On Flipping the Classroom in Large First Year Calculus Courses

ERIC Educational Resources Information Center

Jungic, Veselin; Kaur, Harpreet; Mulholland, Jamie; Xin, Cindy

2015-01-01

Over the course of two years, 2012-2014, we have implemented a "flipping" the classroom approach in three of our large enrolment first year calculus courses: differential and integral calculus for scientists and engineers. In this article we describe the details of our particular approach and share with the reader some experiences of…

Sound production due to large-scale coherent structures. [and identification of noise mechanisms in turbulent shear flow

NASA Technical Reports Server (NTRS)

Gatski, T. B.

1979-01-01

The sound due to the large-scale (wavelike) structure in an infinite free turbulent shear flow is examined. Specifically, a computational study of a plane shear layer is presented, which accounts, by way of triple decomposition of the flow field variables, for three distinct component scales of motion (mean, wave, turbulent), and from which the sound - due to the large-scale wavelike structure - in the acoustic field can be isolated by a simple phase average. The computational approach has allowed for the identification of a specific noise production mechanism, viz the wave-induced stress, and has indicated the effect of coherent structure amplitude and growth and decay characteristics on noise levels produced in the acoustic far field.

On flipping the classroom in large first year calculus courses

NASA Astrophysics Data System (ADS)

Jungić, Veselin; Kaur, Harpreet; Mulholland, Jamie; Xin, Cindy

2015-05-01

Over the course of two years, 2012--2014, we have implemented a 'flipping' the classroom approach in three of our large enrolment first year calculus courses: differential and integral calculus for scientists and engineers. In this article we describe the details of our particular approach and share with the reader some experiences of both instructors and students.

Gender differences in 16-year trends in assault- and police-related problems due to drinking.

PubMed

Timko, Christine; Moos, Bernice S; Moos, Rudolf H

2009-09-01

This study examined the frequency and predictors of physical assault and having trouble with the police due to drinking over 16 years among women and men who, at baseline, were untreated for their alcohol use disorder. Predictors examined were the personal characteristics of impulsivity, self-efficacy, and problem-solving and emotional-discharge coping, as well as outpatient treatment and Alcoholics Anonymous (AA) participation. Women and men were similar on rates of perpetrating assault due to drinking, but men were more likely to have had trouble with the police due to drinking. Respondents who, at baseline, were more impulsive and relied more on emotional discharge coping, and less on problem-solving coping, assaulted others more frequently during the first year of follow-up. Similarly, less problem-solving coping at baseline was related to having had trouble with the police more often at one and 16 years due to drinking. The association between impulsivity and more frequent assault was stronger for women, whereas associations of self-efficacy and problem-solving coping with less frequent assault and police trouble were stronger for men. Participation in AA was also associated with a lower likelihood of having trouble with the police at one year, especially for men. Interventions aimed at decreasing impulsivity and emotional discharge coping, and bolstering self-efficacy and problem-solving coping, during substance abuse treatment, and encouragement to become involved in AA, may be helpful in reducing assaultive and other illegal behaviors.

Years of life gained due to leisure-time physical activity in the U.S.

PubMed

Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T; Blair, Steven N

2013-01-01

Physical inactivity is an important modifiable risk factor for noncommunicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity in the U.S. Data from the National Health and Nutrition Examination Survey (2007-2010); National Health Interview Study mortality linkage (1990-2006); and U.S. Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate to vigorous physical activity); somewhat-active (some moderate to vigorous activity but <500 MET minutes/week); and active (≥ 500 MET minutes/week of moderate to vigorous activity) adults. Analyses were conducted in 2012. Somewhat-active and active non-Hispanic white men had a life expectancy at age 20 years that was ~2.4 years longer than that for the inactive men; this life expectancy advantage was 1.2 years at age 80 years. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 years and 1.6 years at age 80 years. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat-active and active non-Hispanic black men; however, among Hispanics the years-of-life-gained estimates were not significantly different from 0 years gained. Leisure-time physical activity is associated with increases in longevity. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Large Civil Tiltrotor (LCTR2) Interior Noise Predictions due to Turbulent Boundary Layer Excitation

NASA Technical Reports Server (NTRS)

Grosveld, Ferdinand W.

2013-01-01

The Large Civil Tiltrotor (LCTR2) is a conceptual vehicle that has a design goal to transport 90 passengers over a distance of 1800 km at a speed of 556 km/hr. In this study noise predictions were made in the notional LCTR2 cabin due to Cockburn/Robertson and Efimtsov turbulent boundary layer (TBL) excitation models. A narrowband hybrid Finite Element (FE) analysis was performed for the low frequencies (6-141 Hz) and a Statistical Energy Analysis (SEA) was conducted for the high frequency one-third octave bands (125- 8000 Hz). It is shown that the interior sound pressure level distribution in the low frequencies is governed by interactions between individual structural and acoustic modes. The spatially averaged predicted interior sound pressure levels for the low frequency hybrid FE and the high frequency SEA analyses, due to the Efimtsov turbulent boundary layer excitation, were within 1 dB in the common 125 Hz one-third octave band. The averaged interior noise levels for the LCTR2 cabin were predicted lower than the levels in a comparable Bombardier Q400 aircraft cabin during cruise flight due to the higher cruise altitude and lower Mach number of the LCTR2. LCTR2 cabin noise due to TBL excitation during cruise flight was found not unacceptable for crew or passengers when predictions were compared to an acoustic survey on a Q400 aircraft.

Developing NDE Techniques for Large Cryogenic Tanks - Year 2 Report

NASA Technical Reports Server (NTRS)

Arens, Ellen; youngquist, Robert; McFall, Judith; Simmons, Stephen

2010-01-01

The Shuttle Program requires very large cryogenic ground storage tanks in which to store liquid oxygen and hydrogen. The existing Launch Complex-39 Pad tanks, which will be passed onto future launch programs, are over 40 years old and have received minimal refurbishment and only external inspections over the years. The majority of the structure is inaccessible without a full system drain of cryogenic liquid and insulation in the annular region. It was previously thought that there was a limit to the number of temperature cycles that the tanks could handle due to possible insulation compaction before undergoing a costly and time consuming complete overhaul; therefore the tanks were not drained and performance issues with these tanks, specifically the Pad B LH2 tank, were accepted. There is a need and an opportunity, as the Shuttle program ends and work to upgrade the launch pad progresses, to develop innovative non-destructive evaluation (NDE) techniques to analyze the current tanks. Techniques are desired that can aid in determining the extent of refurbishment required to keep the tanks in service for another 20+ years. A non-destructive technique would also be a significant aid in acceptance testing of new and refurbished tanks, saving significant time and money, if corrective actions can be taken before cryogen is introduced to the systems. Year one of this project concentrated on analysis of the current tanks located at LC-39 while cryogen was present. Year two of this project concentrated on analysis of detectable thermal variations on the outer surface of the tanks as the cryogen was drained and the inner vessel warmed to ambient conditions. Two techniques have been deployed in the field to monitor the tank. The first consisted of a displacement sensor to monitor for any expansions at the base of the tank during warm-up that could indicate a compaction issue with the insulation. The second technique was continued thermal monitoring of the tank through and

Cardiac anaplastic large cell lymphoma in an 8-year old boy.

PubMed

Lauten, Melchior; Vieth, Simon; Hart, Christopher; Wössmann, Wilhelm; Tröger, Birte; Härtel, Christoph; Bethge, Martin; Schrauder, André; Cario, Gunnar

2014-01-01

We report on an 8 year old boy with primary cardiac anaplastic large cell lymphoma (ALCL), in whom the diagnosis was challenging and who was treated with modified chemotherapy without radiation therapy according to the ALCL 99 study protocol [1]. Two years and 4 months after completion of therapy the boy is in complete remission with normal cardiac function.

Health-related quality of life two years after injury due to terrorism.

PubMed

Tuchner, Maya; Meiner, Zeev; Parush, Shula; Hartman-Maeir, Adina

2010-01-01

During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL. We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates. The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores. This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and

Bias to CMB lensing reconstruction from temperature anisotropies due to large-scale galaxy motions

NASA Astrophysics Data System (ADS)

Ferraro, Simone; Hill, J. Colin

2018-01-01

Gravitational lensing of the cosmic microwave background (CMB) is expected to be amongst the most powerful cosmological tools for ongoing and upcoming CMB experiments. In this work, we investigate a bias to CMB lensing reconstruction from temperature anisotropies due to the kinematic Sunyaev-Zel'dovich (kSZ) effect, that is, the Doppler shift of CMB photons induced by Compton scattering off moving electrons. The kSZ signal yields biases due to both its own intrinsic non-Gaussianity and its nonzero cross-correlation with the CMB lensing field (and other fields that trace the large-scale structure). This kSZ-induced bias affects both the CMB lensing autopower spectrum and its cross-correlation with low-redshift tracers. Furthermore, it cannot be removed by multifrequency foreground separation techniques because the kSZ effect preserves the blackbody spectrum of the CMB. While statistically negligible for current data sets, we show that it will be important for upcoming surveys, and failure to account for it can lead to large biases in constraints on neutrino masses or the properties of dark energy. For a stage 4 CMB experiment, the bias can be as large as ≈15 % or 12% in cross-correlation with LSST galaxy lensing convergence or galaxy overdensity maps, respectively, when the maximum temperature multipole used in the reconstruction is ℓmax=4000 , and about half of that when ℓmax=3000 . Similarly, we find that the CMB lensing autopower spectrum can be biased by up to several percent. These biases are many times larger than the expected statistical errors. We validate our analytical predictions with cosmological simulations and present the first complete estimate of secondary-induced CMB lensing biases. The predicted bias is sensitive to the small-scale gas distribution, which is affected by pressure and feedback mechanisms, thus making removal via "bias-hardened" estimators challenging. Reducing ℓmax can significantly mitigate the bias at the cost of a decrease

Years of Life Gained Due to Leisure-Time Physical Activity in the United States

PubMed Central

Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T.; Blair, Steven N.

2013-01-01

Background Physical inactivity is an important modifiable risk factor for non-communicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity across the adult lifespan in the United States. Methods Data from the National Health and Nutrition Examination Survey (2007–2010), National Health Interview Study mortality linkage (1990–2006), and US Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate-to-vigorous physical activity), somewhat active (some moderate-to-vigorous activity but <500 metabolic equivalent min/week) and active (≥500 metabolic equivalent min/week of moderate-to-vigorous activity) adults. Analyses were conducted in 2012. Results Somewhat active and active non-Hispanic white men had a life expectancy at age 20 that was around 2.4 years longer than the inactive men; this life expectancy advantage was 1.2 years at age 80. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 and 1.6 years at age 80. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat active and active non-Hispanic black men; however, among Hispanics the years of life gained estimates were more variable and not significantly different from 0 years gained. Conclusions Leisure-time physical activity is associated with increases in longevity in the United States. PMID:23253646

Estimating quality-adjusted life-year loss due to noncommunicable diseases in Korean adults through to the year 2040.

PubMed

Ock, Minsu; Han, Jung Won; Lee, Jin Yong; Kim, Seon-Ha; Jo, Min-Woo

2015-01-01

To estimate the loss in quality-adjusted life-years (QALYs) in Korean adults due to 13 noncommunicable diseases (NCDs) in 2010 and predict changes in QALY loss through to the year 2040. Thirteen NCDs (hypertension, diabetes mellitus, hyperlipidemia, stroke, myocardial infarction, angina, arthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression) were selected from the Korean Community Health Survey 2010. The EuroQol five-dimensional questionnaire index from the Korean Community Health Survey 2010 and the Korean valuation set were used to estimate utility weights according to sex, age, and disease. Morbidity data were also obtained from the Korean Community Health Survey 2010. Mortality data according to disease and life expectancy were retrieved from the Korean Statistical Information Service. To predict future QALY loss, future population projection data from the Korean Statistical Information Service were used as substitutes for 2010 population size. Among the assessed 13 NCDs, the largest total QALY loss was for hypertension (513,113 QALYs; units are omitted hereafter), followed by arthritis (509,317) and stroke (431,049). The largest QALY loss due to mortality was stroke (306,733), whereas the largest QALY loss due to morbidity was arthritis (502,513). By applying the middle estimate of future population, the largest increase in total QALY loss between 2010 and 2040 was for hypertension (840,582), followed by stroke (719,076) and diabetes mellitus (474,607). Hypertension, arthritis, and stroke are important in terms of total QALY loss, which will continuous to increase because of aging. These results could be used to develop cost-effective interventions that reduce the burden of NCDs. Copyright © 2015. Published by Elsevier Inc.

Years of life lost due to encounters with law enforcement in the USA, 2015-2016.

PubMed

Bui, Anthony L; Coates, Matthew M; Matthay, Ellicott C

2018-05-07

To inform discussions on rates, burden and priority-setting in relation to police violence, we quantified the number and rate of years of life lost (YLLs) due to police violence by race/ethnicity and age in the USA, 2015-2016. We used data on the number of deaths due to police violence from 'The Counted', a media-based source compiled by The Guardian . YLLs are the difference between an individual's age at death and their corresponding standard life expectancy at age of death. There were 57 375 and 54 754 YLLs due to police violence in 2015 and 2016, respectively. People of colour comprised 38.5% of the population, but 51.5% of YLLs. YLLs were greatest among those aged 25-34 years, and the number of YLLs at younger ages was greater among people of colour than whites. The number of YLLs due to police violence is substantial. YLLs highlight that police violence disproportionately impacts young people, and the young people affected are disproportionately people of colour. Framing police violence as an important cause of deaths among young adults provides another valuable lens to motivate prevention efforts. © 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.

Years of life lost of inhabitants of rural areas in Poland due to premature mortality caused by external reasons of death 1999-2012.

PubMed

Bryła, Marek; Maniecka-Bryła, Irena; Burzyńska, Monika; Pikala, Małgorzata

2016-12-23

External causes of death are the third most common causes of death, after cardiovascular diseases and malignant neoplasms, in inhabitants of Poland. External causes of death pose the greatest threat to people aged 5-44, which results in a great number of years of life lost. The aim of the study is the analysis of years of life lost due to external causes of death among rural inhabitants in Poland, particularly due to traffic accidents and suicides. The study material included a database created on the basis of 2,100,785 certificates of rural inhabitants in Poland in the period 1999-2012. The SEYLL p (Standard Expected Years of Life Lost per living person) and the SEYLL d (per death) indices were used to determine years of life lost due to external causes of death. Joinpoint models were used to analyze time trends. In the period 1999-2012, 151,037 rural inhabitants died due to external causes, including 27.2% due to traffic accidents and 25.2% due to suicides. In 2012, the SEYLL p was 1,817 per 100,000 males and 298 per 100,000 females. Among males, suicides (SEYLL p = 633 years per 100,000) and traffic accidents (SEYLL p = 473 years per 100,000) contributed to the largest number of years of life lost. Among females, SEYLLp values were: 109 years due to traffic accidents and 69 years due to suicides (per 100,000). Among males, SEYLL p values started to decrease in 2008 at the average annual rate of 3.2%. In the group of females in the period 1999-2012, SEYLL p values were decreasing by 2.4% per year. The decreasing trend of the number of lost years of life due to external causes among rural inhabitants does not apply to suicides among men. The SEYLL p due to this group of causes has been steadily increasing since 1999. Analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

Changes in sick-leave diagnoses over eleven years in a cohort of young adults initially sick-listed due to low back, neck, or shoulder diagnoses.

PubMed

Festin, Karin; Alexanderson, Kristina

2009-05-01

To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Eleven-year prospective cohort study. All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting > or = 28 days with low back, neck, or shoulder diagnoses. For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 22% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

11-Year change in water chemistry of large freshwater Reservoir Danjiangkou, China

NASA Astrophysics Data System (ADS)

Li, Siyue; Ye, Chen; Zhang, Quanfa

2017-08-01

Danjiangkou Reservoir, an important drinking water source, has become a hot spot internationally due to its draining catchment has been increasingly affected by anthropogenic activities. However, its natural water chemistry (major elements) received little attention though it is crucial for water quality and aquatic ecology. Major ions during 2004-2014 were determined using stoichiometry to explore their shifts and the driving factors in the Danjiangkou Reservoir. Results show significant differences in monthly, spatial and annual concentrations of major ions. Waters are controlled by carbonate weathering with the dominant ions of Ca2+ and HCO3- total contributing 74% to the solutes, which are consistent with regional geography. Carbonate dissolution was produced by sulfuric acid and carbonic acid in particular. The relative abundance of Ca2+ gradually decreases, Na+ + K+ abundance, however, has doubled in the recent 11 years. Population and human activities were the major drivers for several major ions, i.e., Cl- and Na+ concentrations were explained by population and GDP, and SO42- by GDP, industrial sewage and energy consumption. Estimation indicated that domestic salts and atmospheric deposition contributed 56% and 22% to Cl-, respectively. We conclude waters in the Reservoir are naturally controlled by rock weathering whilst some key elements largely contributed by anthropogenic activities.

5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore.

PubMed

Sun, Yan; Lee, Sze Haur; Heng, Bee Hoon; Chin, Vivien S

2013-10-03

Stroke is the 4th leading cause of death and 1st leading cause of disability in Singapore. However the information on long-term post stroke outcomes for Singaporean patients was limited. This study aimed to investigate the post stroke outcomes of 5-year survival and rehospitalization due to stroke recurrence for hemorrhagic and ischemic stroke patients in Singapore. The outcomes were stratified by age, ethnic group, gender and stroke types. The causes of death and stroke recurrence were also explored in the study. A multi-site retrospective cohort study. Patients admitted for stroke at any of the three hospitals in the National Healthcare Group of Singapore were included in the study. All study patients were followed up to 5 years. Kaplan-Meier was applied to study the time to first event, death or rehospitalization due to stroke recurrence. Cox proportional hazard model was applied to study the time to death with adjustment for stroke type, age, sex, ethnic group, and admission year. Cumulative incidence model with competing risk was applied for comparing the risks of rehospitalization due to stroke recurrence with death as the competing risk. Totally 12,559 stroke patients were included in the study. Among them, 59.3% survived for 5 years; 18.4% were rehospitalized due to stroke recurrence in 5 years. The risk of stroke recurrence and mortality increased with age in all stroke types. Gender, ethnic group and admitting year were not significantly associated with the risk of mortality or stroke recurrence in hemorrhagic stroke. Male or Malay patient had higher risk of stroke recurrence and mortality in ischemic stroke. Hemorrhagic stroke had higher early mortality while ischemic stroke had higher recurrence and late mortality. The top cause of death among died stroke patients was cerebrovascular diseases, followed by pneumonia and ischemic heart diseases. The recurrent stroke was most likely to be the same type as the initial stroke among rehospitalized stroke

Percutaneous microwave ablation liver partition and portal vein embolization for planned hepatectomy due to large gastrointestinal stromal tumor metastases

PubMed Central

Liu, Jie; Zhang, Chengwu; Hong, Defei; Shang, Minjie; Yao, Weifeng; Chen, Yuan

2017-01-01

Abstract Rationale: The liver is the most frequent site of relapse of gastrointestinal stromal tumors (GISTs). Surgery is always considered to be unsuitable because of the multiple metastases. Patient concerns: In this report, we describe a case of large, multiple GIST liver metastases that were treated with percutaneous microwave ablation liver partition and portal vein embolization for planned hepatectomy (PALPP). A 44-year-old woman had undergone pancreaticoduodenectomy 4 years previously because of the diagnosis of a large duodenal GIST. Large, multiple liver metastases were observed 2 years later. Diagnoses: GIST liver metastasis was diagnosed using percutaneous ultrasound-guided biopsy. Interventions: After 6 months of treatment with imatinib, the liver metastasis was stable. PALPP was performed because of insufficient future liver remnant (FLR) and right trisegmentectomy was successfully completed 10 days later. Outcomes: The patient has had no signs of local or systemic disease during 17 months of postsurgical follow-up. Lessons: PALPP provides a new methodology for treatment of GIST liver metastasis in patients with insufficient FLR, and may have benefit in prolonging a durable remission. PMID:29049221

Risk factors for unintentional injuries due to falls in children aged 0–6 years: a systematic review

PubMed Central

Khambalia, A; Joshi, P; Brussoni, M; Raina, P; Morrongiello, B; Macarthur, C

2006-01-01

Objective To identify risk factors for unintentional injuries due to falls in children aged 0–6 years. Design A systematic review of the literature. Methods Electronic databases from 1966 to March 2005 were comprehensively searched to identify empirical research that evaluated risk factors for unintentional injuries due to falls in children aged 0–6 years and included a comparison group. Results 14 studies met the inclusion criteria. Studies varied by the type of fall injury that was considered (ie, bunk bed, stairway, playground or infant walker) and with respect to the quality of evidence. In general, major risk factors for the incidence or severity of injuries due to falls in children included age of the child, sex, height of the fall, type of surface, mechanism (dropped, stairway or using a walker), setting (day care v home care) and socioeconomic status. Conclusion Despite a high burden, few controlled studies have examined the risk and protective factors for injuries due to falls in children aged 0–6 years. The only study to examine falls from a population health perspective suggests that age, sex and poverty are independent risk factors for injuries due to falls in children. PMID:17170185

Costs resulting from premature mortality due to cardiovascular causes: A 20-year follow-up of the DRECE study.

PubMed

Gómez-de la Cámara, A; Pinilla-Domínguez, P; Vázquez-Fernández Del Pozo, S; García-Pérez, L; Rubio-Herrera, M A; Gómez-Gerique, J A; Gutiérrez-Fuentes, J A; Rivero-Cuadrado, A; Serrano-Aguilar, P

2014-10-01

Cardiovascular diseases are still the leading cause of death in Spain. The DRECE study (Diet and Cardiovascular Disease Risk in Spain), based on a representative cohort of the Spanish general population, analyzed nutritional habits and lifestyle and their association with morbidity and mortality patterns. We estimated the impact, in terms of loss of productivity, of premature mortality attributed to cardiovascular diseases. The loss of productivity attributed to premature mortality was calculated from 1991, based on the potential years of life lost and the potential years of working life lost. During the 20-year follow-up of a cohort of 4779 patients, 225 of these patients died (men, 152). Sixteen percent of the deaths were attributed to cardiovascular disease. The costs due to lost productivity by premature mortality exceeded 29 million euros. Of these, 4 million euros (14% of the total cost) were due to cardiovascular causes. Premature cardiovascular mortality in the DRECE cohort represented a significant social cost due to lost productivity. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Unscheduled load flow effect due to large variation in the distributed generation in a subtransmission network

NASA Astrophysics Data System (ADS)

Islam, Mujahidul

A sustainable energy delivery infrastructure implies the safe and reliable accommodation of large scale penetration of renewable sources in the power grid. In this dissertation it is assumed there will be no significant change in the power transmission and distribution structure currently in place; except in the operating strategy and regulatory policy. That is to say, with the same old structure, the path towards unveiling a high penetration of switching power converters in the power system will be challenging. Some of the dimensions of this challenge are power quality degradation, frequent false trips due to power system imbalance, and losses due to a large neutral current. The ultimate result is the reduced life of many power distribution components - transformers, switches and sophisticated loads. Numerous ancillary services are being developed and offered by the utility operators to mitigate these problems. These services will likely raise the system's operational cost, not only from the utility operators' end, but also reflected on the Independent System Operators and by the Regional Transmission Operators (RTO) due to an unforeseen backlash of frequent variation in the load-side generation or distributed generation. The North American transmission grid is an interconnected system similar to a large electrical circuit. This circuit was not planned but designed over 100 years. The natural laws of physics govern the power flow among loads and generators except where control mechanisms are installed. The control mechanism has not matured enough to withstand the high penetration of variable generators at uncontrolled distribution ends. Unlike a radial distribution system, mesh or loop networks can alleviate complex channels for real and reactive power flow. Significant variation in real power injection and absorption on the distribution side can emerge as a bias signal on the routing reactive power in some physical links or channels that are not distinguishable

Average years of life lost due to breast and cervical cancer and the association with the marginalization index in Mexico in 2000 and 2010.

PubMed

Cervantes, Claudio Alberto Dávila; Botero, Marcela Agudelo

2014-05-01

The objective of this study was to calculate average years of life lost due to breast and cervical cancer in Mexico in 2000 and 2010. Data on mortality in women aged between 20 and 84 years was obtained from the National Institute for Statistics and Geography. Age-specific mortality rates and average years of life lost, which is an estimate of the number of years that a person would have lived if he or she had not died prematurely, were estimated for both diseases. Data was disaggregated into five-year age groups and socioeconomic status based on the 2010 marginalization index obtained from the National Population Council. A decrease in average years of life lost due to cervical cancer (37.4%) and an increase in average years of life lost due breast cancer (8.9%) was observed during the period studied. Average years of life lost due to cervical cancer was greater among women living in areas with a high marginalization index, while average years of life lost due to breast cancer was greater in women from areas with a low marginalization index.

Development of SiC Large Tapered Crystal Growth

NASA Technical Reports Server (NTRS)

Neudeck, Phil

2010-01-01

Majority of very large potential benefits of wide band gap semiconductor power electronics have NOT been realized due in large part to high cost and high defect density of commercial wafers. Despite 20 years of development, present SiC wafer growth approach is yet to deliver majority of SiC's inherent performance and cost benefits to power systems. Commercial SiC power devices are significantly de-rated in order to function reliably due to the adverse effects of SiC crystal dislocation defects (thousands per sq cm) in the SiC wafer.

Effects on aquatic and human health due to large scale bioenergy crop expansion.

PubMed

Love, Bradley J; Einheuser, Matthew D; Nejadhashemi, A Pouyan

2011-08-01

In this study, the environmental impacts of large scale bioenergy crops were evaluated using the Soil and Water Assessment Tool (SWAT). Daily pesticide concentration data for a study area consisting of four large watersheds located in Michigan (totaling 53,358 km²) was estimated over a six year period (2000-2005). Model outputs for atrazine, bromoxynil, glyphosate, metolachlor, pendimethalin, sethoxydim, triflualin, and 2,4-D model output were used to predict the possible long-term implications that large-scale bioenergy crop expansion may have on the bluegill (Lepomis macrochirus) and humans. Threshold toxicity levels were obtained for the bluegill and for human consumption for all pesticides being evaluated through an extensive literature review. Model output was compared to each toxicity level for the suggested exposure time (96-hour for bluegill and 24-hour for humans). The results suggest that traditional intensive row crops such as canola, corn and sorghum may negatively impact aquatic life, and in most cases affect the safe drinking water availability. The continuous corn rotation, the most representative rotation for current agricultural practices for a starch-based ethanol economy, delivers the highest concentrations of glyphosate to the stream. In addition, continuous canola contributed to a concentration of 1.11 ppm of trifluralin, a highly toxic herbicide, which is 8.7 times the 96-hour ecotoxicity of bluegills and 21 times the safe drinking water level. Also during the period of study, continuous corn resulted in the impairment of 541,152 km of stream. However, there is promise with second-generation lignocellulosic bioenergy crops such as switchgrass, which resulted in a 171,667 km reduction in total stream length that exceeds the human threshold criteria, as compared to the base scenario. Results of this study may be useful in determining the suitability of bioenergy crop rotations and aid in decision making regarding the adaptation of large

Deaths and years of life lost due to suboptimal breast-feeding among children in the developing world: a global ecological risk assessment.

PubMed

Lauer, Jeremy A; Betrán, Ana Pilar; Barros, Aluísio J D; de Onís, Mercedes

2006-09-01

We estimate attributable fractions, deaths and years of life lost among infants and children < or = 2 years of age due to suboptimal breast-feeding in developing countries. We compare actual practices to a minimum exposure pattern consisting of exclusive breast-feeding for infants < or = 6 months of age and continued breast-feeding for older infants and children < or = 2 years of age. For infants, we consider deaths due to diarrhoeal disease and lower respiratory tract infections, and deaths due to all causes are considered in the second year of life. Outcome measures are attributable fractions, deaths, years of life lost and offsetting deaths potentially caused by mother-to-child transmission of HIV through breast-feeding. Developing countries. Infants and children < or = 2 years of age. Attributable fractions for deaths due to diarrhoeal disease and lower respiratory tract infections are 55% and 53%, respectively, for the first six months of infancy, 20% and 18% for the second six months, and are 20% for all-cause deaths in the second year of life. Globally, as many as 1.45 million lives (117 million years of life) are lost due to suboptimal breast-feeding in developing countries. Offsetting deaths caused by mother-to-child transmission of HIV through breast-feeding could be as high as 242,000 (18.8 million years of life lost) if relevant World Health Organization recommendations are not followed. The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.

Petermann Glacier, North Greenland: Large Ice-Discharge Episodes from 20 Years of Satellite Observations

NASA Astrophysics Data System (ADS)

Babiker, M.; Johannessen, O. M.; Miles, M. W.; Miles, V. V.

2009-12-01

The major marine-terminating outlet glaciers of Greenland can undergo large mass losses through calving of icebergs and bottom melting from floating ice tongues. Recent observations of outlet glaiers around Greenland have shown that large and rapid changes in solid-ice fluxes are possible. The Petermann glacier in remote northern Greenland is the region’s largest floating-tongue glacier (~70 km by 10 km). In summer 2008 a large calving event was observed, as well as large cracks upstream of the remaining calving front, portending a more massive near-term loss. These observations may herald extraordinary and unprecedented change. However, the long-term variability of calving events and ice velocities are poorly known. Our research goal here is to identify the temporal variability and possible trends in solid-ice flux indicators - variability of the calving front and ice velocity - for Petermann glacier. The methodological approach is observational, based primarily on analysis of 20 years of repetitive satellite data over a period starting from 1990, together with sporadic earlier observations. The multisensor data range from high-resolution optical images from Landsat, SPOT and Terra ASTER and high-resolution synthetic aperture radar (SAR) images from ERS and ENVISAT. These disparate data have been imported, geo-registered and analysed within a Geographic Information System. The following measurements are made: (1) delineating changes in the calving front, (2) estimating the area of glacial ice loss during calving events, and (3) estimating the ice-surface velocity using sequential satellite images. We find evidence of a number of previous calving episodes of similar magnitude to the summer 2008. The ice-velocity estimates compare well with other estimates for particular years, and moreover are relatively consistent during the 20-year period. These findings suggest business-as-usual for Petermann glacier; however, a near-term calving event exceeding those observed

Applying a Linked-Course Model to Foster Inquiry and Integration across Large First-Year Courses

ERIC Educational Resources Information Center

Husband, Brian C.; Bettger, William J.; Murrant, Coral L.; Kirby, Kim; Wright, Patricia A.; Newmaster, Steven G.; Dawson, John F.; Gregory, T. Ryan; Mullen, Robert T.; Nejedly, April; van der Merwe, George; Yankulov, Krassimir; Wolf, Peter

2015-01-01

Many first-year university courses are large and content-driven, which can contribute to low student engagement and difficulty involving students in the dynamic, cross-disciplinary nature of inquiry. Learning communities can address these goals, but their implementation often poses logistical challenges, especially in large courses. Here, we apply…

Secondary hypertension due to isolated interrupted aortic arch in a 45-year-old person: A case report.

PubMed

Zhou, Jian Mei; Liu, Xin Wen; Yang, Yi; Wang, Bo Zhong; Wang, Jian An

2017-12-01

Though it is rare, isolated interrupted aortic arch (IAA) could lead to hypertension. Surgical repair is the only effective curative method to treat IAA conditions and patients with IAA can hardly survive to adulthood with medication alone. We report an IAA case that of a 45-year-old male patient who survived for 45 years without surgical treatment. A 45-year-old man was referred to the hospital presenting with abnormal blood pressure level. Both computed tomography angiogram (CTA) and angiography revealed IAA. The patient was diagnosed as IAA based on computed tomography angiogram (CTA) and angiography. The patient's blood pressure was severely high and refractory. He refused surgical treatment and accepted antihypertensive medication for 10 days. The patient's office blood pressure level was abnormal, fluctuating between 140/90 and 160/100 mm Hg, but 24-hour ambulatory blood pressure monitoring showed normal level. Hypertension due to IAA could be controlled with medications, even surgery is not performed. The discrepancy between ambulatory and office blood pressure levels may be due to the white coat effect.

Rate of deaths due to child abuse and neglect in children 0-3 years of age in Germany.

PubMed

Banaschak, Sibylle; Janßen, Katharina; Schulte, Babette; Rothschild, Markus A

2015-09-01

In recent years, increasing attention has been paid to the issue of (fatal) child abuse and neglect, largely due to the media attention garnered by some headline-grabbing cases. If media statements are to be believed, such cases may be an increasing phenomenon. With these published accounts in mind, publicly available statistics should be analysed with respect to the question of whether reliable statements can be formulated based on these figures. It is hypothesised that certain data, e.g., the Innocenti report published by UNICEF in 2003, may be based on unreliable data sources. For this reason, the generation of such data, and the reliability of the data itself, should also be discussed. Our focus was on publicly available German mortality and police crime statistics (Polizeiliche Kriminalstatistik). These data were classified with respect to child age, data origin, and cause of death (murder, culpable homicide, etc.). In our opinion, the available data could not be considered in formulating reliable scientific statements about fatal child abuse and neglect, given the lack of detail and the flawed nature of the basic data. Increasing the number of autopsies of children 0-3 years of age should be considered as a means to ensure the capture of valid, practical, and reliable data. This could bring about some enlightenment and assist in the development of preemptive strategies to decrease the incidence of (fatal) child abuse and neglect.

Response of ENSO amplitude to global warming in CESM large ensemble: uncertainty due to internal variability

NASA Astrophysics Data System (ADS)

Zheng, Xiao-Tong; Hui, Chang; Yeh, Sang-Wook

2018-06-01

El Niño-Southern Oscillation (ENSO) is the dominant mode of variability in the coupled ocean-atmospheric system. Future projections of ENSO change under global warming are highly uncertain among models. In this study, the effect of internal variability on ENSO amplitude change in future climate projections is investigated based on a 40-member ensemble from the Community Earth System Model Large Ensemble (CESM-LE) project. A large uncertainty is identified among ensemble members due to internal variability. The inter-member diversity is associated with a zonal dipole pattern of sea surface temperature (SST) change in the mean along the equator, which is similar to the second empirical orthogonal function (EOF) mode of tropical Pacific decadal variability (TPDV) in the unforced control simulation. The uncertainty in CESM-LE is comparable in magnitude to that among models of the Coupled Model Intercomparison Project phase 5 (CMIP5), suggesting the contribution of internal variability to the intermodel uncertainty in ENSO amplitude change. However, the causations between changes in ENSO amplitude and the mean state are distinct between CESM-LE and CMIP5 ensemble. The CESM-LE results indicate that a large ensemble of 15 members is needed to separate the relative contributions to ENSO amplitude change over the twenty-first century between forced response and internal variability.

Rate of complications due to neuromuscular scoliosis spine surgery in a 30-years consecutive series.

PubMed

Turturro, Francesco; Montanaro, Antonello; Calderaro, Cosma; Labianca, Luca; Di Sanzo, Vincenzo; Ferretti, Andrea

2017-10-01

The aim of this study was to evaluate the rate of intraoperative and postoperative complications in a large series of patients affected by neuromuscular scoliosis. It was a monocentric retrospective study. In this study have been considered complications those events that significantly affected the course of treatment, such as getting the hospital stay longer, or requiring a subsequent surgical procedure, or corrupting the final result of the treatment. Of the 358 patients affected by neuromuscular scoliosis treated from January 1985 to December 2010, 185 that met the inclusion criteria were included in the study. There were recorded 66 complications in 55/185 patients. Of that 66 complications, 54 complications occurred in 46/120 patients with Luque's instrumentation, while only 12 complications occurred in 9/65 patients with hybrid instrumentation and this difference was statistically significant (p < 0.05); 11/126 patients with pelvic fixation and 5/59 without pelvic fixation, as well as 45/156 patients treated by posterior approach alone and 10/29 patient that underwent combined anterior-posterior approach suffered complications but both this did not result in a statistical significant difference (p > 0.05). The surgical treatment in neuromuscular scoliosis is burdened by a large number of complications. An accurate knowledge of possible complications is mandatory to prepare strategies due to prevent adverse events. A difference in definitions could completely change results in good or bad as well as in our same series the adverse events amounted at almost 30% of cases, but complications that due to complete failure would amount at 9.19% of patients.

Frequency of large volcanic eruptions over the past 200,000 years

NASA Astrophysics Data System (ADS)

Wolff, Eric; Mahony, Sue; Sparks, Steven; Fujita, Shuji; Parrenin, Frédéric; Severi, Mirko; Udisti, Roberto

2017-04-01

Volcanic eruptions play an important role in climate forcing, and over longer periods they are an essential component of the budget of carbon dioxide in the atmosphere. Eruptions of different magnitudes pose hazards at different scales to society and ecosystems. However, establishing the past frequency of eruptions of various magnitudes is challenging. Antarctic ice cores, through their record of episodic sulfate deposition, offer the opportunity to establish such frequencies, at least in those cases where sulfur is injected into the stratosphere and deposited globally. A number of difficulties have to be overcome however. Here, we build on recent work that has used large eruption spikes to synchronise records back to 200,000 years, in particular between the East Antarctic sites of Dome C, Dome Fuji and Vostok. In each record, and for each volcano, we can estimate the amount of sulfate deposited above the background across the years following an eruption; in some cases we will use electrical conductivity data as a surrogate for sulfate. By using the three records together we can place uncertainty estimates on the amount of sulfate deposited for each eruption. We will then test methods for assessing the frequency of eruptions above a given magnitude (in terms of sulfate deposition). We will check these methods using synthetic records which can be applied on top of different backgrounds and snowfall rates, and after appropriate diffusion, to confirm that our methods are robust against such differences through 200,000 years. We will finally establish the frequency of large eruptions through two glacial cycles to assess the validity of suggestions that the rate is higher during periods of deglaciation.

[Aseptic, simultaneous and bilateral mobilisation due to an acetabular shell fracture in a 43 year-old patient].

PubMed

Ceretti, M; Fanelli, M; Pappalardo, S

2014-01-01

The acetabular shell mobilization is the main long-term complication in total hip replacement. Metal-back fracture has also to be considered among the possible causes of shell mobilization. A case is presented of bilateral acetabular shell mobilization due to the trabecular covering de-soldering from the metal-back in a 43 year-old patient, 13-14 years after the first surgery. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

An Example of Large-group Drama and Cross-year Peer Assessment for Teaching Science in Higher Education

NASA Astrophysics Data System (ADS)

Sloman, Katherine; Thompson, Richard

2010-09-01

Undergraduate students pursuing a three-year marine biology degree programme (n = 86) experienced a large-group drama aimed at allowing them to explore how scientific research is funded and the associated links between science and society. In the drama, Year 1 students played the "general public" who decided which environmental research areas should be prioritised for funding, Year 2 students were the "scientists" who had to prepare research proposals which they hoped to get funded, and Year 3 students were the "research panel" who decided which proposals to fund with input from the priorities set by the "general public". The drama, therefore, included an element of cross-year peer assessment where Year 3 students evaluated the research proposals prepared by the Year 2 students. Questionnaires were distributed at the end of the activity to gather: (1) student perceptions on the cross-year nature of the exercise, (2) the use of peer assessment, and (3) their overall views on the drama. The students valued the opportunity to interact with their peers from other years of the degree programme and most were comfortable with the use of cross-year peer assessment. The majority of students felt that they had increased their knowledge of how research proposals are funded and the perceived benefits of the large-group drama included increased critical thinking ability, confidence in presenting work to others, and enhanced communication skills. Only one student did not strongly advocate the use of this large-group drama in subsequent years.

Prevalence of skeletal deformity due to nutritional rickets in children between 1 and 18 years in tea garden community.

PubMed

Chabra, Tarun; Tahbildar, Pranjal; Sharma, Ayush; Boruah, Sushanta; Mahajan, Rajat; Raje, Amrut

2016-01-01

The present study was undertaken to find out the prevalence of skeletal deformity due to nutritional rickets in children aged 1-18 years in tea garden community in Dibrugarh District of Assam. It was a cross-sectional study and two-stage cluster sampling was used. In the selected tea gardens, all the children aged 1-18 years were screened for skeletal deformity by house-to-house visit. The overall prevalence of skeletal deformity was 2.7 per thousand. Majority of children with deformities (57.27%) were between 7 and 12 years of age. Widening of wrists and ankle was the most frequent symptom (53.8%). Most of the children with deformity had moderate malnutrition (77.27%). Most of the children with skeletal deformity belong to lower (v) (45.45%) grade of Kuppuswamy's grading scale. Bilateral genu valgus deformity (54.54%) and bilateral genu varum (25.92%) deformity were the most common deformities. Widening of wrists and ankle was the most frequent symptom (61.66%). Of the 16,274 tea garden children included in our study (male and female) in the age group 1-18 years, 44 had skeletal deformity due to nutritional rickets. The prevalence of skeletal deformity due to nutritional rickets was found to be 2.7 per thousand children, which are significantly higher when compared with the only other such study, which was on general population in Bangladesh.

The Influence of the Several Very Large Solar Proton Events in Years 2000-2003 on the Neutral Middle Atmosphere

NASA Technical Reports Server (NTRS)

Jackman, Charles H.; Sinnhuber, Miriam; Anderson, John; McPeters, Richard D.; FLeming, Eric L.; Russell, James M.

2004-01-01

Solar proton events (SPEs) are known to have caused changes in constituents in the Earth's neutral middle atmosphere. The highly energetic protons produce ionizations, excitations, dissociations, and dissociative ionizations of the background constituents, which lead to the production of HOx (H, OH, HO2) and NOy (N, NO, NO2, NO3, N2O5, HNO3, HO2NO2, ClONO2, BrONO2). The HOx increases lead to short-lived ozone decreases in the mesosphere and upper stratosphere due to the short lifetimes of the HOx constituents. The NOy increases lead to long-lived stratospheric ozone changes because of the long lifetime of the NOy family in this region. The past four years, 2000-2003, have been replete with SPEs and huge fluxes of high energy protons occurred in July and November 2000, September and November 2001, April 2002, and October 2003. Smaller, but still substantial, proton fluxes impacted the Earth during other months from year 2000 to 2003. The Goddard Space Flight Center (GSFC) Two-dimensional (2D) Model was used in computing the influence of the SPEs. The impact of these extremely large SPEs was calculated to be especially large in the upper stratosphere and mesosphere. The results of the GSFC 2D Model will be shown along with comparisons to the Upper Atmosphere Research Satellite (UARS) Halogen Occultation Experiment (HALOE) and Solar Backscatter Ultraviolet 2 (SBUV/2) instruments.

Validity of Caregivers’ Reports on Head Trauma Due to Falls in Young Children Aged Less than 2 Years

PubMed Central

Fujiwara, Takeo; Nagase, Hiroaki; Okuyama, Makiko; Hoshino, Takahiro; Aoki, Kazunori; Nagashima, Tastuya; Nakamura, Hajime

2010-01-01

Objective: The clinical presentations of head trauma due to falls among young children aged less than 2 years are controversial, particularly in Japan, as the history of trauma recounted by a caretaker is not always reliable. The purpose of this study was to assess the validity of caregiver’s reports on head trauma due to falls in young children aged less than 2 years in Japan. Methods: All patients <2 years of age presenting with head trauma resulting from a fall who were admitted to 3 children’s hospitals in Japan from January 2001 to December 2005 were retrospectively reviewed (N = 58). The clinical presentations were compared among groups categorized by the heights from which the patient fell (short (≤120 cm) or long (>120 cm)) and the surface on which the patient landed (carpet, tatami (Japanese mattress), hardwood floor, or concrete). Results: Patients who suffered short falls were more likely to present with subdural hemorrhage (SDH) than those who suffered long falls (74% and 40%, respectively, P = 0.027). More specifically, 62% of short falls showed SDH indicative of shaken baby syndrome (e.g. multilayer SDH). Neurological symptoms, cyanosis, and SDH were more commonly observed in patients who landed on carpeted or tatami surfaces than in those who landed on hardwood or concrete floors. Conclusions: Short falls and landing on soft surfaces resulted in the presentation of severer clinical symptoms than did long falls and landing on hard surfaces, suggesting that the validity of caretakers’ reports on infant or young children’s head trauma due to falls is low. Further research is warranted to investigate the cause of infant head trauma due to falls. PMID:23761991

Assessing the 100-Year Climate Change Mitigation Potential of Large-Scale Tropical Forest Restoration Under the Bonn Challenge

NASA Astrophysics Data System (ADS)

Wheeler, C. E.; Mitchard, E. T.; Lewis, S. L.

2017-12-01

Restoring degraded and deforested tropical lands to sequester carbon is widely considered to offer substantial climate change mitigation opportunities, if conducted over large spatial scales. Despite this assertion, explicit estimates of how much carbon could be sequestered because of large-scale restoration are rare and have large uncertainties. This is principally due to the many different characteristics of land available for restoration, and different potential restoration activities, which together cause very different rates of carbon sequestration. For different restoration pathways: natural regeneration of degraded and secondary forest, timber plantations and agroforestry, we estimate carbon sequestration rates from the published literature. Then based on tropical restoration commitments made under the Bonn challenge and using carbon density maps, these carbon sequestration rates were used to predict total pan-tropical carbon sequestration to 2100. Restoration of degraded or secondary forest via natural regeneration offers the greatest carbon sequestration potential, considerably exceeding the carbon captured by either timber plantations or agroforestry. This is predominantly due to naturally regenerating forests representing a more permanent store of carbon in comparison to timber plantations and agroforestry land-use options, which, due to their rotational nature, result in the sequential return of carbon to the atmosphere. If the Bonn Challenge is to achieve its ambition of providing substantial climate change mitigation from restoration it must incorporate large areas of natural regeneration back to an intact forest state, otherwise it stands to be a missed opportunity in helping meet the Paris climate change goals.

Mortality due to poisoning in a developing agricultural country: trends over 20 years.

PubMed

Senanayake, N; Peiris, H

1995-10-01

The cause of death as recorded in 37,125 death certificates (DCs) issued in the Kandy District over 20 years at 5-year intervals beginning in 1967 were analysed to determine the trends in mortality caused by poisoning in the community. Poisoning accounted for 718 (19.3 per 1000) deaths, the highest number being in the third decade of life (41.9%). Male:female ratio was 3:1. The agent responsible for 77% of the deaths was pesticides. Acids and chemicals accounted for 6.9% of the deaths. Other poisons each contributing to less than 1% of the deaths were: plant poisons, food items, drugs, kerosine oil and alcohol. Nearly half the deaths had occurred outside the town area, at home or in small hospitals in the periphery. Mortality due to poisoning showed an increasing trend during the 20 years, from 11.8 to 43/1000 deaths, and this increase was most marked in the periphery, from 8/1000 to 70/1000. This increase paralleled the increase in suicide figures in the country. Our findings call for a shift in emphasis in public education towards first-aid management of intoxication. Health services of developing countries should provide appropriate resuscitative equipment, and ensure a regular supply of antidotes and other medication to all rural hospitals. Management of pesticide poisoning should be emphasised in the curricula for medical graduates, nurses, and paramedics.

Biohorizons: An eConference to Assess Human Biology in Large, First-Year Classes

ERIC Educational Resources Information Center

Moni, Roger W.; Moni, Karen B.; Poronnik, Philip; Lluka, Lesley J.

2007-01-01

The authors detail the design, implementation and evaluation of an eConference entitled "Biohorizons," using a presage-process-product model to describe the development of an eLearning community. Biohorizons was a summative learning and assessment task aiming to introduce large classes of first-year Human Biology students to the practices of…

A multi-organ biomechanical model to analyze prostate deformation due to large deformation of the rectum

NASA Astrophysics Data System (ADS)

Brock, Kristy K.; Ménard, Cynthia; Hensel, Jennifer; Jaffray, David A.

