aquifers in the northern part of the study area is possible but cannot be substantiated because data are lacking. Interflow between continuous aquifers is evaluated and mapped to define major flow paths. These flow paths delineate tributary flow systems, which converge to form the regional ground-water flow system. The implications of these tributary flow paths in controlling transport away from the underground test areas at Rainier Mesa and Shoshone Mountain are discussed. The obvious data gaps contributing to uncertainties in the delineation of aquifers and development of water-level contours are identified and evaluated.« less

Predevelopment Water-Level Contours for Aquifers in the Rainier Mesa and Shoshone Mountain area of the Nevada Test Site, Nye County, Nevada

USGS Publications Warehouse

Fenelon, Joseph M.; Laczniak, Randell J.; Halford, Keith J.

2008-01-01

Contaminants introduced into the subsurface of the Nevada Test Site at Rainier Mesa and Shoshone Mountain by underground nuclear testing are of concern to the U.S. Department of Energy and regulators responsible for protecting human health and safety. Although contaminants were introduced into low-permeability rocks above the regional flow system, the potential for contaminant movement away from the underground test areas and into the accessible environment is greatest by ground-water transport. The primary hydrologic control on this transport is evaluated and examined through a series of contour maps developed to represent the water-level distribution within each of the major aquifers underlying the area. Aquifers were identified and their extents delineated by merging and analyzing multiple hydrostratigraphic framework models developed by other investigators from existing geologic information. The contoured water-level distribution in each major aquifer was developed from a detailed evaluation and assessment of available water-level measurements. Multiple spreadsheets that accompany this report provide pertinent water-level and geologic data by well or drill hole. Aquifers are mapped, presented, and discussed in general terms as being one of three aquifer types?volcanic aquifer, upper carbonate aquifer, or lower carbonate aquifer. Each of these aquifer types was subdivided and mapped as independent continuous and isolated aquifers, based on the continuity of its component rock. Ground-water flow directions, as related to the transport of test-generated contaminants, were developed from water-level contours and are presented and discussed for each of the continuous aquifers. Contoured water-level altitudes vary across the study area and range from more than 5,000 feet in the volcanic aquifer beneath a recharge area in the northern part of the study area to less than 2,450 feet in the lower carbonate aquifer in the southern part of the study area. Variations in water-level altitudes within any single continuous aquifer range from a few hundred feet in a lower carbonate aquifer to just more than 1,100 feet in a volcanic aquifer. Flow directions throughout the study area are dominantly southward with minor eastward or westward deviations. Primary exceptions are westward flow in the northern part of the volcanic aquifer and eastward flow in the eastern part of the lower carbonate aquifer. Northward flow in the upper and lower carbonate aquifers in the northern part of the study area is possible but cannot be substantiated because data are lacking. Interflow between continuous aquifers is evaluated and mapped to define major flow paths. These flow paths delineate tributary flow systems, which converge to form the regional ground-water flow system. The implications of these tributary flow paths in controlling transport away from the underground test areas at Rainier Mesa and Shoshone Mountain are discussed. The obvious data gaps contributing to uncertainties in the delineation of aquifers and development of water-level contours are identified and evaluated.

Line profile variability in the massive binary HD 152219

NASA Astrophysics Data System (ADS)

Sana, H.; Gosset, E.

2009-07-01

HD 152219 is a massive binary system with O9.5 III and B1-2 III/V components and a short orbital period of 4.2 d. In a previous work, we showed that the primary star (M_{prim}˜21 M_⊙) was presenting clear line profile variabilities (LPVs) that might be caused by nonradial pulsations (NRPs). In the present work, we report on an intensive spectroscopic monitoring, that aimed at unveiling the nature of the detected LPVs. Based on this new data set, we discard the NRPs and point out the Rossiter-McLaughlin effect as % being the cause of the observed LPVs. The upper limit derived on the amplitude of undetected NRPs, if any, is set at a couple of part per thousands of the continuum level.

Effect of parallel refraction on magnetospheric upper hybrid waves

NASA Technical Reports Server (NTRS)

Engel, J.; Kennel, C. F.

1984-01-01

Large amplitude (not less than 10 mV/m) electrostatic plasma waves near the upper hybrid (UH) frequency have been observed from 0 to 50 deg magnetic latitude (MLAT) during satellite plasma-pause crossings. A three-dimensional numerical ray-tracing calculation, based on an electron distribution measured during a GEOS 1 dayside intense upper-hybrid wave event, suggests how UH waves might achieve such large amplitudes away from the geomagnetic equator. Refractive effects largely control the wave amplification and, in particular, the unavoidable refraction due to parallel geomagnetic field gradients restricts growth to levels below those observed. However, a cold electron density gradient parallel to the field can lead to upper hybrid wave growth that can account for the observed emission levels.

LPT. Shield test facility assembly and test building (TAN646). East ...

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

LPT. Shield test facility assembly and test building (TAN-646). East facade of ebor helium wing addition. Camera facing west. Note asbestos-cement siding on stair enclosure and upper-level. Concrete siding at lower level. Metal stack. Monorail protrudes from upper level of south wall at left of view. INEEL negative no. HD-40-7-4 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Multiweek Cell Culture Project for Use in Upper-Level Biology Laboratories

ERIC Educational Resources Information Center

Marion, Rebecca E.; Gardner, Grant E.; Parks, Lisa D.

2012-01-01

This article describes a laboratory protocol for a multiweek project piloted in a new upper-level biology laboratory (BIO 426) using cell culture techniques. Human embryonic kidney-293 cells were used, and several culture media and supplements were identified for students to design their own experiments. Treatments included amino acids, EGF,…