2006-03-01

Magnetic resonance imaging (MRI) with an endorectal receiver coil (ERC) provides superior visualization of the prostate gland and its surrounding anatomy at the expense of large anatomical deformation. The ability to correct for this deformation is critical to integrate the MR images into the CT-based treatment planning for radiotherapy. The ability to quantify and understand the physiological motion due to large changes in rectal filling can also improve the precision of image-guided procedures. The purpose of this study was to understand the biomechanical relationship between the prostate, rectum, and bladder using a finite element-based multi-organ deformable image registration method, 'Morfeus' developed at our institution. Patients diagnosed with prostate cancer were enrolled in the study. Gold seed markers were implanted in the prostate and MR scans performed with the ERC in place and its surrounding balloon inflated to varying volumes (0-100cc). The prostate, bladder, and rectum were then delineated, converted into finite element models, and assigned appropriate material properties. Morfeus was used to assign surface interfaces between the adjacent organs and deform the bladder and rectum from one position to another, obtaining the position of the prostate through finite element analysis. This approach achieves sub-voxel accuracy of image co-registration in the context of a large ERC deformation, while providing a biomechanical understanding of the multi-organ physiological relationship between the prostate, bladder, and rectum. The development of a deformable registration strategy is essential to integrate the superior information offered in MR images into the treatment planning process.

Relapsing pneumonia due to a migrating intrathoracic foreign body in a World War II veteran shot 53 years ago.

PubMed

Langer, D; Petermann, C; Lübbers, H; Lankisch, P G

1999-04-01

In the great majority of cases of long-standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70-year-old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.

5 years of experience with a large-scale mentoring program for medical students.

PubMed

Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

2015-01-01

In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs.

Weak gravitational lensing due to large-scale structure of the universe

NASA Technical Reports Server (NTRS)

Jaroszynski, Michal; Park, Changbom; Paczynski, Bohdan; Gott, J. Richard, III

1990-01-01

The effect of the large-scale structure of the universe on the propagation of light rays is studied. The development of the large-scale density fluctuations in the omega = 1 universe is calculated within the cold dark matter scenario using a smooth particle approximation. The propagation of about 10 to the 6th random light rays between the redshift z = 5 and the observer was followed. It is found that the effect of shear is negligible, and the amplification of single images is dominated by the matter in the beam. The spread of amplifications is very small. Therefore, the filled-beam approximation is very good for studies of strong lensing by galaxies or clusters of galaxies. In the simulation, the column density was averaged over a comoving area of approximately (1/h Mpc)-squared. No case of a strong gravitational lensing was found, i.e., no 'over-focused' image that would suggest that a few images might be present. Therefore, the large-scale structure of the universe as it is presently known does not produce multiple images with gravitational lensing on a scale larger than clusters of galaxies.

Applying results from Physics Education Research in a large first-year service course

NASA Astrophysics Data System (ADS)

Ahrensmeier, Daria

2012-10-01

First-year service courses are among the most challenging teaching appointments, due to factors such as lack of motivation, lack of academic preparation, and huge class size. I will describe how the Labatorial Project at the University of Calgary strives to apply results from Physics Education research on inquiry-based learning, addressing misconceptions, peer instruction etc. to the small group sections of these courses. After a brief overview of the design and implementation of the labatorials for a first-year course for engineering students, I will focus on the aspects of change management and sustainability: how one initial change led to a sequence of related modifications, from the lectures to the exams and TA training, accompanied by a natural process of faculty professional development.

Tetrodotoxin Poisoning Due to Pufferfish and Gastropods, and Their Intoxication Mechanism

PubMed Central

Noguchi, Tamao; Onuki, Kazue; Arakawa, Osamu

2011-01-01

Marine pufferfish generally contain a large amount of tetrodotoxin (TTX) in their skin and viscera, and have caused many incidences of food poisoning, especially in Japan. Edible species and body tissues of pufferfish, as well as their allowable fishing areas, are therefore clearly stipulated in Japan, but still 2 to 3 people die every year due to pufferfish poisoning. TTX is originally produced by marine bacteria, and pufferfish are intoxicated through the food chain that starts with the bacteria. Pufferfish become nontoxic when fed TTX-free diets in a closed environment in which there is no possible invasion of TTX-bearing organisms. On the other hand, TTX poisoning due to marine snails has recently spread through Japan, China, Taiwan, and Europe. In addition, TTX poisoning of dogs due to the ingestion of sea slugs was recently reported in New Zealand. TTX in these gastropods also seems to be exogenous; carnivorous large snails are intoxicated by eating toxic starfish, and necrophagous small-to-medium snails, the viscera of dead pufferfish after spawning. Close attention must be paid to the geographic expansion and/or diversification of TTX-bearing organisms, and to the sudden occurrence of other forms of TTX poisoning due to their ingestion. PMID:23724281

Designed for Learning: A Case Study in Rethinking Teaching and Learning for a Large First Year Class

ERIC Educational Resources Information Center

Goldacre, Lisa; Bolt, Susan; Lambiris, Michael

2013-01-01

This paper presents a case study in which the principles of scholarship were applied to designing an approach to learning suitable for large classes. While this case study describes an Australian first year Business Law unit, the findings presented in this paper would be relevant to a wide range of teachers faced with large enrollments in first…

Search for Spectral Irregularities due to Photon-Axionlike-Particle Oscillations with the Fermi Large Area Telescope.

PubMed

Ajello, M; Albert, A; Anderson, B; Baldini, L; Barbiellini, G; Bastieri, D; Bellazzini, R; Bissaldi, E; Blandford, R D; Bloom, E D; Bonino, R; Bottacini, E; Bregeon, J; Bruel, P; Buehler, R; Caliandro, G A; Cameron, R A; Caragiulo, M; Caraveo, P A; Cecchi, C; Chekhtman, A; Ciprini, S; Cohen-Tanugi, J; Conrad, J; Costanza, F; D'Ammando, F; de Angelis, A; de Palma, F; Desiante, R; Di Mauro, M; Di Venere, L; Domínguez, A; Drell, P S; Favuzzi, C; Focke, W B; Franckowiak, A; Fukazawa, Y; Funk, S; Fusco, P; Gargano, F; Gasparrini, D; Giglietto, N; Glanzman, T; Godfrey, G; Guiriec, S; Horan, D; Jóhannesson, G; Katsuragawa, M; Kensei, S; Kuss, M; Larsson, S; Latronico, L; Li, J; Li, L; Longo, F; Loparco, F; Lubrano, P; Madejski, G M; Maldera, S; Manfreda, A; Mayer, M; Mazziotta, M N; Meyer, M; Michelson, P F; Mirabal, N; Mizuno, T; Monzani, M E; Morselli, A; Moskalenko, I V; Murgia, S; Negro, M; Nuss, E; Okada, C; Orlando, E; Ormes, J F; Paneque, D; Perkins, J S; Pesce-Rollins, M; Piron, F; Pivato, G; Porter, T A; Rainò, S; Rando, R; Razzano, M; Reimer, A; Sánchez-Conde, M; Sgrò, C; Simone, D; Siskind, E J; Spada, F; Spandre, G; Spinelli, P; Takahashi, H; Thayer, J B; Torres, D F; Tosti, G; Troja, E; Uchiyama, Y; Wood, K S; Wood, M; Zaharijas, G; Zimmer, S

2016-04-22

We report on the search for spectral irregularities induced by oscillations between photons and axionlike-particles (ALPs) in the γ-ray spectrum of NGC 1275, the central galaxy of the Perseus cluster. Using 6 years of Fermi Large Area Telescope data, we find no evidence for ALPs and exclude couplings above 5×10^{-12}  GeV^{-1} for ALP masses 0.5≲m_{a}≲5  neV at 95% confidence. The limits are competitive with the sensitivity of planned laboratory experiments, and, together with other bounds, strongly constrain the possibility that ALPs can reduce the γ-ray opacity of the Universe.

An Example of Large-Group Drama and Cross-Year Peer Assessment for Teaching Science in Higher Education

ERIC Educational Resources Information Center

Sloman, Katherine; Thompson, Richard

2010-01-01

Undergraduate students pursuing a three-year marine biology degree programme (n = 86) experienced a large-group drama aimed at allowing them to explore how scientific research is funded and the associated links between science and society. In the drama, Year 1 students played the "general public" who decided which environmental research…

Sheet flow and suspended sediment due to wave groups in a large wave flume

USGS Publications Warehouse

Dohmen-Janssen, C. M.; Hanes, D.M.

2005-01-01

A series of sand bed experiments was carried out in the Large Wave Flume in Hannover, Germany as a component of the SISTEX99 experiment. The experiments focussed on the dynamic sediment response due to wave group forcing over a flat sand bed in order to improve understanding of cross-shore sediment transport mechanisms and determine sediment concentrations, fluxes and net transport rates under these conditions. Sediment concentrations were measured within the sheet flow layer (thickness in the order of 10 grain diameters) and in the suspension region (thickness in the order of centimetres). Within the sheet flow layer, the concentrations are highly coherent with the instantaneous near-bed velocities due to each wave within the wave group. However, in the suspension layer concentrations respond much more slowly to changes in near-bed velocity. At several centimetres above the bed, the suspended sediment concentrations vary on the time scale of the wave group, with a time delay relative to the peak wave within the wave group. The thickness of the sheet flow changes with time. It is strongly coherent with the wave forcing, and is not influenced by the history or sequence of the waves within the group. The velocity of the sediment was also measured within the sheet flow layer some of the time (during the larger wave crests of the group), and the velocity of the fluid was measured at several cm above the sheet flow layer. The grain velocity and concentration estimates can be combined to estimate the sediment flux. The estimates were found to be consistent with previous measurements under monochromatic waves. Under these conditions, without any significant mean current, the sediment flux within the sheet flow layer was found to greatly exceed the sediment flux in the suspension layer. As a result, net transport rates under wave groups are similar to those under monochromatic waves. ?? 2004 Elsevier Ltd. All rights reserved.

Injury due to leg bands in willow flycatchers

USGS Publications Warehouse

Sedgwick, J.A.; Klus, R.J.

1997-01-01

We report an apparently unusually high incidence of leg injury in Willow Flycatchers (Empidonax traillii) as a result of banding and color banding. Color bands and U.S. Fish and Wildlife Service (USFWS) bands applied to Willow Flycatchers from 1988-1995 resulted in an overall leg injury rate of 9.6% to birds returning to our study areas in subsequent years. Most injuries occurred on legs with only color band(s) (58.3%) or on legs with both a USFWS band and a color band (35%); only 6.7% of injuries (4/60) were due to USFWS bands alone, yielding an overall USFWS band injury rate of only 0.6%. Injuries ranged from severe (swollen, bleeding legs; a missing foot) to relatively minor (irritations on the tarsus). Amputation of the foot occurred in 33.9% of the cases. Return rates of adult injured birds in the year(s) following injury were significantly lower than for the population at large.

Drivers and implications of recent large fire years in boreal North America

NASA Astrophysics Data System (ADS)

Veraverbeke, S.; Rogers, B. M.; Goulden, M.; Jandt, R.; Miller, C. E.; Wiggins, E. B.; Randerson, J. T.

2016-12-01

High latitude ecosystems are rapidly transforming because of climate change. Boreal North America recently experienced two exceptionally large fire years: 2014 in the Northwest Territories, Canada, and 2015 in Alaska, USA. We used geospatial climate, lightning, fire, and vegetation datasets to assess the mechanisms contributing to these recent extreme years and to the causes of recent decadal-scale changes in fire dynamics. We found that the two events had a record number of lightning ignitions and unusually high levels of burning near the boreal treeline, contributing to emissions of 164 ± 32 Tg C in the Northwest Territories and 65 ± 13 Tg C in Interior Alaska. The annual number ignitions in both regions displayed a significant increasing trend since 1975, driven by an increase in lightning ignitions. We found that vapor pressure deficit (VPD) in June, lightning, and ignition events were significantly correlated on interannual timescales. Future climate-driven increases in VPD and lightning near the treeline ecotone may enable northward forest expansion within tundra ecosystems.

High Revision Rate for Large-head Metal-on-metal THA at a Mean of 7.1 Years: A Registry Study.

PubMed

Seppänen, Matti; Laaksonen, Inari; Pulkkinen, Pekka; Eskelinen, Antti; Puhto, Ari-Pekka; Kettunen, Jukka; Leskinen, Jarkko; Manninen, Mikko; Mäkelä, Keijo

2018-06-01

Large-diameter head metal-on-metal (MoM) THA has largely been abandoned as a result of higher than anticipated revision rates. However, the majority of these implants are still in situ. Although earlier reports from the Finnish Arthroplasty Register noted similar short-term survivorship between large-diameter head MoM THA and conventional cemented THA, longer term survivorship of this population is unclear. Although reported revision rates for this implant group have been high, the majority of these implants have not been revised and followup is important to improve long-term management. The purposes of this study were (1) to compare the 10-year competing risk survivorship of large-diameter head MoM THA with the survivorship of conventional THA in the Finnish Arthroplasty Register; (2) to report the large-diameter head MoM THA survival at the manufacturer/brand level; and (3) to identify the most common reasons for revision of large-diameter head MoM THA in the Finnish Arthroplasty Register. The six most commonly used large-diameter head (≥ 38 mm) MoM THA devices in Finland between years 2004 and 2013 were selected (n = 10,959 implants). The completeness of the Finnish Registry is > 95% in primary THA and patients are censored from the date of death or at the point of emigration; followup continued until the end of 2015. The conventional THA control group consisted of the two most frequently used devices (Vision/Bimetric and ABG II/ABG II) with metal-on-polyethylene or ceramic-on-ceramic bearing surfaces implanted between 2002 and 2013 (n = 5177). The study group was formed by selecting all pairs of large-diameter head MoM and reference THA protheses within the same age group ( < 49, 50-54, 55-59, 60-64, 65-69, 70-74, and 75+ years), sex, diagnosis (osteoarthritis, other), and hospital yearly operation count (< 100 operations yearly, ≥ 100 operations yearly); 5166 matched pairs were identified. Revision for any reason was considered as the failure endpoint of

Search for Spectral Irregularities due to Photon–Axionlike-Particle Oscillations with the Fermi Large Area Telescope

DOE PAGES

Ajello, M.; Albert, A.; Anderson, B.; ...

2016-04-20

In this paper, we report on the search for spectral irregularities induced by oscillations between photons and axionlike-particles (ALPs) in the γ-ray spectrum of NGC 1275, the central galaxy of the Perseus cluster. Using 6 years of Fermi Large Area Telescope data, we find no evidence for ALPs and exclude couplings above 5 x 10 -12 GeV -1 for ALP masses 0.5 ≲ m a ≲ 5 neV at 95% confidence. Finally, the limits are competitive with the sensitivity of planned laboratory experiments, and, together with other bounds, strongly constrain the possibility that ALPs can reduce the γ-ray opacity ofmore » the Universe.« less

Search for Spectral Irregularities due to Photon-Axionlike-Particle Oscillations with the Fermi Large Area Telescope

NASA Technical Reports Server (NTRS)

Ajello, M.; Albert, A.; Anderson, B.; Baldini, L.; Barbiellini, G.; Bastieri, D.; Bellazzini, R.; Bissaldi, E.; Blandford, R.D.; Mirabal, N.;

[Epidemiology and risk factors in injuries due to fall in infants under one year-old].

PubMed

Jiménez de Domingo, Ana; Rubio García, Elena; Marañon Pardillo, Rafael; Arias Constanti, Vanessa; Frontado Haiek, Luis Alberto; Soriano Arola, Marta; Ripoll Oliveras, Francesc; Remón García, Cristina; Estopiña Ferrer, Gloria; Lorente Romero, Jorge

2017-06-01

To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. The most serious injuries occur in children <3 months and from a height of >50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Testing and Evaluation of Large Stone Mixes Using Marshall Mix Design Procedures

DOT National Transportation Integrated Search

1989-11-01

Premature rutting of heavy duty asphalt pavements has been increasingly experienced in recent years primarily due to high pressure truck tires and increased wheel loads. Many asphalt technologists believe that the use of large size stone (maximum siz...

Prestroke physical activity is associated with good functional outcome and arterial recanalization after stroke due to a large vessel occlusion.

PubMed

Ricciardi, Ana Clara; López-Cancio, Elena; Pérez de la Ossa, Natalia; Sobrino, Tomás; Hernández-Pérez, María; Gomis, Meritxell; Munuera, Josep; Muñoz, Lucía; Dorado, Laura; Millán, Mónica; Dávalos, Antonio; Arenillas, Juan F

2014-01-01

Although multiple studies and meta-analyses have consistently suggested that regular physical activity (PhA) is associated with a decreased stroke risk and recurrence, there is limited data on the possible preconditioning effect of prestroke PhA on stroke severity and prognosis. We aimed to study the association of prestroke PhA with different outcome variables in patients with acute ischemic stroke due to an anterior large vessel occlusion. The Prestroke Physical Activity and Functional Recovery in Patients with Ischemic Stroke and Arterial Occlusion trial is an observational and longitudinal study that included consecutive patients with acute ischemic stroke admitted to a single tertiary stroke center. Main inclusion criteria were: anterior circulation ischemic stroke within 12 h from symptom onset; presence of a confirmed anterior large vessel occlusion, and functional independence previous to stroke. Prestroke PhA was evaluated with the International Physical Activity Questionnaire and categorized into mild, moderate and high levels by means of metabolic equivalent (MET) minutes per week thresholds. The primary outcome measure was good functional outcome at 3 months (modified Rankin scale ≤2). Secondary outcomes were severity of stroke at admission, complete early recanalization, early dramatic neurological improvement and final infarct volume. During the study period, 159 patients fulfilled the above criteria. The mean age was 68 years, 62% were men and the baseline NIHSS score was 17. Patients with high levels of prestroke PhA were younger, had more frequently distal occlusions and had lower levels of blood glucose and fibrinogen at admission. After multivariate analysis, a high level of prestroke PhA was associated with a good functional outcome at 3 months. Regarding secondary outcome variables and after adjustment for relevant factors, a high level of prestroke PhA was independently associated with milder stroke severity at admission, early dramatic

Large uncertainty in permafrost carbon stocks due to hillslope soil deposits

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

Shelef, Eitan; Rowland, Joel C.; Wilson, Cathy J.

Here, northern circumpolar permafrost soils contain more than a third of the global Soil Organic Carbon pool (SOC). The sensitivity of this carbon pool to a changing climate is a primary source of uncertainty in simulationbased climate projections. These projections, however, do not account for the accumulation of soil deposits at the base of hillslopes (hill-toes), and the influence of this accumulation on the distribution, sequestration, and decomposition of SOC in landscapes affected by permafrost. Here we combine topographic models with soil-profile data and topographic analysis to evaluate the quantity and uncertainty of SOC mass stored in perennially frozen hill-toemore » soil deposits. We show that in Alaska this SOC mass introduces an uncertainty that is > 200% than state-wide estimates of SOC stocks (77 PgC), and that a similarly large uncertainty may also pertain at a circumpolar scale. Soil sampling and geophysical-imaging efforts that target hill-toe deposits can help constrain this large uncertainty.« less

Large uncertainty in permafrost carbon stocks due to hillslope soil deposits

DOE PAGES

Shelef, Eitan; Rowland, Joel C.; Wilson, Cathy J.; ...

2017-05-31

Here, northern circumpolar permafrost soils contain more than a third of the global Soil Organic Carbon pool (SOC). The sensitivity of this carbon pool to a changing climate is a primary source of uncertainty in simulationbased climate projections. These projections, however, do not account for the accumulation of soil deposits at the base of hillslopes (hill-toes), and the influence of this accumulation on the distribution, sequestration, and decomposition of SOC in landscapes affected by permafrost. Here we combine topographic models with soil-profile data and topographic analysis to evaluate the quantity and uncertainty of SOC mass stored in perennially frozen hill-toemore » soil deposits. We show that in Alaska this SOC mass introduces an uncertainty that is > 200% than state-wide estimates of SOC stocks (77 PgC), and that a similarly large uncertainty may also pertain at a circumpolar scale. Soil sampling and geophysical-imaging efforts that target hill-toe deposits can help constrain this large uncertainty.« less

Technology Supported Facilitation and Assessment of Small Group Collaborative Inquiry Learning in Large First-Year Classes

ERIC Educational Resources Information Center

Lawrie, Gwendolyn A.; Gahan, Lawrence R.; Matthews, Kelly E.; Weaver, Gabriela C.; Bailey, Chantal; Adams, Peter; Kavanagh, Lydia J.; Long, Phillip D.; Taylor, Matthew

2014-01-01

Collaborative learning activities offer the potential to support mutual knowledge construction and shared understanding amongst students. Introducing collaborative tasks into large first-year undergraduate science classes to create learning environments that foster student engagement and enhance communication skills is appealing. However,…

Stewardship of very large digital data archives

NASA Technical Reports Server (NTRS)

Savage, Patric

1991-01-01

An archive is a permanent store. There are relatively few very large digital data archives in existence. Most business records are expired within five or ten years. Many kinds of business records that do have long lives are embedded in data bases that are continually updated and re-issued cyclically. Also, a great deal of permanent business records are actually archived as microfilm, fiche, or optical disk images - their digital version being an operational convenience rather than an archive. The problems forseen in stewarding the very large digital data archives that will accumulate during the mission of the Earth Observing System (EOS) are addressed. It focuses on the function of shepherding archived digital data into an endless future. Stewardship entails storing and protecting the archive and providing meaningful service to the community of users. The steward will (1) provide against loss due to physical phenomena; (2) assure that data is not lost due to storage technology obsolescence; and (3) maintain data in a current formatting methodology.

[An autopsy case of progressive generalized muscle atrophy over 14 years due to post-polio syndrome].

PubMed

Oki, Ryosuke; Uchino, Akiko; Izumi, Yuishin; Ogawa, Hirohisa; Murayama, Shigeo; Kaji, Ryuji

2016-01-01

We report the case of a 72-year-old man who had contracted acute paralytic poliomyelitis in his childhood. Thereafter, he had suffered from paresis involving the left lower limb, with no relapse or progression of the disease. He began noticing slowly progressive muscle weakness and atrophy in the upper and lower extremities in his 60s. At the age of 72, muscle weakness developed rapidly, and he demonstrated dyspnea on exertion and dysphagia. He died after about 14 years from the onset of muscle weakness symptoms. Autopsy findings demonstrated motoneuron loss and glial scars not only in the plaque-like lesions in the anterior horns, which were sequelae of old poliomyelitis, but also throughout the spine. No Bunina bodies, TDP-43, and ubiquitin inclusions were found. Post-polio syndrome is rarely fatal due to rapid progressive dyspnea and dysphagia. Thus, the pathological findings in the patient are considered to be related to the development of muscle weakness.

Giant Appendicular Mucocele Due to Mucinous Cystadenoma.

PubMed

Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Peker, Onur; Cengiz, Emrah; Karaagaç, Mustafa

2016-01-01

Mucocele of the appendix is a rare clinicopathological entity simulating acute appendicitis. The most common form of the mucocele is cystadenoma, which is characterized by luminal dilatation producing large amounts of mucin. We present a new case of a giant mucocele of appendix with mucinous cystadenoma. A 61-year-old female was admitted with complaints of severe lower right quadrant pain. Ultrasonography and computed tomography (CT) suggested that it was a mucocele, but due to severity of pain, she underwent an emergency operation. Fortunately, without a perforation, it was a giant mucocele and the operation was terminated with an uneventful appendectomy with segmental cecal resection. The histopathological evaluation of the specimen reported to be a mucocele with mucinous cystadenoma with negative surgical margins. The patient was discharged postoperative 6th day, and a control colonoscopy and abdominal CT was planned for 6 months following surgery. Appendicular mucocele is rare and difficult to diagnose preoperatively, and sometimes it may be of large size which increases the risk of perforation. Pseudomyxoma peritonei (PP) is the most feared complication of mucocele perforation. Appendectomy with negative margins is a requirement for adequate treatment for most cases. Utmost care should be taken during surgery to avoid perforation of mucocele. Sertkaya M, Emre A, Pircanoglu EM, Peker O, Cengiz E, Karaagaç M. Giant Appendicular Mucocele Due to Mucinous Cystadenoma. Euroasian J Hepato-Gastroenterol 2016;6(2):186-189.

Multiple large infected scrotal sebaceous cysts masking Fournier's gangrene in a 32-year-old man

PubMed Central

Angus, William; Mistry, Rahul; Floyd, Michael S; Machin, Derek G

2012-01-01

Extensive large sebaceous cysts on the scotum are rare and present a problem only when infected or when cosmesis is deemed unacceptable by the patient. Fournier's gangrene is an infective condition with a high death rate. We describe a case of Fournier's gangrene in a patient masked by multiple large infected scrotal sebaceous cysts. A 32-year-old man with a history of alcohol dependency, cirrhosis and multiple scrotal sebaceous cysts presented with acute scrotal pain and erythema. Necrosis of the area became evident within 12 h of his admission and an emergency surgical debridement was performed. The wound was left open to heal via secondary intention over 4 weeks without complication. Fournier's gangrene is a rapidly progressive condition and early surgical debridement is crucial to achieve satisfactory outcomes. In this case, prompt intervention allowed a large scrotal defect to heal without the need for skin grafting. PMID:22669874

Estimating Viscoelastic Deformation Due to Seasonal Loading

NASA Technical Reports Server (NTRS)

Sauber, Jeanne

2015-01-01

Scientists have been making summer-­-time geodetic measurements in south central Alaska for decades to estimate the rate at which a continental-­-ocean terrane is accreting to the North American continent. Southern Alaska has big earthquakes every century and large, rapidly changing glaciers. In the last decade, primarily as part of the EarthScope Plate Boundary Observatory project, continuous GPS measurements have recorded the response of sites such as the near-­-coastal geodetic site, AB35 to competing processes: uplift and movement to the northwest due to tectonic forces and the response of the solid Earth to seasonal and longer-­-term changes in the cryosphere (snow and ice) surrounding the site. Which process causes the largest displacements of the site? Figure 1 (Blewitt, Nevada Geodetic Lab, 2015) shows the Northward, Eastward, and Upward motion of AB35 between 2007 and 2015. The site is moving rapidly to the north and west reflecting the tectonic convergence of site toward interior Alaska but there is small wiggle on the North component reflecting seasonal displacements of the site associated with snow loading and unloading. However, the Up component, shows a large seasonal signal due to snow loading in the winter (down) and ice and snow melting in the warmer months (site goes up). Between 2007 and the present, the site position is slowly moving upward, due to tectonic forcing but probably associated with longer-­- term ice melting as well. We are using the CIG finite element modeling (FEM) program Pylith to estimate the surface displacements and stresses associated with seasonal loading changes (top figure and Figure 2 far right) for water year 2012, 2011.8 - 2012.8) and the longer-­-term retreat of the surrounding glaciers.

Burden of mortality and years of life lost due to ambient PM10 pollution in Wuhan, China.

PubMed

Zhang, Yunquan; Peng, Minjin; Yu, Chuanhua; Zhang, Lan

2017-11-01

Ambient particulate matter (PM) has been mainly linked with mortality and morbidity when assessing PM-associated health effects. Up-to-date epidemiologic evidence is very sparse regarding the relation between PM and years of life lost (YLL). The present study aimed to estimate the burden of YLL and mortality due to ambient PM pollution. Individual records of all registered deaths and daily data on PM 10 and meteorology during 2009-2012 were obtained in Wuhan, central China. Using a time-series study design, we applied generalized additive model to assess the short-term association of 10-μg/m 3 increase in PM 10 with daily YLL and mortality, adjusting for long-term trend and seasonality, mean temperature, relative humidity, public holiday, and day of the week. A linear-no-threshold dose-response association was observed between daily ambient PM 10 and mortality outcomes. PM 10 pollution along lag 0-1 days was found to be mostly strongly associated with mortality and YLL. The effects of PM 10 on cause-specific mortality and YLL showed generally similar seasonal patterns, with stronger associations consistently occurring in winter and/or autumn. Compared with males and younger persons, females and the elderly suffered more significantly from both increased YLL and mortality due to ambient PM 10 pollution. Stratified analyses by education level (0-6 and 7 + years) demonstrated great mortality impact on both subgroups, whereas only low-educated persons were strongly affected by PM 10 -associated burden of YLL. Our study confirmed that short-term PM 10 exposure was linearly associated with significant increases in both mortality incidence and years of life lost. Given the non-threshold adverse effects on mortality burden, the on-going efforts to reduce particulate air pollution would substantially benefit public health in China. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 12784 - Welded Large Diameter Line Pipe From Japan; Scheduling of a Full Five-Year Review Concerning the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... Diameter Line Pipe From Japan; Scheduling of a Full Five-Year Review Concerning the Antidumping Duty Order on Welded Large Diameter Line Pipe From Japan AGENCY: United States International Trade Commission... revocation of the antidumping duty order on welded large diameter line pipe from Japan would be likely to...

Years of potential life lost and productivity costs due to premature cancer-related mortality in Iran.

PubMed

Khorasani, Soheila; Rezaei, Satar; Rashidian, Hamideh; Daroudi, Rajabali

2015-01-01

Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

Large-Scale Wind-Tunnel Tests of Exhaust Ingestion Due to Thrust Reversal on a Four-Engine Jet Transport during Ground Roll

NASA Technical Reports Server (NTRS)

Tolhurst, William H., Jr.; Hickey, David H.; Aoyagi, Kiyoshi

1961-01-01

Wind-tunnel tests have been conducted on a large-scale model of a swept-wing jet transport type airplane to study the factors affecting exhaust gas ingestion into the engine inlets when thrust reversal is used during ground roll. The model was equipped with four small jet engines mounted in nacelles beneath the wing. The tests included studies of both cascade and target type reversers. The data obtained included the free-stream velocity at the occurrence of exhaust gas ingestion in the outboard engine and the increment of drag due to thrust reversal for various modifications of thrust reverser configuration. Motion picture films of smoke flow studies were also obtained to supplement the data. The results show that the free-stream velocity at which ingestion occurred in the outboard engines could be reduced considerably, by simple modifications to the reversers, without reducing the effective drag due to reversed thrust.

Marvelous but Morbid: Infective endocarditis due to Serratia marcescens.

PubMed

Phadke, Varun K; Jacob, Jesse T

2016-05-01

A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens . Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation. Serratia marcescens is an uncommon cause of infective endocarditis. While this disease has historically been associated with intravenous drug use, more recent reports suggest that it is now largely a consequence of opportunistic infections of the chronically ill. Our case highlights several characteristic features of this infection, including isolation of a non-pigmented strain of the organism, an antibiotic susceptibility profile suggestive of AmpC β-lactamase production, and rapid clinical deterioration with multiple embolic complications resulting in death. In this review we discuss the history, epidemiology, and management of endovascular infections due to Serratia spp., emphasizing the continued importance of considering this organism in the differential diagnosis of endocarditis among intravenous drug users and as a potential indication for surgical therapy.

Marvelous but Morbid: Infective endocarditis due to Serratia marcescens

PubMed Central

Phadke, Varun K.; Jacob, Jesse T.

2016-01-01

A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation. Serratia marcescens is an uncommon cause of infective endocarditis. While this disease has historically been associated with intravenous drug use, more recent reports suggest that it is now largely a consequence of opportunistic infections of the chronically ill. Our case highlights several characteristic features of this infection, including isolation of a non-pigmented strain of the organism, an antibiotic susceptibility profile suggestive of AmpC β-lactamase production, and rapid clinical deterioration with multiple embolic complications resulting in death. In this review we discuss the history, epidemiology, and management of endovascular infections due to Serratia spp., emphasizing the continued importance of considering this organism in the differential diagnosis of endocarditis among intravenous drug users and as a potential indication for surgical therapy. PMID:27346925

[Modelling of the costs of productivity losses due to smoking in Germany for the year 2005].

PubMed

Prenzler, A; Mittendorf, T; von der Schulenburg, J M

2007-11-01

The aim of this study was to estimate disease-related productivity costs attributable to smoking in the year 2005 in Germany. The calculation was based on the updated relative smoking-related disease risk found in the US Cancer Prevention Study II combined with data on smoking prevalence for Germany. With this, smoking-attributable cases resulting in premature mortality, invalidity, and temporal disability to work could be estimated. Neoplasms, diseases of the circulatory and the respiratory systems as well as health problems in children younger than one year were considered in the analysis. The human capital approach was applied to calculate years of potential work loss and productivity costs as a result of smoking. Various sensitivity analyses were conducted to test for robustness of the underlying model. Based on the assumptions within the model, 107,389 deaths, 14,112 invalidity cases, and 1.19 million cases of temporary disability to work were found to be due to smoking in 2005 in Germany, respectively. As a result, productivity costs of 9.6 billion were caused by smoking. The model showed that smoking has a high financial effect. Even so, further analyses are necessary to estimate an overall impact of smoking on the German society.

100 years of mortality due to chronic obstructive pulmonary disease in Australia: the role of tobacco consumption.

PubMed

Adair, T; Hoy, D; Dettrick, Z; Lopez, A D

2012-12-01

Global studies of the long-term association between tobacco consumption and chronic obstructive pulmonary disease (COPD) have relied upon descriptions of trends. To statistically analyse the relationship of tobacco consumption with data on mortality due to COPD over the past 100 years in Australia. Tobacco consumption was reconstructed back to 1887. Log-linear Poisson regression models were used to analyse cumulative cohort and lagged time-specific smoking data and its relationship with COPD mortality. Age-standardised COPD mortality, although likely misclassified with other diseases, decreased for males and females from 1907 until the start of the Second World War in contrast to steadily rising tobacco consumption. Thereafter, COPD mortality rose sharply in line with trends in smoking, peaking in the early 1970s for males and over 20 years later for females, before falling again. Regression models revealed both cumulative and time-specific tobacco consumption to be strongly predictive of COPD mortality, with a time lag of 15 years for males and 20 years for females. Sharp falls in COPD mortality before the Second World War were unrelated to tobacco consumption. Smoking was the primary driver of post-War trends, and the success of anti-smoking campaigns has sharply reduced COPD mortality levels.

Large unexplained suite of chemically reactive compounds present in ambient air due to biomass fires.

PubMed

Kumar, V; Chandra, B P; Sinha, V

2018-01-12

Biomass fires impact global atmospheric chemistry. The reactive compounds emitted and formed due to biomass fires drive ozone and organic aerosol formation, affecting both air quality and climate. Direct hydroxyl (OH) Reactivity measurements quantify total gaseous reactive pollutant loadings and comparison with measured compounds yields the fraction of unmeasured compounds. Here, we quantified the magnitude and composition of total OH reactivity in the north-west Indo-Gangetic Plain. More than 120% increase occurred in total OH reactivity (28 s -1 to 64 s -1 ) and from no missing OH reactivity in the normal summertime air, the missing OH reactivity fraction increased to ~40 % in the post-harvest summertime period influenced by large scale biomass fires highlighting presence of unmeasured compounds. Increased missing OH reactivity between the two summertime periods was associated with increased concentrations of compounds with strong photochemical source such as acetaldehyde, acetone, hydroxyacetone, nitromethane, amides, isocyanic acid and primary emissions of acetonitrile and aromatic compounds. Currently even the most detailed state-of-the art atmospheric chemistry models exclude formamide, acetamide, nitromethane and isocyanic acid and their highly reactive precursor alkylamines (e.g. methylamine, ethylamine, dimethylamine, trimethylamine). For improved understanding of atmospheric chemistry-air quality-climate feedbacks in biomass-fire impacted atmospheric environments, future studies should include these compounds.

School absence due to toothache associated with sociodemographic factors, dental caries status, and oral health-related quality of life in 12- and 15-year-old Thai children.

PubMed

Krisdapong, Sudaduang; Prasertsom, Piyada; Rattanarangsima, Khanit; Sheiham, Aubrey

2013-01-01

The objective of this study is to assess prevalence and extent of school absence due to toothache, dental caries, and Oral Health-Related Quality of Life (OHRQoL) in a subsample of the Thailand national oral health survey. In addition, associations of school absence as the outcome variable with explanatory behavioral and sociodemographic variables, dental caries, and OHRQoL were investigated. Study sample was half of the Sixth Thailand National Oral Health Survey sample (1,063 12-year-old and 811 15-year-old children). Children were orally examined and interviewed about OHRQoL using the Child Oral Impacts on Daily Performances or the Oral Impacts on Daily Performances indices. Children completed a sociodemographic and behavioral questionnaire on school absence due to toothache in current semester. Over a 3-month period, 5.1 percent of 12- and 4.4 percent of 15-year-olds absented themselves from school due to toothache. The number of days absent in 12-year-olds was significantly higher than in 15-year-olds. For 12-year-olds, OHRQoL and toothache were significantly associated with school absence. Severe dental decay was the main dental factor related to school absence but not significantly associated with school absence in the adjusted analyses. Children in lower school grades and those who received dental treatment in current semester were more likely to miss school compared with their counterparts. About one in 20 of Thai school-aged children reported missing school due to toothache. School absence due to toothache was inversely associated with the current year of study and positively with recently receiving dental treatment and with OHRQoL and toothache in 12-year-olds. © 2013 American Association of Public Health Dentistry.

Outpatient commitment and procedural due process.

PubMed

Player, Candice Teri-Lowe

2015-01-01

A large empirical literature on Kendra's Law has assessed the impact of court ordered outpatient treatment on outcomes such as treatment adherence, psychiatric hospitalization, quality of life, and treatment costs. Missing from the empirical literature, however, is a better understanding of procedural due process under Kendra's Law. Procedural due process concerns the safeguards that must be in place when governments deprive persons of their liberties, for example--notice, the right to a hearing and the right to appeal. This article reports the findings from a qualitative study of procedural due process and assisted outpatient treatment hearings under Kendra's Law. Attorneys reported significant barriers to effective advocacy on behalf of their clients. Further, despite the shift from a medical model of civil commitment to a judicial model in the 1970s, by and large judges continue to accord great deference to clinical testimony. Copyright © 2015. Published by Elsevier Ltd.

Large mitochondrial DNA deletion in an infant with addison disease.

PubMed

Duran, Gloria P; Martinez-Aguayo, A; Poggi, H; Lagos, M; Gutierrez, D; Harris, P R

2012-01-01

Mitochondrial diseases are a group of disorders caused by mutations in nuclear DNA or mitochondrial DNA, usually involving multiple organ systems. Primary adrenal insufficiency due to mitochondrial disease is extremely infrequent and has been reported in association with mitochondrial DNA deletion syndromes such as Kearns-Sayre syndrome. To report a 3-year-old boy with Addison disease, congenital glaucoma, chronic pancreatitis, and mitochondrial myopathy due to large mitochondrial DNA deletion. Molecular analysis of mitochondrial DNA samples obtained from peripheral blood, oral mucosa, and muscle tissue. A novel large mitochondrial DNA deletion of 7,372bp was identified involving almost all genes on the big arch of mtDNA. This case reaffirms the association of adrenal insufficiency and mitochondrial DNA deletions and presents new evidence that glaucoma is another manifestation of mitochondrial diseases. Due to the genetic and clinical heterogeneity of mitochondrial disorders, molecular analysis is crucial to confirm diagnosis and to allow accurate genetic counseling.

[Analysis of disability due to ocular complications of diabetes in Tashkent over a ten-year period].

PubMed

Dzhamalova, Sh A; Iskandarova, Sh T; Nabiev, A M

2016-01-01

to study peculiarities of primary and recurrent disability due to ocular complications of diabetes in Tashkent over the years 2003-2012 and to assess the impact of risk factors on the effectiveness of laser photocoagulation of the retina. A total of 347 disability examination reports of diabetic patients with ocular complications were copied and 48 case histories of patients with type II diabetes who underwent laser photocoagulation of the retina - retrospectively analyzed. Stabilization of visual function was used as the effectiveness criterion. The rate of new cases of disability over the studied decade averaged 0.55 per 100,000 population per year, while that of recurrent disability was 1.8 times higher - 0.97. The overall rate of disability was not high - 1.53; at that, severe disability (i.e. grade I and II) prevailed. Both recurrent and primary disability groups were made up by middle-aged patients and those in their retirement age; however, in the recurrent disability group the number of young disabled people was 4.5 times higher than in the primary disability group. Studies of the effectiveness of laser photocoagulation of the retina in relation to the compensation of diabetes and blood pressure level showed that unstable general condition was associated with not only significant deterioration of visual function, but also complications, including severe. The rate of disability due to ocular complications of diabetes is generally not high, however, grades I and II disabilities that require greater social support has been found to prevail in both groups. Most of disabled people are middle-aged (working-age population), which also causes economic damage. In cases of decompensated diabetes and unstable blood pressure, the effectiveness of laser photocoagulation of the retina is reduced.

Burden of disease due to cancer in Spain

PubMed Central

Fernández de Larrea-Baz, Nerea; Álvarez-Martín, Elena; Morant-Ginestar, Consuelo; Gènova-Maleras, Ricard; Gil, Ángel; Pérez-Gómez, Beatriz; López-Abente, Gonzalo

2009-01-01

Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs). Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models), duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function) and disability (weights published in the literature) for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population), 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs) predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability. PMID:19183440

Embolization of a large, symptomatic splenic artery pseudoaneurysm

PubMed Central

Kukliński, Adam; Batycki, Krzysztof; Matuszewski, Wiesław; Ostrach, Andrzej; Kupis, Zbigniew; Łęgowik, Tomasz

2014-01-01

Summary Background Splenic artery aneurysm is the third most common abdominal aneurysm. Most often it is due to pancreatitis. There were only 19 cases of aneurysms larger than 5 cm in diameter described in the literature. Management of splenic artery aneurysms depends on the size and symptoms. Invasive treatment modalities involve open procedures and interventional radiology methods (endovascular). Case Reports A 44-years-old male with chronic pancreatitis, in a gradually worsening general condition due to a large splenic artery aneurysm, was subjected to the procedure. Blood flow through the aneurysm was cut-off by implanting a covered stent between celiac trunk and common hepatic artery. Patient’s general condition rapidly improved, allowing discharge home in good state soon after the procedure. Conclusions Percutaneous embolization appears to be the best method of treatment of large splenic artery aneurysms. Complications of such treatment are significantly less dangerous than those associated with surgery. PMID:25009678

Large bowel resection

MedlinePlus

... blockage in the intestine due to scar tissue Colon cancer Diverticular disease (disease of the large bowel) Other reasons for bowel resection are: Familial polyposis (polyps are growths on the lining of the colon or rectum) Injuries that damage the large bowel ...

Online Lecture Recordings and Lecture Attendance: Investigating Student Preferences in a Large First Year Psychology Course

ERIC Educational Resources Information Center

Yeung, Alexandra; Raju, Sadhana; Sharma, Manjula D.

2016-01-01

While blended learning has been around for some time, the interplay between lecture recordings, lecture attendance and grades needs further examination particularly for large cohorts of over 1,000 students in 500 seat lecture theatres. This paper reports on such an investigation with a cohort of 1,450 first year psychology students' who indicated…

Irreversible climate change due to carbon dioxide emissions.

PubMed

Solomon, Susan; Plattner, Gian-Kasper; Knutti, Reto; Friedlingstein, Pierre

2009-02-10

The severity of damaging human-induced climate change depends not only on the magnitude of the change but also on the potential for irreversibility. This paper shows that the climate change that takes place due to increases in carbon dioxide concentration is largely irreversible for 1,000 years after emissions stop. Following cessation of emissions, removal of atmospheric carbon dioxide decreases radiative forcing, but is largely compensated by slower loss of heat to the ocean, so that atmospheric temperatures do not drop significantly for at least 1,000 years. Among illustrative irreversible impacts that should be expected if atmospheric carbon dioxide concentrations increase from current levels near 385 parts per million by volume (ppmv) to a peak of 450-600 ppmv over the coming century are irreversible dry-season rainfall reductions in several regions comparable to those of the "dust bowl" era and inexorable sea level rise. Thermal expansion of the warming ocean provides a conservative lower limit to irreversible global average sea level rise of at least 0.4-1.0 m if 21st century CO(2) concentrations exceed 600 ppmv and 0.6-1.9 m for peak CO(2) concentrations exceeding approximately 1,000 ppmv. Additional contributions from glaciers and ice sheet contributions to future sea level rise are uncertain but may equal or exceed several meters over the next millennium or longer.

Cutting Balloon Angioplasty of Bilateral Renal Artery Stenosis Due to Takayasu Arteritis in a 5-Year-Old Child with Midterm Follow-Up

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

Gumus, Burcak, E-mail: burcakgumus73@yahoo.com; Cevik, Halime; Vuran, Can

The aim of this report is to demonstrate the successful endovascular treatment of bilateral renal artery stenosis due to Takayasu arteritis by cutting balloon angioplasty in a 5-year-old child with mid-term follow-up.

A Nationwide Survey of Judicial Systems in Large Institutions of Higher Education

ERIC Educational Resources Information Center

Ostroth, D. David; And Others

1978-01-01

Recent developments in student judicial (disciplinary) systems were surveyed at large institutions of higher education. The past five years have seen more standardization of procedural due process and some growth in judicial structures. The dean of students office, instead of student judicial committee(s), still conducts the majority of…

Latin American Clinical Epidemiology Network Series - Paper 5: Years of life lost due to premature death in traffic accidents in Bogota, Colombia.

PubMed

Quitian-Reyes, Hoover; Gómez-Restrepo, Carlos; Gómez, Maria Juliana; Naranjo, Salome; Heredia, Patricia; Villegas, John

2017-06-01

This study aimed to quantify the number of years of life lost in traffic accidents in Bogota, Colombia. The years of life lost were calculated using the 'age-standardized expected years of life lost' method, the table of Japanese adjusted life expectancy and the database of the Institute of Legal Medicine and Forensic Science between September 2012 and August 2013. During a period of 1 year, 430 people died and 10,056.3 years of life were lost in Bogota due to traffic accidents. The mortality burden of traffic accidents in Bogota is high. Further studies are required in order to characterize the accidents and develop effective policy decisions. Copyright © 2016 Elsevier Inc. All rights reserved.

Persistent smoking as a predictor of disability pension due to musculoskeletal diagnoses: a 23 year prospective study of Finnish twins.

PubMed

Ropponen, Annina; Korhonen, Tellervo; Svedberg, Pia; Koskenvuo, Markku; Silventoinen, Karri; Kaprio, Jaakko

2013-12-01

To investigate whether stability or changes in smoking predict disability pension (DP) due to low back diagnoses (LBD) and musculoskeletal diagnoses (MSD) after taking familial confounding into account using a co-twin design. Longitudinal smoking patterns and multiple covariates in a population-based cohort of 17,451 Finnish twins (6959 complete pairs) born before 1958 were surveyed through questionnaires in 1975 and 1981. The outcome data were collected from the national pension registers until the end of 2004. Cox proportional hazards regression models were used for statistical analyses. Disability pension due to low back diagnoses was granted to 408 individuals and disability pension due to musculoskeletal diagnoses to 1177 individuals during the follow-up of 23 years. Being a persistent smoker (current smoker both 1975 and 1981) predicted a significantly increased risk for disability pension (hazard ratio 1.69, 95% confidence interval 1.46, 1.97) compared to those individuals who had never smoked. The association remained when several confounding factors, including familial factors, were taken into account. Persistent smoking predicts early disability pension due to musculoskeletal diagnoses and low back diagnoses independently from numerous confounding factors, including familial effects shared by the co-twins. © 2013.

Diabetes insipidus due to herpes encephalitis in a patient with diffuse large cell lymphoma. A case report.

PubMed

Scheinpflug, K; Schalk, E; Reschke, K; Franke, A; Mohren, M

2006-01-01

The major causes of central diabetes insipidus are neoplastic or infiltrative lesions of the hypothalamus or pituitary, severe head injuries and pituitary or hypothalamic surgery. Central diabetes insipidus caused by viral infections has been rarely reported in immunosuppressed patients, such as those with acquired immunodeficiency syndrome or Cushing's syndrome. We report the case of a 48-year-old woman suffering from diffuse large cell lymphoma, who developed hypotonic polyuria, hypernatriaemia and somnolence after the first course of chemotherapy with CHOEP and rituximab. Diabetes insipidus was diagnosed by low urine osmolarity and an undetectable vasopressin concentration. MRI revealed no pituitary abnormalities but encephalitis, and lumbar punction confirmed herpes zoster infection. To the best of our knowledge this is the first description of central diabetes insipidus in a lymphoma patient caused by an opportunistic CNS-infection.

[Serious product accidents due to the chemical substances used in household products in fiscal years 2007 and 2008].

PubMed

Isama, Kazuo

2009-01-01

The revised consumer product safety law was enforced in 2007. Then, the collection and publication system of the information of product accidents was newly included. Serious product accidents due to the chemical substances used in household products had 32 cases in fiscal years 2007 and 2008. These household products were a desk mat, a sectional bed, a spray-type adhesive, a paint and an adhesive for table tennis rackets. The safety measure of the household product was explained based on the law for the control of household products containing harmful substances.

A "La Niña-like" state occurring in the second year after large tropical volcanic eruptions during the past 1500 years

NASA Astrophysics Data System (ADS)

Sun, Weiyi; Liu, Jian; Wang, Bin; Chen, Deliang; Liu, Fei; Wang, Zhiyuan; Ning, Liang; Chen, Mingcheng

2018-04-01

Using an ensemble of nine El Niño/Southern Oscillation (ENSO) reconstructed proxies and volcano eruption proxies for the past 1500 years, this study shows that a significant La Niña state emerges in the second year (year (2) hereafter) after large tropical volcanic eruptions. The reasons for the development of La Niña are investigated using the Community Earth System Model (CESM). In the volcanic eruption experiment (Vol), a robust La Niña signal occurs in year (2), resembling the proxy records. The eastward positioning of the western North Pacific anomalous anticyclone (WNPAC) in Vol plays a critical role in the advanced decay of year (2) warming and the strong intensification of cooling in the equatorial eastern Pacific. The enhanced easterlies located on the southern edge of the WNPAC can stimulate consecutive oceanic upwelling Kelvin waves, shallowing the thermocline in the eastern Pacific, thereby resulting in a greater cooling rate by the enhanced thermocline feedback and cold zonal advection. Over the equatorial eastern Pacific, the reduced shortwave radiation contributes to the advanced decay of warming, while the upward latent heat flux augments the strong intensification of the cooling. Essentially, the eastward positioning of the WNPAC is a result of the volcanic forcing. The volcanic effect cools the maritime continent more than its adjacent oceans, thus pushing convective anomalies eastward during year (1). This induces vertical thermal advection and upward surface latent heat flux, thereby suppressing the development of warm Sea Surface Temperature over the central-western Pacific and causing the eastward positioning of the WNPAC in Vol.

Risk to life due to flooding in post-Katrina New Orleans

NASA Astrophysics Data System (ADS)

Miller, A.; Jonkman, S. N.; Van Ledden, M.

2014-01-01

After the catastrophic flooding of New Orleans due to hurricane Katrina in the year 2005, the city's hurricane protection system has been improved to provide protection against a hurricane load with a 1/100 per year exceedance frequency. This paper investigates the risk to life in post-Katrina New Orleans. In a risk-based approach the probabilities and consequences of various flood scenarios have been analyzed for the central area of the city (the metro bowl) to give a preliminary estimate of the risk to life in the post-Katrina situation. A two-dimensional hydrodynamic model has been used to simulate flood characteristics of various breaches. The model for estimation of fatality rates is based on the loss of life data for Hurricane Katrina. Results indicate that - depending on the flood scenario - the estimated loss of life in case of flooding ranges from about 100 to nearly 500, with the highest life loss due to breaching of the river levees leading to large flood depths. The probability and consequence estimates are combined to determine the individual risk and societal risk for New Orleans. When compared to risks of other large scale engineering systems (e.g. other flood prone areas, dams and the nuclear sector) and acceptable risk criteria found in literature, the risks for the metro bowl are found to be relatively high. Thus, despite major improvements to the flood protection system, the flood risk of post-Katrina New Orleans is still expected to be significant. Effects of reduction strategies on the risk level are discussed as a basis for further evaluation.

[Dehydration due to "mouth broken"].

PubMed

Meijler, D P M; van Mossevelde, P W J; van Beek, R H T

2012-09-01

Two children were admitted to a medical centre due to dehydration after an oral injury and the extraction of a tooth. One child complained of "mouth broken". Dehydration is the most common water-electrolyte imbalance in children. Babies and young children are prone to dehydration due to their relatively large body surface area, the high percentage extracellular fluid, and the limited ability of the kidneys to conserve water. After the removal ofa tooth, after an oral trauma or in case of oral discomfort, a child is at greater risk of dehydration by reduced fluid and food intake due to oral pain and/or discomfort and anxiety to drink. In those cases, extra attention needs to be devoted to the intake of fluids.

Fat embolism due to bilateral femoral fracture: a case report.

PubMed

Porpodis, Konstantinos; Karanikas, Michael; Zarogoulidis, Paul; Konoglou, Maria; Domvri, Kalliopi; Mitrakas, Alexandros; Boglou, Panagiotis; Bakali, Stamatia; Iordanidis, Alkis; Zervas, Vasilis; Courcoutsakis, Nikolaos; Katsikogiannis, Nikolaos; Zarogoulidis, Konstantinos

2012-01-01

Fat embolism syndrome is usually associated with surgery for large bone fractures. Symptoms usually occur within 36 hours of hospitalization after traumatic injury. We present a case with fat embolism syndrome due to femur fracture. Prompt supportive treatment of the patient's respiratory system and additional pharmaceutical treatment provided the positive clinical outcome. There is no specific therapy for fat embolism syndrome; prevention, early diagnosis, and adequate symptomatic treatment are very important. Most of the studies in the last 20 years have shown that the incidence of fat embolism syndrome is reduced by early stabilization of the fractures and the risk is even further decreased with surgical correction rather than conservative management.

Soil carbon sequestration due to post-Soviet cropland abandonment: estimates from a large-scale soil organic carbon field inventory.

PubMed

Wertebach, Tim-Martin; Hölzel, Norbert; Kämpf, Immo; Yurtaev, Andrey; Tupitsin, Sergey; Kiehl, Kathrin; Kamp, Johannes; Kleinebecker, Till

2017-09-01

The break-up of the Soviet Union in 1991 triggered cropland abandonment on a continental scale, which in turn led to carbon accumulation on abandoned land across Eurasia. Previous studies have estimated carbon accumulation rates across Russia based on large-scale modelling. Studies that assess carbon sequestration on abandoned land based on robust field sampling are rare. We investigated soil organic carbon (SOC) stocks using a randomized sampling design along a climatic gradient from forest steppe to Sub-Taiga in Western Siberia (Tyumen Province). In total, SOC contents were sampled on 470 plots across different soil and land-use types. The effect of land use on changes in SOC stock was evaluated, and carbon sequestration rates were calculated for different age stages of abandoned cropland. While land-use type had an effect on carbon accumulation in the topsoil (0-5 cm), no independent land-use effects were found for deeper SOC stocks. Topsoil carbon stocks of grasslands and forests were significantly higher than those of soils managed for crops and under abandoned cropland. SOC increased significantly with time since abandonment. The average carbon sequestration rate for soils of abandoned cropland was 0.66 Mg C ha -1  yr -1 (1-20 years old, 0-5 cm soil depth), which is at the lower end of published estimates for Russia and Siberia. There was a tendency towards SOC saturation on abandoned land as sequestration rates were much higher for recently abandoned (1-10 years old, 1.04 Mg C ha -1  yr -1 ) compared to earlier abandoned crop fields (11-20 years old, 0.26 Mg C ha -1  yr -1 ). Our study confirms the global significance of abandoned cropland in Russia for carbon sequestration. Our findings also suggest that robust regional surveys based on a large number of samples advance model-based continent-wide SOC prediction. © 2017 John Wiley & Sons Ltd.

Occupational factors associated with the potential years of working life lost due to a non-work related permanent disability.

PubMed

Duran, Xavier; Martínez, José Miguel; Benavides, Fernando G

2013-01-01

To analyze the association between occupational factors (number of contracts and occupational category) and potential years of working life lost (PYWLL) due to non-work related permanent disability (PD). The study design was a retrospective cohort of 11,812 workers affiliated with the Social Security System in Spain that began a non-work related PD between 2004 and 2009. The PYWLL was defined as the time in years between the age at which a worker initiates a PD and age 65 or the age of reinstatement to a job. The PYWLL was analyzed by calculating the quartiles and using an approach based on a median regression. The difference in medians of PYWLL between men and women was 2.49 years (95% CI: 2.01-2.97); between skilled non-manual and unskilled manual workers was 1.88 years (95% CI: 1.08-2.69); between workers with three or more contracts and workers with a single contract in the period was 3.78 years (95% CI: 3.28-4.29). Women, non-skilled workers and employees that have had more contracts within the period of study are those with greatest loss of PYWLL. This suggests that individuals with poorer working and employment conditions could have more PYWLL.

Evolution of precipitation extremes in two large ensembles of climate simulations

NASA Astrophysics Data System (ADS)

Martel, Jean-Luc; Mailhot, Alain; Talbot, Guillaume; Brissette, François; Ludwig, Ralf; Frigon, Anne; Leduc, Martin; Turcotte, Richard

2017-04-01

Recent studies project significant changes in the future distribution of precipitation extremes due to global warming. It is likely that extreme precipitation intensity will increase in a future climate and that extreme events will be more frequent. In this work, annual maxima daily precipitation series from the Canadian Earth System Model (CanESM2) 50-member large ensemble (spatial resolution of 2.8°x2.8°) and the Community Earth System Model (CESM1) 40-member large ensemble (spatial resolution of 1°x1°) are used to investigate extreme precipitation over the historical (1980-2010) and future (2070-2100) periods. The use of these ensembles results in respectively 1 500 (30 years x 50 members) and 1200 (30 years x 40 members) simulated years over both the historical and future periods. These large datasets allow the computation of empirical daily extreme precipitation quantiles for large return periods. Using the CanESM2 and CESM1 large ensembles, extreme daily precipitation with return periods ranging from 2 to 100 years are computed in historical and future periods to assess the impact of climate change. Results indicate that daily precipitation extremes generally increase in the future over most land grid points and that these increases will also impact the 100-year extreme daily precipitation. Considering that many public infrastructures have lifespans exceeding 75 years, the increase in extremes has important implications on service levels of water infrastructures and public safety. Estimated increases in precipitation associated to very extreme precipitation events (e.g. 100 years) will drastically change the likelihood of flooding and their extent in future climate. These results, although interesting, need to be extended to sub-daily durations, relevant for urban flooding protection and urban infrastructure design (e.g. sewer networks, culverts). Models and simulations at finer spatial and temporal resolution are therefore needed.

Irreversible climate change due to carbon dioxide emissions

PubMed Central

Solomon, Susan; Plattner, Gian-Kasper; Knutti, Reto; Friedlingstein, Pierre

2009-01-01

The severity of damaging human-induced climate change depends not only on the magnitude of the change but also on the potential for irreversibility. This paper shows that the climate change that takes place due to increases in carbon dioxide concentration is largely irreversible for 1,000 years after emissions stop. Following cessation of emissions, removal of atmospheric carbon dioxide decreases radiative forcing, but is largely compensated by slower loss of heat to the ocean, so that atmospheric temperatures do not drop significantly for at least 1,000 years. Among illustrative irreversible impacts that should be expected if atmospheric carbon dioxide concentrations increase from current levels near 385 parts per million by volume (ppmv) to a peak of 450–600 ppmv over the coming century are irreversible dry-season rainfall reductions in several regions comparable to those of the “dust bowl” era and inexorable sea level rise. Thermal expansion of the warming ocean provides a conservative lower limit to irreversible global average sea level rise of at least 0.4–1.0 m if 21st century CO2 concentrations exceed 600 ppmv and 0.6–1.9 m for peak CO2 concentrations exceeding ≈1,000 ppmv. Additional contributions from glaciers and ice sheet contributions to future sea level rise are uncertain but may equal or exceed several meters over the next millennium or longer. PMID:19179281

Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study.

PubMed

Yang, Cheng-San; Chen, Solomon Chih-Cheng; Yang, Yung-Cheng; Huang, Li-Chung; Guo, How-Ran; Yang, Hsin-Yi

2017-10-03

The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan. We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions. A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18-29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years. Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.

Concrete alteration due to 55 years of exposure to river water: Chemical and mineralogical characterisation

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

Rosenqvist, Martin; Bertron, Alexandra; Fridh, Katja

This article presents a study on concrete alteration mechanisms due to 55 years of exposure to river water. Many hydro power structures in cold regions suffer from concrete deterioration at the waterline. Progressive disintegration of the concrete surface leads to exposure of the coarse aggregate and eventually the reinforcing steel. Concrete cylinders drilled out at four vertically different locations on the upstream face of a concrete dam were analysed by electron microprobe analysis, X-ray diffraction, thermogravimetry and scanning electron microscopy. Long-term exposure to the river water, which is regarded as soft water, has led to chemical and mineralogical zonation ofmore » the cement paste. Up to five zones with different chemical and mineralogical composition, parallel to the upstream face, were observed in the outermost 8–9 mm of the concrete. Decalcification, precipitation of secondary ettringite and the formation of a magnesium-rich silica gel constitute the major changes that define the zones.« less

Large wood budget and transport dynamics on a large river using radio telemetry

USGS Publications Warehouse

Schenk, Edward R.; Moulin, Bertrand; Hupp, Cliff R.; Richte, Jean M.

2014-01-01

Despite the abundance of large wood (LW) river studies there is still a lack of understanding of LW transport dynamics on large low gradient rivers. This study used 290 radio frequency identification tagged (RFID) LW and 54 metal (aluminum) tagged LW, to quantify the percent of in-channel LW that moves per year and what variables play a role in LW transport dynamics. Aluminum tags were installed and monitored on LW in-transit during the rising limb of a flood, the mean distance traveled by those pieces during the week was 13.3 river kilometers (km) with a maximum distance of 72 km. RFID tagged LW moved a mean of 11.9 km/yr with a maximum observed at 101.1 km/yr. Approximately 41% of LW low on the bank moves per year. The high rate of transport and distance traveled is likely due to the lack of interaction between LW floating in the channel and the channel boundaries, caused primarily by the width of the channel relative to length of the LW. Approximately 80% of the RFID tags moved past a fixed reader during the highest 20% of river stage per year. LW transport and logjam dynamics are complicated at high flows as pieces form temporary jams that continually expand and contract. Unlike most other studies, key members that create a logjam were defined more by stability than jam size or channel/hydrologic conditions. Finally, using an existing geomorphic database for the river, and data from this study, we were able to develop a comprehensive LW budget showing that 5% of the in-channel LW population turns over each year (input from mass wasting and fluvial erosion equals burial, decomposition, and export out of system) and another 16% of the population moving within the system.

Greenhouse effect due to atmospheric nitrous oxide

NASA Technical Reports Server (NTRS)

Yung, Y. L.; Wang, W. C.; Lacis, A. A.

1976-01-01

The greenhouse effect due to nitrous oxide in the present atmosphere is about 0.8 K. Increase in atmospheric N2O due to perturbation of the nitrogen cycle by man may lead to an increase in surface temperature as large as 0.5 K by 2025, or 1.0 K by 2100. Other climatic effects of N2O are briefly discussed.

Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population.

PubMed

Gabriel, Rodney A; Kim, Helen; Sidney, Stephen; McCulloch, Charles E; Singh, Vineeta; Johnston, S Claiborne; Ko, Nerissa U; Achrol, Achal S; Zaroff, Jonathan G; Young, William L

2010-01-01

To evaluate whether increased neuroimaging use is associated with increased brain arteriovenous malformation (BAVM) detection, we examined detection rates in the Kaiser Permanente Medical Care Program of northern California between 1995 and 2004. We reviewed medical records, radiology reports, and administrative databases to identify BAVMs, intracranial aneurysms (IAs: subarachnoid hemorrhage [SAH] and unruptured aneurysms), and other vascular malformations (OVMs: dural fistulas, cavernous malformations, Vein of Galen malformations, and venous malformations). Poisson regression (with robust standard errors) was used to test for trend. Random-effects meta-analysis generated a pooled measure of BAVM detection rate from 6 studies. We identified 401 BAVMs (197 ruptured, 204 unruptured), 570 OVMs, and 2892 IAs (2079 SAHs and 813 unruptured IAs). Detection rates per 100 000 person-years were 1.4 (95% CI, 1.3 to 1.6) for BAVMs, 2.0 (95% CI, 1.8 to 2.3) for OVMs, and 10.3 (95% CI, 9.9 to 10.7) for IAs. Neuroimaging utilization increased 12% per year during the time period (P<0.001). Overall, rates increased for IAs (P<0.001), remained stable for OVMs (P=0.858), and decreased for BAVMs (P=0.001). Detection rates increased 15% per year for unruptured IAs (P<0.001), with no change in SAHs (P=0.903). However, rates decreased 7% per year for unruptured BAVMs (P=0.016) and 3% per year for ruptured BAVMs (P=0.005). Meta-analysis yielded a pooled BAVM detection rate of 1.3 (95% CI, 1.2 to 1.4) per 100 000 person-years, without heterogeneity between studies (P=0.25). Rates for BAVMs, OVMs, and IAs in this large, multiethnic population were similar to those in other series. During 1995 to 2004, a period of increasing neuroimaging utilization, we did not observe an increased rate of detection of unruptured BAVMs, despite increased detection of unruptured IAs.

External human factors in incident management team decisionmaking and their effect on large fire suppression expenditures

Treesearch

Janie Canton-Tompson; Krista M. Gebert; Brooke Thompson; Greg Jones; David Calkin; Geoff Donovan

2008-01-01

Large wildland fires are complex, costly events influenced by a vast array of physical, climatic, and social factors. Changing climate, fuel buildup due to past suppression, and increasing populations in the wildland-urban interface have all been blamed for the extreme fire seasons and rising suppression expenditures of recent years. With each high-cost year comes a...

Enhancing students' critical thinking in science: A two-year design based exploration in a large undergraduate science course

NASA Astrophysics Data System (ADS)

Yoo, Suhyun

The purpose of this study was to explore how to enhance students' critical thinking in an introductory undergraduate science course. As a design experiment, this study aimed to design, develop, implement, and refine learning activities, and investigate how the learning activities worked in fostering students' critical thinking in a large size classroom context. In this study, critical thinking in science was framed with six categories, 1) identifying decisions, 2) evaluating decisions, 3) providing own decision, 4) argument and justification for own decision, 5) presenting supporting data/evidence, and 6) integrating other perspectives, as the result of literature review. To enhance critical thinking, three design principles, 1) authentic task, 2) question prompts, and 3) peer interaction, were associated with the learning activities for two consecutive years. The research context was within a large general science course and the learning activities for a module were designed, implemented and refined for two years. Specially, changes in design strategies were made in the two design principles, question prompts and peer interaction, after the 1st implementation. With regard to the use of question prompts, the students of the 2nd year were provided with procedural and elaborative question prompts, while those of the 1st year only received procedural question prompts embedded in the Group and Community Discussion Charts. Second, instead of being engaged six times in two types of discussions, group and community discussions, the students of the 2nd year were required to take part in a community discussion twice and to prepare for the discussion by learning about and understanding important aspects of dealing with the hurricane situation. For individual preparation, elaborative question prompts were embedded in the Individual Worksheet. Quantitative and qualitative research methods were taken to investigate how the two different designs of the 1st and 2nd years worked

Modelling potential changes in marine biogeochemistry due to large-scale offshore tidal energy extraction

NASA Astrophysics Data System (ADS)

van der Molen, Johan

2015-04-01

Tidal power generation through submerged turbine-type devices is in an advanced stage of testing, and large-scale applications are being planned in areas with high tidal current speeds. The potential impact of such large-scale applications on the hydrography can be investigated using hydrodynamical models. In addition, aspects of the potential impact on the marine ecosystem can be studied using biogeochemical models. In this study, the coupled hydrodynamics-biogeochemistry model GETM-ERSEM is used in a shelf-wide application to investigate the potential impact of large-scale tidal power generation in the Pentland Firth. A scenario representing the currently licensed power extraction suggested i) an average reduction in M2 tidal current velocities of several cm/s within the Pentland Firth, ii) changes in the residual circulation of several mm/s in the vicinity of the Pentland Firth, iii) an increase in M2 tidal amplitude of up to 1 cm to the west of the Pentland Firth, and iv) a reduction of several mm in M2 tidal amplitude along the east coast of the UK. A second scenario representing 10 times the currently licensed power extraction resulted in changes that were approximately 10 times as large. Simulations including the biogeochemistry model for these scenarios are currently in preparation, and first results will be presented at the the conference, aiming at impacts on primary production and benthic production.

Due Process Hearing Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2009-01-01

William is 9 years of age, residing with his parent within the boundaries of an unnamed district ("the District"). As a student with autism he is eligible for special education programming and services. There was one issue presented for this due process hearing: What was the appropriate program and placement for him for the 2008-2009 school year?…

HVSR Response Evolution due to Seasonal Variation: Observations from 2 Years of Continuous Monitoring

NASA Astrophysics Data System (ADS)

Nurse, K. B.; Milkereit, B.

2017-12-01

The seismic Horizontal to Vertical Spectral Ratio analysis technique reliably gives overburden depth to bedrock, for an independently determined Vs, based on the frequency of the main resonance peak. Above this, smaller resonances reflect the velocity structure within the overburden itself. This range in the HVSR response shows sufficient sensitivity to be exploited as a monitoring tool, to detect change in seismic physical properties and from that, change in overburden conditions. To explore the variation of the response, several 3C geophones have been deployed in southern Ontario, Canada since December 2015 (and ongoing). The local geology is a sedimentary basin with 30m of overburden, a simple 2D environment well suited for the HVSR method. Data are collected for 15s per minute, with an effective frequency band of 2-400Hz. HVSR estimates are produced for each sampling period and archived. Over these two years, winter freeze/thaw, saturated spring and summer draught conditions were sampled. H/V daily averages are dominated by the stable 3Hz resonance due to the overall surface layer, but smaller spectral peaks up to 100Hz are clear and evolve in frequency and amplitude over the collection period. Ground freeze/thaw cycles are clearly evident by significant reduction in the horizontal field, but also the changing of the soil moisture content throughout the year causes subtle shifts in the response (correlated to rain events and water table variation). The long term sampling does show a sensitivity of the HVSR method to the overburden in proximity to the sensor, and suggests a possibility for its use in monitoring soil / water-table conditions. But it also highlights that the estimate from an isolated H/V acquisition does include this variability and needs to be adequately quantified in VS30 estimates.

Wind and wave extremes over the world oceans from very large ensembles

NASA Astrophysics Data System (ADS)

Breivik, Øyvind; Aarnes, Ole Johan; Abdalla, Saleh; Bidlot, Jean-Raymond; Janssen, Peter A. E. M.

2014-07-01

Global return values of marine wind speed and significant wave height are estimated from very large aggregates of archived ensemble forecasts at +240 h lead time. Long lead time ensures that the forecasts represent independent draws from the model climate. Compared with ERA-Interim, a reanalysis, the ensemble yields higher return estimates for both wind speed and significant wave height. Confidence intervals are much tighter due to the large size of the data set. The period (9 years) is short enough to be considered stationary even with climate change. Furthermore, the ensemble is large enough for nonparametric 100 year return estimates to be made from order statistics. These direct return estimates compare well with extreme value estimates outside areas with tropical cyclones. Like any method employing modeled fields, it is sensitive to tail biases in the numerical model, but we find that the biases are moderate outside areas with tropical cyclones.

Extremely large nonsaturating magnetoresistance and ultrahigh mobility due to topological surface states in the metallic Bi2Te3 topological insulator

NASA Astrophysics Data System (ADS)

Shrestha, K.; Chou, M.; Graf, D.; Yang, H. D.; Lorenz, B.; Chu, C. W.

2017-05-01

Weak antilocalization (WAL) effects in Bi2Te3 single crystals have been investigated at high and low bulk charge-carrier concentrations. At low charge-carrier density the WAL curves scale with the normal component of the magnetic field, demonstrating the dominance of topological surface states in magnetoconductivity. At high charge-carrier density the WAL curves scale with neither the applied field nor its normal component, implying a mixture of bulk and surface conduction. WAL due to topological surface states shows no dependence on the nature (electrons or holes) of the bulk charge carriers. The observations of an extremely large nonsaturating magnetoresistance and ultrahigh mobility in the samples with lower carrier density further support the presence of surface states. The physical parameters characterizing the WAL effects are calculated using the Hikami-Larkin-Nagaoka formula. At high charge-carrier concentrations, there is a greater number of conduction channels and a decrease in the phase coherence length compared to low charge-carrier concentrations. The extremely large magnetoresistance and high mobility of topological insulators have great technological value and can be exploited in magnetoelectric sensors and memory devices.

Fat embolism due to bilateral femoral fracture: a case report

PubMed Central

Porpodis, Konstantinos; Karanikas, Michael; Zarogoulidis, Paul; Konoglou, Maria; Domvri, Kalliopi; Mitrakas, Alexandros; Boglou, Panagiotis; Bakali, Stamatia; Iordanidis, Alkis; Zervas, Vasilis; Courcoutsakis, Nikolaos; Katsikogiannis, Nikolaos; Zarogoulidis, Konstantinos

2012-01-01

Fat embolism syndrome is usually associated with surgery for large bone fractures. Symptoms usually occur within 36 hours of hospitalization after traumatic injury. We present a case with fat embolism syndrome due to femur fracture. Prompt supportive treatment of the patient’s respiratory system and additional pharmaceutical treatment provided the positive clinical outcome. There is no specific therapy for fat embolism syndrome; prevention, early diagnosis, and adequate symptomatic treatment are very important. Most of the studies in the last 20 years have shown that the incidence of fat embolism syndrome is reduced by early stabilization of the fractures and the risk is even further decreased with surgical correction rather than conservative management. PMID:22287848

Army Hearing Program Talking Points Calendar Year 2016

DTIC Science & Technology

2017-09-12

Reserve ARMY HEARING PROGRAM TALKING POINTS CALENDAR YEAR 2016 TIP No. 51-065-0817 2 BACKGROUND Hearing health in the Army has improved...over time, largely due to the dedicated work of hearing health experts. However, noise-induced hearing loss and associated problems have not been...eliminated. The Army Hearing Program continually evolves to address hearing health challenges, and maintains the momentum to build iteratively upon

Increasing stress on disaster-risk finance due to large floods

NASA Astrophysics Data System (ADS)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen C. J. H.; Mechler, Reinhard; Botzen, W. J. Wouter; Bouwer, Laurens M.; Pflug, Georg; Rojas, Rodrigo; Ward, Philip J.

2014-04-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. So far, little is known about such flood hazard interdependencies across regions and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins. We present probabilistic trends in continental flood risk, and demonstrate that observed extreme flood losses could more than double in frequency by 2050 under future climate change and socio-economic development. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Galaxies 800 million years after the Big Bang seen with the Atacama Large Millimetre Array

NASA Astrophysics Data System (ADS)

Smit, Renske

2018-01-01

The identification of galaxies in the first billion years after the Big Bang presents a challenge for even the largest optical telescopes. When the Atacama Large Millimetre Array (ALMA) started science operations in 2011 it presented a tantalising opportunity to identify and characterise these first sources of light in a new window of the electromagnetic spectrum. I will present new sources successfully identified at z=6.8 using ALMA; the first spectroscopic confirmations of typical star-forming galaxies during the Epoch or Reionization using a sub-millimetre telescope. Moreover, these observations reveal the gas kinematics of such distant sources for the first time. The velocity gradient in these galaxies indicate that these galaxies likely have similar dynamical properties as the turbulent, yet rotation-dominated disks that have been observed for Hα emitting galaxies 2 billion years later at cosmic noon. This novel approach for confirming galaxies during Reionization paves the way for larger studies of distant galaxies with spectroscopic redshifts. Particularly important, this opens up opportunities for the measurement of high angular-resolution dynamics in galaxies less than one billion years after the Big Bang.

Emerging Risks Due to New Injecting Patterns in Hungary During Austerity Times.

PubMed

Tarján, Anna; Dudás, Mária; Gyarmathy, V Anna; Rusvai, Erzsébet; Tresó, Bálint; Csohán, Ágnes

2015-01-01

As a consequence of the massive restructuring of drug availability, heroin injection in Hungary was largely replaced by the injecting of new psychoactive substances (NPS) starting in 2010. In the following years in our sero-prevalence studies we documented higher levels of injecting paraphernalia sharing, daily injection-times, syringe reuse, and HCV prevalence among stimulant injectors, especially among NPS injectors. Despite the increasing demand, in 2012 the number of syringes distributed dropped by 35% due to austerity measures. Effects of drug market changes and the economic recession may have future epidemiological consequences. Study limitations are noted and future needed research is suggested.

Lost life years due to premature deaths caused by diseases of the digestive system in Poland in 2013

PubMed

Paciej, Paulina; Ciabiada, Beata; Maniecka-Bryła, Irena

In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years. The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013. The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death). In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1). The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.

Electrical injuries due to railway high tension cables.

PubMed

Reichl, M; Kay, S

1985-08-01

We have noted a large number of young boys being admitted to our Unit with burns due to railway high tension cables. On review of these cases we have noted: most of the burns were due to arcing, there is a high level of ignorance among the population at risk. We propose some ways of preventing these injuries.

Auditory agnosia due to long-term severe hydrocephalus caused by spina bifida - specific auditory pathway versus nonspecific auditory pathway.

PubMed

Zhang, Qing; Kaga, Kimitaka; Hayashi, Akimasa

2011-07-01

A 27-year-old female showed auditory agnosia after long-term severe hydrocephalus due to congenital spina bifida. After years of hydrocephalus, she gradually suffered from hearing loss in her right ear at 19 years of age, followed by her left ear. During the time when she retained some ability to hear, she experienced severe difficulty in distinguishing verbal, environmental, and musical instrumental sounds. However, her auditory brainstem response and distortion product otoacoustic emissions were largely intact in the left ear. Her bilateral auditory cortices were preserved, as shown by neuroimaging, whereas her auditory radiations were severely damaged owing to progressive hydrocephalus. Although she had a complete bilateral hearing loss, she felt great pleasure when exposed to music. After years of self-training to read lips, she regained fluent ability to communicate. Clinical manifestations of this patient indicate that auditory agnosia can occur after long-term hydrocephalus due to spina bifida; the secondary auditory pathway may play a role in both auditory perception and hearing rehabilitation.

[Malnutrition due to an extremely 'healthy' diet; a new eating disorder?].

PubMed

Nauta, K; Toxopeus, K; Eekhoff, E M W

2016-01-01

A 71-year-old male was admitted to our hospital with heart failure, cachexia and biochemical disturbances due to a diet consisting of exclusively vegetables, oil and water. Our investigations showed that this diet was a consequence of an excessive preoccupation with health. The patient did not meet criteria for an eating disorder or other DSM-IV psychiatric disorder. We conclude that malnutrition due to health fad diets may be an underestimated medical problem. There is no specific psychopathological disorder that covers this behaviour, and there is no knowledge of its epidemiology. Popular literature is paying a great deal attention to orthorexia nervosa, an alleged eating disorder that describes a pathological obsession with healthy food. In medical literature this concept has been largely neglected, although eating disorder specialists frequently observe this behaviour in their practice. More clinical and scientific attention for this phenomenon is necessary to determine its epidemiology, validity and clinical picture.

Large Survey of Neutron Spectrum Moments Due to ICF Drive Asymmetry

NASA Astrophysics Data System (ADS)

Field, J. E.; Munro, D.; Spears, B.; Peterson, J. L.; Brandon, S.; Gaffney, J. A.; Hammer, J.; Langer, S.; Nora, R. C.; Springer, P.; ICF Workflow Collaboration Collaboration

2016-10-01

We have recently completed the largest HYDRA simulation survey to date ( 60 , 000 runs) of drive asymmetry on the new Trinity computer at LANL. The 2D simulations covered a large space of credible perturbations to the drive of ICF implosions on the NIF. Cumulants of the produced birth energy spectrum for DD and DT reaction neutrons were tallied using new methods. Comparison of the experimental spectra with our map of predicted spectra from simulation should provide a wealth of information about the burning plasma region. We report on our results, highlighting areas of agreement (and disagreement) with experimental spectra. We also identify features in the predicted spectra that might be amenable to measurement with improved diagnostics. Prepared by LLNL under Contract DE-AC52-07NA27344. IM release #: LLNL-PROC-697321.

Sleep Patterns as Predictors for Disability Pension Due to Low Back Diagnoses: A 23-Year Longitudinal Study of Finnish Twins

PubMed Central

Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko

2013-01-01

Study Objectives: Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. Design and Setting: A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Interventions: Not applicable. Participants: There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Measurements and Results: Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Conclusions: Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors. Citation: Ropponen A; Silventoinen K; Hublin C; Svedberg P; Koskenvuo M; Kaprio J. Sleep patterns as predictors

Changes of etiology, incidence and outcomes of severe acute kidney injury during a 12-year period (2001-2012) in large university hospital.

PubMed

Skarupskiene, Inga; Balciuviene, Vilma; Ziginskiene, Edita; Kuzminskis, Vytautas; Vaiciuniene, Ruta; Bumblyte, Inga Arune

2016-11-01

Despite improvement in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise. The aim of our study was to analyze the changes during a 12-year period in etiology, incidence and outcomes of severe AKI, which required dialysis, in a large single centre. We performed retrospective analysis of all the patients (n=3215) with severe AKI hospitalized and dialysed in the hospital of Lithuanian university of health sciences Kauno Klinikos (HLUHS KK) during the period of 2001-2012. During a 12-year period, the incidence of severe AKI increased from 154 to 597 cases/p.m.p. The mean age of the patients increased from 58.2±19.2 years in 2001 to 65.7±17 years in 2012 (P<0.001). The number of men (n=2012; 62.6%) was significantly higher than that of women (n=1201; 37.4%; P<0.001). The causes of severe AKI were renal (n=1128; 35.1%), prerenal (n=642; 20%), obstructive (n=310; 9.6%) and in 12.7% of the patients-multifactorial. Overall, the most frequent cause of AKI was acute tubular necrosis (n=1069; 33.2%). The renal replacement therapy (RRT) was discontinued due to improved kidney function in 45.3% of cases. 8.1% of the patients remained dialysis dependent. The mortality rate was 44%. During a 12-year period, the number of the patients with severe AKI increased three times with the predominance of men and elderly people. There was an observed increase in multifactorial causes of severe AKI; however, ATN remained dominant over the decade. The mortality rate remained high, almost half of the patients died, less than 10% remained dialysis dependent, the rest had the improvement of renal function. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male.

PubMed

Heiner, Jason D; Eng, Katisha D; Bialowas, Todd A; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male

PubMed Central

Heiner, Jason D.; Eng, Katisha D.; Bialowas, Todd A.; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening. PMID:23326701

Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain.

PubMed

Pedersen, Pernille; Nielsen, Claus Vinther; Jensen, Ole Kudsk; Jensen, Chris; Labriola, Merete

2018-05-01

To evaluate differences in employment status, during a five-year follow-up period in patients on sick leave due to low back pain who had participated in a trial comparing a brief and a multidisciplinary intervention. From 2004 to 2008, 535 patients were referred to the Spine Centre at the Regional Hospital in Silkeborg if they had been on sick leave for 3-16 weeks due to low back pain. All patients underwent a clinical examination by a rehabilitation physician and a physiotherapist, and were randomised to either the brief intervention or the multidisciplinary intervention. The outcome was employment status from randomisation to five years of follow-up and was measured by the mean number of weeks in four different groups of employment status (sequence analysis) and a fraction of the number of weeks working (work participation score) that were accumulated over the years. A total of 231 patients were randomised to the brief intervention and 233 patients to the multidisciplinary intervention. No statistically significant differences in the mean weeks spent within the different employment statuses were found between the two intervention groups. After five years of follow-up, participants in the multidisciplinary intervention had a 19% higher risk of not having a work participation score above 75% compared to participants in the brief intervention. After five years of follow-up no differences in employment status were found between participants in the brief and the multidisciplinary intervention.

Large impact of reorganization energy on photovoltaic conversion due to interfacial charge-transfer transitions.

PubMed

Fujisawa, Jun-ichi

2015-05-14

Interfacial charge-transfer (ICT) transitions are expected to be a novel charge-separation mechanism for efficient photovoltaic conversion featuring one-step charge separation without energy loss. Photovoltaic conversion due to ICT transitions has been investigated using several TiO2-organic hybrid materials that show organic-to-inorganic ICT transitions in the visible region. In applications of ICT transitions to photovoltaic conversion, there is a significant problem that rapid carrier recombination is caused by organic-inorganic electronic coupling that is necessary for the ICT transitions. In order to solve this problem, in this work, I have theoretically studied light-to-current conversions due to the ICT transitions on the basis of the Marcus theory with density functional theory (DFT) and time-dependent DFT (TD-DFT) calculations. An apparent correlation between the reported incident photon-to-current conversion efficiencies (IPCE) and calculated reorganization energies was clearly found, in which the IPCE increases with decreasing the reorganization energy consistent with the Marcus theory in the inverted region. This activation-energy dependence was systematically explained by the equation formulated by the Marcus theory based on a simple excited-state kinetic scheme. This result indicates that the reduction of the reorganization energy can suppress the carrier recombination and enhance the IPCE. The reorganization energy is predominantly governed by the structural change in the chemical-adsorption moiety between the ground and ICT excited states. This work provides crucial knowledge for efficient photovoltaic conversion due to ICT transitions.

Cystic echinococcosis in children - the seventeen-year experience of two large medical centers in Serbia.

PubMed

Djuricic, Slavisa M; Grebeldinger, Slobodan; Kafka, Dejan I; Djan, Igor; Vukadin, Miroslav; Vasiljevic, Zorica V

2010-06-01

Cystic echinococcosis (CE) is a public health problem in countries having such endemic areas. Epidemiological studies of CE, especially pediatric, are rare. The aim of this study was to evaluate epidemiological and clinical characteristics of CE in children in Serbia. Data were obtained retrospectively from the case records of patients under the age of 18 years admitted for surgical treatment of CE at two large pediatric medical institutions in the period 1990-2006. Patients' age, number of cysts and their anatomic location were evaluated in relation to differences by patients' gender and socio-geographic status (urban or rural origin). The study included 149 children with 272 hydatid cysts. The mean age of patients was 10.1+/-3.8 years. There were no significant differences in the number of patients in relation to gender and urban:rural origin. There were no significant differences in patients' age at the time of surgery or the number of cysts per patient when patients' gender or socio-geographic status was evaluated. The anatomic location of cysts was as follows: liver (N=165; 60.7%), lungs (N=82; 30.1%), and other locations (N=25; 9.2%). Multiple cysts, and combined liver/lung involvement were identified in 34.2% (N=51), and 6.0% (N=9) of patients, respectively. Hepatic cysts were significantly more common in girls than in boys. There were no significant differences in anatomic location of cysts between socio-geographic groups. The large number of infected children during a long period of investigation indicates an active transmission of disease and a lack of program for control and prevention of CE in Serbia.

Increasing stress on disaster risk finance due to large floods

NASA Astrophysics Data System (ADS)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen; Mechler, Reinhard; Botzen, Wouter; Bouwer, Laurens; Pflug, Georg; Rojas, Rodrigo; Ward, Philip

2014-05-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. To date, little is known about such flood hazard interdependencies across regions, and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins and that these correlations can, or should, be used in national to continental scale risk assessment. We present probabilistic trends in continental flood risk, and demonstrate that currently observed extreme flood losses could more than double in frequency by 2050 under future climate change and socioeconomic development. The results demonstrate that accounting for tail dependencies leads to higher estimates of extreme losses than estimates based on the traditional assumption of independence between basins. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Connectedness to the criminal community and the community at large predicts 1-year post-release outcomes among felony offenders

PubMed Central

Folk, Johanna B.; Mashek, Debra; Tangney, June; Stuewig, Jeffrey; Moore, Kelly E.

2016-01-01

Connectedness to one's community relates to positive psychological and behavioral outcomes. But what implications do connectedness to distinct communities—the criminal community and the community at large—have for inmates about to be released from jail? This study (N = 383) prospectively examined connectedness to the criminal community and community at large prior to release from jail, and functioning at one-year post-release. Connectedness to the community at large positively predicted community adjustment whereas connectedness to the criminal community positively predicted recidivism. Targeting both types of community connectedness may enhance interventions intended to undermine recidivism and increase positive outcomes for inmates. PMID:27524842

Frequency of Cushing's syndrome due to ACTH-secreting adrenal medullary lesions: a retrospective study over 10 years from a single center.

PubMed

Falhammar, Henrik; Calissendorff, Jan; Höybye, Charlotte

2017-01-01

Cushing's syndrome due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions has occasionally been described. We retrospectively reviewed all 164 cases of Cushing's syndrome and 77 cases of pheochromocytomas during 10 years. Of all cases with Cushing's syndrome, only two cases (1.2 %) were due to ectopic adrenocorticotropic hormone production from adrenal medullary lesions (one case of pheochromocytoma and one case of adrenal medullary hyperplasia). Of all pheochromocytomas only the above-mentioned case (1.3 %) also gave rise to an ectopic adrenocorticotropic hormone syndrome. The clinical presentation of adrenocorticotropic hormone-secreting pheochromocytoma and adrenal medullary hyperplasia can be anything from mild to dramatic. These are rare conditions important to bear in mind in the workup of a patient with Cushing's syndrome or with pheochromocytoma. The identification of ectopic adrenocorticotropic hormone secretion from adrenal medullary lesions can be life-saving.

Large forest fires in Canada, 1959-1997

NASA Astrophysics Data System (ADS)

Stocks, B. J.; Mason, J. A.; Todd, J. B.; Bosch, E. M.; Wotton, B. M.; Amiro, B. D.; Flannigan, M. D.; Hirsch, K. G.; Logan, K. A.; Martell, D. L.; Skinner, W. R.

2003-01-01

A Large Fire Database (LFDB), which includes information on fire location, start date, final size, cause, and suppression action, has been developed for all fires larger than 200 ha in area for Canada for the 1959-1997 period. The LFDB represents only 3.1% of the total number of Canadian fires during this period, the remaining 96.9% of fires being suppressed while <200 ha in size, yet accounts for ~97% of the total area burned, allowing a spatial and temporal analysis of recent Canadian landscape-scale fire impacts. On average ~2 million ha burned annually in these large fires, although more than 7 million ha burned in some years. Ecozones in the boreal and taiga regions experienced the greatest areas burned, with an average of 0.7% of the forested land burning annually. Lightning fires predominate in northern Canada, accounting for 80% of the total LFDB area burned. Large fires, although small in number, contribute substantially to area burned, most particularly in the boreal and taiga regions. The Canadian fire season runs from late April through August, with most of the area burned occurring in June and July due primarily to lightning fire activity in northern Canada. Close to 50% of the area burned in Canada is the result of fires that are not actioned due to their remote location, low values-at-risk, and efforts to accommodate the natural role of fire in these ecosystems. The LFDB is updated annually and is being expanded back in time to permit a more thorough analysis of long-term trends in Canadian fire activity.

On axial temperature gradients due to large pressure drops in dense fluid chromatography.

PubMed

Colgate, Sam O; Berger, Terry A

2015-03-13

The effect of energy degradation (Degradation is the creation of net entropy resulting from irreversibility.) accompanying pressure drops across chromatographic columns is examined with regard to explaining axial temperature gradients in both high performance liquid chromatography (HPLC) and supercritical fluid chromatography (SFC). The observed effects of warming and cooling can be explained equally well in the language of thermodynamics or fluid dynamics. The necessary equivalence of these treatments is reviewed here to show the legitimacy of using whichever one supports the simpler determination of features of interest. The determination of temperature profiles in columns by direct application of the laws of thermodynamics is somewhat simpler than applying them indirectly by solving the Navier-Stokes (NS) equations. Both disciplines show that the preferred strategy for minimizing the reduction in peak quality caused by temperature gradients is to operate columns as nearly adiabatically as possible (i.e. as Joule-Thomson expansions). This useful fact, however, is not widely familiar or appreciated in the chromatography community due to some misunderstanding of the meaning of certain terms and expressions used in these disciplines. In fluid dynamics, the terms "resistive heating" or "frictional heating" have been widely used as synonyms for the dissipation function, Φ, in the NS energy equation. These terms have been widely used by chromatographers as well, but often misinterpreted as due to friction between the mobile phase and the column packing, when in fact Φ describes the increase in entropy of the system (dissipation, ∫TdSuniv>0) due to the irreversible decompression of the mobile phase. Two distinctly different contributions to the irreversibility are identified; (1) ΔSext, viscous dissipation of work done by the external surroundings driving the flow (the pump) contributing to its warming, and (2) ΔSint, entropy change accompanying decompression of

Optimization of large matrix calculations for execution on the Cray X-MP vector supercomputer

NASA Technical Reports Server (NTRS)

Hornfeck, William A.

1988-01-01

A considerable volume of large computational computer codes were developed for NASA over the past twenty-five years. This code represents algorithms developed for machines of earlier generation. With the emergence of the vector supercomputer as a viable, commercially available machine, an opportunity exists to evaluate optimization strategies to improve the efficiency of existing software. This result is primarily due to architectural differences in the latest generation of large-scale machines and the earlier, mostly uniprocessor, machines. A sofware package being used by NASA to perform computations on large matrices is described, and a strategy for conversion to the Cray X-MP vector supercomputer is also described.

Twenty years of artificial directional selection have shaped the genome of the Italian Large White pig breed.

PubMed

Schiavo, G; Galimberti, G; Calò, D G; Samorè, A B; Bertolini, F; Russo, V; Gallo, M; Buttazzoni, L; Fontanesi, L

2016-04-01

In this study, we investigated at the genome-wide level if 20 years of artificial directional selection based on boar genetic evaluation obtained with a classical BLUP animal model shaped the genome of the Italian Large White pig breed. The most influential boars of this breed (n = 192), born from 1992 (the beginning of the selection program of this breed) to 2012, with an estimated breeding value reliability of >0.85, were genotyped with the Illumina Porcine SNP60 BeadChip. After grouping the boars in eight classes according to their year of birth, filtered single nucleotide polymorphisms (SNPs) were used to evaluate the effects of time on genotype frequency changes using multinomial logistic regression models. Of these markers, 493 had a PBonferroni  < 0.10. However, there was an increasing number of SNPs with a decreasing level of allele frequency changes over time, representing a continuous profile across the genome. The largest proportion of the 493 SNPs was on porcine chromosome (SSC) 7, SSC2, SSC8 and SSC18 for a total of 204 haploblocks. Functional annotations of genomic regions, including the 493 shifted SNPs, reported a few Gene Ontology terms that might underly the biological processes that contributed to increase performances of the pigs over the 20 years of the selection program. The obtained results indicated that the genome of the Italian Large White pigs was shaped by a directional selection program derived by the application of methodologies assuming the infinitesimal model that captured a continuous trend of allele frequency changes in the boar population. © 2015 Stichting International Foundation for Animal Genetics.

Hydrologic effects of large southwestern USA wildfires significantly increase regional water supply: fact or fiction?

NASA Astrophysics Data System (ADS)

Wine, M. L.; Cadol, D.

2016-08-01

In recent years climate change and historic fire suppression have increased the frequency of large wildfires in the southwestern USA, motivating study of the hydrological consequences of these wildfires at point and watershed scales, typically over short periods of time. These studies have revealed that reduced soil infiltration capacity and reduced transpiration due to tree canopy combustion increase streamflow at the watershed scale. However, the degree to which these local increases in runoff propagate to larger scales—relevant to urban and agricultural water supply—remains largely unknown, particularly in semi-arid mountainous watersheds co-dominated by winter snowmelt and the North American monsoon. To address this question, we selected three New Mexico watersheds—the Jemez (1223 km2), Mogollon (191 km2), and Gila (4807 km2)—that together have been affected by over 100 wildfires since 1982. We then applied climate-driven linear models to test for effects of fire on streamflow metrics after controlling for climatic variability. Here we show that, after controlling for climatic and snowpack variability, significantly more streamflow discharged from the Gila watershed for three to five years following wildfires, consistent with increased regional water yield due to enhanced infiltration-excess overland flow and groundwater recharge at the large watershed scale. In contrast, we observed no such increase in discharge from the Jemez watershed following wildfires. Fire regimes represent a key difference between the contrasting responses of the Jemez and Gila watersheds with the latter experiencing more frequent wildfires, many caused by lightning strikes. While hydrologic dynamics at the scale of large watersheds were previously thought to be climatically dominated, these results suggest that if one fifth or more of a large watershed has been burned in the previous three to five years, significant increases in water yield can be expected.

Revisiting SNR Puppis A with Seven Years of Fermi Large Area Telescope Observations

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

Xin, Yu-Liang; Guo, Xiao-Lei; Liao, Neng-Hui

Puppis A is a very famous and extensively studied supernova remnant that shows strong evidence of shock-cloud interaction. We reanalyze its GeV γ -ray emission using seven years of Pass 8 data recorded by the Fermi Large Area Telescope. The morphology of the γ -ray emission is more compatible with that of the thermal X-ray and IR emissions than the radio image, which suggests a possible correlation between the gamma-ray-emitting region and dense clouds. The γ -ray spectrum in the energy range of 1–500 GeV shows a break at 7.92 ± 1.91 GeV, with photon indices of 1.81 ± 0.08more » below the break and 2.53 ± 0.12 above the break, which can naturally explain the lack of TeV γ -ray emission from Puppis A. The multi-wavelength observations favor a hadronic origin for the γ -ray emission.« less

Disease Burden Due to Herpes Zoster among Population Aged ≥50 Years Old in China: A Community Based Retrospective Survey.

PubMed

Li, Yan; An, Zhijie; Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Xu, Jianfang; Ma, Yujie; Tu, Qiufeng; Li, Qi; Wang, Huaqing

2016-01-01

To understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy. Retrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old. The cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010-2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50-years old (52.3/1000 vs 15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50-years old to 8.55/1,000 among 80-year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000 vs 18.7/1,000; annual incidence rate, 3.95/1000 vs 2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000 vs 17.2/1,000; annual incidence rate, 7.65/1000 vs 2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7-795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left. Incidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China.

Usefulness of the Pipeline Embolic Device for Large and Giant Carotid Cavernous Aneurysms

PubMed Central

Hiramatsu, Ryo; Ohnishi, Hiroyuki; Yagi, Ryokichi; Kuroiwa, Toshihiko

2017-01-01

Purpose Conventional coil embolization for large carotid cavernous aneurysms (CCAs) has limited utility due to its inability to prevent recurrences and reduce mass effect. Trapping of the parent artery may have a risk of ischemic complications due to intracranial perfusion disorders. We successfully treated 24 patients with large CCAs using a flow diverter (Pipeline™ embolic device: PED), and this report discusses the safety and efficacy of this method. Materials and Methods Twenty four patients (23 females, mean age 71.5 years old) with large CCAs, including 6 giant CCAs, were treated with a PED over three years. Under sufficient dual anti-platelet management, the PED was deployed over the orifice of the aneurysm. Two patients required multiple telescoping stents. Clinical and radiological states were checked with MRI at 1, 3 and 6 months post-surgically. Angiographic follow-up was performed at 6 months. Results In all patients, PED was appropriately deployed. Stagnation of contrast with eclipse signs was observed post-angiogram in 21 cases. One patient requiring 5 telescoping stents experienced temporary ischemic symptoms. Fourteen patients experienced improvement of ocular motor impairment deficiency, including 6 patients who recovered. Angiograms at 6 months follow-up showed complete occlusion in 63% (12/19) of patients, and MRI showed reduction of aneurysm volume in 89% (17/19) of patients. Conclusion Flow diverters for large CCAs showed promising clinical and radiological efficacy. They can shrink the aneurysm and improve symptoms without sacrificing the parent artery. It will be necessary to summarize the cases and to verify the long-term results. PMID:28955510

Possible seasonality in large deep-focus earthquakes

NASA Astrophysics Data System (ADS)

Zhan, Zhongwen; Shearer, Peter M.

2015-09-01

Large deep-focus earthquakes (magnitude > 7.0, depth > 500 km) have exhibited strong seasonality in their occurrence times since the beginning of global earthquake catalogs. Of 60 such events from 1900 to the present, 42 have occurred in the middle half of each year. The seasonality appears strongest in the northwest Pacific subduction zones and weakest in the Tonga region. Taken at face value, the surplus of northern hemisphere summer events is statistically significant, but due to the ex post facto hypothesis testing, the absence of seasonality in smaller deep earthquakes, and the lack of a known physical triggering mechanism, we cannot rule out that the observed seasonality is just random chance. However, we can make a testable prediction of seasonality in future large deep-focus earthquakes, which, given likely earthquake occurrence rates, should be verified or falsified within a few decades. If confirmed, deep earthquake seasonality would challenge our current understanding of deep earthquakes.

Lessons learned from twenty-year operation of the Large Helical Device poloidal coils made from cable-in-conduit conductors

NASA Astrophysics Data System (ADS)

Takahata, Kazuya; Moriuchi, Sadatomo; Ooba, Kouki; Takami, Shigeyuki; Iwamoto, Akifumi; Mito, Toshiyuki; Imagawa, Shinsaku

2018-04-01

The Large Helical Device (LHD) superconducting magnet system consists of two pairs of helical coils and three pairs of poloidal coils. The poloidal coils use cable-in-conduit (CIC) conductors, which have now been adopted in many fusion devices, with forced cooling by supercritical helium. The poloidal coils were first energized with the helical coils on March 27, 1998. Since that time, the coils have experienced 54,600 h of steady cooling, 10,600 h of excitation operation, and nineteen thermal cycles for twenty years. During this period, no superconducting-to-normal transition of the conductors has been observed. The stable operation of the poloidal coils demonstrates that a CIC conductor is suited to large-scale superconducting magnets. The AC loss has remained constant, even though a slight decrease was observed in the early phase of operation. The hydraulic characteristics have been maintained without obstruction over the entire period of steady cooling. The experience gained from twenty years of operation has also provided lessons regarding malfunctions of peripheral equipment.

Social tension as precursor of large damaging earthquake: legend or reality?

NASA Astrophysics Data System (ADS)

Molchanov, O.

2008-11-01

Using case study of earthquake (EQ) activity and war conflicts in Caucasus during 1975 2002 time interval and correlation analysis of global distribution of damaging EQs and war-related social tension during 1901 2005 period we conclude:

• There is a statistically reliable increase of social tension several years (or several months in case study) before damaging EQs,
• There is evident decrease of social tension several years after damaging EQs, probably due to society consolidation,
• Preseismic effect is absent for the large EQs in unpopulated areas,
• There is some factual background for legendary belief in Almighty retribution for social abnormal behavior.

The future of large old trees in urban landscapes.

PubMed

Le Roux, Darren S; Ikin, Karen; Lindenmayer, David B; Manning, Adrian D; Gibbons, Philip

2014-01-01

Large old trees are disproportionate providers of structural elements (e.g. hollows, coarse woody debris), which are crucial habitat resources for many species. The decline of large old trees in modified landscapes is of global conservation concern. Once large old trees are removed, they are difficult to replace in the short term due to typically prolonged time periods needed for trees to mature (i.e. centuries). Few studies have investigated the decline of large old trees in urban landscapes. Using a simulation model, we predicted the future availability of native hollow-bearing trees (a surrogate for large old trees) in an expanding city in southeastern Australia. In urban greenspace, we predicted that the number of hollow-bearing trees is likely to decline by 87% over 300 years under existing management practices. Under a worst case scenario, hollow-bearing trees may be completely lost within 115 years. Conversely, we predicted that the number of hollow-bearing trees will likely remain stable in semi-natural nature reserves. Sensitivity analysis revealed that the number of hollow-bearing trees perpetuated in urban greenspace over the long term is most sensitive to the: (1) maximum standing life of trees; (2) number of regenerating seedlings ha(-1); and (3) rate of hollow formation. We tested the efficacy of alternative urban management strategies and found that the only way to arrest the decline of large old trees requires a collective management strategy that ensures: (1) trees remain standing for at least 40% longer than currently tolerated lifespans; (2) the number of seedlings established is increased by at least 60%; and (3) the formation of habitat structures provided by large old trees is accelerated by at least 30% (e.g. artificial structures) to compensate for short term deficits in habitat resources. Immediate implementation of these recommendations is needed to avert long term risk to urban biodiversity.

The Future of Large Old Trees in Urban Landscapes

PubMed Central

Le Roux, Darren S.; Ikin, Karen; Lindenmayer, David B.; Manning, Adrian D.; Gibbons, Philip

2014-01-01

Large old trees are disproportionate providers of structural elements (e.g. hollows, coarse woody debris), which are crucial habitat resources for many species. The decline of large old trees in modified landscapes is of global conservation concern. Once large old trees are removed, they are difficult to replace in the short term due to typically prolonged time periods needed for trees to mature (i.e. centuries). Few studies have investigated the decline of large old trees in urban landscapes. Using a simulation model, we predicted the future availability of native hollow-bearing trees (a surrogate for large old trees) in an expanding city in southeastern Australia. In urban greenspace, we predicted that the number of hollow-bearing trees is likely to decline by 87% over 300 years under existing management practices. Under a worst case scenario, hollow-bearing trees may be completely lost within 115 years. Conversely, we predicted that the number of hollow-bearing trees will likely remain stable in semi-natural nature reserves. Sensitivity analysis revealed that the number of hollow-bearing trees perpetuated in urban greenspace over the long term is most sensitive to the: (1) maximum standing life of trees; (2) number of regenerating seedlings ha−1; and (3) rate of hollow formation. We tested the efficacy of alternative urban management strategies and found that the only way to arrest the decline of large old trees requires a collective management strategy that ensures: (1) trees remain standing for at least 40% longer than currently tolerated lifespans; (2) the number of seedlings established is increased by at least 60%; and (3) the formation of habitat structures provided by large old trees is accelerated by at least 30% (e.g. artificial structures) to compensate for short term deficits in habitat resources. Immediate implementation of these recommendations is needed to avert long term risk to urban biodiversity. PMID:24941258

Neonatal Meningoventriculitis Due to Proteus Mirabilis – A Case Report

PubMed Central

Juyal, Deepak; Rathaur, Vyas Kumar; Sharma, Neelam

2013-01-01

A five day old full term born baby was admitted to our Neonatal Intensive Care Unit with seizures, opisthotonous posture and was icteric upto thigh. Baby had a three day history of poor feeding, lethargy and abnormal body movements. Mother was a 29 years old primigravida and had a normal vaginal delivery at home. Sepsis profile of the patient was requested, lumbar puncture and ventricular tap was performed. Patient was put on third generation cephalosporins, aminoglycosides and phenobarbitone. Culture and sensitivity report of blood, Cerebro spinal fluid and ventricular fluid showed Proteus mirabilis. Computerized Tomography scan showed a large parenchymal lesion in the right frontal lobe and diffuse ependymal enhancement along both the lateral ventricles suggestive of meningoventriculitis. We hereby present a fatal case of neonatal meningoventriculitis due to Proteus mirabilis. PMID:23543669

Massive pericardial effusion without cardiac tamponade due to subclinical hypothyroidism (Hashimoto's disease).

PubMed

Papakonstantinou, Panteleimon E; Gourniezakis, Nikolaos; Skiadas, Christos; Patrianakos, Alexandros; Gikas, Achilleas

2018-05-01

Hypothyroidism is a significant cause of pericardial effusion. However, large pericardial effusions due to hypothyroidism are extremely rare. Hormone replacement therapy is the cornerstone of treatment for hypothyroidism and regular follow-up of patients after initiation of the therapy is indicated. Herein, the case of a 70-year-old woman with a massive pericardial effusion due to Hashimoto's disease is presented. A 70-year-old female from a rural village on the island of Crete, Greece, was admitted to our hospital due to a urinary tract infection. She was under hormone replacement therapy with levothyroxine 100 µg once a day for Hashimoto's disease. Two years previously, the patient had had an episode of pericarditis due to hypothyroidism and had undergone a computed tomography-guided pericardiocentesis. The patient did not have regular follow-up and did not take the hormone replacement therapy properly. On admission, the patient's chest X-ray incidentally showed a possible pericardial effusion. The patient was referred for echocardiography, which revealed a massive pericardial effusion. Beck's triad was absent. Thyroid hormones were consistent with subclinical hypothyroidism: thyroid-stimulating hormone (TSH) 30.25 mIU/mL (normal limits: 0.25-3.43); free thyroxin 4 0.81 ng/dL (normal limits: 0.7-1.94). The patient had a score of 5 on the scale outlined by the European Society of Cardiology (ESC) position statement on triage strategy for cardiac tamponade and, despite the absence of cardiac tamponade, a pericardiocentesis was performed after 48 hours. The patient was treated with 125 µg levothyroxine orally once daily. This was a rare case of an elderly female patient from a rural village with chronic massive pericardial effusion due to subclinical hypothyroidism without cardiac tamponade. Hypothyroidism should be included in the differential diagnosis of pericardial effusion, especially in a case of unexplained pericardial fluid. Initiation of hormone

[Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)].

PubMed

López, Cristina; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

2016-04-01

The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; P<.001) and higher mortality from NAEs (68% vs 45%; P=.006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p=001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P=.06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%; P=.001). Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Healthy Life-Years Lost and Excess Bed-Days Due to 6 Patient Safety Incidents: Empirical Evidence From English Hospitals.

PubMed

Hauck, Katharina D; Wang, Shaolin; Vincent, Charles; Smith, Peter C

2017-02-01

There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years. To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days. The study used cross-sectional analysis of the medical records of all inpatients treated in 273 English hospitals. Patients with 6 types of preventable incidents were identified. Total attributable loss of HLYs was estimated through propensity score matching by considering the hypothetical remaining length and quality of life had the incident not occurred. The 6 incidents resulted in an annual loss of 68 HLYs and 934 excess bed-days per 100,000 population. Preventable pressure ulcers caused the loss of 26 HLYs and 555 excess bed-days annually. Deaths in low-mortality procedures resulted in 25 lost life-years and 42 bed-days. Deep-vein thrombosis/pulmonary embolisms cost 12 HLYs, and 240 bed-days. Postoperative sepsis, hip fractures, and central-line infections cost <6 HLYs and 100 bed-days each. The burden caused by the 6 incidents is roughly comparable with the UK burden of Multiple Sclerosis (80 DALYs per 100,000), HIV/AIDS and Tuberculosis (63 DALYs), and Cervical Cancer (58 DALYs). There were marked differences in the harm caused by the incidents, despite the public attention all of them receive. Decision makers can use the results to prioritize resources into further research and effective interventions.

Infeasibility of endoscopic transmural drainage due to pancreatic pseudocyst wall calcifications - case report.

PubMed

Krajewski, Andrzej; Lech, Gustaw; Makiewicz, Marcin; Kluciński, Andrzej; Wojtasik, Monika; Kozieł, Sławomir; Słodkowski, Maciej

2017-02-28

Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role. For endoscopic transmural drainage, it is necessary that the cyst wall adheres to the stomach or duodenum, making a visible impression. We present a very rare case of infeasibility of endoscopic drainage of a postinflammatory pancreatic pseudocyst, impressing the stomach, due to cyst wall calcifications. A 55-year-old man after acute pancreatitis presented with a 1-year history of epigastric pain and was admitted due to a postinflammatory pseudocyst in the body and tail of pancreas. On admission, blood tests, including CA 19-9 and CEA, were normal. An ultrasound examination revealed a 100-mm pseudocyst in the tail of pancreas, which was confirmed on CT and EUS. Acoustic shadowing caused by cyst wall calcifications made the cyst unavailable to ultrasound assessment and percutaneous drainage. Gastroscopy revealed an impression on the stomach wall from the outside. The patient was scheduled for endoscopic transmural drainage. After insufflation of the stomach, a large mass protruding from the wall was observed. The stomach mucosa was punctured with a cystotome needle knife, and the pancreatic cyst wall was reached. Due to cyst wall calcifications, endoscopic drainage of the cyst was unfeasible. Profuse submucosal bleeding at the puncture site was stopped by placing clips. The patient was scheduled for open surgery, and distal pancreatectomy with splenectomy was performed. The histopathological examination confirmed the initial diagnosis

Improved moving window cross-spectral analysis for resolving large temporal seismic velocity changes in permafrost

DOE PAGES

James, S. R.; Knox, H. A.; Abbott, R. E.; ...

2017-04-13

Cross correlations of seismic noise can potentially record large changes in subsurface velocity due to permafrost dynamics and be valuable for long-term Arctic monitoring. We applied seismic interferometry, using moving window cross-spectral analysis (MWCS), to 2 years of ambient noise data recorded in central Alaska to investigate whether seismic noise could be used to quantify relative velocity changes due to seasonal active-layer dynamics. The large velocity changes (>75%) between frozen and thawed soil caused prevalent cycle-skipping which made the method unusable in this setting. We developed an improved MWCS procedure which uses a moving reference to measure daily velocity variationsmore » that are then accumulated to recover the full seasonal change. This approach reduced cycle-skipping and recovered a seasonal trend that corresponded well with the timing of active-layer freeze and thaw. Lastly, this improvement opens the possibility of measuring large velocity changes by using MWCS and permafrost monitoring by using ambient noise.« less

Chylous ascites associated with intestinal obstruction from volvulus due to Petersen's hernia: report of a case.

PubMed

Akama, Yuichi; Shimizu, Tetsuya; Fujita, Itsuo; Kanazawa, Yoshikazu; Kakinuma, Daisuke; Kanno, Hitoshi; Yamagishi, Aya; Arai, Hiroki; Uchida, Eiji

2016-12-01

Chylous ascites is an uncommon finding which is usually associated with recent abdominal/oncologic or retroperitoneal surgery. It is not usually seen in cases of acute obstruction. A patient who had previously undergone a laparoscopy-assisted distal gastrectomy with Roux-en-Y reconstruction for early gastric cancer presented with acute abdominal pain and epigastric fullness. Computed tomography suggested small bowel obstruction due to volvulus. We were able to reduce the volvulus and close a Petersen's hernia without resecting the bowel; a large amount of chylous ascites was an incidental finding. We present a case of chylous ascites occurring in a setting of small bowel obstruction due to Petersen's hernia, 3 years after successful distal gastrectomy for early gastric cancer, with no evidence of tumor recurrence.

Large Urethro-Vesico-Vaginal Fistula due to a Vaginal Foreign Body in a 22-Year-Old Woman: Case Report and Literature Review.

PubMed

D'Elia, Carolina; Curti, Pierpaolo; Cerruto, Maria Angela; Monaco, Carmelo; Artibani, Walter

2015-01-01

In the non-industrialized countries of Africa and Asia obstetric fistulas are more frequently caused by prolonged labour, whereas in countries with developed healthcare systems they are generally the result of complications of gynaecological surgery or, rarely, benign pathologies like inflammation or foreign bodies. A 22-year-old woman was brought to the gynaecology clinic because of foul-smelling vaginal discharge. On pelvic examination a ring-like foreign body was impacted between the anterior and posterior vaginal wall. MRI scan confirmed the presence of a cylindrical foreign body in the vagina and the patient revealed that she had 'involuntarily' inserted a plastic bubble bath cap into the vagina. At surgery removal of the cap was difficult and at the end of the manoeuver evidence of a huge urethro-vesico-vaginal fistula occurred. The patient was discharged with bilateral ureteral stents and suprapubic catheter. After 3 months we performed an end-to-end anastomotic urethroplasty to repair the urethral avulsion and restored the bladder/trigonal and vaginal/cervical defects with 3 layers of sutures; 3 months later the patient had no complaints. Complex genital fistulas represent an extremely debilitating morbidity. In our case, a vaginal approach was successful, but the choice between an abdominal or vaginal approach depends on the surgeon's experience and training. © 2015 S. Karger AG, Basel.

A Large, First-Year, Introductory, Multi-Sectional Biological Concepts of Health Course Designed to Develop Skills and Enhance Deeper Learning

ERIC Educational Resources Information Center

Murrant, Coral L.; Dyck, David J.; Kirkland, James B.; Newton, Genevieve S.; Ritchie, Kerry L.; Tishinsky, Justine M.; Bettger, William J.; Richardson, Nicolette S.

2015-01-01

Large first-year biology classes, with their heavy emphasis on factual content, contribute to low student engagement and misrepresent the dynamic, interdisciplinary nature of biological science. We sought to redesign a course to deliver fundamental biology curriculum through the study of health, promote skills development, and encourage a deeper…

Closing the feedback loop: engaging students in large first-year mathematics test revision sessions using pen-enabled screens

NASA Astrophysics Data System (ADS)

Donovan, Diane; Loch, Birgit

2013-01-01

How can active learning, peer learning and prompt feedback be achieved in large first-year mathematics classes? Further, what technologies may support these aims? In this article, we assert that test revision sessions in first-year mathematics held in a technology-enhanced lecture theatre can be highly interactive with students solving problems, learning from each other and receiving immediate feedback. This is facilitated by pen-enabled screens and synchronization software. We argue that the educational benefits achievable through the technology do outweigh the technological distractions, and that these benefits can be achieved by focused, targeted one-off sessions and not only by a semester-long, regular approach. Repeat mid-semester test revision sessions were offered on a non-compulsory basis using pen-enabled screens for all students. Students worked practice test questions and marked solutions to mathematical problems on the screens. Students' work was then displayed anonymously for their peers to see. Answers were discussed with the whole class. We discuss outcomes from two offerings of these sessions using student feedback and lecturer reflections and show the impact of participation on self-reported student confidence. Pedagogical approaches that the technology allowed for the first time in a large class are highlighted. Students responded uniformly positively.

A Modified Gibson Assembly Method for Cloning Large DNA Fragments with High GC Contents.

PubMed

Li, Lei; Jiang, Weihong; Lu, Yinhua

2018-01-01

Gibson one-step, isothermal assembly method (Gibson assembly) can be used to efficiently assemble large DNA molecules by in vitro recombination involving a 5'-exonuclease, a DNA polymerase and a DNA ligase. In the past few years, this robust DNA assembly method has been widely applied to seamlessly construct genes, genetic pathways and even entire genomes. Here, we expand this method to clone large DNA fragments with high GC contents, such as antibiotic biosynthetic gene clusters from Streptomyces . Due to the low isothermal condition (50 °C) in the Gibson reaction system, the complementary overlaps with high GC contents are proposed to easily form mismatched linker pairings, which leads to low assembly efficiencies mainly due to vector self-ligation. So, we modified this classic method by the following two steps. First, a pair of universal terminal single-stranded DNA overhangs with high AT contents are added to the ends of the BAC vector. Second, two restriction enzyme sites are introduced into the respective sides of the designed overlaps to achieve the hierarchical assembly of large DNA molecules. The optimized Gibson assembly method facilitates fast acquisition of large DNA fragments with high GC contents from Streptomyces.

Mortality and morbidity due to gastric dilatation-volvulus syndrome in pedigree dogs in the UK.

PubMed

Evans, Katy M; Adams, Vicki J

2010-07-01

To estimate breed-specific risk of death due to, and prevalence of, gastric dilatation-volvulus (GDV) in UK pedigree dogs. Data were available on the reported cause of and age at death and occurrence of and age at diagnosis of disease from the 2004 purebred dog health survey. A total of 15,881 dogs of 165 breeds had died in the previous 10 years; GDV was the cause of death in 65 breeds. There were 36,006 live dogs of 169 breeds of which 48 breeds had experienced > or =1 episodes of GDV. Prevalence ratios were used to estimate breed-specific GDV mortality and morbidity risks. Gastric dilatation-volvulus was the cause of death for 389 dogs, representing 2.5% (95% CI: 2.2-2.7) of all deaths reported and the median age at death was 7.92 years. There were 253 episodes in 238 live dogs. The median age at first diagnosis was five years. Breeds at greatest risk of GDV mortality were the bloodhound, Grand Bleu de Gascogne, German longhaired pointer and Neapolitan mastiff. Breeds at greatest risk of GDV morbidity were the Grand Bleu de Gascogne, bloodhound, otterhound, Irish setter and Weimaraner. These results suggest that 16 breeds, mainly large/giant, are at increased risk of morbidity/mortality due to GDV.

Large forest fires in Canada, 1959-1997

NASA Astrophysics Data System (ADS)

Stocks, B. J.; Mason, J. A.; Todd, J. B.; Bosch, E. M.; Wotton, B. M.; Amiro, B. D.; Flannigan, M. D.; Hirsch, K. G.; Logan, K. A.; Martell, D. L.; Skinner, W. R.

2002-01-01

A Large Fire Database (LFDB), which includes information on fire location, start date, final size, cause, and suppression action, has been developed for all fires larger than 200 ha in area for Canada for the 1959-1997 period. The LFDB represents only 3.1% of the total number of Canadian fires during this period, the remaining 96.9% of fires being suppressed while <200 ha in size, yet accounts for ˜97% of the total area burned, allowing a spatial and temporal analysis of recent Canadian landscape-scale fire impacts. On average ˜2 million ha burned annually in these large fires, although more than 7 million ha burned in some years. Ecozones in the boreal and taiga regions experienced the greatest areas burned, with an average of 0.7% of the forested land burning annually. Lightning fires predominate in northern Canada, accounting for 80% of the total LFDB area burned. Large fires, although small in number, contribute substantially to area burned, most particularly in the boreal and taiga regions. The Canadian fire season runs from late April through August, with most of the area burned occurring in June and July due primarily to lightning fire activity in northern Canada. Close to 50% of the area burned in Canada is the result of fires that are not actioned due to their remote location, low values-at-risk, and efforts to accommodate the natural role of fire in these ecosystems. The LFDB is updated annually and is being expanded back in time to permit a more thorough analysis of long-term trends in Canadian fire activity.

Southern African Large Telescope (SALT) project: progress and status after 2 years

NASA Astrophysics Data System (ADS)

Meiring, Jacobus G.; Buckley, David A. H.; Lomberg, Michael C.; Stobie, Robert S.

2003-02-01

The Southern African Large Telescope (SALT) is a 10-m class optical/IR segmented mirror telescope based on the groundbreaking, low cost, Hobby-Eberly Telescope (HET) design. Approval to construct and operate SALT, which will be the largest single optical telescope in the Southern Hemisphere, was given by the South African Government in November 1999, after sufficient guarantees of matching funding from international partners were secured. Facility construction started in January 2001, and SALT is due to start operations by December 2004. SALT will enable a quantum leap in astronomical research capability in Southern Africa, and indeed the continent, where currently the largest telescope is a modest 1.9-m, dating to the 1940s. A substantial amount of design work for SALT has been completed, sourced from multiple suppliers, with ~60% South African content. South African industry is well equipped to handle the construction of most of the telescope, the exceptions being the glass ceramic mirror blanks (from LZOS in Russia), the polishing and ion figuring of these (Eastman Kodak in the USA), and fabrication of the four-element spherical aberration corrector (SAGEM in France). This paper will present (1) the scientific requirements, (2) the specified performance of SALT, (3) the basic design, with emphasis on the innovative modifications to the HET design that enable significantly improved performance, (4) the progress and status of the project, currently in its construction phase, (5) the first generation instrument suite, (6) the management and organisation of the project and (7) the international partnership in SALT.

Contract Law, Due Process, and the NCAA.

ERIC Educational Resources Information Center

Dickerson, Jaffe D.; Chapman, Mayer

1978-01-01

The NCAA has enjoyed almost total freedom from judicial scrutiny of its rules, procedures, and official acts in large part because of its private nature as an unincorporated association. The function of the NCAA, California State University, Hayward v NCAA, and due process of the student-athlete are discussed. (MLW)

Small and large wetland fragments are equally suited breeding sites for a ground-nesting passerine.

PubMed

Pasinelli, Gilberto; Mayer, Christian; Gouskov, Alexandre; Schiegg, Karin

2008-06-01

Large habitat fragments are generally thought to host more species and to offer more diverse and/or better quality habitats than small fragments. However, the importance of small fragments for population dynamics in general and for reproductive performance in particular is highly controversial. Using an information-theoretic approach, we examined reproductive performance and probability of local recruitment of color-banded reed buntings Emberiza schoeniclus in relation to the size of 18 wetland fragments in northeastern Switzerland over 4 years. We also investigated if reproductive performance and recruitment probability were density-dependent. None of the four measures of reproductive performance (laying date, nest failure probability, fledgling production per territory, fledgling condition) nor recruitment probability were found to be related to wetland fragment size. In terms of fledgling production, however, fragment size interacted with year, indicating that small fragments were better reproductive grounds in some years than large fragments. Reproductive performance and recruitment probability were not density-dependent. Our results suggest that small fragments are equally suited as breeding grounds for the reed bunting as large fragments and should therefore be managed to provide a habitat for this and other specialists occurring in the same habitat. Moreover, large fragments may represent sinks in specific years because a substantial percentage of all breeding pairs in our study area breed in large fragments, and reproductive failure in these fragments due to the regularly occurring floods may have a much stronger impact on regional population dynamics than comparable events in small fragments.

Increased Frequency of Large Blowdown Formation in Years With Hotter Dry Seasons in the Northwestern Amazon

NASA Astrophysics Data System (ADS)

Rifai, S. W.; Anderson, L. O.; Bohlman, S.

2015-12-01

Blowdowns, which are large tree mortality events caused by downbursts, create large pulses of carbon emissions in the short term and alter successional dynamics and species composition of forests, thus affecting long term biogeochemical cycling of tropical forests. Changing climate, especially increasing temperatures and frequency of extreme climate events, may cause changes in the frequency of blowdowns, but there has been little spatiotemporal analysis to associate the interannual variation in the frequency of blowdowns with annual climate parameters. We mapped blowdowns greater than 25 ha using a time series of Landsat images from 1984-2012 in the northwestern Amazon to estimate the annual size distribution of these blowdowns. The difference in forest area affected by blowdowns between the years with the highest and lowest blowdown activity were on the order of 10 - 30 times greater depending on location. Spatially, we found the probability of large blowdowns to be higher in regions with higher annual rainfall. Temporally, we found a positive correlation between the probability of large blowdown events and maximum dry season air temperature (R2 = 0.1-0.46). Mean and maximum blowdown size also increased with maximum dry season air temperature. The strength of these relationships varied between scene locations which may be related to cloud cover obscuring the land surface in the satellite images, or biophysical characteristics of the sites. Potentially, elevated dry season temperatures during the transition from the dry season to the wet season (October - December) may exacerbate atmospheric instabilities, which promote downburst occurrences. Most global circulation models predict dry season air temperatures to increase 2-5 ℃ in the northwestern Amazon by 2050. Should the blowdown disturbance regime continue increasing with elevated dry season temperatures, the northwestern Amazon is likely to experience more catastrophic tree mortality events which has direct

Due Process Hearing Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2009-01-01

"Chuck" is a 10-year-old student residing in an unnamed District ("the District"), identified as eligible for specially designed instruction because of a specific learning disability. His parents' due process complaint (filed in December 2008) requested compensatory education for the period September 2006 to June 2008. They believed that Chuck,…

Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery.

PubMed

Greenberg, Jason H; Devarajan, Prasad; Thiessen-Philbrook, Heather R; Krawczeski, Catherine; Parikh, Chirag R; Zappitelli, Michael

2018-06-01

We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase-associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.

Factors driving diabetes care improvement in a large medical group: ten years of progress.

PubMed

Sperl-Hillen, JoAnn M; O'Connor, Patrick J

2005-08-01

The purpose of this study was to document trends in diabetes quality of care and coinciding strategies for quality improvement over 10 years in a large medical group. Adults with diagnosed diabetes mellitus were identified each year from 1994 (N = 5610) to 2003 (N = 7650), and internal medical group data quantified improvement trends. Multivariate analysis was used to identify factors that did and did not contribute to improvement trends. Median glycosylated hemoglobin A1C (A1C) levels improved from 8.3% in 1994 to 6.9% in 2003 (P <.001). Mean low-density lipoprotein (LDL) cholesterol measurements improved from 132 mg/dL in 1995 to 97 mg/dL in 2003 (P <.001). Both A1C (P <.01) and LDL improvement (P <.0001) were driven by drug intensification, leadership commitment to diabetes improvement, greater continuity of primary care, participation in local and national diabetes care improvement initiatives, and allocation of multidisciplinary resources at the clinic level to improve diabetes care. Resources were spent on nurse and dietitian educators, active outreach to high-risk patients facilitated by registries, physician opinion leader activities including clinic-based training programs, and financial incentives to primary care clinics. Use of endocrinology referrals was stable throughout the period at about 10% of patients per year, and there were no disease management contracts to outside vendors over the study period. Electronic medical records did not favorably affect glycemic control or lipid control in this setting. This primary care-based system achieved A1C and LDL reductions sufficient to reduce macrovascular and microvascular risk by about 50% according to landmark studies; further risk reduction should be attainable through better blood pressure control. Strategies for diabetes improvement need to be customized to address documented gaps in quality of care, provider prescribing behaviors, and patient characteristics.

Unusual infections due to Listeria monocytogenes in the Southern California Desert.

PubMed

Cone, Lawrence A; Somero, Michael S; Qureshi, Farsana J; Kerkar, Shuba; Byrd, Richard G; Hirschberg, Joel M; Gauto, Anibal R

2008-11-01

During the past 22 years, 14 patients have been hospitalized with infection due to Listeria monocytogenes at the Eisenhower Medical Center, a regional 300-bed hospital in the desert southwest of Southern California. A large number of patients are retired, elderly, and have underlying and often systemic disease. Blood agar and routine media were inoculated with liquid from a sterile site such as blood, cerebrospinal fluid, or joint fluid and observed daily for growth. Appropriate biochemical studies were used to speciate the organism. While bacteremia and meningitis constitute 75% of infections in most studies, they made up only 36% of patients in the current study. Listeriosis occurred mostly in patients with infected aortic aneurysms and brain abscesses, and in prosthetic joint infections. While mortality is generally stated to be around 45% in patients with listeriosis, it was 35% in this study. However, there were no deaths in five patients with bacteremia or meningitis inferring that organ involvement poses a greater hazard for survival. Listeriosis usually presents as a bacteremia or meningitis due to a food-borne invasive infection. In the desert of Southern California most cases are seen in older patients with underlying disease and present with infected aortic aneurysms, prosthetic joints, and brain abscesses. They represent a greater threat to survival due to organ involvement.

Effects of Grid Resolution on Modeled Air Pollutant Concentrations Due to Emissions from Large Point Sources: Case Study during KORUS-AQ 2016 Campaign

NASA Astrophysics Data System (ADS)

Ju, H.; Bae, C.; Kim, B. U.; Kim, H. C.; Kim, S.

2017-12-01

Large point sources in the Chungnam area received a nation-wide attention in South Korea because the area is located southwest of the Seoul Metropolitan Area whose population is over 22 million and the summertime prevalent winds in the area is northeastward. Therefore, emissions from the large point sources in the Chungnam area were one of the major observation targets during the KORUS-AQ 2016 including aircraft measurements. In general, horizontal grid resolutions of eulerian photochemical models have profound effects on estimated air pollutant concentrations. It is due to the formulation of grid models; that is, emissions in a grid cell will be assumed to be mixed well under planetary boundary layers regardless of grid cell sizes. In this study, we performed series of simulations with the Comprehensive Air Quality Model with eXetension (CAMx). For 9-km and 3-km simulations, we used meteorological fields obtained from the Weather Research and Forecast model while utilizing the "Flexi-nesting" option in the CAMx for the 1-km simulation. In "Flexi-nesting" mode, CAMx interpolates or assigns model inputs from the immediate parent grid. We compared modeled concentrations with ground observation data as well as aircraft measurements to quantify variations of model bias and error depending on horizontal grid resolutions.

Dephasing due to Nuclear Spins in Large-Amplitude Electric Dipole Spin Resonance.

PubMed

Chesi, Stefano; Yang, Li-Ping; Loss, Daniel

2016-02-12

We analyze effects of the hyperfine interaction on electric dipole spin resonance when the amplitude of the quantum-dot motion becomes comparable or larger than the quantum dot's size. Away from the well-known small-drive regime, the important role played by transverse nuclear fluctuations leads to a Gaussian decay with characteristic dependence on drive strength and detuning. A characterization of spin-flip gate fidelity, in the presence of such additional drive-dependent dephasing, shows that vanishingly small errors can still be achieved at sufficiently large amplitudes. Based on our theory, we analyze recent electric dipole spin resonance experiments relying on spin-orbit interactions or the slanting field of a micromagnet. We find that such experiments are already in a regime with significant effects of transverse nuclear fluctuations and the form of decay of the Rabi oscillations can be reproduced well by our theory.

Due Process Hearing Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2008-01-01

Ben is a 16-year-old student who resides with his family in an unnamed School District. He is eligible for special education by reason of specific learning disability and ADHD. His parents requested a due process hearing, alleging that the District failed to provide him with a free appropriate public education (FAPE) and requesting reimbursement…

Natural and Human Impacts on Recent Development of Asian Large Rivers and Deltas

NASA Astrophysics Data System (ADS)

Liu, P.; Lu, C.

2014-12-01

Most recent data analysis indicates sediment loads in most of Asian large rivers (like, Yellow, Yangtze, Pearl, Chao Phraya, Indus, Krishna, Godavari, etc) have decreased up to 80-90% in the past 60 years. Correspondingly, most of Asian large river deltas are facing severe sediment starving; delta shoreline comparisons indicate that some are under strong coastal erosion. For examples, the Yellow River Delta has been retreating since 1990s when its annual sediment load has kept below 300 million tons. The Yangtze River delta kept growing before Three Gorges Dams was operating, and began to be eroded from the year 2003 to 2009, and then prograded locally due to the Deep Water Navigation Project. The Mekong Delta shoreline has also been dynamically changing with the sediment flux variation, eroding from 1989 to 1996 and prograding from 1996 to 2002. More information is available at http://www.meas.ncsu.edu/sealevel

Socioeconomic inequalities in cause-specific mortality after disability retirement due to different diseases.

PubMed

Polvinen, A; Laaksonen, M; Gould, R; Lahelma, E; Leinonen, T; Martikainen, P

2015-03-01

Socioeconomic inequalities in both disability retirement and mortality are large. The aim of this study was to examine socioeconomic differences in cause-specific mortality after disability retirement due to different diseases. We used administrative register data from various sources linked together by Statistics Finland and included an 11% sample of the Finnish population between the years 1987 and 2007. The data also include an 80% oversample of the deceased during the follow-up. The study included men and women aged 30-64 years at baseline and those who turned 30 during the follow-up. We used Cox regression analysis to examine socioeconomic differences in mortality after disability retirement. Socioeconomic differences in mortality after disability retirement were smaller than in the population in general. However, manual workers had a higher risk of mortality than upper non-manual employees after disability retirement due to mental disorders and cardiovascular diseases, and among men also diseases of the nervous system. After all-cause disability retirement, manual workers ran a higher risk of cardiovascular and alcohol-related death. However, among men who retired due to mental disorders or cardiovascular diseases, differences in social class were found for all causes of death examined. For women, an opposite socioeconomic gradient in mortality after disability retirement from neoplasms was found. Conclusions: The disability retirement process leads to smaller socioeconomic differences in mortality compared with those generally found in the population. This suggests that the disability retirement system is likely to accurately identify chronic health problems with regard to socioeconomic status. © 2014 the Nordic Societies of Public Health.

Craniopharyngioma with hyperprolactinaemia due to a prolactinoma.

PubMed Central

Wheatley, T; Clark, J D; Stewart, S

1986-01-01

A case is presented in which a histologically proven prolactin secreting pituitary macroadenoma was associated with a large suprasellar craniopharyngioma. The pre-operative prolactin concentration was 8180 mU/l. Although hyperprolactinaemia up to 3000 mU/l in patients with a craniopharyngioma is usually due to stalk compression, greater values may indicate an associated prolactinoma. Images PMID:3794737

Maculopathy due to drug inhalation.

PubMed

Asensio-Sánchez, V M; Gonzalez-Buendia, L; Marcos-Fernández, M

2014-08-01

A case of maculopathy due to "poppers" is described. Poppers is a drug composed of various forms of alkyl nitrite. A 39 year-old man, who had been using poppers for years, was seen in the clinic with phosphenes, reduced visual acuity and central scotoma. The SD-OCT in the right eye showed disruption at the level of the IS/OS junction line. The SD-OCT scan in the left eye showed an outer rectangular retinal hole and an outer retinal cyst. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Environmental due diligence within multinational corporations

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

MacLean, R.

1997-08-01

Superfund and other state and federal regulations that emerged during the 80`s dramatically changed the way corporations managed property transactions. At the beginning of that decade there were very few engineers experienced in environmental due diligence. Over the past 15 years a sophisticated consulting industry has emerged to support companies in their effort to minimize liabilities associated with contaminated property. There is now a wealth of published literature on environmental due diligence, including generally accepted standards for investigating property contamination from organizations such as ASTM. This paper examines the current state of environmental due diligence among multinationals. It presents themore » underlying reasons for the current ad hoc nature of due diligence investigations and what companies can do to improve their policies and communication networks. A summary is given of the best practices used by industry leaders to minimize liabilities.« less

A flipped mode teaching approach for large and advanced electrical engineering courses

NASA Astrophysics Data System (ADS)

Ravishankar, Jayashri; Epps, Julien; Ambikairajah, Eliathamby

2018-05-01

A fully flipped mode teaching approach is challenging for students in advanced engineering courses, because of demanding pre-class preparation load, due to the complex and analytical nature of the topics. When this is applied to large classes, it brings an additional complexity in terms of promoting the intended active learning. This paper presents a novel selective flipped mode teaching approach designed for large and advanced courses that has two aspects: (i) it provides selective flipping of a few topics, while delivering others in traditional face-to-face teaching, to provide an effective trade-off between the two approaches according to the demands of individual topics and (ii) it introduces technology-enabled live in-class quizzes to obtain instant feedback and facilitate collaborative problem-solving exercises. The proposed approach was implemented for a large fourth year course in electrical power engineering over three successive years and the criteria for selecting between the flipped mode teaching and traditional teaching modes are outlined. Results confirmed that the proposed approach improved both students' academic achievements and their engagement in the course, without overloading them during the teaching period.

Large Capacity SMES for Voltage Dip Compensation

NASA Astrophysics Data System (ADS)

Iwatani, Yu; Saito, Fusao; Ito, Toshinobu; Shimada, Mamoru; Ishida, Satoshi; Shimanuki, Yoshio

Voltage dips of power grids due to thunderbolts, snow damage, and so on, cause serious damage to production lines of precision instruments, for example, semiconductors. In recent years, in order to solve this problem, uninterruptible power supply systems (UPS) are used. UPS, however, has small capacity, so a great number of UPS are needed in large factories. Therefore, we have manufactured the superconducting magnetic energy storage (SMES) system for voltage dip compensation able to protect loads with large capacity collectively. SMES has advantages such as space conservation, long lifetime and others. In field tests, cooperating with CHUBU Electric Power Co., Inc. we proved that SMES is valuable for compensating voltage dips. Since 2007, 10MVA SMES improved from field test machines has been running in a domestic liquid crystal display plant, and in 2008, it protected plant loads from a number of voltage dips. In this paper, we report the action principle and components of the improved SMES for voltage dip compensation, and examples of waveforms when 10MVA SMES compensated voltage dips.

Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

PubMed Central

2009-01-01

Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk. PMID:19946578

Three consecutive years of road closures due to natural hazards in the Weisstannen valley, Canton of St-Gallen, Switzerland

NASA Astrophysics Data System (ADS)

Voumard, Jérémie; Derron, Marc-Henri; Jaboyedoff, Michel

2017-04-01

The Weisstannen small alpine valley located in the Canton of St-Gallen, Switzerland, has been affected by four different natural hazards these three last years. Its unique access road has been cut off height times during this period: by an earth slide in January 2014, by three debris flows in August 2015, by one debris flow in September 2016, by two floods in June and July 2016 and by a rockfall in May 2016. Although the valley is sparsely populated, 240 people have been affected by the height road closures due to these events. In addition to road damages, several buildings, of which a restaurant (with EUR 190'000 damages) and an animal shelter, have been damaged. In Switzerland, some roads of 15 communes have been affected by natural hazards at least three times in five years (2012-2016). Then the Weisstannen valley is not an exception at the communal level. However, it is the only valley whose unique access was cut off three consecutive years. With these repeated events, the population of the valley does not understand how possible it is to end up in such a situation in a country accustomed to natural hazards. In the media and social media, people do not hide their irritation regarding to this situation: "Have the authorities failed to take into account natural dangers despite of the 4.7 million Euro allocated for a flood protection project? Who is responsible of those repeated damages? Why the situation did not improve after the events of the first year and then the second year? ". In the present work, we try to shed the light on this peculiar case analysing the causes of road closures, studying meteorological, topographical, hydrological and geological data for each events. The effectiveness of the new protective measures built between the events are assessed, as the future planned protectives measures. Road closures consequences on the population and the economy are also estimated. Finally, we estimate the probability of having new road closures in the

Repair of a Large Main Pulmonary Artery Aneurysm in a 71-Year-Old Jehovah's Witness Patient

PubMed Central

Henn, Lucas W.; Esmailian, Fardad

2013-01-01

Pulmonary artery aneurysm is a rarely reported and poorly studied entity; most mentions in the literature are in case series and case reports. Cardiac surgery in Jehovah's Witness patients is occurring more frequently because of improved techniques of blood conservation. We report the repair of a large pulmonary artery aneurysm in a 71-year-old woman who was a Jehovah's Witness. Using total cardiopulmonary bypass, we replaced the main pulmonary artery and both branches with Gelweave tube-grafts, because the fragility of a homograft presented possible bleeding problems. The patient recovered rapidly, and her symptoms were greatly improved. We think that a patient's status as a Jehovah's Witness need not preclude potentially life-saving cardiac operations. PMID:23914038

Repair of a large main pulmonary artery aneurysm in a 71-year-old Jehovah's Witness patient.

PubMed

Henn, Lucas W; Esmailian, Fardad

2013-01-01

Pulmonary artery aneurysm is a rarely reported and poorly studied entity; most mentions in the literature are in case series and case reports. Cardiac surgery in Jehovah's Witness patients is occurring more frequently because of improved techniques of blood conservation. We report the repair of a large pulmonary artery aneurysm in a 71-year-old woman who was a Jehovah's Witness. Using total cardiopulmonary bypass, we replaced the main pulmonary artery and both branches with Gelweave tube-grafts, because the fragility of a homograft presented possible bleeding problems. The patient recovered rapidly, and her symptoms were greatly improved. We think that a patient's status as a Jehovah's Witness need not preclude potentially life-saving cardiac operations.

[Analysis of the impact of mortality due to suicides in Mexico, 2000-2012].

PubMed

Dávila Cervantes, Claudio Alberto; Ochoa Torres, María del Pilar; Casique Rodríguez, Irene

2015-12-01

The objective of this study was to analyze the burden of disease due to suicide in Mexico using years of life lost (YLL) between 2000 and 2012 by sex, age group (for those under 85 years of age) and jurisdiction. Vital statistics on mortality and population estimates were used to calculate standardized mortality rates and years of life lost due to suicide. Between 2000 and 2012 a sustained increase in the suicide mortality rate was observed in Mexico. The age group with the highest rate was 85 years of age or older for men, and 15-19 years of age for women. The highest impact in life expectancy due to suicide occurred at 20 to 24 years of age in men and 15 to 19 years of age in women. The states with the highest mortality due to suicide were located in the Yucatan Peninsula (Yucatan, Quintana Roo and Campeche). Mortality due to suicide in Mexico has increased continually. As suicides are preventable, the implementation of health public policies through timely identification, integral prevention strategies and the detailed study of associated risk factors is imperative.

Onychomycosis due to nondermatophytic molds.

PubMed

Hwang, Sung Min; Suh, Moo Kyu; Ha, Gyoung Yim

2012-05-01

Although there have been many studies about onychomycosis due to nondermatophytic molds (NDM), few studies about etiologic agents including NDM in onychomycosis have been reported in Korea. This study investigated onychomycosis due to NDM in the Gyeongju area of Korea. In the 10-year period from 1999~2009, we reviewed 59 patients with onychomycosis due to NDM. The etiologic agents were identified by cultures on Sabouraud's Dextrose agar with and without cycloheximide. In some cases, internal transcribed spacer sequence analysis was done. NDM isolated considered pathogens when the presence of fungal elements was identified by direct microscopy observation and in follow-up cultures yielding the same fungi. Onychomycosis due to NDM comprised 2.3% of all onychomycosis. Of the 59 patients with onychomycosis due to NDM, 84.7% were toenail onychomycosis and 15.3% were fingernail onychomycosis. The incidence rate was highest in the fifth decade (27.1%). The ratio of male to female patients was 1:1.6. The frequency of associated diseases, in descending order, was hypertension, diabetes mellitus, and cerebral hematoma. Distal and lateral subungual onychomycosis (86.4%) was the most common clinical type of onychomycosis. Aspergillus spp. was the most frequently isolated etiologic agent of onychomycosis due to NDM (83.0%). Other causative agents were Scopulariopsis brevicaulis (10.2%), Acremonium spp. (3.4%), Fusarium solani (1.7%), and Chaetomium globosum (1.7%). Because of the increase in onychomycosis due to NDM, we suggest the need of a careful mycological examination in patients with onychomycosis.

Influenza and Pneumonia Mortality in 66 Large Cities in the United States in Years Surrounding the 1918 Pandemic

PubMed Central

Acuna-Soto, Rodolfo; Viboud, Cécile; Chowell, Gerardo

2011-01-01

The 1918 influenza pandemic was a major epidemiological event of the twentieth century resulting in at least twenty million deaths worldwide; however, despite its historical, epidemiological, and biological relevance, it remains poorly understood. Here we examine the relationship between annual pneumonia and influenza death rates in the pre-pandemic (1910–17) and pandemic (1918–20) periods and the scaling of mortality with latitude, longitude and population size, using data from 66 large cities of the United States. The mean pre-pandemic pneumonia death rates were highly associated with pneumonia death rates during the pandemic period (Spearman ρ = 0.64–0.72; P<0.001). By contrast, there was a weak correlation between pre-pandemic and pandemic influenza mortality rates. Pneumonia mortality rates partially explained influenza mortality rates in 1918 (ρ = 0.34, P = 0.005) but not during any other year. Pneumonia death counts followed a linear relationship with population size in all study years, suggesting that pneumonia death rates were homogeneous across the range of population sizes studied. By contrast, influenza death counts followed a power law relationship with a scaling exponent of ∼0.81 (95%CI: 0.71, 0.91) in 1918, suggesting that smaller cities experienced worst outcomes during the pandemic. A linear relationship was observed for all other years. Our study suggests that mortality associated with the 1918–20 influenza pandemic was in part predetermined by pre-pandemic pneumonia death rates in 66 large US cities, perhaps through the impact of the physical and social structure of each city. Smaller cities suffered a disproportionately high per capita influenza mortality burden than larger ones in 1918, while city size did not affect pneumonia mortality rates in the pre-pandemic and pandemic periods. PMID:21886792

Prognostic Factors of Returning to Work after Sick Leave due to Work-Related Common Mental Disorders: A One- and Three-Year Follow-Up Study.

PubMed

Netterstrøm, Bo; Eller, Nanna Hurwitz; Borritz, Marianne

2015-01-01

The aim of this paper was to assess the prognostic factors of return to work (RTW) after one and three years among people on sick leave due to occupational stress. Methods. The study population comprised 223 completers on sick leave, who participated in a stress treatment program. Self-reported psychosocial work environment, life events during the past year, severity of the condition, occupational position, employment sector, marital status, and medication were assessed at baseline. RTW was assessed with data from a national compensation database (DREAM). Results. Self-reported high demands, low decision authority, low reward, low support from leaders and colleagues, bullying, high global symptom index, length of sick leave at baseline, and stressful negative life events during the year before baseline were associated with no RTW after one year. Low work ability and full-time sick leave at inclusion were predictors after three years too. Being single was associated with no RTW after three years. The type of treatment, occupational position, gender, age, and degree of depression were not associated with RTW after one or three years. Conclusion. The impact of the psychosocial work environment as predictor for RTW disappeared over time and only the severity of the condition was a predictor for RTW in the long run.

Evaluation of root force? container seedlings of four oak species for bottomland forest restoration in southern Indiana: 2 year results

Treesearch

Dale R. Weigel; Daniel C. Dey

2005-01-01

Bottomland forest restoration has become an area of interest in the last 10 to 15 years due to large scale bottomland flooding. Seed sources for large heavy seeded species such as the various native bottomland oaks are nonexistent, thus planting seedlings is needed to increase the proportion of heavy seeded trees to diversify bottomland forests. Nursery-grown bareroot...

Endoscopic surgical management of a large Morel-Lavallée lesion.

PubMed

Walls, Andrew; McMahon, Samuel E; MacDonald, Jonathan; Bunn, Jonathan

2017-09-23

The Morel-Lavallée lesion is a closed degloving injury that usually occurs following high-energy trauma. We present a case demonstrating endoscopic management of this lesion. A 44-year-old man fell from scaffolding. Initial assessment demonstrated no significant injury. An ultrasound scan 2 days post injury revealed a large fluid collection along the lateral right thigh. This subsequently became infected and did not respond to antibiotic therapy.Due to the extent of the lesion, we were reluctant to perform a traditional open drainage. An endoscopic probe was inserted at the proximal and distal poles of the lesion and the wound debrided.This resulted in a rapid improvement in symptoms and a complete resolution of the lesion at 1 year postsurgery, with no wound-associated morbidity.This is only the second description of endoscopic debridement of a large, acute Morel-Lavallée lesion, with an excellent outcome. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[A Case of Hyperammonemia Caused by Urinary Tract Infection Due to Urease-Producing Bacteria].

PubMed

Emura, Masahiro; Tsuchihashi, Kazunari; Shimizu, Yosuke; Kanamaru, Sojun; Matoba, Shun; Ito, Noriyuki

2016-08-01

We present here a rare case of hyperammonemia without liver dysfunction or portal-systemic shunting. The patient was an 80-year-old woman with a history of neurogenic bladder. She was admitted to a nearby hospital for vomiting, diarrhea and consciousness disturbance. Two days after admission, she was transferred to our hospital because of persistant consciousness disturbance. Laboratory data revealed hyperammonemia, but there was no indication of liver dysfunction. Moreover abdominal computed tomography did not reveal any clear finding of liver disease or portal-systemic shunting, but we noted multiple large bladder diverticula. Antibiotic therapy, tracheal intubation, ventilator management and bladder catheterization were performed. The patient's level of consciousness improved rapidly. Urinary culture revealed Bacteroides ureolyticus (urease-producing bacteria). The patient was diagnosed with hyperammonemia and a urinary tract infection due to urease-producing bacteria. Thus, physicians should be aware that obstructive urinary tract infections due to urease-producing bacteria can also be the cause of hyperammonemia.

Canary in the coal mine: Historical oxygen decline in the Gulf of St. Lawrence due to large scale climate changes

NASA Astrophysics Data System (ADS)

Claret, M.; Galbraith, E. D.; Palter, J. B.; Gilbert, D.; Bianchi, D.; Dunne, J. P.

2016-02-01

The regional signature of anthropogenic climate change on the atmosphere and upper ocean is often difficult to discern from observational timeseries, dominated as they are by decadal climate variability. Here we argue that a long-term decline of dissolved oxygen concentrations observed in the Gulf of S. Lawrence (GoSL) is consistent with anthropogenic climate change. Oxygen concentrations in the GoSL have declined markedly since 1930 due primarily to an increase of oxygen-poor North Atlantic Central Waters relative to Labrador Current Waters (Gilbert et al. 2005). We compare these observations to a climate warming simulation using a very high-resolution global coupled ocean-atmospheric climate model. The numerical model (CM2.6), developed by the Geophysical Fluid Dynamics Laboratory, is strongly eddying and includes a biogeochemical module with dissolved oxygen. The warming scenario shows that oxygen in the GoSL decreases and it is associated to changes in western boundary currents and wind patterns in the North Atlantic. We speculate that the large-scale changes behind the simulated decrease in GoSL oxygen have also been at play in the real world over the past century, although they are difficult to resolve in noisy atmospheric data.

Two years of Functional Electrical Stimulation by large surface electrodes for denervated muscles improve skin epidermis in SCI

PubMed Central

Albertin, Giovanna; Kern, Helmut; Hofer, Christian; Guidolin, Diego; Porzionato, Andrea; Rambaldo, Anna; Caro, Raffaele De; Piccione, Francesco; Marcante, Andrea; Zampieri, Sandra

2018-01-01

Our previous studies have shown that severely atrophic Quadriceps muscles of spinal cord injury (SCI) patients suffering with complete conus and cauda equina lesions, and thus with permanent denervation-induced atrophy and degeneration of muscle fibers, were almost completely rescued to normal size after two years of home-based Functional Electrical Stimulation (h-bFES). Since we used large surface electrodes to stimulate the thigh muscles, we wanted to know if the skin was affected by long-term treatment. Here we report preliminary data of morphometry of skin biopsies harvested from legs of 3 SCI patients before and after two years of h-bFES to determine the total area of epidermis in transverse skin sections. By this approach we support our recently published results obtained randomly measuring skin thickness in the same biopsies after H-E stain. The skin biopsies data of three subjects, taken together, present indeed a statistically significant 30% increase in the area of the epidermis after two years of h-bFES. In conclusion, we confirm a long term positive modulation of electrostimulated epidermis, that correlates with the impressive improvements of the FES-induced muscle strength and bulk, and of the size of the muscle fibers after 2-years of h-bFES. PMID:29686823

Two-Year Outcome of Aflibercept in Patients with Pigment Epithelial Detachment due to Neovascular Age-Related Macular Degeneration (nAMD) Refractory to Ranibizumab

PubMed Central

Dumas, Stéphane; Coscas, Florence

2017-01-01

Purpose To evaluate the response of intravitreal aflibercept injection (IAI) in eyes with detachment of retinal pigment epithelium (DEP) secondary to nAMD refractory to monthly ranibizumab. Patients and Methods This is a retrospective, multicenter study. All patients received 3 IAI then treated as needed every 4 weeks for 12 months. During the second year, the eyes were treated with a treat- and-extend regimen. Results Forty-four eyes were included. Best-corrected visual acuity improved significantly after the loading phase (3.1 ± 6.4 letters) and at 6 months (2.8 ± 6.4 letters), but change was not significant at 1 year and 2 years. The height of the DEP was significantly decreased at 3 months and 6 months, but the difference did not reach statistical difference at 1 and 2 years. Rate of eyes with complete resolution of exudation was 59% after the loading phase and 34.3% at 2 years. Mean interval of anti-VEGF injection was extended from 31 ± 2.6 days to 61 ± 5 days after conversion. Conclusions Aflibercept intravitreal injection in patients with fibrovascular DEP due to nAMD who respond poorly to monthly ranibizumab led to short-term functional and anatomical improvement. Reduction of intravitreal injection frequency was obtained until 2 years of follow-up. PMID:29093970

Biodegradable hybrid tissue engineering scaffolds for reconstruction of large bone defects

NASA Astrophysics Data System (ADS)

Barati, Danial

Complex skeletal injuries and large bone fractures are still a significant clinical problem in US. Approximately 1.5 million Americans (veterans, their families, and civilians) every year suffer from bone loss due to traumatic skeletal injuries, infection, and resection of primary tumors that require extensive grafting to bridge the gap. The US bone graft market is over $2.2 billion a year. Due to insufficient mechanical stability, lack of vascularity, and inadequate resorption of the graft, patients with traumatic large skeletal injuries undergo multiple costly operations followed by extensive recovery steps to maintain proper bone alignment and length. Current strategies for repairing damaged or diseased bones include autologous or allograft bone transplantations. However, limited availability of autografts and risk of disease transmission associated with allografts have necessitated the search for the development of new bone graft options and strategies. The overall goal of this project is to develop a much-needed bone-mimetic engineered graft as a substitute for current strategies providing required bone grafts for reconstruction of large bone defects. This project will use the structure of natural cortical bone as a guide to produce an engineered bone graft with balanced strength, osteogenesis, vascularization, and resorption. The outcome of this project will be a biodegradable hybrid scaffold system (similar to natural cortical bone) including a mechanically strong scaffold allowing for mechanical stability of the load-bearing defect site and a soft and highly porous structure such as a hydrogel phase which will allow for efficient cell and growth factor delivery into the defect implantation site, cell niche establishment and promotion of mineralization. Successful completion of this project will transform bone graft technology for regeneration of complex bone defects from a frozen or freeze-dried allograft to a safe, infection-free, mechanically

Physicians in transition: practice due diligence.

PubMed

Paterick, Timothy E

2013-01-01

The landscape of healthcare is changing rapidly. That landscape is now a business model of medicine. That rapid change resulting in a business model is affecting physicians professionally and personally. The new business model of medicine has led to large healthcare organizations hiring physicians as employees. The role of a physician as an employee has many limitations in terms of practice and personal autonomy. Employed physicians sign legally binding employment agreements that are written by the legal team working for the healthcare organization. Thus physicians should practice due diligence before signing the employment agreement. "Due diligence" refers to the care a reasonable person should take before entering into an agreement with another party. That reasonable person should seek expertise to represent his or her interests when searching a balanced agreement between the physician and organization.

Treatment strategies and outcomes in diffuse large B-cell lymphoma among 1011 patients aged 75 years or older: A Danish population-based cohort study.

PubMed

Juul, Maja Bech; Jensen, Pernille Hammershoej; Engberg, Henriette; Wehberg, Sonja; Dessau-Arp, Andriette; Haziri, Donika; Kristensen, Helene Bjoerg; Baech, Joachim; Schurmann, Lene; Clausen, Michael Roost; Valentin, Rebecca; Knudsen, Lene Meldgaard; Munksgaard, Lars; El-Galaly, Tarec Christoffer; Frederiksen, Henrik; Larsen, Thomas Stauffer

2018-06-20

Optimal treatment strategy for the oldest patients with diffuse large B-cell lymphoma (DLBCL) remains controversial, as this group often is precluded from clinical trials, and population-based studies are limited. All Danish DLBCL-patients ≥75 years diagnosed from 2003 to 2012 were identified, using the Danish National Lymphoma Registry (LYFO). Information regarding baseline characteristics, treatment, comorbidities and outcomes was retrieved from LYFO, the Danish National health registries and medical records. Patients were stratified by age (75-79; 80-84 and 85 + years), comorbidity score and treatment modality (standard treatment [R-CHOP/CHOP-like], less intensive regimens or palliative treatment). A total of 1011 patients were included. Standard treatment was initiated in 64%, ranging from 83% among patients aged 75-79 years to 32% among patient aged 85 + years. With standard treatment, median overall survival (OS) estimates were 4·6, 2·6, and 1·9 years for the age groups 75-79, 80-84 and 85+ years. Among patient aged 75-79 and 80-84 years, OS was superior with standard treatment, although high comorbidity scores attenuated this association. Among patients aged 85+ years, survival was not influenced by treatment intensity. Patients ≥80 years had similar OS regardless of intended (R-)CHOP dosing, whereas patients of 75-79 years scheduled for full dose had higher OS. Standard treatment was not associated with increased hospitalisation. Standard treatment is feasible with good outcomes in a large proportion of elderly DLBCL-patients. Planned dose reduction in patients aged ≥80 years had no negative impact on OS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Five years after the Metric Conversion Act, where do we stand? Survey of large US manufacturing and mining firms (the Fortune Magazine 1000)

NASA Astrophysics Data System (ADS)

1980-12-01

A mail survey of randomly chosen 202 of the 1000 largest manufacturing and mining firms, as listed by Fortune magazine, was conducted in late 1979 and early 1980. About 64 percent (112 firms) responded with useful data. This Executive Summary draws on the full report (U.S. Metric Board 1979 Survey of Selected Large U.S. Firms and Industries, Lisa King, King Research, Inc., May 1980; AD-A-091-618) and provides an overview of the study's findings. Some selected findings are: (1) about 30 percent of the large firms produce at least one hard metric product; (2) about 48 percent of foreign sales are of metric products; (3) little corporate coordination and planning seems to accompany conversion to the metric system; (4) about one-third of the firms see laws and regulations as impeding conversion; (5) over 50 percent see lack of customers demand as inhibiting conversion; (6) the most realistic time period for conversion is 10 years, the minimum time for conversion (under pressure) is three years, and the preferred time (at the firm's own pace) is eight years.

Large magnetocaloric effect of NdGa compound due to successive magnetic transitions

NASA Astrophysics Data System (ADS)

Zheng, X. Q.; Xu, J. W.; Shao, S. H.; Zhang, H.; Zhang, J. Y.; Wang, S. G.; Xu, Z. Y.; Wang, L. C.; Chen, J.; Shen, B. G.

2018-05-01

The magnetic behavior and MCE property of NdGa compound were studied in detail. According to the temperature dependence of magnetization (M-T) curve at 0.01 T, two sharp changes were observed at 20 K (TSR) and 42 K (TC), respectively, corresponding to spin reorientation and FM-PM transition. Isothermal magnetization curves up to 5 T at different temperatures were measured and magnetic entropy change (ΔSM) was calculated based on M-H data. Temperature dependences of -ΔSM for a field change of 0-2 T and 0-5 T show that there are two peaks on the curves corresponding to TSR and TC, respectively. The value of the two peaks is 6.4 J/kg K and 15.5 J/kg K for the field change of 0-5 T. Since the two peaks are close, the value of -ΔSM in the temperature range between TSR and TC keeps a large value. The excellent MCE performance of NdGa compound benefits from the existence of two successive magnetic transitions.

Resonance Trapping due to Nebula Disk Torques

NASA Astrophysics Data System (ADS)

Hahn, J. M.; Ward, W. R.

1996-03-01

A protoplanet embedded in the solar nebula launches spiral density waves from its Lindblad resonances in the gas disk, and its gravitational attraction for these disturbances results in a mutual torque exerted between the protoplanet and the disk. Consequently the orbit of a sufficiently massive protoplanet may decay on a timescale shorter than the nebula lifetime, and this mechanism is most significant during the formation of the cores of the giant planets. Due to their increased mobility, migrating protoplanets may have been able to accrete large swaths of the disk and/or encounter other protoplanets. Thus disk torques may have played an important role in determining the formation history and orbit spacings of the giant planets. An interesting phenomenon also associated with orbit decay is resonance trapping, whereby a large body is able to halt further orbit decay of smaller bodies at commensurability resonances. Examples of this effect include the trapping of planetesimals experiencing aerodynamic gas drag and dust suffering Poynting-Robertson drag. Below we address the cosmogonic implications of resonance trapping of planetary embryos experiencing orbit decay due to nebula disk torques. The following employs an approach similar to Malhotra's (1993) discussion of the gas drag trapping problem.

Interannual kinetics (2010-2013) of large wood in a river corridor exposed to a 50-year flood event and fluvial ice dynamics

NASA Astrophysics Data System (ADS)

Boivin, Maxime; Buffin-Bélanger, Thomas; Piégay, Hervé

2017-02-01

Semi-alluvial rivers of the Gaspé Peninsula, Québec, are prone to produce and transport vast quantities of large wood (LW). The high rate of lateral erosion owing to high energy flows and noncohesive banks is the main process leading to the recruitment of large wood, which in turn initiates complex patterns of wood accumulation and reentrainment within the active channel. The delta of the Saint-Jean River (SJR) has accumulated large annual wood fluxes since 1960 that culminated in a wood raft of > 3-km in length in 2014. To document the kinetics of large wood on the main channel of SJR, four annual surveys were carried out from 2010 to 2013 to locate and describe > 1000 large wood jams (LWJ) and 2000 large wood individuals (LWI) along a 60-km river section. Airborne and ground photo/video images were used to estimate the wood volume introduced by lateral erosion and to identify local geomorphic conditions that control wood mobility and deposits. Video camera analysis allowed the examination of transport rates from three hydrometeorological events for specific river sections. Results indicate that the volume of LW recruited between 2010 and 2013 represents 57% of the total LW production over the 2004-2013 period. Volumes of wood deposited along the 60-km section were four times higher in 2013 than in 2010. Increases in wood amount occurred mainly in upper alluvial sections of the river, whereas decreases were observed in the semi-alluvial middle sections. Observations suggest that the 50-year flood event of 2010 produced large amounts of LW that were only partly exported out of the basin so that a significant amount was still available for subsequent floods. Large wood storage continued after this flood until a similar flood or an ice-breakup event could remobilise these LW accumulations into the river corridor. Ice-jam floods transport large amounts of wood during events with fairly low flow but do not contribute significantly to recruitment rates (ca. 10 to 30

An Outbreak of Food-Borne Typhoid Fever Due to Salmonella enterica Serotype Typhi in Japan Reported for the First Time in 16 Years

PubMed Central

Kobayashi, Tetsuro; Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Ohmagari, Norio; Uryu, Hideko; Yamada, Ritsuko; Kashiwa, Naoyuki; Nei, Takahito; Ehara, Akihito; Takei, Reiko; Mori, Nobuaki; Yamada, Yasuhiro; Hayasaka, Tomomi; Kagawa, Narito; Sugawara, Momoko; Suzaki, Ai; Takahashi, Yuno; Nishiyama, Hiroyuki; Morita, Masatomo; Izumiya, Hidemasa; Ohnishi, Makoto

2016-01-01

For the first time in 16 years, a food-borne outbreak of typhoid fever due to Salmonella enterica serotype Typhi was reported in Japan. Seven patients consumed food in an Indian buffet at a restaurant in the center of Tokyo, while one was a Nepali chef in the restaurant, an asymptomatic carrier and the implicated source of this outbreak. The multiple-locus variable-number tandem repeat analysis showed 100% consistency in the genomic sequence for five of the eight cases. PMID:26621565

Dragging force on galaxies due to streaming dark matter

NASA Technical Reports Server (NTRS)

Hara, Tetsuya; Miyoshi, Shigeru

1990-01-01

It has been reported that galaxies in large regions (approx. 10(exp 2) Mpc), including some clusters of galaxies, may be streaming coherently with velocities up to 600 km/sec or more with respect to the rest frame determined by the microwave background radiation. On the other hand, it is suggested that the dominant mass component of the universe is dark matter. Because we can only speculate the motion of dark matter from the galaxy motions, much attention should be paid to the correlation of velocities between the observed galaxies and cold dark matter. So the authors investigated whether such coherent large-scale streaming velocities are due to dark matter or only to baryonic objects which may be formed by piling up of gases due to some explosive events. It seems that, although each galaxy will not follow the motion of dark matter, clusters of galaxies may represent the velocity field of dark matter. The origin of the velocity field of dark matter would be due to the initial adiabatic perturbations and, in fact, the observed peculiar velocities of clusters are within the allowed region constrained from the isotropy of the microwave background radiation.

Bilateral endogenous necrotizing scleritis due to Aspergillus oryzae.

PubMed

Stenson, S; Brookner, A; Rosenthal, S

1982-01-01

A case of bilateral necrotizing scleritis due to Aspergillus oryzae is reported. The patient was a former addict of intravenous narcotics treated five years previously for meningitis due to the same organism. A seeding focus in the thoracic spine was eventually found. The patient responded well to combined local and systemic therapy with amphotericin B, flucytosine, and natamycin. This represents, to the best of our knowledge, both the first reported case of ocular disease due to this species of Aspergillus and of isolated scleral, nonintraocular involvement in endogenous oculomycosis.

Risk to life due to flooding in post-Katrina New Orleans

NASA Astrophysics Data System (ADS)

Miller, A.; Jonkman, S. N.; Van Ledden, M.

2015-01-01

Since the catastrophic flooding of New Orleans due to Hurricane Katrina in 2005, the city's hurricane protection system has been improved to provide protection against a hurricane load with a 1/100 per year exceedance frequency. This paper investigates the risk to life in post-Katrina New Orleans. In a flood risk analysis the probabilities and consequences of various flood scenarios have been analyzed for the central area of the city (the metro bowl) to give a preliminary estimate of the risk to life in the post-Katrina situation. A two-dimensional hydrodynamic model has been used to simulate flood characteristics of various breaches. The model for estimation of fatality rates is based on the loss of life data for Hurricane Katrina. Results indicate that - depending on the flood scenario - the estimated loss of life in case of flooding ranges from about 100 to nearly 500, with the highest life loss due to breaching of the river levees leading to large flood depths. The probability and consequence estimates are combined to determine the individual risk and societal risk for New Orleans. When compared to risks of other large-scale engineering systems (e.g., other flood prone areas, dams and the nuclear sector) and acceptable risk criteria found in literature, the risks for the metro bowl are found to be relatively high. Thus, despite major improvements to the flood protection system, the flood risk to life of post-Katrina New Orleans is still expected to be significant. Indicative effects of reduction strategies on the risk level are discussed as a basis for further evaluation and discussion.

Determinants Of Impoverishment Due To Out Of Pocket Payments In Nigeria.

PubMed

Aregbeshola, Bolaji Samson; Khan, Samina Mohsin

2017-01-01

Poverty is an extreme consequence of out of pocket payments in countries with health systems that do not provide financial risk protection through mandatory health insurance coverage for people in both the formal and informal sectors. The study assessed the determinants of impoverishment due to out of pocket payments in Nigeria. Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors associated with impoverishment in Nigeria. Household and individual characteristics associated with impoverishment were determined using binary logistic regression. A significance level of p<0.05 was used. Results show that lack of health insurance, having a member above 65 years, large household size, household socio-economic status, type of illness suffered, type of health facility visited, geo-political zones, education of household heads and location were major determinants of impoverishment due to out of pocket health expenditure. Findings from the study show that most households and individuals are vulnerable to financial risk due to this regressive source of payments for health care services. This explains why the level of poverty keeps increasing in spite of the numerous poverty alleviation programs across the country. Policy makers and political actors need to design a new health system financing policy that will increase financial risk protection for people in both the formal and informal sectors. Governments and decision makers have to focus on health as a determinant of economic well-being.

A large neutral fraction of cosmic hydrogen a billion years after the Big Bang.

PubMed

Wyithe, J Stuart B; Loeb, Abraham

2004-02-26

The fraction of ionized hydrogen left over from the Big Bang provides evidence for the time of formation of the first stars and quasar black holes in the early Universe; such objects provide the high-energy photons necessary to ionize hydrogen. Spectra of the two most distant known quasars show nearly complete absorption of photons with wavelengths shorter than the Lyman alpha transition of neutral hydrogen, indicating that hydrogen in the intergalactic medium (IGM) had not been completely ionized at a redshift of z approximately 6.3, about one billion years after the Big Bang. Here we show that the IGM surrounding these quasars had a neutral hydrogen fraction of tens of per cent before the quasar activity started, much higher than the previous lower limits of approximately 0.1 per cent. Our results, when combined with the recent inference of a large cumulative optical depth to electron scattering after cosmological recombination therefore suggest the presence of a second peak in the mean ionization history of the Universe.

Global earthquake casualties due to secondary effects: A quantitative analysis for improving PAGER losses

USGS Publications Warehouse

Wald, David J.

2010-01-01

This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey’s (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER’s overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra–Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability.

Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study.

PubMed

Hefferon, Kate; Murphy, Helen; McLeod, Janice; Mutrie, Nanette; Campbell, Anna

2013-10-01

Due to the amount of literature supporting exercise participation after cancer diagnosis, there has been recent interest in barriers to exercise engagement among cancer patients. However, little is known regarding reasons why people choose to disengage and how this disengagement occurs over time. This study aimed to qualitatively study the perceived barriers to exercise implementation, 5-year post-breast cancer diagnosis. Eighty-three female breast cancer survivors participated in a one-to-one semi-structured interview, regarding their experience of exercise over the past 5 years following their original participation in a group-based structured exercise intervention after diagnosis (41 from intervention and 42 from original control group). The data were analysed using inductive thematic analysis. The findings included three main themes and several subthemes regarding the women's perceived barriers: psychological barriers (lack of motivation, fears, dislike of gym, not being the 'sporty type'), physical barriers (the ageing process, cancer treatment and other physical co-morbidities, fatigue and weight gain) and contextual and environmental barriers (employment, traditional female care-giving roles, proximity/access to facilities, seasonal weather). The findings add inductive support to the current survivor health research advocating the use of activity immediately after diagnosis, as well as the need for tailored activity programmes in order to overcome potential obstacles.

A First Large-Cohort Study of Personality-Trait Stability Over the 40 Years Between Elementary School and Midlife

PubMed Central

Hampson, Sarah E.; Goldberg, Lewis R.

2008-01-01

This report provides some initial findings from an investigation of the relations between childhood Big Five personality traits assessed by elementary-school teachers and similar traits assessed 40 years later by self-reports at midlife. Our analyses are based on data from a relatively large and culturally diverse sample (N = 799) that was first assessed between 1959 and 1967 when the participants were children in Hawaii. Short-term (1-3 years) test retest reliabilities were lower (.22 -.53) within childhood when personality is developing than within adulthood (.70 -.79) when personality stability may be at its peak. Stability coefficients across the 40-year interval between the childhood assessment and two measures of adulthood personality were higher for Extraversion (e.g., .29) and Conscientiousness (e.g., .25) than for Openness (e.g., .16), Agreeableness (e.g., .08) and Neuroticism (e.g., .00). Construct continuity between childhood and adulthood was evaluated by canonical analysis and by structural-equation modeling and indicated continuity at both a broad, two-dimensional level and at the level of the Big Five. The findings are discussed in relation to Caspi, Roberts, and Shiner’s (2005) principles of rank-order personality stability. PMID:17014298

Large-Scale Preventive Chemotherapy for the Control of Helminth Infection in Western Pacific Countries: Six Years Later

PubMed Central

Montresor, Antonio; Cong, Dai Tran; Sinuon, Mouth; Tsuyuoka, Reiko; Chanthavisouk, Chitsavang; Strandgaard, Hanne; Velayudhan, Raman; Capuano, Corinne M.; Le Anh, Tuan; Tee Dató, Ah S.

2008-01-01

In 2001, Urbani and Palmer published a review of the epidemiological situation of helminthiases in the countries of the Western Pacific Region of the World Health Organization indicating the control needs in the region. Six years after this inspiring article, large-scale preventive chemotherapy for the control of helminthiasis has scaled up dramatically in the region. This paper analyzes the most recent published and unpublished country information on large-scale preventive chemotherapy and summarizes the progress made since 2000. Almost 39 million treatments were provided in 2006 in the region for the control of helminthiasis: nearly 14 million for the control of lymphatic filariasis, more than 22 million for the control of soil-transmitted helminthiasis, and over 2 million for the control of schistosomiasis. In general, control of these helminthiases is progressing well in the Mekong countries and Pacific Islands. In China, despite harboring the majority of the helminth infections of the region, the control activities have not reached the level of coverage of countries with much more limited financial resources. The control of food-borne trematodes is still limited, but pilot activities have been initiated in China, Lao People's Democratic Republic, and Vietnam. PMID:18846234

Risk for large-scale fires in boreal forests of Finland under changing climate

NASA Astrophysics Data System (ADS)

Lehtonen, I.; Venäläinen, A.; Kämäräinen, M.; Peltola, H.; Gregow, H.

2015-08-01

The target of this work was to assess the impact of projected climate change on the number of large forest fires (over 10 ha fires) and burned area in Finland. For this purpose, we utilized a strong relationship between fire occurrence and the Canadian fire weather index (FWI) during 1996-2014. We used daily data from five global climate models under representative concentration pathway RCP4.5 and RCP8.5 scenarios. The model data were statistically downscaled onto a high-resolution grid using the quantile-mapping method before performing the analysis. Our results suggest that the number of large forest fires may double or even triple during the present century. This would increase the risk that some of the fires could develop into real conflagrations which have become almost extinct in Finland due to active and efficient fire suppression. Our results also reveal substantial inter-model variability in the rate of the projected increase in forest-fire danger. We moreover showed that the majority of large fires occur within a relatively short period in May and June due to human activities and that FWI correlates poorer with the fire activity during this time of year than later in summer when lightning is more important cause of fires.

Sleep patterns as predictors for disability pension due to low back diagnoses: a 23-year longitudinal study of Finnish twins.

PubMed

Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko

2013-06-01

Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Not applicable. There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors.

Estimation of the collective ionizing dose in the Portuguese population for the years 2011 and 2012, due to nuclear medicine exams.

PubMed

Costa, F; Teles, P; Nogueira, A; Barreto, A; Santos, A I; Carvalho, A; Martins, B; Oliveira, C; Gaspar, C; Barros, C; Neves, D; Costa, D; Rodrigues, E; Godinho, F; Alves, F; Cardoso, G; Cantinho, G; Conde, I; Vale, J; Santos, J; Isidoro, J; Pereira, J; Salgado, L; Rézio, M; Vieira, M; Simãozinho, P; Almeida, P; Castro, R; Parafita, R; Pintão, S; Lúcio, T; Reis, T; Vaz, P

2015-01-01

In 2009-2010 a Portuguese consortium was created to implement the methodologies proposed by the Dose Datamed II (DDM2) project, aiming to collect data from diagnostic X-ray and nuclear medicine (NM) procedures, in order to determine the most frequently prescribed exams and the associated ionizing radiation doses for the Portuguese population. The current study is the continuation of this work, although it focuses only on NM exams for the years 2011 and 2012. The annual frequency of each of the 28 selected NM exams and the average administered activity per procedure was obtained by means of a nationwide survey sent to the 35 NM centres in Portugal. The results show a reduction of the number of cardiac exams performed in the last two years compared with 2010, leading to a reduction of the annual average effective dose of Portuguese population due to NM exams from 0.08 mSv ± 0.017 mSv/caput to 0.059 ± 0.011 mSv/caput in 2011 and 0.054 ± 0.011 mSv/caput in 2012. Portuguese total annual average collective effective dose due to medical procedures was estimated to be 625.6 ± 110.9 manSv in 2011 and 565.1 ± 117.3 manSv in 2012, a reduction in comparison with 2010 (840.3 ± 183.8 manSv). The most frequent exams and the ones that contributed the most for total population dose were the cardiac and bone exams, although a decrease observed in 2011 and in 2012 was verified. The authors intend to perform this study periodically to identify trends in the annual Portuguese average effective dose and to help to raise awareness about the potential dose optimization. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Brief communication: Loss of life due to Hurricane Harvey

NASA Astrophysics Data System (ADS)

Jonkman, Sebastiaan N.; Godfroy, Maartje; Sebastian, Antonia; Kolen, Bas

2018-04-01

An analysis was made of the loss of life caused by Hurricane Harvey. Information was collected for 70 fatalities that occurred due to the event and were recovered within the first 2 weeks after landfall. Most fatalities occurred due to drowning (81 %), particularly in and around vehicles. Males (70 %) and people over 50 years old (56 %) were overrepresented in the dataset. More than half of the fatalities occurred in the greater Houston area (n = 37), where heavy rainfall and dam releases caused unprecedented urban flooding. The majority of fatalities were recovered outside the designated 100- and 500-year flood hazard areas.

Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative.

PubMed

Espinosa-Muñoz, E; Ramírez-Ocaña, D; Martín-García, A M; Ruiz-García, F J; Puentes-Zarzuela, C

The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131 I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131 I at this age, makes this case unique. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Geriatric Trauma Patients With Cervical Spine Fractures due to Ground Level Fall: Five Years Experience in a Level One Trauma Center.

PubMed

Wang, Hao; Coppola, Marco; Robinson, Richard D; Scribner, James T; Vithalani, Veer; de Moor, Carrie E; Gandhi, Raj R; Burton, Mandy; Delaney, Kathleen A

2013-04-01

It has been found that significantly different clinical outcomes occur in trauma patients with different mechanisms of injury. Ground level falls (GLF) are usually considered "minor trauma" with less injury occurred in general. However, it is not uncommon that geriatric trauma patients sustain cervical spine (C-spine) fractures with other associated injuries due to GLF or less. The aim of this study is to determine the injury patterns and the roles of clinical risk factors in these geriatric trauma patients. Data were reviewed from the institutional trauma registry of our local level 1 trauma center. All patients had sustained C-spine fracture(s). Basic clinical characteristics, the distribution of C-spine fracture(s), and mechanism of injury in geriatric patients (65 years or older) were compared with those less than 65 years old. Furthermore, different clinical variables including age, gender, Glasgow coma scale (GCS), blood alcohol level, and co-existing injuries were analyzed by multivariate logistic regression in geriatric trauma patients due to GLF and internally validated by random bootstrapping technique. From 2006 - 2010, a total of 12,805 trauma patients were included in trauma registry, of which 726 (5.67%) had sustained C-spine fracture(s). Among all C-spine fracture patients, 19.15% (139/726) were geriatric patients. Of these geriatric patients 27.34% (38/139) and 53.96% (75/139) had C1 and C2 fractures compared with 13.63% (80/587) and 21.98% (129/587) in young trauma patients (P < 0.001). Of geriatric trauma patients 13.67% (19/139) and 18.71% (26/139) had C6 and C7 fractures compared with 32.03% (188/587) and 41.40% (243/587) in younger ones separately (P < 0.001). Furthermore, 53.96% (75/139) geriatric patients had sustained C-spine fractures due to GLF with more upper C-spine fractures (C1 and C2). Only 3.2% of those had positive blood alcohol levels compared with 52.9% of younger patients (P < 0.001). In addition, 6.34% of geriatric patients due

Efficacy and safety of two doses of Norditropin® (somatropin) in short stature due to Noonan syndrome: a 2-year randomized, double-blind, multicenter trial in Japanese patients.

PubMed

Ozono, Keiichi; Ogata, Tsutomu; Horikawa, Reiko; Matsubara, Yoichi; Ogawa, Yoshihisa; Nishijima, Keiji; Yokoya, Susumu

2018-02-26

This randomized double-blind multicenter trial (NCT01927861) evaluated the growth-promoting effect and safety of Norditropin ® (NN220; somatropin) in Japanese children with short stature due to Noonan syndrome. Prepubertal children aged 3-<11 years (boys) or 3-<10 years (girls) with Noonan syndrome were randomized to receive GH 0.033 mg/kg/day (n = 25, mean age 6.57 years, 11 females) or 0.066 mg/kg/day (n = 26, mean age 6.06 years, eight females) for 104 weeks. Change in height standard deviation score (HSDS) from baseline was analyzed based on an ANCOVA model. Baseline HSDS was -3.24. Estimated change in HSDS [95% CI] after 104 weeks' treatment was 0.84 [0.66, 1.02] and 1.47 [1.29, 1.64] for the lower and higher doses, respectively; estimated mean difference 0.63 [0.38, 0.88], p < 0.0001. Rates and patterns of adverse events (AEs) were similar between groups. Most were mild and reported as unlikely to be related to Norditropin ® . There were no withdrawals due to AEs. Insulin-like growth factor-I SDS increased from -1.71 to -0.64 (0.033 mg/kg/day) and to 0.63 (0.066 mg/kg/day). HbA 1c increased slightly (0.033 mg/kg/day: +0.14%; 0.066 mg/kg/day: +0.13%); glucose profiles were almost unchanged; insulin profiles increased in both groups in the oral glucose tolerance test. There were no clinically significant abnormal electrocardiogram or echocardiography findings. We conclude that Norditropin ® at doses of 0.033 mg/kg/day or 0.066 mg/kg/day for 104 weeks increases height in Japanese children with short stature due to Noonan syndrome, with a favorable safety profile. The effect was greater with 0.066 mg/kg/day compared with 0.033 mg/kg/day.

[Analysis on absentees due to injury during 2012-2013 school year from 32 primary schools in Hubei province].

PubMed

Tan, Li; Yan, Weirong; Wang, Ying; Fan, Yunzhou; Jiang, Hongbo; Yang, Wenwen; Nie, Shaofa

2014-09-01

To analyze absentees due to injury among primary school pupils in Hubei, 2012-2013; and to provide theoretical basis for the prevention and control of injuries. A total of 32 primary schools in Qianjiang city and Shayang county were sampled to conduct injury absenteeism surveillance, and the total number of students was 21 493. The surveillance contents included absent dates, genders, grades, initial or return absent, and the detailed absent reasons. The classification of injury was based on the 10th Revision of the international classification of diseases developed by WHO. Data from 2012-2013 school-year were extracted from the surveillance system for analysis. The total surveillance period was 182 days, of which the fall semester was 98 days and the spring semester was 84 days. The absenteeism rate and injury rate in different characteristics of primary school students were compared by χ² test, and the possible risk factors of injury were preliminary explored by calculating the RR (95% CI) value. The total daily injury absenteeism rate was 8.26/100 100 during 2012-2013 school-year in 32 primary schools in Hubei province, which was higher in fall semester (9.16/100 000), Qianjiang area (9.63/100 000), rural primary schools (13.44/100 000), boys (9.57/100 000), 1-2 grades (10.41/100 000), and the differences were significant (P < 0.05). The total injury rate was 0.46%. Rural primary schools (RR = 2.32, 95% CI: 1.46-3.70), boys (RR = 1.88, 95% CI: 1.23-2.87), and 3-4 grades (RR = 1.85, 95% CI: 1.10-3.09) were identified as high-risk factors, while using city primary schools, girls, and 5-6 grades as references, respectively. The injury absenteeism rate and injury rate were more higher in rural primary schools, boys and low or middle grades in Hubei province during 2012 to 2013 school year, so monitoring and preventive measures should be focused on those students.

Acidification of lake water due to drought

NASA Astrophysics Data System (ADS)

Mosley, L. M.; Zammit, B.; Jolley, A. M.; Barnett, L.

2014-04-01

Droughts are predicted to increase in many river systems due to increased demand on water resources and climate variability. A severe drought in the Murray-Darling Basin of Australia from 2007 to 2009 resulted in unprecedented declines in water levels in the Lower Lakes (Ramsar-listed ecosystem of international importance) at the end of the river system. The receding water exposed large areas (>200 km2) of sediments on the lake margins. The pyrite (FeS2) in these sediments oxidised and generated high concentrations of acidity. Upon rewetting of the exposed sediments, by rainfall or lake refill, surface water acidification (pH 2-3) occurred in several locations (total area of 21.7 km2). High concentrations of dissolved metals (Al, As, Co, Cr, Cu, Fe, Mn, Ni, Zn), which greatly exceeded aquatic ecosystem protection guidelines, were mobilised in the acidic conditions. In many areas neutralisation of the surface water acidity occurred naturally during lake refill, but aerial limestone dosing was required in two areas to assist in restoring alkalinity. However acidity persists in the submerged lake sediment and groundwater several years after surface water neutralisation. The surface water acidification proved costly to manage and improved water management in the Murray-Darling Basin is required to prevent similar events occurring in the future.

Evolution of Precipitation Extremes in Three Large Ensembles of Climate Simulations - Impact of Spatial and Temporal Resolutions

NASA Astrophysics Data System (ADS)

Martel, J. L.; Brissette, F.; Mailhot, A.; Wood, R. R.; Ludwig, R.; Frigon, A.; Leduc, M.; Turcotte, R.

2017-12-01

Recent studies indicate that the frequency and intensity of extreme precipitation will increase in future climate due to global warming. In this study, we compare annual maxima precipitation series from three large ensembles of climate simulations at various spatial and temporal resolutions. The first two are at the global scale: the Canadian Earth System Model (CanESM2) 50-member large ensemble (CanESM2-LE) at a 2.8° resolution and the Community Earth System Model (CESM1) 40-member large ensemble (CESM1-LE) at a 1° resolution. The third ensemble is at the regional scale over both Eastern North America and Europe: the Canadian Regional Climate Model (CRCM5) 50-member large ensemble (CRCM5-LE) at a 0.11° resolution, driven at its boundaries by the CanESM-LE. The CRCM5-LE is a new ensemble issued from the ClimEx project (http://www.climex-project.org), a Québec-Bavaria collaboration. Using these three large ensembles, change in extreme precipitations over the historical (1980-2010) and future (2070-2100) periods are investigated. This results in 1 500 (30 years x 50 members for CanESM2-LE and CRCM5-LE) and 1200 (30 years x 40 members for CESM1-LE) simulated years over both the historical and future periods. Using these large datasets, the empirical daily (and sub-daily for CRCM5-LE) extreme precipitation quantiles for large return periods ranging from 2 to 100 years are computed. Results indicate that daily extreme precipitations generally will increase over most land grid points of both domains according to the three large ensembles. Regarding the CRCM5-LE, the increase in sub-daily extreme precipitations will be even more important than the one observed for daily extreme precipitations. Considering that many public infrastructures have lifespans exceeding 75 years, the increase in extremes has important implications on service levels of water infrastructures and public safety.

Four years of UAS Imagery Reveals Vegetation Change Due to Permafrost Thaw

NASA Astrophysics Data System (ADS)

DelGreco, J. L.; Herrick, C.; Varner, R. K.; McArthur, K. J.; McCalley, C. K.; Garnello, A.; Finnell, D.; Anderson, S. M.; Crill, P. M.; Palace, M. W.

2017-12-01

Warming trends in sub-arctic regions have resulted in thawing of permafrost which in turn induces change in vegetation across peatlands. Collapse of palsas (i.e. permafrost plateaus) has also been correlated to increases in methane (CH4) emissions to the atmosphere. Vegetation change provides new microenvironments that promote CH4 production and emission, specifically through plant interactions and structure. By quantifying the changes in vegetation at the landscape scale, we will be able to understand the impact of thaw on CH4 emissions in these complex and climate sensitive northern ecosystems. We combine field-based measurements of vegetation composition and high resolution Unmanned Aerial Systems (UAS) imagery to characterize vegetation change in a sub-arctic mire. At Stordalen Mire (1 km x 0.5 km), Abisko, Sweden, we flew a fixed-wing UAS in July of each year between 2014 and 2017. High precision GPS ground control points were used to georeference the imagery. Seventy-five randomized square-meter plots were measured for vegetation composition and individually classified into one of five cover types, each representing a different stage of permafrost degradation. With this training data, each year of imagery was classified by cover type. The developed cover type maps were also used to estimate CH4 emissions across the mire based on average flux CH4 rates from each cover type obtained from flux chamber measurements collected at the mire. This four year comparison of vegetation cover and methane emissions has indicated a rapid response to permafrost thaw and changes in emissions. Estimation of vegetation cover types is vital in our understanding of the evolution of northern peatlands and its future role in the global carbon cycle.

Transseptal Guidewire Stabilization for Device Closure of a Large Pulmonary Arteriovenous Malformation

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

Joseph, George, E-mail: joseph59@gmail.com; Kunwar, Brajesh Kumar, E-mail: kunwar_brajesh@yahoo.com

A 46-year-old man presenting with massive hemoptysis was found to have a large pulmonary arteriovenous malformation (PAVM) in the right lung. Closure of the PAVM with an Amplatzer-type duct occluder was hampered by inability to advance the device delivery sheath into the PAVM due to vessel tortuosity and inadequate guidewire support. Atrial septal puncture was performed and a femorofemoral arteriovenous guidewire loop through the right pulmonary artery, PAVM, and left atrium was created. Traction on both ends of the guidewire loop allowed advancement of the device delivery sheath into the PAVM and successful completion of the procedure. Transseptal guidewire stabilizationmore » can be a valuable option during device closure of large PAVMs when advancement, stability, or kinking of the device delivery sheath is an issue.« less

Occupational asthma due to colophony in non-industrial environments.

PubMed

Mariano, A; Paredes, I; Nuti, R; Innocenti, A

1993-01-01

Colophony is largely used in industrial environments, like the electronics and the rubber tyre industries, but it is also present in non-industrial environments as a constituent of glues and paper. For this reason it is one of the commonest skin sensitizers. Many cases of occupational asthma due to colophony have been described, but reports apart from electronic industry are not common. The case is described of a subject employed in administrative work who developed asthma due to colophony from using sealing wax to seal samples of food packages.

Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea

PubMed Central

2017-01-01

Purpose This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002–2013. Methods A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions. PMID:29093985

Human infections due to Staphylococcus pseudintermedius, an emerging zoonosis of canine origin: report of 24 cases.

PubMed

Somayaji, R; Priyantha, M A R; Rubin, J E; Church, D

2016-08-01

Staphylococcus pseudintermedius has been recently identified as a novel species within the genus Staphylococcus, and is commonly associated with infections in dogs. Currently, there are few reports of human infections due to this bacterium. To use a population-based approach to describe the characteristics of human S. pseudintermedius infections in a large Canadian healthcare region. All adult cases aged ≥18 years identified at a large regional laboratory from April 1, 2013 to April 1, 2015 who had at least one positive culture for S. pseudintermedius were retrospectively reviewed. A combination of phenotypic methods, mass spectrometry (i.e., MALDI-TOF), and cpn60 sequencing were used to identify S. pseudintermedius. Chart review was conducted, and cases were analysed descriptively. Twenty-seven isolates of S. pseudintermedius from 24 human cases were included for analysis. 58.3% were male with median age of 61 years (IQR 55-70.5). Most patients [22 (92.1%)] had confirmed contact with dogs at time of infection. S. pseudintermedius was isolated in 18 cases (75.0%) of skin and soft tissue infections (SSTI), and 2 invasive cases (8.3%) including a prosthetic joint and bloodstream infection. The other 4 patients were considered to be colonized (skin - 3; lung - 1). Methicillin resistance was identified in 3 cases with 6 total isolates (22.2%); multi-drug resistance was also demonstrated commonly. S. pseudintermedius is most commonly associated with SSTIs in humans. Transmission probably occurs from a pet dog. Species-level identification of S. pseudintermedius is important due to the high prevalence of antibiotic resistance, particularly to methicillin. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-term sickness absence due to adjustment disorder.

PubMed

Catalina-Romero, C; Pastrana-Jiménez, J I; Tenas-López, M J; Martínez-Muñoz, P; Ruiz-Moraga, M; Fernández-Labandera, C; Calvo-Bonacho, E

2012-07-01

Although adjustment disorder is frequently reported in clinical settings, scientific evidence is scarce regarding its impact on sickness absence and the variables associated with sickness absence duration. To report sickness absence duration and to identify predictors of long-term sickness absence in patients with adjustment disorder. This observational, prospective study included subjects with non-work-related sickness absence (>15 days) after a diagnosis of adjustment disorder. A stepwise logistic regression analysis was conducted to identify the best predictors of long-term sickness absence (≥ 6 months). There were 1182 subjects in the final analysis. The median duration of sickness absence due to adjustment disorder was 91 days. Twenty-two per cent of the subjects reported long-term sickness absence. After multivariate analysis, comorbidity (OR = 2.23, 95% CI 1.43-3.49), age (25-34 years old versus <25 years old: OR = 2.78, 95% CI 1.27-6.07; 35-44 years old versus <25 years old: OR = 3.70, 95% CI 1.71-7.99; 45-54 years old versus <25 years old: OR = 3.58, 95% CI 1.60-8.02; ≥ 55 years old versus <25 years old: OR = 6.35, 95% CI 2.64-15.31) and occupational level (blue collar versus white collar: OR = 1.52, 95% CI 1.10-2.09) remained significantly associated with long-term sickness absence. Comorbidity was the strongest predictor. It is possible to predict long-term sickness absence due to adjustment disorder on the basis of demographic, work-related and clinical information available during the basic assessment of the patient.

Higher Atmosphere Heating due to black carbon Over the Northern Part of India

NASA Astrophysics Data System (ADS)

Tiwari, S.; Singh, S., , Dr

2017-12-01

Light-absorbing, atmospheric particles have gained greater attention in recent years because of their direct and indirect impacts on regional and global climate. Atmospheric black carbon (BC) aerosol (also called soot particle) is a leading climate warming agent, yet uncertainties in the global direct aerosol radiative forcing remain large. Based on a year of aerosol absorption measurements at seven wavelengths, BC concentrations were investigated in Dhanbad, the coal capital of India. Coal is routinely burned for cooking and residential heat as well as in small industries. The mean daily concentrations of ultraviolet-absorbing black carbon measured at 370 nm (UVBC) and black carbon measured at 880 nm (BC) were 9.8 ± 5.7 and 6.5 ± 3.8 μg m-3, respectively. The difference between UVBC and BC, Delta-C, is an indicator of biomass or residential coal burning and averaged 3.29 ± 4.61 μg m-3. An alternative approach uses the calculation of the Angstrom Exponent (AE) to estimate the amounts of biomass/coal and traffic BC. Biomass/coal burning contributed 87% and fossil fuel combustion contributed 13% to the annual average BC concentration. In the post-monsoon season, potential source contribution function analysis showed that air masses came from the central and northwestern Indo-Gangetic Plains resulting in mean UVBC values of 10.9 μg m-3 and BC of 7.2 μg m-3. The mean winter UVBC and BC concentrations were 15.0 and 10.1 μg m-3, respectively. These highest values were largely driven by local sources under conditions of poor dispersion. The direct radiative forcing (DRF) due to UVBC and BC at the surface (SFC) and the top of the atmosphere (TOA) were calculated. The mean atmospheric heating rates due to UVBC and BC were estimated to be 1.40°K day-1 and 1.18°K day-1, respectively. This high heating rate may affect the monsoon circulation in this region.

Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry

PubMed Central

Gurav, Abhijit Ningappa; Shete, Abhijeet Rajendra; Naiktari, Ritam

2015-01-01

Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect. PMID:26941526

Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry.

PubMed

Gurav, Abhijit Ningappa; Shete, Abhijeet Rajendra; Naiktari, Ritam

2015-01-01

Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect.

Three-year lifecycle, large body, and very high threshold temperature in the cricket Gryllus argenteus for special adaptation to desiccation cycle in Malawi.

PubMed

Kosumi, Takuya; Takeda, Makio

2017-08-08

In temperate climates, the initiation and termination of diapause synchronize the stress-tolerant stage with the stressful season and reproduction with the non-stressful season in many insects. Synchronization is often regulated by photoperiodism.Voltinism and the ultimate size of adults are also important determinants for their lifecycle, and different diapause stages and voltinism patterns are known in crickets.Here, we investigated the life history of the African cricket Gryllus argenteus from Malawi, which is a typical arid tropical highland. The climate is characterized by alternating arid and wet seasons, each of which lasts for half a year, and where the available heat mass is much less than lowlands at the same latitude. We first measured the nymphal duration at each rearing temperature and calculated the lower developmental threshold (t 0 ) to be 20.19 °C based on Ikemoto and Takai (2000) and 19.38 °C based on a conventional line-fitting method. These values are very high relative to many other insects. The local temperature in winter does not fall below 15 °C, but this is much higher than the lethal limit. This suggested that critical stress in this locality was not coldness but low precipitation in winter. We estimated, based both on local temperature change and the Ikemoto and Takai's t 0 , that G. argenteus required 3 years to complete its lifecycle unlike wet lowland species, where univoltinism or multi-voltinism are commonplace. Photoperiodism was observed in this species, but due to a lag between annual cycles in photoperiod, temperature, and humidity, photoperiodism alone cannot atune their lifecycle with local conditions.Synchronization in this species was achieved by three different adaptations: photoperiodism, high t 0 , and large body size, which give it a long lifecycle. Although the species cannot achieve a univoltine lifecycle because of its high t 0 value, it can escape from dry season by entering diapause at moderate temperatures

Three-year lifecycle, large body, and very high threshold temperature in the cricket Gryllus argenteus for special adaptation to desiccation cycle in Malawi

NASA Astrophysics Data System (ADS)

Kosumi, Takuya; Takeda, Makio

2017-10-01

In temperate climates, the initiation and termination of diapause synchronize the stress-tolerant stage with the stressful season and reproduction with the non-stressful season in many insects. Synchronization is often regulated by photoperiodism. Voltinism and the ultimate size of adults are also important determinants for their lifecycle, and different diapause stages and voltinism patterns are known in crickets. Here, we investigated the life history of the African cricket Gryllus argenteus from Malawi, which is a typical arid tropical highland. The climate is characterized by alternating arid and wet seasons, each of which lasts for half a year, and where the available heat mass is much less than lowlands at the same latitude. We first measured the nymphal duration at each rearing temperature and calculated the lower developmental threshold ( t 0) to be 20.19 °C based on Ikemoto and Takai (2000) and 19.38 °C based on a conventional line-fitting method. These values are very high relative to many other insects. The local temperature in winter does not fall below 15 °C, but this is much higher than the lethal limit. This suggested that critical stress in this locality was not coldness but low precipitation in winter. We estimated, based both on local temperature change and the Ikemoto and Takai's t 0, that G. argenteus required 3 years to complete its lifecycle unlike wet lowland species, where univoltinism or multi-voltinism are commonplace. Photoperiodism was observed in this species, but due to a lag between annual cycles in photoperiod, temperature, and humidity, photoperiodism alone cannot atune their lifecycle with local conditions. Synchronization in this species was achieved by three different adaptations: photoperiodism, high t 0, and large body size, which give it a long lifecycle. Although the species cannot achieve a univoltine lifecycle because of its high t0 value, it can escape from dry season by entering diapause at moderate temperatures

Global earthquake casualties due to secondary effects: A quantitative analysis for improving rapid loss analyses

USGS Publications Warehouse

Marano, K.D.; Wald, D.J.; Allen, T.I.

2010-01-01

This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER's overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra-Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability. ?? Springer Science+Business Media B.V. 2009.

Preoperative diagnosis of obscure gastrointestinal bleeding due to a GIST of the jejunum: a case report.

PubMed

Gourgiotis, Stavros; Kotoulas, Dimitrios; Aloizos, Stavros; Kolovou, Aikaterini; Salemis, Nikolaos S; Kantounakis, Ioannis

2009-09-10

Gastrointestinal stromal tumours are rare mesenchymal neoplasms affecting the digestive tract or nearby structures within the abdomen. We present a case of a 66-year-old female patient who presented with obscure anemia due to gastrointestinal bleeding and underwent exploratory laparotomy during which a large gastrointestinal stromal tumour of the small intestine was discovered. Examining the preoperative results of video capsule endoscopy, computed tomography, and angiography and comparing them with the operative findings we discuss which of these investigations plays the most important role in the detection and localization of gastrointestinal stromal tumours. A sort review of the literature is also conducted on these rare mesenchymal tumours.

Preoperative diagnosis of obscure gastrointestinal bleeding due to a GIST of the jejunum: a case report.

PubMed

Gourgiotis, Stavros; Kotoulas, Dimitrios; Aloizos, Stavros; Kolovou, Aikaterini; Salemis, Nikolaos S; Kantounakis, Ioannis

2009-11-25

Gastrointestinal stromal tumours (GISTs) are rare mesenchymal neoplasms affecting the digestive tract or nearby structures within the abdomen. We present a case of a 66-year-old female patient who presented with obscure anemia due to gastrointestinal bleeding and underwent exploratory laparotomy during which a large GIST of the small intestine was discovered. Examining the preoperative results of video capsule endoscopy, computed tomography, and angiography and comparing them with the operative findings we discuss which of these investigations plays the most important role in the detection and localization of GIST. A sort review of the literature is also conducted on these rare mesenchymal tumours.

Linking Large-Scale Reading Assessments: Measuring International Trends over 40 Years

ERIC Educational Resources Information Center

Strietholt, Rolf; Rosén, Monica

2016-01-01

Since the start of the new millennium, international comparative large-scale studies have become one of the most well-known areas in the field of education. However, the International Association for the Evaluation of Educational Achievement (IEA) has already been conducting international comparative studies for about half a century. The present…

Endoscopic Removal of a Nitinol Mesh Stent from the Ureteropelvic Junction after 15 Years

PubMed Central

Smrkolj, Tomaž; Šalinović, Domagoj

2015-01-01

We report a rare case of a patient with a large stone encrusted on a nitinol mesh stent in the ureteropelvic junction. The stent was inserted in the year 2000 after failure of two pyeloplasty procedures performed due to symptomatic ureteropelvic junction stenosis. By combining minimally invasive urinary stone therapies—extracorporeal shock wave lithotripsy, semirigid ureterorenoscopy with laser lithotripsy, and percutaneous nephrolithotomy—it was possible to completely remove the encrusted stone and nitinol mesh stent that was implanted for 15 years, rendering the patient symptom and obstruction free. PMID:26697258

The Frequency of Gastric Amyloidosis in Baboons. A 22-year Survey at a Large Primate Facility

PubMed Central

Rubio, Carlos A.; Dick, Edward J.; Hubbard, Gene B.

2012-01-01

Background Systemic amyloidosis, caused by abnormal tissue accretion of plasma proteins, affects several organs of the gastrointestinal (GI) tract. Gastric amyloidosis, rare in humans, has only been reported once in animals. Materials and Methods Gastric amyloidosis was sought for in baboons with systemic amyloidosis. Results During the past 22 years (between January 1986 and January 2007) a mean of 3,315 baboons/year (range 2,578–3,931) were housed at the Southwest National Primate Research Center. Gastric amyloidosis was found in 9 (10.2%) of the 88 baboons having a diagnosis of systemic amyloidosis. Consequently, the prevalence of gastric amyloidosis occurring since 1986 at this facility was 0.41 baboons/year. Gastric amyloid deposits were found in the interstitial aspect of the lamina propria, replacing normal mucosal structures, in the submucosal stroma along the interface with the muscularis mucosae and in the interstitial tissue of submucosal lymphoid aggregates. In one of the animals, lumps of amyloid deposits with giant cells were found in the gastric mucosa. Conclusion Baboons with systemic amyloidosis usually show increasing frequency of amyloid deposits in the liver, large intestine, lymph nodes, spleen and the small intestine. We now demonstrate that it may also involve the stomach. Why certain organs of the GI tract in baboons are more susceptible than others to be affected by the process of systemic amyloidosis remains unexplained. The apparent natural resistance of the stomach of baboons to be affected by systemic amyloidosis deserves further investigation. The review of the literature indicates that this is only the second report on gastric amyloidosis in baboons. PMID:19180988

Ten years maintaining MACAO-VLTI units in operation in the Very Large Telescope at Paranal Observatory

NASA Astrophysics Data System (ADS)

Salgado, F.; Hudepohl, G.

2016-07-01

More than 10 years have already passed since the first Multiple Application Curvature Adaptive Optics (MACAO) facilities got the first light in UT2 the 18th of April, 2003, in the Very Large Telescope (VLT) at Paranal Observatory. The achievable image sharpness of a ground-based telescope is normally limited by the effect of atmospheric turbulence. However, with Adaptive Optics (AO) techniques, this major drawback can be overcome so that the telescope produces images that are as sharp as theoretically possible, i.e., as if they were taken from space. [1] The intention of this document is summarize in few pages some highlights related with the activities needed to keep MACAO units in operation. Some statistics of problems based in Action Remedy tool is included, showing how through these years the number of problems has been reduced, even when there are still some unsolved ones. Some lessons have been learned and there are others one to learn. Corrective and predictive maintenance performed are shown too like the current measurements, transfer functions measurements, thermography pictures, health checks measuring interaction matrix and flat vectors to detect dead APDs or short circuits in the DM, etc. Some forced interventions are included as well like the removal of the cabinets from Coude rooms to avoid that acoustic noise and vibrations perturb the operations, the deformable mirrors reached by cooling leaks and a mirror that got rusty are shown too. Well knowledge of the system, good interaction between different disciplines groups to perform corrective and preventive maintenance seems to be key aspects of keeping it under control and operative during all these years leading to this good result.

Future climate forcing potentially without precedent in the last 420 million years

PubMed Central

Foster, Gavin L.; Royer, Dana L.; Lunt, Daniel J.

2017-01-01

The evolution of Earth's climate on geological timescales is largely driven by variations in the magnitude of total solar irradiance (TSI) and changes in the greenhouse gas content of the atmosphere. Here we show that the slow ∼50 Wm−2 increase in TSI over the last ∼420 million years (an increase of ∼9 Wm−2 of radiative forcing) was almost completely negated by a long-term decline in atmospheric CO2. This was likely due to the silicate weathering-negative feedback and the expansion of land plants that together ensured Earth's long-term habitability. Humanity's fossil-fuel use, if unabated, risks taking us, by the middle of the twenty-first century, to values of CO2 not seen since the early Eocene (50 million years ago). If CO2 continues to rise further into the twenty-third century, then the associated large increase in radiative forcing, and how the Earth system would respond, would likely be without geological precedent in the last half a billion years. PMID:28375201

The seesaw space, a vector space to identify and characterize large-scale structures at 1 AU

NASA Astrophysics Data System (ADS)

Lara, A.; Niembro, T.

2017-12-01

We introduce the seesaw space, an orthonormal space formed by the local and the global fluctuations of any of the four basic solar parameters: velocity, density, magnetic field and temperature at any heliospheric distance. The fluctuations compare the standard deviation of a moving average of three hours against the running average of the parameter in a month (consider as the local fluctuations) and in a year (global fluctuations) We created this new vectorial spaces to identify the arrival of transients to any spacecraft without the need of an observer. We applied our method to the one-minute resolution data of WIND spacecraft from 1996 to 2016. To study the behavior of the seesaw norms in terms of the solar cycle, we computed annual histograms and fixed piecewise functions formed by two log-normal distributions and observed that one of the distributions is due to large-scale structures while the other to the ambient solar wind. The norm values in which the piecewise functions change vary in terms of the solar cycle. We compared the seesaw norms of each of the basic parameters due to the arrival of coronal mass ejections, co-rotating interaction regions and sector boundaries reported in literature. High seesaw norms are due to large-scale structures. We found three critical values of the norms that can be used to determined the arrival of coronal mass ejections. We present as well general comparisons of the norms during the two maxima and the minimum solar cycle periods and the differences of the norms due to large-scale structures depending on each period.

Geriatric Trauma Patients With Cervical Spine Fractures due to Ground Level Fall: Five Years Experience in a Level One Trauma Center

PubMed Central

Wang, Hao; Coppola, Marco; Robinson, Richard D.; Scribner, James T.; Vithalani, Veer; de Moor, Carrie E.; Gandhi, Raj R.; Burton, Mandy; Delaney, Kathleen A.

2013-01-01

Background It has been found that significantly different clinical outcomes occur in trauma patients with different mechanisms of injury. Ground level falls (GLF) are usually considered “minor trauma” with less injury occurred in general. However, it is not uncommon that geriatric trauma patients sustain cervical spine (C-spine) fractures with other associated injuries due to GLF or less. The aim of this study is to determine the injury patterns and the roles of clinical risk factors in these geriatric trauma patients. Methods Data were reviewed from the institutional trauma registry of our local level 1 trauma center. All patients had sustained C-spine fracture(s). Basic clinical characteristics, the distribution of C-spine fracture(s), and mechanism of injury in geriatric patients (65 years or older) were compared with those less than 65 years old. Furthermore, different clinical variables including age, gender, Glasgow coma scale (GCS), blood alcohol level, and co-existing injuries were analyzed by multivariate logistic regression in geriatric trauma patients due to GLF and internally validated by random bootstrapping technique. Results From 2006 - 2010, a total of 12,805 trauma patients were included in trauma registry, of which 726 (5.67%) had sustained C-spine fracture(s). Among all C-spine fracture patients, 19.15% (139/726) were geriatric patients. Of these geriatric patients 27.34% (38/139) and 53.96% (75/139) had C1 and C2 fractures compared with 13.63% (80/587) and 21.98% (129/587) in young trauma patients (P < 0.001). Of geriatric trauma patients 13.67% (19/139) and 18.71% (26/139) had C6 and C7 fractures compared with 32.03% (188/587) and 41.40% (243/587) in younger ones separately (P < 0.001). Furthermore, 53.96% (75/139) geriatric patients had sustained C-spine fractures due to GLF with more upper C-spine fractures (C1 and C2). Only 3.2% of those had positive blood alcohol levels compared with 52.9% of younger patients (P < 0.001). In addition, 6

Five-year study of ocular injuries due to fireworks in India.

PubMed

Malik, Archana; Bhala, Soniya; Arya, Sudesh K; Sood, Sunandan; Narang, Subina

2013-08-01

To study the demographic profile, cause, type and severity of ocular injuries, their complications and final visual outcome following fireworks around the time of Deepawali in India. Case records of patients who presented with firework-related injuries during 2005-2009 at the time of Deepawali were reviewed. Data with respect to demographic profile of patients, cause and time of injury, time of presentation and types of intervention were analyzed. Visual acuity at presentation and final follow-up, anterior and posterior segment findings, and any diagnostic and surgical interventions carried out were noted. One hundred and one patients presented with firework-related ocular injuries, of which 77.5 % were male. The mean age was 17.60 ± 11.9 years, with 54 % being ≤14 years of age. The mean time of presentation was 8.9 h. Seventeen patients had open globe injury (OGI) and 84 had closed globe injury (CGI). Fountains were the most common cause of CGI and bullet bombs were the most common cause of OGI. Mean log MAR visual acuity at presentation was 0.64 and 1.22 and at last follow-up was 0.09 and 0.58 for CGI and OGI, respectively (p < 0.05). Patients with CGI had a better visual outcome. Three patients with OGI developed permanent blindness. Factors associated with poor visual outcome included poor initial visual acuity, OGI, intraocular foreign body (IOFB), retinal detachment and development of endophthalmitis. Firework injuries were seen mostly in males and children. Poor visual outcome was associated with poor initial visual acuity, OGI, IOFB, retinal detachment and development of endophthalmitis, while most patients with CGI regained good vision.

Automatic localization of backscattering events due to particulate in urban areas

NASA Astrophysics Data System (ADS)

Gaudio, P.; Gelfusa, M.; Malizia, Andrea; Parracino, Stefano; Richetta, M.; Murari, A.; Vega, J.

2014-10-01

Particulate matter (PM), emitted by vehicles in urban traffic, can greatly affect environment air quality and have direct implications on both human health and infrastructure integrity. The consequences for society are relevant and can impact also on national health. Limits and thresholds of pollutants emitted by vehicles are typically regulated by government agencies. In the last few years, the interest in PM emissions has grown substantially due to both air quality issues and global warming. Lidar-Dial techniques are widely recognized as a costeffective alternative to monitor large regions of the atmosphere. To maximize the effectiveness of the measurements and to guarantee reliable, automatic monitoring of large areas, new data analysis techniques are required. In this paper, an original tool, the Universal Multi-Event Locator (UMEL), is applied to the problem of automatically indentifying the time location of peaks in Lidar measurements for the detection of particulate matter emitted by anthropogenic sources like vehicles. The method developed is based on Support Vector Regression and presents various advantages with respect to more traditional techniques. In particular, UMEL is based on the morphological properties of the signals and therefore the method is insensitive to the details of the noise present in the detection system. The approach is also fully general, purely software and can therefore be applied to a large variety of problems without any additional cost. The potential of the proposed technique is exemplified with the help of data acquired during an experimental campaign in the field in Rome.

Allergic Maculo-Papular Exanthema Due To Terbinafine

PubMed Central

Koch, André; Tchernev, Georgi; Wollina, Uwe

2017-01-01

We report on a 76-year-old male patient who developed a maculopapular generalised exanthema due to terbinafine. Prick test was negative; patch test revealed a positive reaction after 48 h confirming the delayed-type allergic reaction. Non-pustular exanthema has only rarely been reported for terbinafine. PMID:28785353

Premature mortality in India due to PM2.5 and ozone exposure

NASA Astrophysics Data System (ADS)

Ghude, Sachin D.; Chate, D. M.; Jena, C.; Beig, G.; Kumar, R.; Barth, M. C.; Pfister, G. G.; Fadnavis, S.; Pithani, Prakash

2016-05-01

This bottom-up modeling study, supported by new population census 2011 data, simulates ozone (O3) and fine particulate matter (PM2.5) exposure on local to regional scales. It quantifies, present-day premature mortalities associated with the exposure to near-surface PM2.5 and O3 concentrations in India using a regional chemistry model. We estimate that PM2.5 exposure leads to about 570,000 (CI95: 320,000-730,000) premature mortalities in 2011. On a national scale, our estimate of mortality by chronic obstructive pulmonary disease (COPD) due to O3 exposure is about 12,000 people. The Indo-Gangetic region accounts for a large part (~42%) of the estimated mortalities. The associated lost life expectancy is calculated as 3.4 ± 1.1 years for all of India with highest values found for Delhi (6.3 ± 2.2 years). The economic cost of estimated premature mortalities associated with PM2.5 and O3 exposure is about 640 (350-800) billion USD in 2011, which is a factor of 10 higher than total expenditure on health by public and private expenditure.

Readmissions due to traffic accidents at a general hospital.

PubMed

Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

2015-01-01

to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories. among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%). The causes of the return to the hospital were: need to continue the surgical treatment (63.2%), surgical site infection (26.3%) and fall related to the physical sequelae of the trauma (10.5%). The rehospitalization rate corresponded to 174/1,000 people/year. the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

Use of large-scale atmospheric energetics for understanding the dynamics of contrasting Indian summer monsoon rainfall in different years

NASA Astrophysics Data System (ADS)

Dutta, Somenath; Narkhedkar, Sanjay G.; Mukhopadhyay, Parthasarathi; Yadav, Mamta; Sunitha Devi

2018-06-01

An attempt has been made to understand the dynamics of contrasting Indian summer monsoon rainfall (ISMR) in different years during 1979-2017, from large-scale atmospheric energetics aspects. Daily values of eddy and zonal available potential energy (APE), their generation, eddy and zonal kinetic energy (KE), conversions of zonal KE and eddy APE to eddy KE, and conversions of zonal APE to zonal KE and eddy APE were computed over the region bounded by 65°E-95°E and 5°N-35°N during the period 1 May to 30 September for 39 years (1979-2017), using daily ECMWF reanalyzed atmospheric data at 0.125° × 0.125° resolution (3 components of wind and temperature). ISMR was classified into three categories, viz., deficient and below normal, normal and above normal and excess. The daily anomaly of these energetics parameters in each of these years was computed using jackknife method and then the composite of the daily anomalies of these parameters constructed for the years with the above-mentioned three categories of ISMR. The following salient features emerge from this study: Analysis of composite anomaly shows that in case of excess and above normal (below normal and deficient) ISMR, C(A Z , K Z) was less (more) than normal. In case of excess and above normal (below normal and deficient) ISMR, C(A E , K E) was more (less) than normal. Broadly, C(A Z , A E) was more than normal in the years with deficient and below normal ISMR, whereas it was less than normal for years with excess and above normal ISMR. Broadly, G(A Z) was below normal for the years with above normal and excess ISMR, whereas it was above normal for the years with below normal and deficient ISMR. Total kinetic energy and total conversion to eddy kinetic energy was above normal for the years with above normal and excess ISMR.

Visual impairment due to retinopathy of prematurity (ROP) in New Zealand: a 22-year review.

PubMed

Tan, Zachary; Chong, CheeFoong; Darlow, Brian; Dai, Shuan

2015-06-01

To evaluate retinopathy of prematurity (ROP)-related visual impairment in New Zealand children. 22-year retrospective review of medical records of children with moderate to severe visual impairment registered with the Blind and Low Vision Education Network New Zealand. The cohort was divided into two periods (1991-2004; 2005-2012) for analysis. 232 children with ROP were treated in the study period (109 in period 1, 123 in period 2). 36 children, 63.9% of whom were of male sex, were identified with subsequent significant visual impairment (27 in period 1, 9 in period 2). The incidence of new cases of visual impairment from ROP declined from 271.6 infants/100 000 live very preterm births per annum (period 1) to 146.1 per annum (period 2). Mean gestational age and mean birth weight were comparable between the two study periods. 75% of children with visual impairment from ROP received treatment for their condition (period 1, 74.1%; period 2, 77.8%) and modalities used changed significantly over time. The modal visual outcome overall was Snellen visual acuity <6/18-6/60 (55.6%) (period 1, 51.9%; period 2, 66.7%). The proportion of children with no light perception bilaterally decreased over time (period 1, 3.7%; period 2, 0%). There has been a reduction in the incidence of infants with significant visual impairment from ROP over time in New Zealand, likely due to progress in clinical management of ROP. Our study suggests the current ROP screening criteria of <31 weeks' gestation or <1250 g are of sufficient breadth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Density Limit due to SOL Convection

NASA Astrophysics Data System (ADS)

D'Ippolito, D. A.; Myra, J. R.; Russell, D. A.

2004-11-01

Recent measurements on C-Mod(M. Greenwald, Plasma Phys. Contr. Fusion 44), R27 (2002). suggest there is a density limit due to rapid convection in the SOL: this region starts in the far SOL but expands inward to the separatrix as the density approaches the Greenwald limit. This idea is supported by a recent analysis(D. A. Russell et al., Lodestar Report LRC-04-99 (2004).) of a 3D BOUT code turbulence simulation(X. Q. Xu et al., Bull. APS 48), 184 (2003), paper KP1-20. with neutral fueling of the X-point region. Our work suggests that rapid outwards convection of plasma by turbulent coherent structures (``blobs'') occurs when the X-point collisionality is sufficiently large. Here, we calculate a density limit due to loss of thermal equilibrium in the edge plasma due to rapid radial convective heat transport. We expect a synergistic effect between blob convection and X-point cooling. The cooling increases the parallel resistivity at the X-point, ``disconnects'' the blobs electrically from the sheaths, and increases their radial velocity,(D.A. D'Ippolito et al., 2004 Sherwood Meeting, paper 1C 43.) which in turn further cools the X-points. Progress on a theoretical model will be reported.

Improving Mortality in End-Stage Renal Disease due to Granulomatosis with Polyangiitis from 1995 to 2014.

PubMed

Wallace, Zachary S; Zhang, Yuqing; Lu, Na; Stone, John H; Choi, Hyon K

2018-01-23

Granulomatosis with polyangiitis (GPA) often affects the kidneys, frequently leading to end-stage renal disease (ESRD). Cardiovascular disease (CVD) and infections are common causes of death in GPA and ESRD. Our objective was to examine temporal trends in the mortality of GPA-ESRD in a large nationwide cohort. We identified ESRD due to GPA in the US Renal Data System (USRDS) between 1995 and 2014, using nephrologists' coding for the ESRD etiology. The cohort was divided into four five-year subcohorts based on year of ESRD onset (1995-1999; 2000-2004; 2005-2009; 2010-2014) to assess trends in mortality rates and hazard ratios (HRs) for overall death and cause-specific death, adjusting for potential confounders. Between 1995 and 2014, there were 5,929 incident cases of GPA-ESRD. The mortality rate (per 100 patient-years) declined from 19.0 in 1995-1999 to 15.3 in 2010-2014 (P=0.01). The adjusted mortality HR of the 2010-2014 cohort was 0.77 (95% CI, 0.66-0.90), compared with the 1995-1999 cohort (P-for-trend <0.001). The corresponding cause-specific mortality HRs after accounting for competing risk were 0.61 (95% CI, 0.47-0.80) for CVD death and 0.42 (95% CI, 0.28-0.63) for infection death (both P-for-trends <0.001). In this study of nearly all patients who developed ESRD due to GPA in the US over two decades, we found significant improvements in mortality among GPA-ESRD patients. Cause-specific death due to CVD and infections each declined significantly during the study period. These findings are encouraging and likely reflect improved management of both GPA and ESRD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Automatic trajectory measurement of large numbers of crowded objects

NASA Astrophysics Data System (ADS)

Li, Hui; Liu, Ye; Chen, Yan Qiu

2013-06-01

Complex motion patterns of natural systems, such as fish schools, bird flocks, and cell groups, have attracted great attention from scientists for years. Trajectory measurement of individuals is vital for quantitative and high-throughput study of their collective behaviors. However, such data are rare mainly due to the challenges of detection and tracking of large numbers of objects with similar visual features and frequent occlusions. We present an automatic and effective framework to measure trajectories of large numbers of crowded oval-shaped objects, such as fish and cells. We first use a novel dual ellipse locator to detect the coarse position of each individual and then propose a variance minimization active contour method to obtain the optimal segmentation results. For tracking, cost matrix of assignment between consecutive frames is trainable via a random forest classifier with many spatial, texture, and shape features. The optimal trajectories are found for the whole image sequence by solving two linear assignment problems. We evaluate the proposed method on many challenging data sets.

Modeling long-term carbon residue in the ocean-atmosphere system following large CO2 emissions

NASA Astrophysics Data System (ADS)

Towles, N. J.; Olson, P.; Gnanadesikan, A.

2013-12-01

We use the LOSCAR carbon cycle model (Zeebe et al., 2009; Zeebe, 2012) to calculate the residual carbon in the ocean and atmosphere following large CO2 emissions. We consider the system response to CO2 emissions ranging from 100 to 20000 PgC, and emission durations from 100 yr to 100 kyr, subject to a wide range of system parameters such as the strengths of silicate weathering and the oceanic biological carbon pump. We define the carbon gain factor as the ratio of residual carbon in the ocean-atmosphere to the total emitted carbon. For moderate sized emissions shorter than about 50 kyr, we find that the carbon gain factor grows during the emission and peaks at about 1.7, primarily due to the erosion of carbonate marine sediments. In contrast, for longer emissions, the carbon gain factor peaks at a smaller value, and for very large emissions (more than 5000 PgC), the gain factor decreases with emission size due to carbonate sediment exhaustion. This gain factor is sensitive to model parameters such as low latitude efficiency of the biological pump. The timescale for removal of the residual carbon (reducing the carbon gain factor to zero) depends strongly on the assumed sensitivity of silicate weathering to atmospheric pCO2, and ranges from less than one million years to several million years.

Empirical Estimates of Tree Carbon Storage Over a Century due to Fire Reduction in California Montane Conifer Forests.

NASA Astrophysics Data System (ADS)

Bouldin, J.

2008-12-01

Fire reduction policies are globally widespread and cause large changes in natural disturbance regimes. They should affect C accrual rates, but there is uncertainty in both modeling- and empirically-based estimates on the rate, and sometimes even the sign thereof, due to a lack of high quality data and to the confounding by logging or other ecological changes. Here I present data on tree density and C stock changes over 93 years from a never-logged, mid-montane (1370 to 2130 m) landscape in the central Sierra Nevada, California. Literature-based mean pre-1870 fire return intervals in the region were on the order of 8 to 20 years, but declined precipitously afterwards. The area was originally sampled without bias in 1911, and in 2004 I randomly re-sampled 20 1.6 ha plots in the area. I found very large increases in tree density and tree C, with mean tree densities increasing in each of 13 diameter classes. Total density increased from 54 to 289 trees per ha (530 percent); the smallest diameter class increased 1100 percent while progressively larger classes had smaller relative increases. Allometrically estimated increases in tree C across the size classes were more uniform, and total tree C, excluding fine roots, increased from 100 to 228 Mg C per ha. These values very likely underestimate ecosystem C gain, because likely increases in snags, down logs, small trees, shrubs, and forest litter and duff are not included. Also, sheep grazing likely hampered regeneration in the few decades following initial fire declines, and recent controlled burns in 65 percent of the plots have likely reduced C levels somewhat. In many Sierran locations, controlled burns are now quite risky due to increased fuel loads and the consequent risk of historically unnatural catastrophic crown fires. Such fires instantly release very high C amounts and continue to emit C for many years due to dead wood decomposition and increased soil respiration. There is also a substantial risk of permanent

Urine cytology of nonurothelial malignancies-a 10-year experience in a large multihospital healthcare system.

PubMed

Savant, Deepika; Bajaj, Jaya; Gimenez, Cecilia; Rafael, Oana C; Mirzamani, Neda; Chau, Karen; Klein, Melissa; Das, Kasturi

2017-01-01

Urine cytology is the most frequently utilized test to detect urothelial cancer. Secondary bladder neoplasms need to be recognized as this impacts patient management. We report our experience on nonurothelial malignancies (NUM) detected in urine cytology over a 10-year period. A 10-year retrospective search for patients with biopsy-proven NUM to the urothelial tract yielded 25 urine samples from 14 patients. Two cytopathologists blinded to the original cytology diagnosis reviewed the cytology and histology slides. The incidence, cytomorphologic features, diagnostic accuracy, factors influencing the diagnostic accuracy, and clinical impact of the cytology result were studied. The incidence of NUM was <1%. The male:female ratio was 1.3. An abnormality was detected in 60% of the cases; however, in only 4% of the cases, a primary site was identified accurately. Of the false negatives, 96% was deemed as sampling errors and 4% was interpretational. Patient management was not impacted in any of the false-negative cases due to concurrent or past tissue diagnosis. Colon cancer was the most frequent secondary tumor. Sampling error attributed to the false-negative results. Necrosis and dirty background was often associated with metastatic lesions from colon. Obtaining history of a primary tumor elsewhere was a key factor in diagnosis of a metastatic lesion. Hematopoietic malignancies remain to be a diagnostic challenge. Cytospin preparations were superior for evaluating nuclear detail and background material as opposed to monolayer (Thinprep) technology. Diagnostic accuracy was improved by obtaining immunohistochemistry. Diagn. Cytopathol. 2016. © 2016 Wiley Periodicals, Inc. Diagn. Cytopathol. 2017;45:22-28. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Developing NDE Techniques for Large Cryogenic Tanks

NASA Technical Reports Server (NTRS)

Parker, Don; Starr, Stan; Arens, Ellen

2011-01-01

The Shuttle Program requires very large cryogenic ground storage tanks in which to store liquid oxygen and hydrogen. The existing Pads A and B Launch Complex-39 tanks, which will be passed onto future launch programs, are 45 years old and have received minimal refurbishment and only external inspections over the years. The majority of the structure is inaccessible without a full system drain of cryogenic liquid and granular insulation in the annular region. It was previously thought that there was a limit to the number of temperature cycles that the tanks could handle due to possible insulation compaction before undergoing a costly and time consuming complete overhaul; therefore the tanks were not drained and performance issues with these tanks, specifically the Pad B liquid hydrogen tank, were accepted. There is a needind an opportunity, as the Shuttle program ends and work to upgrade the launch pads progresses, to develop innovative non-destructive evaluation (NDE) techniques to analyze the current tanks. Techniques are desired that can aid in determining the extent of refurbishment required to keep the tanks in service for another 20+ years. A nondestructive technique would also be a significant aid in acceptance testing of new and refurbished tanks, saving significant time and money, if corrective actions can be taken before cryogen is introduced to the systems.

Endovascular therapy versus thrombolysis in patients with large vessel occlusions within the anterior circulation aged ≥80 years.

PubMed

Kastrup, Andreas; Brunner, Freimuth; Hildebrandt, Helmut; Roth, Christian; Winterhalter, Michael; Papanagiotou, Panagiotis

2018-03-16

In patients with large vessel occlusions, endovascular treatment (ET) has been shown to be superior to intravenous thrombolysis (IVT) in recent trials. However, the effectiveness of ET in elderly patients is uncertain. Using our stroke database, we compared the rates of good outcome (modified Rankin scale (mRS) ≤2), excellent outcome (mRS 0-1), poor outcome (mRS 5-6) at discharge, in-hospital death, infarct size, and symptomatic intracranial hemorrhage (SICH) in patients aged ≥80 years with distal intracranial carotid artery, M1 and M2 occlusions during two time periods. From January 2008 to October 2012, 217 patients were treated with IVT and, from November 2012 to October 2017, 209 patients received ET with stent retrievers (with or without IVT). Significantly more patients in the ET group than in the IVT group had a good outcome (25% vs 16%, P<0.05), as well as an excellent outcome (12% vs 4%, P<0.01). Significantly fewer patients in the ET group than in the IVT group died (14% vs 22%, P<0.05) or had a poor outcome (35% vs 52%, P<001). The SICH rates were lower after ET than after IVT (1% vs 6%, P<0.01), and the infarct sizes were smaller after ET than after IVT. Compared with IVT, the routine use of ET significantly improved the early clinical and radiological outcome in patients with anterior circulation large vessel occlusions aged ≥80 years. Nevertheless, poor outcome rates were high so the role of ET needs to be defined further in this population. © 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.

Effectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims database.

PubMed

Shibata, Natsumi; Kimura, Shinya; Hoshino, Takahiro; Takeuchi, Masato; Urushihara, Hisashi

2018-05-11

To date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1-15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting. We conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies. The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination. Total study population throughout the four consecutive influenza seasons was over 116,000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons. We confirmed the clinical effectiveness of influenza vaccination in children aged 1-15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications

Large Salt Dust Storms Follow a 30-Year Rainfall Cycle in the Mar Chiquita Lake (Córdoba, Argentina)

PubMed Central

Stein, Ariel F.

2016-01-01

Starting in 2006, a new source of intense salt dust storms developed in Mar Chiquita (Córdoba, Argentina), the largest saline lake in South America. Storms originate from vast mudflats left by a 30-year expansion-retreat cycle of the lake due to changes in the regional rainfall regime. The annual frequency of salt dust storms correlated with the size of the salt mudflats. Events were restricted to the coldest months, and reached up to 800 km from the source. Occurrence of dust storms was associated with specific surface colors and textures easily identifiable in satellite images. High-emission surfaces were characterized by the presence of sodium sulfate hydrous/anhydrous crystals (mirabilite and thenardite), and a superficial and variable water table, which may result in the periodic development of a characteristic “fluffy” surface derived from salt precipitation-dissolution processes. HYSPLIT model simulation estimates a deposition maximum near the sources (of about 2.5 kg/ha/yr), and a decreasing trend from the emission area outwards, except for the relative secondary maximum modeled over the mountain ranges in southern Bolivia and northern Argentina due to an orographic effect. The 2009 total deposition of salt dust generated in Mar Chiquita was estimated at 6.5 million tons. PMID:27258088

Large Salt Dust Storms Follow a 30-Year Rainfall Cycle in the Mar Chiquita Lake (Córdoba, Argentina).

PubMed

Bucher, Enrique H; Stein, Ariel F

2016-01-01

Starting in 2006, a new source of intense salt dust storms developed in Mar Chiquita (Córdoba, Argentina), the largest saline lake in South America. Storms originate from vast mudflats left by a 30-year expansion-retreat cycle of the lake due to changes in the regional rainfall regime. The annual frequency of salt dust storms correlated with the size of the salt mudflats. Events were restricted to the coldest months, and reached up to 800 km from the source. Occurrence of dust storms was associated with specific surface colors and textures easily identifiable in satellite images. High-emission surfaces were characterized by the presence of sodium sulfate hydrous/anhydrous crystals (mirabilite and thenardite), and a superficial and variable water table, which may result in the periodic development of a characteristic "fluffy" surface derived from salt precipitation-dissolution processes. HYSPLIT model simulation estimates a deposition maximum near the sources (of about 2.5 kg/ha/yr), and a decreasing trend from the emission area outwards, except for the relative secondary maximum modeled over the mountain ranges in southern Bolivia and northern Argentina due to an orographic effect. The 2009 total deposition of salt dust generated in Mar Chiquita was estimated at 6.5 million tons.

Recent TB transmission, clustering and predictors of large clusters in London, 2010–2012: results from first 3 years of universal MIRU-VNTR strain typing

PubMed Central

Hamblion, Esther L; Le Menach, Arnaud; Anderson, Laura F; Lalor, Maeve K; Brown, Tim; Abubakar, Ibrahim; Anderson, Charlotte; Maguire, Helen; Anderson, Sarah R

2016-01-01

Background The incidence of TB has doubled in the last 20 years in London. A better understanding of risk groups for recent transmission is required to effectively target interventions. We investigated the molecular epidemiological characteristics of TB cases to estimate the proportion of cases due to recent transmission, and identify predictors for belonging to a cluster. Methods The study population included all culture-positive TB cases in London residents, notified between January 2010 and December 2012, strain typed using 24-loci multiple interspersed repetitive units-variable number tandem repeats. Multivariable logistic regression analysis was performed to assess the risk factors for clustering using sociodemographic and clinical characteristics of cases and for cluster size based on the characteristics of the first two cases. Results There were 10 147 cases of which 5728 (57%) were culture confirmed and 4790 isolates (84%) were typed. 2194 (46%) were clustered in 570 clusters, and the estimated proportion attributable to recent transmission was 34%. Clustered cases were more likely to be UK born, have pulmonary TB, a previous diagnosis, a history of substance abuse or alcohol abuse and imprisonment, be of white, Indian, black-African or Caribbean ethnicity. The time between notification of the first two cases was more likely to be <90 days in large clusters. Conclusions Up to a third of TB cases in London may be due to recent transmission. Resources should be directed to the timely investigation of clusters involving cases with risk factors, particularly those with a short period between the first two cases, to interrupt onward transmission of TB. PMID:27417280

Aerophagia due to abdomino-phrenic dyssynergia in a 2-year-old child.

PubMed

Ercoli, Pablo; García, Belinda; Del Campo, Enrique; Pinillos, Sergio

2018-05-01

We report the case of a previously healthy 2-year-old child who presented with significant abdominal distension. After several interventions that proved ineffective, pathologic aerophagia was eventually diagnosed. In pediatrics, pathologic aerophagia is an uncommon disorder that almost exclusively affects children with an underlying neurological condition. It may lead to multiple diagnostic tests and unnecessary aggressive therapies. A recent case report associated aerophagia with a novel concept of abdomino-phrenic dyssynergia.

Comprehensive Analysis of Large Sets of Age-Related Physiological Indicators Reveals Rapid Aging around the Age of 55 Years.

PubMed

Lixie, Erin; Edgeworth, Jameson; Shamir, Lior

2015-01-01

While many studies show a correlation between chronological age and physiological indicators, the nature of this correlation is not fully understood. To perform a comprehensive analysis of the correlation between chronological age and age-related physiological indicators. Physiological aging scores were deduced using principal component analysis from a large dataset of 1,227 variables measured in a cohort of 4,796 human subjects, and the correlation between the physiological aging scores and chronological age was assessed. Physiological age does not progress linearly or exponentially with chronological age: a more rapid physiological change is observed around the age of 55 years, followed by a mild decline until around the age of 70 years. These findings provide evidence that the progression of physiological age is not linear with that of chronological age, and that periods of mild change in physiological age are separated by periods of more rapid aging. © 2015 S. Karger AG, Basel.

Thermodynamics of water structural reorganization due to geometric confinement

NASA Astrophysics Data System (ADS)

Stroberg, Wylie; Lichter, Seth

2015-03-01

Models of aqueous solvation have successfully quantified the behavior of water near convex bodies. However, many important processes occurring in aqueous solution involve interactions between solutes and surfaces with complicated non-convex geometries. Examples include the folding of proteins, hydrophobic association of solutes, ligand-receptor binding, and water confined within nanotubes and pores. For these geometries, models for solvation of convex bodies fail to account for the added interactions associated with structural confinement. Due to water's propensity to form networks of hydrogen bonds, small alterations to the confining geometry can induce large structural rearrangement within the water. We perform systematic Monte Carlo simulations of water confined to cylindrical cavities of varying aspect ratio to investigate how small geometric changes to the confining geometry may cause large changes to the structure and thermodynamic state of water. Using the Wang-Landau algorithm, we obtain free energies, enthalpies, entropies, and heat capacities across a broad range of temperatures, and show how these quantities are influenced by the structural rearrangement of water molecules due to geometric perturbations.

Unplanned Reoperations in Neurosurgical Patients Due to Postoperative Bleeding

PubMed Central

Zheng, Xin-Rui; Chen, Tao; Yang, Yue-Fan; Rao, Wei; Wang, Guan-Ying; Zhang, Shan-Hong; Fei, Zhou

2015-01-01

Abstract The aim of this study is to investigate the incidence of unplanned reoperations from all causes due to bleeding in neurosurgical patients. The medical records of patients who received neurosurgical procedures at our hospital were retrospectively reviewed and data of patients who received reoperations were extracted and summarized. A literature review was conducted of the Medline, Cochrane, EMBASE, and Google Scholar databases up to November 2013. The main outcome measure was the rate of unplanned reoperations due to bleeding. At our hospital, 68 patients with a mean age of 41.5 ± 21.5 years (range, 7 months to 76 years) received an unplanned reoperation. More than 70% of the patients were older than 18 years, 64.7% were males, and 94.1% had cranial surgery. Almost 60% of the patients received >1 blood transfusion (58.8%) after the first surgery. Of the 68 patients, 35 (51.5%) received a second operation due to bleeding. Univariate logistic regression analysis only showed that an increasing time interval between the first and second surgery was associated with a decreased chance of the reoperation being performed due to bleeding (odds ratio [OR] = 0.843, 95% confidence interval [CI]: 0.720–0.987; P = .033). Of 229 studies identified, 5 retrospective reports with a total of 1375 patients were included in the analysis. The rate of reoperations for bleeding in the 5 studies ranged from 4.2% to 31.5%. Employing measures to reduce postoperative bleeding may help reduce the rate of unplanned neurosurgical reoperations. PMID:26061301

The Phenotype of the Musculocontractural Type of Ehlers-Danlos Syndrome due to CHST14 Mutations

PubMed Central

Janecke, Andreas R.; Li, Ben; Boehm, Manfred; Krabichler, Birgit; Rohrbach, Marianne; Müller, Thomas; Fuchs, Irene; Golas, Gretchen; Katagiri, Yasuhiro; Ziegler, Shira G.; Gahl, William A.; Wilnai, Yael; Zoppi, Nicoletta; Geller, Herbert M.; Giunta, Cecilia; Slavotinek, Anne; Steinmann, Beat

2016-01-01

The musculocontractural type of Ehlers-Danlos syndrome (MC-EDS) has been recently recognized as a clinical entity. MC-EDS represents a differential diagnosis within the congenital neuromuscular and connective tissue disorders spectrum. Thirty-one and three patients have been reported with MC-EDS so far with biallelic mutations identified in CHST14 and DSE, respectively, encoding two enzymes necessary for dermatan sulfate (DS) biosynthesis. We report seven additional patients with MC-EDS from four unrelated families, including the follow-up of a sib-pair originally reported with the kyphoscoliotic type of EDS in 1975. Brachycephaly, a characteristic facial appearance, an asthenic build, hyperextensible and bruisable skin, tapering fingers, instability of large joints, and recurrent formation of large subcutaneous hematomas are always present. Three of seven patients hadmildly elevated serum creatine kinase. The oldest patient was blind due to retinal detachment at 45 years and died at 59 years from intracranial bleeding; her affected brother died at 28 years from fulminant endocarditis. All patients in this series harbored homozygous, predicted loss-of-function CHST14 mutations. Indeed, DS was not detectable in fibroblasts from two unrelated patients with homozygous mutations. Patient fibroblasts produced higher amounts of chondroitin sulfate, showed intracellular retention of collagen types I and III, and lacked decorin and thrombospondin fibrils compared with control. A great proportion of collagen fibrils were not integrated into fibers, and fiber bundles were dispersed into the ground substance in one patient, all of which is likely to contribute to the clinical phenotype. This report should increase awareness for MC-EDS. PMID:26373698

Risk of large-scale fires in boreal forests of Finland under changing climate

NASA Astrophysics Data System (ADS)

Lehtonen, I.; Venäläinen, A.; Kämäräinen, M.; Peltola, H.; Gregow, H.

2016-01-01

The target of this work was to assess the impact of projected climate change on forest-fire activity in Finland with special emphasis on large-scale fires. In addition, we were particularly interested to examine the inter-model variability of the projected change of fire danger. For this purpose, we utilized fire statistics covering the period 1996-2014 and consisting of almost 20 000 forest fires, as well as daily meteorological data from five global climate models under representative concentration pathway RCP4.5 and RCP8.5 scenarios. The model data were statistically downscaled onto a high-resolution grid using the quantile-mapping method before performing the analysis. In examining the relationship between weather and fire danger, we applied the Canadian fire weather index (FWI) system. Our results suggest that the number of large forest fires may double or even triple during the present century. This would increase the risk that some of the fires could develop into real conflagrations which have become almost extinct in Finland due to active and efficient fire suppression. However, the results reveal substantial inter-model variability in the rate of the projected increase of forest-fire danger, emphasizing the large uncertainty related to the climate change signal in fire activity. We moreover showed that the majority of large fires in Finland occur within a relatively short period in May and June due to human activities and that FWI correlates poorer with the fire activity during this time of year than later in summer when lightning is a more important cause of fires.

26 CFR 1.6655-4 - Large corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 13 2013-04-01 2013-04-01 false Large corporations. 1.6655-4 Section 1.6655-4... Large corporations. (a) Large corporation defined. The term large corporation means any corporation (or a predecessor corporation) that had taxable income of at least $1,000,000 for any taxable year...

26 CFR 1.6655-4 - Large corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 13 2011-04-01 2011-04-01 false Large corporations. 1.6655-4 Section 1.6655-4... Large corporations. (a) Large corporation defined. The term large corporation means any corporation (or a predecessor corporation) that had taxable income of at least $1,000,000 for any taxable year...

26 CFR 1.6655-4 - Large corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 13 2014-04-01 2014-04-01 false Large corporations. 1.6655-4 Section 1.6655-4... Large corporations. (a) Large corporation defined. The term large corporation means any corporation (or a predecessor corporation) that had taxable income of at least $1,000,000 for any taxable year...

26 CFR 1.6655-4 - Large corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 13 2012-04-01 2012-04-01 false Large corporations. 1.6655-4 Section 1.6655-4... Large corporations. (a) Large corporation defined. The term large corporation means any corporation (or a predecessor corporation) that had taxable income of at least $1,000,000 for any taxable year...

A rare case of mycetoma due to curvularia.

PubMed

Shinde, Rupali S; Hanumantha, Sreedevi; Mantur, Basappa G; Parande, Mahantesh V

2015-01-01

Mycetoma due to Curvularia is a rare clinical entity. Here, we report a case of 27-year-old female presented with multiple swellings and discharging wounds around left shoulder joint since 12 years. Local examination showed diffuse nodular swellings over left anterior chest wall, posterior chest wall, and axilla. Multiple nodules and discharging sinuses were seen. Fungal culture of the biopsy of the lesion revealed Curvularia species. Patient showed significant clinical improvement with itraconazole therapy.

Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control.

PubMed

Chapman, Simon; Wakefield, Melanie A

2013-05-01

In the 50 years since the twentieth century's smoking epidemic began to decline from the beginning of the 1960s, hundreds of millions of smokers around the world have stopped smoking permanently. Overwhelmingly, most stopped without any formal assistance in the form of medication or professional assistance, including many millions of former heavy smokers. Nascent discussion about national and global tobacco endgame scenarios is dominated by an assumption that transitioning from cigarettes to alternative forms of potent, consumer-acceptable forms of nicotine will be essential to the success of endgames. This appears to uncritically assume (1) the hardening hypothesis: that as smoking prevalence moves toward and below 10%, the remaining smokers will be mostly deeply addicted, and will be largely unable to stop smoking unless they are able to move to other forms of 'clean' nicotine addiction such as e-cigarettes and more potent forms of nicotine replacement; and (2) an overly medicalised view of smoking cessation that sees unassisted cessation as both inefficient and inhumane. In this paper, we question these assumptions. We also note that some vanguard nations which continue to experience declining smoking prevalence have long banned smokeless tobacco and non-therapeutic forms of nicotine delivery. We argue that there are potentially risky consequences of unravelling such bans when history suggests that large-scale cessation is demonstrably possible.

Benefit-Cost Analysis of Foot and Mouth Disease Control in Large Ruminants in Cambodia.

PubMed

Young, J R; Suon, S; Rast, L; Nampanya, S; Windsor, P A; Bush, R D

2016-10-01

Foot and mouth disease (FMD) is endemic in Cambodia and throughout the Greater Mekong Subregion and causes significant losses to rural smallholders owning the majority of the national large ruminant population. However, due to underreporting, paucity of knowledge of FMD impacts, limited veterinary capacity and deficits of data available for analysis, the quantifiable benefits of a national FMD control programme are unknown. To address this deficit, existing literature and research data from the 'Best practice health and husbandry of cattle, Cambodia' project conducted between 2007 and 2012, were used to develop a three-phase analysis framework to: assess the impacts of the recent widespread FMD epizootic in Cambodia in 2010, conduct a value chain analysis of the large ruminant market and estimate the costs and benefits for a national large ruminant biannual FMD vaccination programme. A trader survey conducted in 2010-2011 provided cattle and buffalo value chain information and was matched to village herd structure data to calculate a total large ruminant farm-gate value of USD 1.271 billion in 2010. Monte Carlo simulation modelling that implemented a 5-year biannual vaccination programme at a cost of USD 6.3 an animal per year identified a benefit-cost ratio of 1.40 (95% CI 0.96-2.20) when accounting for recent prices of cattle and buffalo in Cambodia and based on an expected annual incidence of 0.2 (assuming one major epizootic in the 5-year vaccination programme). Given that the majority of the large ruminants are owned by rural smallholders, and mostly the poor are involved in agricultural employment, the successful implementation of an FMD control programme in Cambodia would be expected to avoid estimated losses of USD 135 million; equivalent to 10.6% of the 2010 farm-gate value and contributing to important reductions in rural poverty and food insecurity. © 2014 Blackwell Verlag GmbH.

Brain Stem Infarction Due to Basilar Artery Dissection in a Patient with Moyamoya Disease Four Years after Successful Bilateral Revascularization Surgeries.

PubMed

Abe, Takatsugu; Fujimura, Miki; Mugikura, Shunji; Endo, Hidenori; Tominaga, Teiji

2016-06-01

Moyamoya disease (MMD) is a rare cerebrovascular disease with an unknown etiology and is characterized by intrinsic fragility in the intracranial vascular walls such as the affected internal elastic lamina and thinning medial layer. The association of MMD with intracranial arterial dissection is extremely rare, whereas that with basilar artery dissection (BAD) has not been reported previously. A 46-year-old woman developed brain stem infarction due to BAD 4 years after successful bilateral superficial temporal artery-middle cerebral artery anastomosis with indirect pial synangiosis for ischemic-onset MMD. She presented with sudden occipitalgia and subsequently developed transient dysarthria and mild hemiparesis. Although a transient ischemic attack was initially suspected, her condition deteriorated in a manner that was consistent with left hemiplegia with severe dysarthria. Magnetic resonance (MR) imaging revealed brain stem infarction, and MR angiography delineated a double-lumen sign in the basilar artery, indicating BAD. She was treated conservatively and brain stem infarction did not expand. One year after the onset of brain stem infarction, her activity of daily living is still dependent (modified Rankin Scale of 4), and there were no morphological changes associated with BAD or recurrent cerebrovascular events during the follow-up period. The association of MMD with BAD is extremely rare. While considering the common underlying pathology such as an affected internal elastic lamina and fragile medial layer, the occurrence of BAD in a patient with MMD in a stable hemodynamic state is apparently unique. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A case of phytodermatitis due to the Ceratocephalus falcatus.

PubMed

Gönül, Müzeyyen; Cakmak, Seray Külcü

2014-03-01

Many people widely use herbal therapies for health problems in the world. Although these herbal therapies sometimes may be useful for some disorders they are not risk free. Ceratocephalus falcatus is an annual, wild plant which is a member of Ranunculaceae family. There are few case reports of phytodermatitis due to the Ranunculaceae family. We present a 58-year-old woman with irritant phytodermatitis due to C. falcatus.

Reconstruction of large cranial defect with alloplastic material (bone cement-cold cure polymethyl-methacrylate resin).

PubMed

Hallur, Neelakamal; Goudar, Gayatri; Sikkerimath, Basavaraj; Gudi, Santosh S; Patil, Ravi S

2010-06-01

A 40-years-old male patient reported to our department with a chief complaint of persistent palatal fluid discharge and large depressed forehead defect. He gave a history of trauma 20 months back due to head on collision to electric pole and underwent surgery twice for open reduction and fixation of facial skeletal fractures. After 9 months of surgery again a third surgery was performed for the removal of frontal bone due to infection and osteomyelitis at the same site. Extra-oral examination revealed a large fronto-cranial defect extending from superior border of frontal bone to supra-orbital margins bilaterally in length, and from frontal right lateral to frontal left lateral side in width, measuring 8.0 cm in length, 10.5 cm in width and 1.5 to 2.0 cm in depth. Intra-oral sinus fluid discharge was from left posterior palatal region. Preoperative CT was taken and reconstruction of fronto-cranial defect was successfully performed with bone cement. Alloplastic implant reconstruction achieved an excellent esthetic result without any complications.

Coupled SWAT-MODFLOW Model Development for Large Basins

NASA Astrophysics Data System (ADS)

Aliyari, F.; Bailey, R. T.; Tasdighi, A.

2017-12-01

Water management in semi-arid river basins requires allocating water resources between urban, industrial, energy, and agricultural sectors, with the latter competing for necessary irrigation water to sustain crop yield. Competition between these sectors will intensify due to changes in climate and population growth. In this study, the recently developed SWAT-MODFLOW coupled hydrologic model is modified for application in a large managed river basin that provides both surface water and groundwater resources for urban and agricultural areas. Specific modifications include the linkage of groundwater pumping and irrigation practices and code changes to allow for the large number of SWAT hydrologic response units (HRU) required for a large river basin. The model is applied to the South Platte River Basin (SPRB), a 56,980 km2 basin in northeastern Colorado dominated by large urban areas along the front range of the Rocky Mountains and agriculture regions to the east. Irregular seasonal and annual precipitation and 150 years of urban and agricultural water management history in the basin provide an ideal test case for the SWAT-MODFLOW model. SWAT handles land surface and soil zone processes whereas MODFLOW handles groundwater flow and all sources and sinks (pumping, injection, bedrock inflow, canal seepage, recharge areas, groundwater/surface water interaction), with recharge and stream stage provided by SWAT. The model is tested against groundwater levels, deep percolation estimates, and stream discharge. The model will be used to quantify spatial groundwater vulnerability in the basin under scenarios of climate change and population growth.

Epidemiological features and financial loss due to clinically diagnosed Haemorrhagic Septicemia in bovines in Karnataka, India.

PubMed

Govindaraj, G; Krishnamoorthy, P; Nethrayini, K R; Shalini, R; Rahman, H

2017-09-01

The epidemiological features and financial losses due to Haemorrhagic Septicemia (HS) in bovines were studied in Karnataka state using the primary data collected from 133 clinically diagnosed HS affected farms. The various losses due to HS and the Benefit- Cost of the vaccination programme in cattle and water buffaloes were studied using mathematical models. The number of HS outbreaks were higher during the year 2002 and peaked during 2005 and thereafter declined due to targeted vaccination against HS. The morbidity and mortality risks were lower in large farms than medium and small farms, and lower in indigenous cattle compared to high yielding crossbred cattle and water buffaloes. The disease occurrence was more in in-milk animals causing serious economic loss to the farmers. Most outbreaks were observed during monsoon season, though the disease was prevalent throughout the year. The mean milk loss per animal was $2, $11 and $50 in indigenous cattle, water buffaloes and crossbred cattle, respectively. In the case of draught animals, the average effective draught power was unavailable for 1.2days/outbreak resulting in a loss of $5 per affected oxen. The treatment and extra labor expenses incurred per animal were $24 and $7, respectively. The average loss per animal due to mortality loss was $275, $284 and $415 in case of indigenous cattle, water buffaloes and crossbred cattle, respectively. The projected loss for the state of Karnataka were $23.89, $17.92 and $11.95 million under high, medium and low HS incidence scenarios, respectively. The Benefit Cost Analysis (BCA) of the vaccination against HS has been estimated at 5.97:1, 4.48:1 and 2.98:1 under high, medium and low incidence scenarios, respectively. The results highlight the important epidemiological features and financial losses to the affected households and the state of Karnataka. Copyright © 2017 Elsevier B.V. All rights reserved.

[Case of large sphenoid ridge meningioma treated by 2-stage surgery].

PubMed

Oi, Sachie; Saito, Kiyoshi; Ichikawa, Masahiro; Aimi, Yuri; Okada, Takeshi; Nagatani, Tetsuya; Shimoyama, Yoshie

2008-10-01

Large skull base meningiomas frequently encase the major cerebral vessels and cranial nerves, and receive blood supply from the branches of the internal carotid artery. One-stage resection of these tumors is difficult due to the long time needed for surgery and profuse bleeding from the tumor. We report herein a case of large sphenoid ridge atypical meningioma that was successfully resected using a combination of two-stage surgery and irradiation. A 56-year-old man was referred to us with mild left hemiparesis and visual deterioration. Computed tomography and magnetic resonance imaging showed a large sphenoid ridge meningioma. Angiography showed blood supply from the branches of both external and internal carotid arteries, and pial blood supply from the middle cerebral artery. In the first surgery after embolization of feeder vessels from the external carotid artery, the tumor was still hemorrhagic and was partially resected with 2,374 ml of blood loss. Symptoms were improved after the first surgery. Pathological diagnosis was atypical meningioma. In the second surgery after 40 Gy of irradiation, the remnant tumor was no longer hemorrhagic and was totally resected. Staged surgery with irradiation is one treatment option for large vascular skull base meningiomas, particularly for atypical meningiomas.

Incidence and risk of hospitalisation due to shingles and chickenpox in patients with rheumatic diseases treated with TNF antagonists.

PubMed

García-Doval, Ignacio; Pérez-Zafrilla, Beatriz; Descalzo, Miguel Angel; Roselló, Rosa; Hernández, Maria Victoria; Gómez-Reino, Juan J; Carmona, Loreto

2010-10-01

To estimate the incidence of hospitalisation due to varicella zoster virus (VZV) infection in patients treated with tumour necrosis factor (TNF) antagonists for inflammatory rheumatic conditions and to compare it with the expected rate in the general population. Secondary data analysis was performed of two large databases: (1) the national registry of rheumatic diseases patients treated with biological agents (BIOBADASER); and (2) the national hospital discharge database Conjunto Mínimo Básico de Datos al Alta Hospitalaria. Hospitalisations due to shingles or chickenpox were analysed. For each condition the incidence rate (IR) and the age and gender standardised IR per 100,000 person-years plus the standardised incidence ratio (SIR) and the standardised incidence difference (SID) were estimated. In patients exposed to TNF antagonists, the estimated IR of hospitalisation due to shingles was 32 cases per 100,000 patient-years (95% CI 14 to 78), the expected rate in the general population was 3.4 (95% CI 3.2 to 3.5), the SIR was 9 (95% CI 3 to 20) and the SID was 26 (95% CI 14 to 37). The estimated IR of hospitalisation due to chickenpox was 26 cases per 100,000 (95% CI 10 to 69), the expected rate was 1.9 (95% CI 1.8 to 2.0), the SIR was 19 (95% CI 5 to 47) and the SID 33 (95% CI 21 to 45). Patients suffering rheumatic diseases exposed to TNF antagonists are hospitalised due to VZV infections significantly more frequently than expected in the general population. Since the absolute IR of hospitalisations due to chickenpox and shingles is low in these patients, the implementation of risky preventive measures may not be justified at present.

Five Years of Tamoxifen Continues to Benefit Women 15 Years after Treatment

Cancer.gov

In a large randomized clinical trial, women with early-stage breast cancer who received 5 years of adjuvant treatment with tamoxifen had better outcomes up to 15 years after the start of treatment than those who received 2 years of tamoxifen therapy.

A large parosteal ossifying lipoma of lower limb encircling the femur

PubMed Central

2014-01-01

Introduction Lipoma is a benign soft tissue neoplasm that may contain mesenchymal elements, as a result of metaplastic process. Ossification in benign and malignant soft tissue tumors can also manifest due to metaplastic process. Case presentation A 45 year old woman presented with a large thigh mass. The mass was developed one and a half year ago which insidiously increased in size and was associated with movement restriction. Radiological findings revealed soft tissue neoplasm on antero-medial aspect of thigh encircling the femur and displacing adjacent muscles. Fine trabeculations were seen in neoplasm suggestive of ossification. Excision of the mass was performed and histopathology revealed adipocytes with mature bony trabeculae possessing prominent osteoblastic rimming suggestive of ossifying lipoma. Conclusion It is important to recognize this variant of lipoma as it is associated with a better clinical outcome in contrast to most of the deep seated soft tissue neoplasms. Secondly it should also be differentiated from myositis ossificans and heterologous differentiation in other soft tissue neoplasms. We suggest an algorithmic approach to the diagnosis of ossifying soft tissue neoplasms histopathologically. Mature bony trabeculae with prominent osteoblastic rimming in a soft tissue lesion are due to a metaplastic process and should not be confused with osteosarcoma. PMID:24433545

Metastatic bone lesion due to methotrexate and etanercept 24 years after breast cancer treatment

PubMed Central

Yano, Shuichi

2014-01-01

A 72-year-old woman with rheumatoid arthritis presented with lumbar vertebral bone metastasis 24 years after mammectomy and radiotherapy for breast cancer. She was treated with prednisolone and methotrexate (MTX) for 11 months to which 10 mg of etanercept twice a week was added for a further 8 months. On the basis of this result, the possibility of a metastatic bone lesion appearing many years after cancer treatment should be considered when planning MTX and etanercept therapy. PMID:24729113

The Serpent Strikes: Simulation in a Large First-Year Course.

ERIC Educational Resources Information Center

Schrag, Philip G.

1989-01-01

A year-long simulation of a single case supplements a traditional civil procedure course at Georgetown University. Experience with the approach suggests that design features can reduce the burdens on the instructor without reducing course effectiveness, making the approach feasible even with larger classes. (MSE)

[Gastric perforation caused by primary gastric diffuse large B cell lymphoma].

PubMed

Kim, Ju Seok; Rou, Woo Sun; Ahn, Byung Moo; Moon, Hee Seok; Kang, Sun Hyung; Sung, Jae Kyu; Jeong, Hyun Yong; Song, Kyu-Sang

2015-01-01

Spontaneous gastric perforation is a rare complication of gastric lymphoma that is potentially life threatening since it can progress to sepsis and multi-organ failure. Morbidity also increases due to prolonged hospitalization and delay in initiating chemotherapy. Therefore prompt diagnosis and appropriate treatment is critical to improve prognosis. A 64-year-old man presented to the emergency department with severe abdominal pain. Chest X-ray showed free air below the right diaphragm. Abdominal CT scan also demonstrated free air in the peritoneal cavity with large wall defect in the lesser curvature of gastric lower body. Therefore, the patient underwent emergency operation and primary closure was done. Pathologic specimen obtained during surgery was compatible to diffuse large B cell lymphoma. Fifteen days after primary closure, the patient received subtotal gastrectomy and chemotherapy was initiated after recovery. Patient is currently being followed-up at outpatient department without any particular complications. Herein, we report a rare case of gastric lymphoma that initially presented as peritonitis because of spontaneous gastric perforation.

Large catchment area recharges Titan's Ontario Lacus

NASA Astrophysics Data System (ADS)

Dhingra, Rajani D.; Barnes, Jason W.; Yanites, Brian J.; Kirk, Randolph L.

2018-01-01

We seek to address the question of what processes are at work to fill Ontario Lacus while other, deeper south polar basins remain empty. Our hydrological analysis indicates that Ontario Lacus has a catchment area spanning 5.5% of Titan's surface and a large catchment area to lake surface area ratio. This large catchment area translates into large volumes of liquid making their way to Ontario Lacus after rainfall. The areal extent of the catchment extends to at least southern mid-latitudes (40°S). Mass conservation calculations indicate that runoff alone might completely fill Ontario Lacus within less than half a Titan year (1 Titan year = 29.5 Earth years) assuming no infiltration. Cassini Visual and Infrared Mapping Spectrometer (VIMS) observations of clouds over the southern mid and high-latitudes are consistent with precipitation feeding Ontario's large catchment area. This far-flung rain may be keeping Ontario Lacus filled, making it a liquid hydrocarbon oasis in the relatively dry south polar region.

Computational Simulation of Large Droplet Icing

DOT National Transportation Integrated Search

1996-01-01

Certification for flight into known icing remains one of the more challenging goals for aircraft manufacturers. This activity has been further complicated by the current interest in large droplet icing. Due to the lack of data available on the meteor...

Epidemiology of burns due to domestic flammable agents.

PubMed

Pegg, S P; Beecham, L; Dore, N; Hrdlicka, D; Hukins, C

1990-04-01

An analysis of the epidemiological factors relating to domestic flammable agents has shown that 17.7 per cent of admissions over a 5-year period were involved in domestic flammable injuries; 87.7 per cent of the patients were male, with 38.9 per cent being young males between 12 and 19 years old. Petrol and diesel accounted for 56.8 per cent of the burns and the average body surface area burned was 17.7 per cent. Most commonly the face, hands and limbs were burned, and the average length of stay was 18.25 days, 69.2 per cent of the burns were due to human error and were thus potentially preventable, 21.2 per cent had predisposing conditions with 8.9 per cent being due to alcohol. It was considered that the strategies to prevent these burns injuries should be aimed particularly at young males.

Battery technologies for large-scale stationary energy storage.

PubMed

Soloveichik, Grigorii L

2011-01-01

In recent years, with the deployment of renewable energy sources, advances in electrified transportation, and development in smart grids, the markets for large-scale stationary energy storage have grown rapidly. Electrochemical energy storage methods are strong candidate solutions due to their high energy density, flexibility, and scalability. This review provides an overview of mature and emerging technologies for secondary and redox flow batteries. New developments in the chemistry of secondary and flow batteries as well as regenerative fuel cells are also considered. Advantages and disadvantages of current and prospective electrochemical energy storage options are discussed. The most promising technologies in the short term are high-temperature sodium batteries with β″-alumina electrolyte, lithium-ion batteries, and flow batteries. Regenerative fuel cells and lithium metal batteries with high energy density require further research to become practical.

The modified tibial tubercle osteotomy for anterior knee pain due to chondromalacia patellae in adults: A five-year prospective study.

PubMed

Jack, C M; Rajaratnam, S S; Khan, H O; Keast-Butler, O; Butler-Manuel, P A; Heatley, F W

2012-08-01

To assess the effectiveness of a modified tibial tubercle osteotomy as a treatment for arthroscopically diagnosed chondromalacia patellae. A total of 47 consecutive patients (51 knees) with arthroscopically proven chondromalacia, who had failed conservative management, underwent a modified Fulkerson tibial tubercle osteotomy. The mean age was 34.4 years (19.6 to 52.2). Pre-operatively, none of the patients exhibited signs of patellar maltracking or instability in association with their anterior knee pain. The minimum follow-up for the study was five years (mean 72.6 months (62 to 118)), with only one patient lost to follow-up. A total of 50 knees were reviewed. At final follow-up, the Kujala knee score improved from 39.2 (12 to 63) pre-operatively to 57.7 (16 to 89) post-operatively (p < 0.001). The visual analogue pain score improved from 7.8 (4 to 10) pre-operatively to 5.0 (0 to 10) post-operatively. Overall patient satisfaction with good or excellent results was 72%. Patients with the lowest pre-operative Kujala score benefitted the most. Older patients benefited less than younger ones. The outcome was independent of the grade of chondromalacia. Six patients required screw removal. There were no major complications. We conclude that this modification of the Fulkerson procedure is a safe and useful operation to treat anterior knee pain in well aligned patellofemoral joints due to chondromalacia patellae in adults, when conservative measures have failed.

Bronchopleural cutaneous fistula due to Eikenella corrodens.

PubMed

Wong, Kin-Sun; Huang, Yhu-Chering

2005-01-01

The aim of this paper is to review the subject and to report on and discuss a case of bronchopleural cutaneous fistula due to Eikenella corrodens. A 16-year-old girl was brought to our hospital with fever and blood-tinged sputum 2 weeks prior to her admission. She suffered from neurologic sequelae of herpetic encephalitis and had been bed-ridden since 5 years of age. A longitudinal paraspinal soft mass had been noted in the previous week by her mother. She had been given oral feeding despite frequent choking for the past few years. On palpation, the mass can be squeezed to follow the least resistance of subcutaneous space longitudinally extending to the lower thoracic region. Chest computed tomography scan revealed right lower lobe necrotizing pneumonitis and a pleuro-cutaneous fistula leading to the subcutaneous air locules. A protracted course of antibiotics was prescribed and subcutaneous air trapping decreased in size over 8 weeks. Eikenella corrodens has increasingly been implicated as a potential causative pathogen in pleuropulmonary infections. Pleuro-cutaneous fistula and abscess formation complicating empyema and necrotizing pneumonitis due to E. corrodens infection have not been reported. A bulging thoracic subcutaneous lesion waxes and wanes with respiration suggest the possibility of a pleruo-cutaneous fistula. Treatment of Eikenella empyema using antibiotics without surgical decortication requires a prolonged course of antibiotic therapy.

Neck swelling due to skull base (pseudo)meningocele protruding through a congenital skull base bone defect: a case report.

PubMed

Sharma, Rajeev; Singh, Bhoopendra; Kedia, Shweta; Laythalling, Rajinder Kumar

2017-02-01

Meningocele is defined as a protrusion of the meninges through an opening in the skull or spinal column, forming a bulge or sac filled with cerebrospinal fluid. A pseudomeningocele is defined as a cerebrospinal fluid (CSF) collection formed due to escape of CSF through a dural defect with trapping of CSF into the surrounding soft tissues. We herby report rare occurrence of a large (pseudo)meningocele in a young patient with congenital skull base defect presenting as upper lateral neck swelling. We present the case of a 17-year-old boy who had painless progressive swelling right side of the upper neck without any history of meningitis or CSF leak. He had a history of undergoing cranioplasty using steel plates for nontraumatic boggy swelling right parieto-occipital region at the age of 5 years at another hospital. Clinical examination showed painless swelling right side of the upper neck, with positive cough impulse and transillumination. CT head with cisternography showed a large right skull base defect through which a large pseudomeningocele was herniating, thus producing upper neck swelling and compressing oral cavity. The neck swelling and intraoral bulge reduced in size after the coperitoneal shunt. Differential diagnosis of (pseudo)meningocele should be considered while evaluating a painless progressive upper neck swelling having cough impulse and transillumination in a young patient.

Subsidence due to peat oxidation and impact on drainage infrastructures in a farmland catchment south of the Venice Lagoon

NASA Astrophysics Data System (ADS)

Gambolati, G.; Putti, M.; Teatini, P.; Gasparetto Stori, G.

2006-03-01

Large agricultural areas reclaimed in the past century, south of the Venice Lagoon, have experienced significant land subsidence due to oxidation of peat organic soils. This has exposed the region to flood hazard particularly during severe storms and has contributed to increase the marginal management cost of the infrastructures (ditches, levees, pumping stations) designed to operate the drainage system. Direct measurements and indirect evidence from the channel network suggest a land settlement between 1.5 and 2 m over the past 70 years. This paper provides an overview of the problem with important information on its most recent evolution.

Cerebral infarction due to smoker’s polycythemia

PubMed Central

Thakur, Kiran Teresa; Westover, M Brandon

2011-01-01

A 65-year-old man presented with fluctuating focal neurological deficits and neuroimaging findings of multiple small cerebral infarctions. His medical investigation revealed a >100 pack/year smoking history, and a haematocrit >60. Subsequent investigations led to a diagnosis of cerebral infarction due to smoker’s polycythemia, the third such case reported in the medical literature. The patient’s neurological deficits resolved completely with subsequent haematocrit reduction. This brief report reviews the differential diagnosis of polycythemia, current knowledge of the mechanisms by which smoker’s polycythemia may lead to ischemic stroke, and recommendations for management. PMID:22675101

Association between earthquake events and cholera outbreaks: a cross-country 15-year longitudinal analysis.

PubMed

Sumner, Steven A; Turner, Elizabeth L; Thielman, Nathan M

2013-12-01

Large earthquakes can cause population displacement, critical sanitation infrastructure damage, and increased threats to water resources, potentially predisposing populations to waterborne disease epidemics such as cholera. Problem The risk of cholera outbreaks after earthquake disasters remains uncertain. A cross-country analysis of World Health Organization (WHO) cholera data that would contribute to this discussion has yet to be published. A cross-country longitudinal analysis was conducted among 63 low- and middle-income countries from 1995-2009. The association between earthquake disasters of various effect sizes and a relative spike in cholera rates for a given country was assessed utilizing fixed-effects logistic regression and adjusting for gross domestic product per capita, water and sanitation level, flooding events, percent urbanization, and under-five child mortality. Also, the association between large earthquakes and cholera rate increases of various degrees was assessed. Forty-eight of the 63 countries had at least one year with reported cholera infections during the 15-year study period. Thirty-six of these 48 countries had at least one earthquake disaster. In adjusted analyses, country-years with ≥10,000 persons affected by an earthquake had 2.26 times increased odds (95 CI, 0.89-5.72, P = .08) of having a greater than average cholera rate that year compared to country-years having <10,000 individuals affected by an earthquake. The association between large earthquake disasters and cholera infections appeared to weaken as higher levels of cholera rate increases were tested. A trend of increased risk of greater than average cholera rates when more people were affected by an earthquake in a country-year was noted. However these findings did not reach statistical significance at traditional levels and may be due to chance. Frequent large-scale cholera outbreaks after earthquake disasters appeared to be relatively uncommon.

Tinea incognito due to Trichophyton mentagrophytes.

PubMed

Sánchez-Castellanos, María Elena; Mayorga-Rodríguez, Jorge Arturo; Sandoval-Tress, Cecilia; Hernández-Torres, Mercedes

2007-01-01

Tinea incognito is a ringworm infection modified by corticosteroids. We report a case of a 2-year-old girl who developed tinea incognito due to Trichophyton mentagrophytes after applying methylprednisolone aceponate for 3 months. Diagnosis was confirmed by histopathologic and mycological examination, which led to the identification of Trichophyton mentagrophytes var. mentagrophytes, a zoophilic dermatophyte. Previous corticosteroid use in dermatophyte infections can alter their clinical appearance leading to misdiagnosis and delay in appropriate therapy.

An Unusual Case of Caecal Volvulus due to Appendicitis, Successfully Managed by Caecopexy.

PubMed

Bhatti, Samiullah; Khan, Mahmood Ayyaz; Farooka, Waris; Butt, Usman Ismat; Rehman, Usman Ali; Malik, Awais Amjad

2017-03-01

Caecal volvulus is a rare cause of intestinal obstruction. Caecal volvulus precipitated by acute appendicitis is even rarer. We report an unusual case of caecal volvulus with acute appendicitis as a cause. A 55-year female presented in surgical emergency with 3 days history of abdominal pain, distension and absolute constipation; and 2 days history of vomiting. Her past surgical history was significant for hysterectomy 5 years back. On examination, abdomen was distended and bowel sounds exaggerated. X-ray abdomen erect showed a single large air fluid level in the right hemiabdomen. A preoperative diagnosis of intestinal obstruction due to adhesions was made and patient prepared for exploratory laparotomy. On exploration, a huge caecum was lying in the midline and was twisted around a band arising from the appendix and attached deep into the pelvis. The appendix was densely inflammed. The volvulus was de-twisted in a counter clockwise manner. Viability of the caecum was confirmed and appendectomy was done. Caecopexy was performed and abdomen was closed. Postoperative recovery of the patient was uneventful and she was safely discharged on 5th postoperative day.

Variations of net ecosystem production due to seasonal precipitation differences in a tropical dry forest of northwest Mexico

NASA Astrophysics Data System (ADS)

Verduzco, Vivian S.; Garatuza-Payán, Jaime; Yépez, Enrico A.; Watts, Christopher J.; Rodríguez, Julio C.; Robles-Morua, Agustin; Vivoni, Enrique R.

2015-10-01

Due to their large extent and high primary productivity, tropical dry forests (TDF) are important contributors to atmospheric carbon exchanges in subtropical and tropical regions. In northwest Mexico, a bimodal precipitation regime that includes winter precipitation derived from Pacific storms and summer precipitation from the North American monsoon (NAM) couples water availability with ecosystem processes. We investigated the net ecosystem production of a TDF ecosystem using a 4.5 year record of water and carbon fluxes obtained from the eddy covariance method complemented with remotely sensed data. We identified a large CO2 efflux at the start of the summer season that is strongly related to the preceding winter precipitation and greenness. Since this CO2 efflux occurs prior to vegetation green-up, we infer that respiration is mainly due to decomposition of soil organic matter accumulated from the prior growing season. Overall, ecosystem respiration has an important effect on the net ecosystem production but can be overwhelmed by the strength of the primary productivity during the NAM. Precipitation characteristics during NAM have significant controls on sustaining carbon fixation in the TDF into the fall season. We identified that a threshold of ~350 to 400 mm of monsoon precipitation leads to a switch in the annual carbon balance in the TDF ecosystem from a net source (+102 g C/m2/yr) to a net sink (-249 g C/m2/yr). This monsoonal precipitation threshold is typically exceeded one out of every 2 years. The close coupling of winter and summer periods with respect to carbon fluxes suggests that the annual carbon balance is dependent on precipitation amounts in both seasons in TDF ecosystems.

Effect of large wood retention at check dams on sediment continuity

NASA Astrophysics Data System (ADS)

Schmocker, Lukas; Schalko, Isabella; Weitbrecht, Volker

2017-04-01

Large wood transport during flood events may seriously increase the damage potential due to accumulations at river infrastructures. The large wood is therefore mostly retained upstream of populated areas using retention structures that often combine a check dam with a debris rack. One disadvantages of this structures is, that the bed-load gets retained along with the wood. Especially if large wood blocks the rack early during a flood event, sediment continuity is completely interrupted. This may lead to severe bed erosion downstream of the check dam. So far, no common design to retain large wood but maintain sediment continuity is available. One attempt to separate the large wood from the bed-load was made with the large wood retention structure at River Sihl in Zürich, Switzerland. The retention of the large wood occurs in a bypass channel located along the main river. The bypass is located at an outer river bend, where a separation of bed-load and large wood results due to the secondary currents induced by the river curvature. Large wood floats towards the outer bend due to inertia and the secondary currents whereas bed-load remains at the inner bend. The bypass is separated by a side weir from the main river to ensure that the bed-load remains in the river during bed forming discharges and flood events. New model test are currently carried out at the Laboratory of Hydraulics, Hydrology, and Glaciology (VAW) of ETH Zurich, where sediment continuity should be achieved using an inclined rack. The rack is inclined in flow direction with a degree of 45° to 20°. First results show that the large wood deposits at the upper part of the rack whereas the lower part of the rack remains free for bed-load transport. Furthermore, the backwater rise for the inclined rack due to the accumulated wood is considerably reduced compared to a vertical rack, as a large part of the rack remains clear for the flow to pass. The findings of this studies help to understand the complex

Hand Hygiene Program Decreases School Absenteeism Due to Upper Respiratory Infections.

PubMed

Azor-Martinez, Ernestina; Cobos-Carrascosa, Elena; Seijas-Vazquez, Maria Luisa; Fernández-Sánchez, Carmen; Strizzi, Jenna M; Torres-Alegre, Pilar; Santisteban-Martínez, Joaquin; Gimenez-Sanchez, Francisco

2016-12-01

We assessed the effectiveness of a handwashing program using hand sanitizer to prevent school absenteeism due to upper respiratory infections (URIs). This was a randomized, controlled, and open study on a sample of 1341 children 4-12 years old, attending 5 state schools in Almería (Spain), with an 8-month follow-up. The experimental group (EG) washed their hands with soap and water, together with using hand sanitizer, and the control group followed their usual handwashing procedures. Absenteeism rates due to URIs were compared between the 2 groups through a multivariate Poisson regression analysis. The percent of days missed in both groups were compared with a z test. Overall, 1271 cases of school absenteeism due to URIs were registered. Schoolchildren from the EG had a 38% lower risk of absenteeism due to URIs, incidence rate ratio: 0.62, 95% confidence interval: 0.55-0.70, and a decrease in absenteeism of 0.45 episodes/child/academic year, p < .001. Pupils missed 2734 school days due to URIs and the percentage of days absent was significantly lower in the EG, p < .001. Use of hand sanitizer plus handwashing with soap accompanied by educational support is an effective measure to reduce absenteeism due to URIs. © 2016, American School Health Association.

Smoking-related deaths averted due to three years of policy progress

PubMed Central

Ellis, Jennifer A; Mays, Darren; Huang, An-Tsun

2013-01-01

Abstract Objective To evaluate the global impact of adopting highest-level MPOWER tobacco control policies in different countries and territories from 2007 to 2010. Methods Policy effect sizes based on previously-validated SimSmoke models were applied to determine the reduction in the number of smokers as a result of policy adoption during this period. Based on previous research suggesting that half of all smokers die from smoking, we also derived the estimated smoking-attributable deaths (SADs) averted due to MPOWER policy implementation. The results from use of this simple yet powerful method are consistent with those predicted by using previously validated SimSmoke models. Findings In total, 41 countries adopted at least one highest-level MPOWER policy between 2007 and 2010. As a result of all policies adopted during this period, the number of smokers is estimated to have dropped by 14.8 million, with a total of 7.4 million SADs averted. The largest number of SADs was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700 000), cessation treatments (380 000), and bans on tobacco marketing (306 000). Conclusion From 2007 to 2010, 41 countries and territories took action that will collectively prevent nearly 7.5 million smoking-related deaths globally. These findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies. PMID:23825878

Large-for-size liver transplant: a single-center experience.

PubMed

Akdur, Aydincan; Kirnap, Mahir; Ozcay, Figen; Sezgin, Atilla; Ayvazoglu Soy, Hatice Ebru; Karakayali Yarbug, Feza; Yildirim, Sedat; Moray, Gokhan; Arslan, Gulnaz; Haberal, Mehmet

2015-04-01

The ideal ratio between liver transplant graft mass and recipient body weight is unknown, but the graft probably must weigh 0.8% to 2.0% recipient weight. When this ratio > 4%, there may be problems due to large-for-size transplant, especially in recipients < 10 kg. This condition is caused by discrepancy between the small abdominal cavity and large graft and is characterized by decreased blood supply to the liver graft and graft dysfunction. We evaluated our experience with large-for-size grafts. We retrospectively evaluated 377 orthotopic liver transplants that were performed from 2001-2014 in our center. We included 188 pediatric transplants in our study. There were 58 patients < 10 kg who had living-donor living transplant with graft-to-bodyweight ratio > 4%. In 2 patients, the abdomen was closed with a Bogota bag. In 5 patients, reoperation was performed due to vascular problems and abdominal hypertension, and the abdomen was closed with a Bogota bag. All Bogota bags were closed in 2 weeks. After closing the fascia, 10 patients had vascular problems that were diagnosed in the operating room by Doppler ultrasonography, and only the skin was closed without fascia closure. No graft loss occurred due to large-for-size transplant. There were 8 patients who died early after transplant (sepsis, 6 patients; brain death, 2 patients). There was no major donor morbidity or donor mortality. Large-for-size graft may cause abdominal compartment syndrome due to the small size of the recipient abdominal cavity, size discrepancies in vascular caliber, insufficient portal circulation, and disturbance of tissue oxygenation. Abdominal closure with a Bogota bag in these patients is safe and effective to avoid abdominal compartment syndrome. Early diagnosis by ultrasonography in the operating room after fascia closure and repeated ultrasonography at the clinic may help avoid graft loss.

Load concentration due to missing members in planar faces of a large space truss

NASA Technical Reports Server (NTRS)

Waltz, J. E.

1979-01-01

A large space structure with members missing was investigated using a finite element analysis. The particular structural configuration was the tetrahedral truss, with attention restricted to one of its planar faces. Initially the finite element model of a complete face was verified by comparing it with known results for some basic loadings. Then an analysis was made of the structure with members near the center removed. Some calculations were made on the influence of the mesh size of a structure containing a hexagonal hole, and an analysis was also made of a structure with a rigid hexagonal insert. In general, load concentration effects in these trusses were significantly lower than classical stress concentration effects in an infinitely wide isotropic plate with a circular rigid inclusion, although larger effects were obtained when a hole extended over several rings of elements.

A Case Study of Factors That Influenced the Attrition or Retention of Two First-Year Special Education Teachers

ERIC Educational Resources Information Center

Grant, Marquis C.

2017-01-01

The issue of attrition and retention has been a chronic problem in the field of education for decades. School districts across the United States are experiencing shortages of qualified special education teachers largely due to high turnover rates, with many of these teachers electing not to return after their first year of teaching. In fact,…

Generation of large-scale vorticity in rotating stratified turbulence with inhomogeneous helicity: mean-field theory

NASA Astrophysics Data System (ADS)

Kleeorin, N.

2018-06-01

We discuss a mean-field theory of the generation of large-scale vorticity in a rotating density stratified developed turbulence with inhomogeneous kinetic helicity. We show that the large-scale non-uniform flow is produced due to either a combined action of a density stratified rotating turbulence and uniform kinetic helicity or a combined effect of a rotating incompressible turbulence and inhomogeneous kinetic helicity. These effects result in the formation of a large-scale shear, and in turn its interaction with the small-scale turbulence causes an excitation of the large-scale instability (known as a vorticity dynamo) due to a combined effect of the large-scale shear and Reynolds stress-induced generation of the mean vorticity. The latter is due to the effect of large-scale shear on the Reynolds stress. A fast rotation suppresses this large-scale instability.

Development of a large commercial camel embryo transfer program: 20 years of scientific research.

PubMed

Anouassi, Abdelhaq; Tibary, Ahmed

2013-01-10

Embryo transfer in camels was initiated to respond to demand from the camel industry particularly in the United Arab Emirates since 1990. This paper reviews the research performed in critical areas of reproductive physiology and reproductive function evaluation that constitute a pre-requisite for a successful embryo transfer program. A description of donor and recipient management as well as a retrospective evaluation of calf production in the embryo transfer program at Sweihan, UAE is provided. The program utilized two management systems for donors, with and without ovarian superstimulation. Non-stimulated donors are flushed every 14-15 days with a mean embryo production per year per female of 8.5±3.1 (mean±SEM). Response to gonadotropin stimulation is extremely variable. FSH doses and frequency of administration is often adjusted to a specific female. In the period of 1990-2010, 11,477 embryos were transferred to recipients. Transfers from 1990 to 2009 (n=10,600) resulted in 2858 weaned calves, representing an overall efficiency (% weaned calves/transfer) of 27%. Pregnancy rates at 60 days post transfer varied from 19 to 44%. Pregnancy length following transfer is extremely variable. A major challenge in a large embryo transfer program is finding good quality recipients. Causes of pregnancy and neonatal losses are under study. Copyright © 2012 Elsevier B.V. All rights reserved.

Clinics in diagnostic imaging. 159. Jejunal intussusception due to Peutz-Jeghers syndrome.

PubMed

Krishnan, Vijay; Chawla, Ashish; Wee, Eric; Peh, Wilfred C G

2015-02-01

A 21-year-old woman presented with acute onset of upper abdominal pain. A diagnosis of Peutz-Jeghers syndrome (PJS) was made based on the clinical picture of perioral pigmentation with imaging findings of transient jejunojejunal intussusceptions and small bowel polyps, and confirmed by characteristic histopathological appearances of Peutz-Jeghers polyps. PJS is a rare hereditary condition characterised by unique hamartomatous polyps, perioral mucocutaneous pigmentations, and increased susceptibility to gastrointestinal and extraintestinal neoplasms. Patients usually present with recurrent abdominal pain due to intussusception caused by polyps. Other modes of presentations include rectal bleeding and melaena. We describe the imaging findings of PJS and provide a brief review of bowel polyposis syndromes. The latter are relatively rare disorders characterised by multiple polyps in the large or small intestine, with associated risk of malignancies and other extraintestinal manifestations. Awareness of the manifestations and early diagnosis of these syndromes is crucial to prevent further complications.

Distributional Impacts of Large Dams in China

NASA Astrophysics Data System (ADS)

Bao, X.

2010-12-01

Dams on a river are believed to have heterogeneous impacts to the upstream, local and downstream areas. Generally, irrigation dams will bring benefits to the downstream by facilitating more irrigation, while it will bring negative impacts to upstream due to inundation or no impact to local area as a combination result of population dislocation and economic benefits. This paper checked the impacts of large dams (above 100 meters) on the upstream, downstream and local area, using 2000-2008 county level data in China. Robust heterogeneous impacts of different categories of dams (mainly dams serving for irrigation, hydropower, or other purposes) were found on different areas, using IV regression approaches. Dams higher than 100 meters are significantly and heterogeneously impacting agricultural production, urban employment and rural per capita income. Its beneficial impact on agriculture production is significant for downstream especially in continuous drought years. But its impacts on social welfare indicators, such as primary school enrollment and hospital beds, are not heterogeneously different across regions.

Readmissions due to traffic accidents at a general hospital 1

PubMed Central

Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

2015-01-01

Abstract Objective: to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. Methods: victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories. Results: among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%). The causes of the return to the hospital were: need to continue the surgical treatment (63.2%), surgical site infection (26.3%) and fall related to the physical sequelae of the trauma (10.5%). The rehospitalization rate corresponded to 174/1,000 people/year. Conclusion: the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation. PMID:26444172

Large Brown Oval

NASA Image and Video Library

1996-01-29

This large brown oval, photographed on Mar. 2, 1979 by NASA Voyager 1. Features of this sort are not rare on Jupiter and have an average lifetime of one to two years. Above the feature is the pale orange North Temperate Belt. http://photojournal.jpl.nasa.gov/catalog/PIA00015

The Influence of Large Solar Proton Events on the Atmosphere

NASA Technical Reports Server (NTRS)

Jackman, Charles H.

2012-01-01

Solar proton events (SPEs) can cause changes in constituents in the Earth s polar middle atmosphere. A number of large SPEs have occurred over the past 50 years and tend to happen most frequently near solar maximum. The highly energetic protons cause ionizations, excitations, dissociations, and dissociative ionizations of the background constituents. Complicated ion chemistry leads to HOx (H, OH, HO2) production and dissociation of N2 leads to NOy (N, NO, NO2, NO3, N2O5, HNO3, HO2NO2, ClONO2, BrONO2) production. Both the HOx and NOy increases can result in changes to ozone in the stratosphere and mesosphere. The HOx increases lead to short-lived (days) ozone decreases in the mesosphere and upper stratosphere. The NOy increases lead to long-lived (several months) stratospheric ozone changes because of the long lifetime of NOy constituents in this region. UARS HALogen Occultation Experiment (HALOE) instrument observations showed SPE-caused polar stratospheric NOx (NO+NO2) increases over 10 ppbv in September 2000 due to the very large SPE of July 2000, which are reasonably well simulated with the Whole Atmosphere Community Climate Model (WACCM). WACCM-computed SPE-caused polar stratospheric ozone decreases >10% continued for up to 5 months past the largest events in the past 50 years, however, SPE-caused total ozone changes were not found to be statistically significant. Small polar middle atmospheric temperature changes of <4 K have also been predicted to occur as a result of the larger SPEs. The polar atmospheric effects of large SPEs during solar cycle 23 and 24 will be emphasized in this presentation.

Enucleation of pancreatic solid pseudopapillary neoplasm: Short-term and long-term outcomes from a 7-year large single-center experience.

PubMed

Wang, Xing; Chen, Yong-Hua; Tan, Chun-Lu; Zhang, Hao; Xiong, Jun-Jie; Chen, Hong-Yu; Ke, Neng-Wen; Liu, Xu-Bao

2018-05-01

Enucleation is increasingly used for pancreatic solid pseudopapillary neoplasm (SPN) to preserve function of the pancreas. The data was limited due to rarity of this low-grade neoplasm. We sought to describe the indications, operative technique, short and long-term outcomes after enucleation with largest series of enucleated SPNs. Data collected retrospectively from 110 patients with SPN who underwent pancreatectomy between 2009 and 2016 in our institution were reviewed. Thirty-one patients underwent enucleation were identified for analysis, and compared with the 70 patients underwent conventional pancreatic resection. Of the 31 patients, 27 (87.1%) were women, and the mean age was 29.8 years (range, 11-49 years). Enucleated SPNs were mostly located in the head/uncinate process of the pancreas (38.7%). Overall morbidity was 25.8%, mainly due to POPF (19.4%), and severe morbidity was only 6.5% with no death. Compared with conventional pancreatic resection, enucleation had a shorter duration of surgery (P < 0.001), less blood loss (P < 0.001), lower rate of exocrine insufficiency (P = 0.033) and comparable morbidity (P = 1), with no increased risk of tumor recurrence (P = 1). The rate of endocrine insufficiency after enucleation seemed lower (Nil vs. 4.5%, P = 0.55). Enucleation of SPN of the pancreas appears to be feasible and safe for preserving exocrine and endocrine function of the gland. Enucleation with negative surgical margin seems adequate with no increased risk of tumor recurrence. Enucleation could be seriously considered as an alternative to conventional resection for this frequently young population. Copyright © 2018. Published by Elsevier Ltd.

Quantifying the burden of disease due to premature mortality in Hong Kong using standard expected years of life lost.

PubMed

Plass, Dietrich; Chau, Patsy Yuen Kwan; Thach, Thuan Quoc; Jahn, Heiko J; Lai, Poh Chin; Wong, Chit Ming; Kraemer, Alexander

2013-09-18

To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010. To estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted. In 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were "trachea, bronchus and lung cancers", "ischaemic heart disease" and "lower respiratory infections" together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong's standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL

Large-scale tropospheric transport in the Chemistry-Climate Model Initiative (CCMI) simulations

NASA Astrophysics Data System (ADS)

Orbe, Clara; Yang, Huang; Waugh, Darryn W.; Zeng, Guang; Morgenstern, Olaf; Kinnison, Douglas E.; Lamarque, Jean-Francois; Tilmes, Simone; Plummer, David A.; Scinocca, John F.; Josse, Beatrice; Marecal, Virginie; Jöckel, Patrick; Oman, Luke D.; Strahan, Susan E.; Deushi, Makoto; Tanaka, Taichu Y.; Yoshida, Kohei; Akiyoshi, Hideharu; Yamashita, Yousuke; Stenke, Andreas; Revell, Laura; Sukhodolov, Timofei; Rozanov, Eugene; Pitari, Giovanni; Visioni, Daniele; Stone, Kane A.; Schofield, Robyn; Banerjee, Antara

2018-05-01

Understanding and modeling the large-scale transport of trace gases and aerosols is important for interpreting past (and projecting future) changes in atmospheric composition. Here we show that there are large differences in the global-scale atmospheric transport properties among the models participating in the IGAC SPARC Chemistry-Climate Model Initiative (CCMI). Specifically, we find up to 40 % differences in the transport timescales connecting the Northern Hemisphere (NH) midlatitude surface to the Arctic and to Southern Hemisphere high latitudes, where the mean age ranges between 1.7 and 2.6 years. We show that these differences are related to large differences in vertical transport among the simulations, in particular to differences in parameterized convection over the oceans. While stronger convection over NH midlatitudes is associated with slower transport to the Arctic, stronger convection in the tropics and subtropics is associated with faster interhemispheric transport. We also show that the differences among simulations constrained with fields derived from the same reanalysis products are as large as (and in some cases larger than) the differences among free-running simulations, most likely due to larger differences in parameterized convection. Our results indicate that care must be taken when using simulations constrained with analyzed winds to interpret the influence of meteorology on tropospheric composition.

Intervertebral infection due to Candida albicans in an intravenous heroin abuser.

PubMed Central

Rowe, I F; Wright, E D; Higgens, C S; Burnie, J P

1988-01-01

A 25 year old woman who had received intravenous heroin over one year previously developed an intervertebral abscess due to infection with Candida albicans. Immunological investigation of this patient showed no evidence of a specific defect in the host response to candida. Images PMID:3382272

The personal and national costs of lost labour force participation due to arthritis: an economic study

PubMed Central

2013-01-01

Background The costs of arthritis to the individuals and the state are considerable. Methods Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Results Individuals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation. When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65. Conclusions The costs of arthritis to the individuals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. Individuals bear the economic costs of lost income and the reduction of their savings over the long term. PMID:23452565

The VELA-X-Pulsar Wind Nebula Revisited with Four Years of Fermi Large Area Telescope Observations

NASA Technical Reports Server (NTRS)

Grondin, M. -H.; Romani, R. W.; Lemoine-Goumard, M.; Guillemot, L.; Harding, Alice K.; Reposeur, T.

2013-01-01

The Vela supernova remnant (SNR) is the closest SNR to Earth containing an active pulsar, the Vela pulsar (PSR B0833-45). This pulsar is an archetype of the middle-aged pulsar class and powers a bright pulsar wind nebula (PWN), Vela-X, spanning a region of 2deg × 3deg south of the pulsar and observed in the radio, X-ray, and very high energy ?-ray domains. The detection of the Vela-X PWN by the Fermi Large Area Telescope (LAT) was reported in the first year of the mission. Subsequently, we have reinvestigated this complex region and performed a detailed morphological and spectral analysis of this source using 4 yr of Fermi-LAT observations. This study lowers the threshold for morphological analysis of the nebula from 0.8 GeV to 0.3 GeV, allowing for the inspection of distinct energy bands by the LAT for the first time. We describe the recent results obtained on this PWN and discuss the origin of the newly detected spatial features.

The Vela-X pulsar wind nebula revisited with four years of Fermi Large Area Telescope observations

DOE PAGES

Grondin, M. -H.; Romani, R. W.; Lemoine-Goumard, M.; ...

2013-08-21

Here, the Vela supernova remnant (SNR) is the closest SNR to Earth containing an active pulsar, the Vela pulsar (PSR B0833–45). This pulsar is an archetype of the middle-aged pulsar class and powers a bright pulsar wind nebula (PWN), Vela-X, spanning a region of 2° × 3° south of the pulsar and observed in the radio, X-ray, and very high energy γ-ray domains. The detection of the Vela-X PWN by the Fermi Large Area Telescope (LAT) was reported in the first year of the mission. Subsequently, we have reinvestigated this complex region and performed a detailed morphological and spectral analysismore » of this source using 4 yr of Fermi-LAT observations. This study lowers the threshold for morphological analysis of the nebula from 0.8 GeV to 0.3 GeV, allowing for the inspection of distinct energy bands by the LAT for the first time. We describe the recent results obtained on this PWN and discuss the origin of the newly detected spatial features.« less

Large calcified subdural empyema.

PubMed

Sarkar, S; Mazumder, U; Chowdhury, D; Dey, S K; Hossain, M; Nag, U K; Riaz, B K

2012-04-01

Subdural empyema is a known disease entity; however, calcified subdural empyema is uncommon. The authors present a case of an 11-year-old boy in whom there was diagnosed a chronic calcified subdural empyema 10 years after an attack of meningitis. The patient had suffered from generalized tonic clonic seizures occurring 2-6 times in a month. A large fronto-temporo-parietal craniotomy was carried out and the subdural empyema filled with numerous uncharacteristic tissue fragments with thick pus together with the partially calcified and ossified capsule was removed. The empyema mass was found to be sterile for bacteria. After the operation, no epileptic seizure occurred and the boy is on sodium valporate. We must emphasize the unusual occurrence of the chronic subdural empyema presenting with calcification-ossification and large size as observed in our case.

Experimental Observation of Convective Cell Formation due to a Fast Wave Antenna in the Large Plasma Device

NASA Astrophysics Data System (ADS)

Martin, M. J.; Gekelman, W.; Van Compernolle, B.; Pribyl, P.; Carter, T.

2017-11-01

An experiment in a linear device, the Large Plasma Device, is used to study sheaths caused by an actively powered radio frequency (rf) antenna. The rf antenna used in the experiment consists of a single current strap recessed inside a copper box enclosure without a Faraday screen. A large increase in the plasma potential was observed along magnetic field lines that connect to the antenna limiter. The electric field from the spatial variation of the rectified plasma potential generated E →×B→0 flows, often referred to as convective cells. The presence of the flows generated by these potentials is confirmed by Mach probes. The observed convective cell flows are seen to cause the plasma in front of the antenna to flow away and cause a density modification near the antenna edge. These can cause hot spots and damage to the antenna and can result in a decrease in the ion cyclotron range of frequencies antenna coupling.

Experimental Observation of Convective Cell Formation due to a Fast Wave Antenna in the Large Plasma Device.

PubMed

Martin, M J; Gekelman, W; Van Compernolle, B; Pribyl, P; Carter, T

2017-11-17

An experiment in a linear device, the Large Plasma Device, is used to study sheaths caused by an actively powered radio frequency (rf) antenna. The rf antenna used in the experiment consists of a single current strap recessed inside a copper box enclosure without a Faraday screen. A large increase in the plasma potential was observed along magnetic field lines that connect to the antenna limiter. The electric field from the spatial variation of the rectified plasma potential generated E[over →]×B[over →]_{0} flows, often referred to as convective cells. The presence of the flows generated by these potentials is confirmed by Mach probes. The observed convective cell flows are seen to cause the plasma in front of the antenna to flow away and cause a density modification near the antenna edge. These can cause hot spots and damage to the antenna and can result in a decrease in the ion cyclotron range of frequencies antenna coupling.

A review of sensing technologies for small and large-scale touch panels

NASA Astrophysics Data System (ADS)

Akhtar, Humza; Kemao, Qian; Kakarala, Ramakrishna

2017-06-01

A touch panel is an input device for human computer interaction. It consists of a network of sensors, a sampling circuit and a micro controller for detecting and locating a touch input. Touch input can come from either finger or stylus depending upon the type of touch technology. These touch panels provide an intuitive and collaborative workspace so that people can perform various tasks with the use of their fingers instead of traditional input devices like keyboard and mouse. Touch sensing technology is not new. At the time of this writing, various technologies are available in the market and this paper reviews the most common ones. We review traditional designs and sensing algorithms for touch technology. We also observe that due to its various strengths, capacitive touch will dominate the large-scale touch panel industry in years to come. In the end, we discuss the motivation for doing academic research on large-scale panels.

Food poisoning due to Salmonella Enteritidis--a case report.

PubMed

Ogata, Mamoru; Ago, Kazutoshi; Ago, Mihoko; Nakashima, Hiroshi; Hayashi, Takahito

2009-04-01

A male in his early seventies complained of abdominal pain and diarrhea at 7h after ingesting a small piece of gratin from a box lunch prepared by a caterer. He was admitted to a hospital, but died 37 h later. Dozens of people who had eaten the same box lunch also complained of diarrhea. All of them recovered after medical treatment. A later investigation demonstrated Salmonella Enteritidis (SE) in the gratin from the box lunch. An autopsy revealed very severe typhloenteritis with edema and submucosal hemorrhage. The digestive tract contained fluid contents without foodstuffs. Bacteriological examination revealed SE in the contents of the lower ileum and large intestine. Based on these findings, we concluded that the cause of death was food poisoning due to SE. In this case, ingesting only a small piece of contaminated food caused fatal food poisoning due to SE. These results emphasize the importance of prevention against food poisoning due to Salmonella, particularly SE.

Life history of a large flake biface

NASA Astrophysics Data System (ADS)

Baena Preysler, Javier; Torres Navas, Concepción; Sharon, Gonen

2018-06-01

Bifaces, primarily handaxes and cleavers, are the hallmark of the Acheulian techno-complex lithic industry. They spread across Africa and Eurasia during the Early to Middle Pleistocene. While many attempts have been made to define and describe the typology and technology of these tools, most focus on a single stage in their manufacture and usage, from quarry to discard. These attempts are fragmented, primarily due to the fact that at no single site are all stages of biface manufacture and use represented. An additional factor that appears to impede attempts to present the full "life cycle" of bifaces is the view of all Acheulian assemblages as belonging to a single cultural entity. While all assemblages belong to the same techno-complex, distinct stages and phases should be recognized, each different in typology, technology, and probably also in chronology. This research focuses on the large flake stage of the Acheulian. Data accumulated over many years of research from different regions are analyzed together in an attempt to present a holistic view of the life cycle of a biface. The study of particular Acheulian sites from the Levant and Western Europe enables us to reconstruct all stages of the biface, from raw material exploitation to final discard. The result is a model more comprehensive and precise than those suggested previously for understanding the Large Flake Acheulian.

MEASUREMENT OF RF LOSSES DUE TO TRAPPED FLUX IN A LARGE-GRAIN NIOBIUM CAVITY

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

Gianluigi Ciovati; Alex Gurevich

Trapped magnetic field in superconducting niobium is a well known cause of radio-frequency (RF) residual losses. In this contribution, we present the results of RF tests on a single-cell cavity made of high-purity large grain niobium before and after allowing a fraction of the Earth’s magnetic field to be trapped in the cavity during the cooldown below the critical temperature Tc. This experiment has been done on the cavity before and after a low temperature baking. Temperature mapping allowed us to determine the location of hot-spots with high losses and to measure their field dependence. The results show not onlymore » an increase of the low-field residual resistance, but also a larger increase of the surface resistance for intermediate RF field (higher "medium field Qslope"), which depends on the amount of the trapped flux. These additional field-dependent losses can be described as losses of pinned vortices oscillating under the applied RF magnetic field.« less

Large apparent electric size of solid-state nanopores due to spatially extended surface conduction.

PubMed

Lee, Choongyeop; Joly, Laurent; Siria, Alessandro; Biance, Anne-Laure; Fulcrand, Rémy; Bocquet, Lydéric

2012-08-08

Ion transport through nanopores drilled in thin membranes is central to numerous applications, including biosensing and ion selective membranes. This paper reports experiments, numerical calculations, and theoretical predictions demonstrating an unexpectedly large ionic conduction in solid-state nanopores, taking its origin in anomalous entrance effects. In contrast to naive expectations based on analogies with electric circuits, the surface conductance inside the nanopore is shown to perturb the three-dimensional electric current streamlines far outside the nanopore in order to meet charge conservation at the pore entrance. This unexpected contribution to the ionic conductance can be interpreted in terms of an apparent electric size of the solid-state nanopore, which is much larger than its geometric counterpart whenever the number of charges carried by the nanopore surface exceeds its bulk counterpart. This apparent electric size, which can reach hundreds of nanometers, can have a major impact on the electrical detection of translocation events through nanopores, as well as for ionic transport in biological nanopores.

Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control

PubMed Central

Chapman, Simon; Wakefield, Melanie A

2013-01-01

In the 50 years since the twentieth century's smoking epidemic began to decline from the beginning of the 1960s, hundreds of millions of smokers around the world have stopped smoking permanently. Overwhelmingly, most stopped without any formal assistance in the form of medication or professional assistance, including many millions of former heavy smokers. Nascent discussion about national and global tobacco endgame scenarios is dominated by an assumption that transitioning from cigarettes to alternative forms of potent, consumer-acceptable forms of nicotine will be essential to the success of endgames. This appears to uncritically assume (1) the hardening hypothesis: that as smoking prevalence moves toward and below 10%, the remaining smokers will be mostly deeply addicted, and will be largely unable to stop smoking unless they are able to move to other forms of ‘clean’ nicotine addiction such as e-cigarettes and more potent forms of nicotine replacement; and (2) an overly medicalised view of smoking cessation that sees unassisted cessation as both inefficient and inhumane. In this paper, we question these assumptions. We also note that some vanguard nations which continue to experience declining smoking prevalence have long banned smokeless tobacco and non-therapeutic forms of nicotine delivery. We argue that there are potentially risky consequences of unravelling such bans when history suggests that large-scale cessation is demonstrably possible. PMID:23591504

[Analysis of the trend and impact of mortality due to external causes: Mexico, 2000-2013].

PubMed

Dávila Cervantes, Claudio Alberto; Pardo Montaño, Ana Melisa

2016-01-01

The objective of this study was to analyze mortality due to the main external causes of death (traffic accidents, other accidents, homicides and suicides) in Mexico, calculating the years of life lost between 0 and 100 years of age and their contribution to the change in life expectancy between 2000 and 2013, at the national level, by sex and age group. Data came from mortality vital statistics of the Instituto Nacional de Estadística y Geografía (INEGI) [National Institute of Statistics and Geography]. The biggest impact in mortality due to external causes occurred in adolescent and adult males 15-49 years of age; mortality due to these causes remained constant in males and slightly decreased in females. Mortality due to traffic accidents and other accidents decreased, with a positive contribution to life expectancy, but this effect was canceled out by the increase in mortality due to homicides and suicides. Mortality due to external causes can be avoided through interventions, programs and prevention strategies as well as timely treatment. It is necessary to develop multidisciplinary studies on the dynamics of the factors associated with mortality due to these causes.

26 CFR 1.6655-4 - Large corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Large corporations. 1.6655-4 Section 1.6655-4... corporations. (a) Large corporation defined. The term large corporation means any corporation (or a predecessor corporation) that had taxable income of at least $1,000,000 for any taxable year during the testing period...

Projected Years Lost due to Disabilities (YLDs) for bacillary dysentery related to increased temperature in temperate and subtropical cities of China.

PubMed

Zhang, Ying; Bi, Peng; Sun, Yuwei; Hiller, Janet E

2012-02-01

The impact of climate change on enteric infection has been a concern in recent years. This study aims to project disability burdens of bacillary dysentery (BD) associated with increasing temperature in different climatic zones in China. Years Lost due to Disabilities (YLDs) were used as the measure of burden of bacillary dysentery in this study. A temperate city in northern China and a subtropical city in southern China were selected as the study areas. The quantitative relationship between temperature and the number of cases in each city was base on the regression models developed in our previous studies. YLDs for bacillary dysentery in 2000 were used as the baseline data. Projection of YLDs for bacillary dysentery in 2020 and 2050 under future temperature scenarios were conducted. Demographic changes over the next 20 to 50 years in study cities were considered in the projections. Under the temperature scenarios alone, the YLDs for bacillary dysentery may increase by up to 80% by 2020 and 174% by 2050 in the temperate city and up to 75% increase in the YLDs by 2020 and a 147% increase by 2050 in the tropical city. Considering potential changes in both temperature and population size and structure, if other factors remain constant, compared with the YLDs observed in 2000, the YLDs for bacillary dysentery may double by 2020 and triple by 2050 in both the temperate and subtropical cities in China. The temperature-related health burden of enteric infection in China may greatly increase in the future if there is no effective intervention. Relevant public health strategies should be developed at an earlier stage to prevent and reduce the impact of infectious disease associated with climate change.

Partial drift volume due to a self-propelled swimmer

NASA Astrophysics Data System (ADS)

Chisholm, Nicholas G.; Khair, Aditya S.

2018-01-01

We assess the ability of a self-propelled swimmer to displace a volume of fluid that is large compared to its own volume via the mechanism of partial drift. The swimmer performs rectilinear locomotion in an incompressible, unbounded Newtonian fluid. The partial drift volume D is the volume of fluid enclosed between the initial and final profiles of an initially flat circular disk of marked fluid elements; the disk is initially aligned perpendicular to the direction of locomotion and subsequently distorted due to the passage of the swimmer, which travels a finite distance. To focus on the possibility of large-scale drift, we model the swimmer simply as a force dipole aligned with the swimming direction. At zero Reynolds number (Re =0 ), we demonstrate that D grows without limit as the radius of the marked fluid disk h is made large, indicating that a swimmer at Re =0 can generate a partial drift volume much larger than its own volume. Next, we consider a steady swimmer at small Re , which is modeled as the force-dipole solution to Oseen's equation. Here, we find that D no longer diverges with h , which is due to inertial screening of viscous forces, and is effectively proportional to the magnitude of the force dipole exerted by the swimmer. The validity of this result is extended to Re ≥O (1 ) —the realm of intermediate-Re swimmers such as copepods—by taking advantage of the fact that, in this case, the flow is also described by Oseen's equations at distances much larger than the characteristic linear dimension of the swimmer. Next, we utilize an integral momentum balance to demonstrate that our analysis for a steady inertial swimmer also holds, in a time-averaged sense, for an unsteady swimmer that does not experience a net acceleration over a stroke cycle. Finally, we use experimental data to estimate D for a few real swimmers. Interestingly, we find that D depends heavily on the kinematics of swimming, and, in certain cases, D can be significantly greater

Late-Life Depressive Symptoms and Lifetime History of Major Depression: Cognitive Deficits are Largely Due to Incipient Dementia rather than Depression.

PubMed

Heser, Kathrin; Bleckwenn, Markus; Wiese, Birgitt; Mamone, Silke; Riedel-Heller, Steffi G; Stein, Janine; Lühmann, Dagmar; Posselt, Tina; Fuchs, Angela; Pentzek, Michael; Weyerer, Siegfried; Werle, Jochen; Weeg, Dagmar; Bickel, Horst; Brettschneider, Christian; König, Hans-Helmut; Maier, Wolfgang; Scherer, Martin; Wagner, Michael

2016-08-01

Late-life depression is frequently accompanied by cognitive impairments. Whether these impairments indicate a prodromal state of dementia, or are a symptomatic expression of depression per se is not well-studied. In a cohort of very old initially non-demented primary care patients (n = 2,709, mean age = 81.1 y), cognitive performance was compared between groups of participants with or without elevated depressive symptoms and with or without subsequent dementia using ANCOVA (adjusted for age, sex, and education). Logistic regression analyses were computed to predict subsequent dementia over up to six years of follow-up. The same analytical approach was performed for lifetime major depression. Participants with elevated depressive symptoms without subsequent dementia showed only small to medium cognitive deficits. In contrast, participants with depressive symptoms with subsequent dementia showed medium to very large cognitive deficits. In adjusted logistic regression models, learning and memory deficits predicted the risk for subsequent dementia in participants with depressive symptoms. Participants with a lifetime history of major depression without subsequent dementia showed no cognitive deficits. However, in adjusted logistic regression models, learning and orientation deficits predicted the risk for subsequent dementia also in participants with lifetime major depression. Marked cognitive impairments in old age depression should not be dismissed as "depressive pseudodementia", but require clinical attention as a possible sign of incipient dementia. Non-depressed elderly with a lifetime history of major depression, who remained free of dementia during follow-up, had largely normal cognitive performance.

[Sialoendoscopy-assisted sialolithectomy for large parotid stones].

PubMed

Zhao, Jian; Zhang, Lei; Liu, Deng-gao; Zhang, Zu-yan; Yu, Guang-yan

2014-02-18

To explore the clinical application of endoscope-assisted operative retrieval of large parotid stones as a minimally invasive alternative. From January 2010 to April 2013, 6 patients (male: 5, female: 1, age from 30-62 years, and median age: 49.5 years)suffering from recurred swelling of parotid gland due to sialoliths were treated by endoscope-assisted parotid surgery in Peking University School and Hospital of Stomatology. All of the patients underwent clinical, ultrasonographic and cone-beam CT (CBCT) examinations to get the detailed information of the number, location and size of stones, which was recorded in the medical records. endoscope-assisted parotid surgery was performed under general anesthesia in all the 6 cases after the failure of basket or forcep retrieval firstly. During the operation, sialoendoscope was used to locate the stone exactly and then the calculus was exposed through a pre-auricular approach and released by incising the duct. The postoperative complications were recorded and observed during the follow-up periods. Preoperative radiological examinations showed that all of the sialoliths were near the hilum of parotid gland ducts in the 6 cases, which were 5-9 mm in diameter. All of the stones were removed successfully by endoscope-assisted operative retrieval. The incisions healed smoothly in all the 6 cases. There were no cases of facial nerve weakness, infection or salivary fistula. After a mean follow-up of 19 months (ranging from 6-36 months), 5 patients remained asymptomatic and 1 patient had mild obstructed or infective symptoms. The final results were satisfied. It is suggested that endoscope-assisted operative retrieval is a viable minimally invasive alternative to remove the large or recalcitrant parotid stones with a high successful rate and low complications.

Eosinophilic ascites due to severe eosinophilic ileitis.

PubMed

Setia, Namrata; Ghobrial, Peter; Liron, Pantanowitz

2010-09-17

There is a broad etiology for effusion eosinophilia that includes allergic, reactive, infectious, immune, neoplastic, and idiopathic causes. We report and describe the cytomorphologic findings of a rare case of eosinophilic ascites due to severe eosinophilic ileitis. A 17-year-old male manifested acutely with eosinophilic ascites due to severe biopsy-proven subserosal eosinophilic ileitis. Isolated peritoneal fluid submitted for cytologic evaluation revealed that 65% eosinophils were present in a bloody background. The patient responded to corticosteroids, with complete resolution of his ascites. Eosinophilic gastroenteritis with subserosal involvement should be added to the list of causes for eosinophils in peritoneal fluid. The finding of eosinophilic ascites, with appropriate clinical and laboratory findings, may warrant the need to perform laparoscopic intestinal biopsies to confirm the diagnosis.

Medial temporal lobe atrophy ratings in a large 75-year-old population-based cohort: gender-corrected and education-corrected normative data.

PubMed

Velickaite, V; Ferreira, D; Cavallin, L; Lind, L; Ahlström, H; Kilander, L; Westman, E; Larsson, E-M

2018-04-01

To find cut-off values for different medial temporal lobe atrophy (MTA) measures (right, left, average, and highest), accounting for gender and education, investigate the association with cognitive performance, and to compare with decline of cognitive function over 5 years in a large population-based cohort. Three hundred and ninety 75-year-old individuals were examined with magnetic resonance imaging of the brain and cognitive testing. The Scheltens's scale was used to assess visually MTA scores (0-4) in all subjects. Cognitive tests were repeated in 278 of them after 5 years. Normal MTA cut-off values were calculated based on the 10th percentile. Most 75-year-old individuals had MTA score ≤2. Men had significantly higher MTA scores than women. Scores for left and average MTA were significantly higher in highly educated individuals. Abnormal MTA was associated with worse results in cognitive test and individuals with abnormal right MTA had faster cognitive decline. At age 75, gender and education are confounders for MTA grading. A score of ≥2 is abnormal for low-educated women and a score of ≥2.5 is abnormal for men and high-educated women. Subjects with abnormal right MTA, but normal MMSE scores had developed worse MMSE scores 5 years later. • Gender and education are confounders for MTA grading. • We suggest cut-off values for 75-year-olds, taking gender and education into account. • Males have higher MTA scores than women. • Higher MTA scores are associated with worse cognitive performance.

Subsidence due to Excessive Groundwater Withdrawal in the San Joaquin Valley, California

NASA Astrophysics Data System (ADS)

Corbett, F.; Harter, T.; Sneed, M.

2011-12-01

Francis Corbett1, Thomas Harter1 and Michelle Sneed2 1Department of Land Air and Water Resources, University of California, Davis. 2U.S. Geological Survey Western Remote Sensing and Visualization Center, Sacramento. Abstract: Groundwater development within the Central Valley of California began approximately a century ago. Water was needed to supplement limited surface water supplies for the burgeoning population and agricultural industries, especially within the arid but fertile San Joaquin Valley. Groundwater levels have recovered only partially during wet years from drought-induced lows creating long-term groundwater storage overdraft. Surface water deliveries from Federal and State sources led to a partial alleviation of these pressure head declines from the late 1960s. However, in recent decades, surface water deliveries have declined owing to increasing environmental pressures, whilst water demands have remained steady. Today, a large portion of the San Joaquin Valley population, and especially agriculture, rely upon groundwater. Groundwater levels are again rapidly declining except in wet years. There is significant concern that subsidence due to groundwater withdrawal, first observed at a large scale in the middle 20th century, will resume as groundwater resources continue to be depleted. Previous subsidence has led to problems such as infrastructure damage and flooding. To provide a support tool for groundwater management on a naval air station in the southern San Joaquin Valley (Tulare Lake Basin), a one-dimensional MODFLOW subsidence model covering the period 1925 to 2010 was developed incorporating extensive reconstruction of historical subsidence and water level data from various sources. The stratigraphy used for model input was interpreted from geophysical logs and well completion reports. Gaining good quality data proved problematic, and often values needed to be estimated. In part, this was due to the historical lack of awareness/understanding of

Search for Cosmic-Ray Electron and Positron Anisotropies with Seven Years of Fermi Large Area Telescope Data.

PubMed

Abdollahi, S; Ackermann, M; Ajello, M; Albert, A; Atwood, W B; Baldini, L; Barbiellini, G; Bellazzini, R; Bissaldi, E; Bloom, E D; Bonino, R; Bottacini, E; Brandt, T J; Bruel, P; Buson, S; Caragiulo, M; Cavazzuti, E; Chekhtman, A; Ciprini, S; Costanza, F; Cuoco, A; Cutini, S; D'Ammando, F; de Palma, F; Desiante, R; Digel, S W; Di Lalla, N; Di Mauro, M; Di Venere, L; Donaggio, B; Drell, P S; Favuzzi, C; Focke, W B; Fukazawa, Y; Funk, S; Fusco, P; Gargano, F; Gasparrini, D; Giglietto, N; Giordano, F; Giroletti, M; Green, D; Guiriec, S; Harding, A K; Jogler, T; Jóhannesson, G; Kamae, T; Kuss, M; Larsson, S; Latronico, L; Li, J; Longo, F; Loparco, F; Lubrano, P; Magill, J D; Malyshev, D; Manfreda, A; Mazziotta, M N; Meehan, M; Michelson, P F; Mitthumsiri, W; Mizuno, T; Moiseev, A A; Monzani, M E; Morselli, A; Negro, M; Nuss, E; Ohsugi, T; Omodei, N; Paneque, D; Perkins, J S; Pesce-Rollins, M; Piron, F; Pivato, G; Principe, G; Rainò, S; Rando, R; Razzano, M; Reimer, A; Reimer, O; Sgrò, C; Simone, D; Siskind, E J; Spada, F; Spandre, G; Spinelli, P; Strong, A W; Tajima, H; Thayer, J B; Torres, D F; Troja, E; Vandenbroucke, J; Zaharijas, G; Zimmer, S

2017-03-03

The Large Area Telescope on board the Fermi Gamma-ray Space Telescope has collected the largest ever sample of high-energy cosmic-ray electron and positron events since the beginning of its operation. Potential anisotropies in the arrival directions of cosmic-ray electrons or positrons could be a signature of the presence of nearby sources. We use almost seven years of data with energies above 42 GeV processed with the Pass 8 reconstruction. The present data sample can probe dipole anisotropies down to a level of 10^{-3}. We take into account systematic effects that could mimic true anisotropies at this level. We present a detailed study of the event selection optimization of the cosmic-ray electrons and positrons to be used for anisotropy searches. Since no significant anisotropies have been detected on any angular scale, we present upper limits on the dipole anisotropy. The present constraints are among the strongest to date probing the presence of nearby young and middle-aged sources.

Airplane wing vibrations due to atmospheric turbulence

NASA Technical Reports Server (NTRS)

Pastel, R. L.; Caruthers, J. E.; Frost, W.

1981-01-01

The magnitude of error introduced due to wing vibration when measuring atmospheric turbulence with a wind probe mounted at the wing tip was studied. It was also determined whether accelerometers mounted on the wing tip are needed to correct this error. A spectrum analysis approach is used to determine the error. Estimates of the B-57 wing characteristics are used to simulate the airplane wing, and von Karman's cross spectrum function is used to simulate atmospheric turbulence. It was found that wing vibration introduces large error in measured spectra of turbulence in the frequency's range close to the natural frequencies of the wing.

Large-Scale Disasters

NASA Astrophysics Data System (ADS)

Gad-El-Hak, Mohamed

"Extreme" events - including climatic events, such as hurricanes, tornadoes, and drought - can cause massive disruption to society, including large death tolls and property damage in the billions of dollars. Events in recent years have shown the importance of being prepared and that countries need to work together to help alleviate the resulting pain and suffering. This volume presents a review of the broad research field of large-scale disasters. It establishes a common framework for predicting, controlling and managing both manmade and natural disasters. There is a particular focus on events caused by weather and climate change. Other topics include air pollution, tsunamis, disaster modeling, the use of remote sensing and the logistics of disaster management. It will appeal to scientists, engineers, first responders and health-care professionals, in addition to graduate students and researchers who have an interest in the prediction, prevention or mitigation of large-scale disasters.

The incidence of public sector hospitalisations due to dog bites in Australia 2001-2013.

PubMed

Rajshekar, Mithun; Blizzard, Leigh; Julian, Roberta; Williams, Anne-Marie; Tennant, Marc; Forrest, Alex; Walsh, Laurence J; Wilson, Gary

2017-08-01

To estimate the incidence of dog bite-related injuries requiring public sector hospitalisation in Australia during the period 2001-13. Summary data on public sector hospitalisations due to dog bite-related injuries with an ICD 10-AM W54.0 coding were sourced from the Australian Institute of Health and Welfare for the study period 2001-2013. In Australia, on average, 2,061 persons were hospitalised each year for treatment for dog bite injuries at an annual rate of 12.39 (95%CI 12.25-12.53) per 100,000 during 2001-13. The highest annual rates of 25.95 (95%CI 25.16-26.72) and 18.42 (95%CI 17.75-19.07) per 100,000 were for age groups 0-4 and 5-9 years respectively. Rates of recorded events increased over the study period and reached 16.15 (95%CI 15.78-16.52) per 100,000 during 2011-13. Dog bites are a largely unrecognised and growing public health problem in Australia. Implications for public health: There is an increasing public sector burden of hospitalisations for injuries from dog bites in Australia. © 2017 Menzies Institute for Medical Research.

Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study.

PubMed

Humphriss, Rachel; Hall, Amanda; May, Margaret; Macleod, John

2011-01-01

The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Pavement damage due to different tire and loading configurations on secondary roads.

DOT National Transportation Integrated Search

2009-10-15

Due to the large percentage of goods moved by commercial trucks and its ever-growing freight industry, the U.S. needs innovative technologies to improve the efficiency of trucking operations and ensure continuous growth of the economy. One example of...

UK asbestos imports and mortality due to idiopathic pulmonary fibrosis.

PubMed

Barber, C M; Wiggans, R E; Young, C; Fishwick, D

2016-03-01

Previous studies have demonstrated that the rising mortality due to mesothelioma and asbestosis can be predicted from historic asbestos usage. Mortality due to idiopathic pulmonary fibrosis (IPF) is also rising, without any apparent explanation. To compare mortality due to these conditions and examine the relationship between mortality and national asbestos imports. Mortality data for IPF and asbestosis in England and Wales were available from the Office for National Statistics. Data for mesothelioma deaths in England and Wales and historic UK asbestos import data were available from the Health & Safety Executive. The numbers of annual deaths due to each condition were plotted separately by gender, against UK asbestos imports 48 years earlier. Linear regression models were constructed. For mesothelioma and IPF, there was a significant linear relationship between the number of male and female deaths each year and historic UK asbestos imports. For asbestosis mortality, a similar relationship was found for male but not female deaths. The annual numbers of deaths due to asbestosis in both sexes were lower than for IPF and mesothelioma. The strength of the association between IPF mortality and historic asbestos imports was similar to that seen in an established asbestos-related disease, i.e. mesothelioma. This finding could in part be explained by diagnostic difficulties in separating asbestosis from IPF and highlights the need for a more accurate method of assessing lifetime occupational asbestos exposure. © Crown copyright 2015.

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

Mortality due to Hymenoptera stings in Costa Rica, 1985-2006.

PubMed

Prado, Mónica; Quirós, Damaris; Lomonte, Bruno

2009-05-01

To analyze mortality due to Hymenoptera stings in Costa Rica during 1985-2006. Records of deaths due to Hymenoptera stings in 1985-2006 were retrieved from Instituto Nacional de Estadística y Censos (National Statistics and Census Institute). Mortality rates were calculated on the basis of national population reports, as of 1 July of each year. Information for each case included age, gender, and the province in which the death occurred. In addition, reports of Hymenoptera sting accidents received by the Centro Nacional de Intoxicaciones (National Poison Center, CNI) in 1995-2006 were obtained to assess exposure to these insects. Over the 22-year period analyzed, 52 fatalities due to Hymenoptera stings were recorded. Annual mortality rates varied from 0-1.73 per 1 million inhabitants, with a mean of 0.74 (95% confidence interval: 0.46-0.93). The majority of deaths occurred in males (88.5%), representing a male to female ratio of 7.7:1. A predominance of fatalities was observed in the elderly (50 years of age and older), as well as in children less than 10 years of age. The province with the highest mortality rate was Guanacaste. The CNI documented 1,591 reports of Hymenoptera stings (mostly by bees) in 1995-2006, resulting in an annual average of 133 cases, with only a slight predominance of males over females (1.4:1). Stings by Hymenoptera, mostly by bees, constitute a frequent occurrence in Costa Rica that can be life-threatening in a small proportion of cases, most often in males and the elderly. The annual number of fatalities fluctuated from 0-6, averaging 2.4 deaths per year. Awareness should be raised not only among the general population, but also among health care personnel that should consider this risk in the clinical management of patients stung by Hymenoptera.

Mortality trends due to chronic obstructive pulmonary disease in Brazil.

PubMed

Graudenz, Gustavo Silveira; Gazotto, Gabriel Pereira

2014-01-01

The purpose of this study was to update and analyze data on mortality trend due to chronic obstructive pulmonary disease (COPD) in Brazil. Initially, the specific COPD mortality rates were calculated from 1989 to 2009 using data collected from DATASUS (Departamento de Informática do SUS - Brazilian Health System Database). Then, the polynomial regression models from the observed functional relation were estimated based on mortality coefficients and study years. We verified that the general mortality rates due to COPD in Brazil showed an increasing trend from 1989 to 2004, and then decreased. Both genders showed the same increasing tendencies until 2004 and decreased thereafter. The age group under 35 years old showed a linear decreasing trend. All other age groups showed quadratic tendencies, with increases until the years of 1998-1999 and then decreasing. The South and Southeast regions showed the highest COPD mortality rates with increasing trends until the years 2001-2002 and then decreased. The North, Northeast and Central-West regions showed lower mortality rates but increasing trend. This is the first report of COPD mortality stabilization in Brazil since 1980.

[Work days lost due to health problems in industry].

PubMed

Yano, Sylvia Regina Trindade; Santana, Vilma Sousa

2012-05-01

This cross-sectional study estimated the prevalence of work days lost due to health problems and associated factors among industrial workers. The study population was a simple random cluster sample of 3,403 workers from 16 to 65 years of age in the city of Salvador, Bahia State, Brazil. Data were collected with individual home interviews. Among industrial workers, one-year prevalence of work days lost to health problems was 12.5%, of which 5.5% were directly work-related and 4.1% aggravated by work. There were no statistically significant differences when compared to other worker categories. Self-perceived workplace hazards, history of work-related injury, and poor self-rated health were associated with work days lost due to work-related injuries/diseases. The findings showed that work days lost are common among both industrial and non-industrial workers, thereby affecting productivity and requiring prevention programs.

Hospitalizations due to rotavirus gastroenteritis in Catalonia, Spain, 2003-2008

PubMed Central

2011-01-01

Background Rotavirus is the most common cause of severe gastroenteritis among young children in Spain and worldwide. We evaluated hospitalizations due to community and hospital-acquired rotavirus gastroenteritis (RVGE) and estimated related costs in children under 5 years old in Catalonia, Spain. Results We analyzed hospital discharge data from the Catalan Health Services regarding hospital admissions coded as infectious gastroenteritis in children under 5 for the period 2003-2008. In order to estimate admission incidence, we used population estimates for each study year published by the Statistic Institut of Catalonia (Idescat). The costs associated with hospital admissions due to rotavirus diarrhea were estimated for the same years. A decision tree model was used to estimate the threshold cost of rotavirus vaccine to achieve cost savings from the healthcare system perspective in Catalonia. From 2003 through 2008, 10655 children under 5 years old were admitted with infectious gastroenteritis (IGE). Twenty-two percent of these admissions were coded as RVGE, yielding an estimated average annual incidence of 104 RVGE hospitalizations per 100000 children in Catalonia. Eighty seven percent of admissions for RVGE occurred during December through March. The mean hospital stay was 3.7 days, 0.6 days longer than for other IGE. An additional 892 cases of presumed nosocomial RVGE were detected, yielding an incidence of 2.5 cases per 1000 child admissions. Total rotavirus hospitalization costs due to community acquired RVGE for the years 2003 and 2008 were 431,593 and 809,224 €, respectively. According to the estimated incidence and hospitalization costs, immunization would result in health system cost savings if the cost of the vaccine was 1.93 € or less. At a vaccine cost of 187 € the incremental cost per hospitalization prevented is 195,388 € (CI 95% 159,300; 238,400). Conclusions The burden of hospitalizations attributable to rotavirus appeared to be lower in

Plasma drag on a dust grain due to Coulomb collisions

NASA Technical Reports Server (NTRS)

Northrop, T. G.; Birmingham, T. J.

1990-01-01

Expressions are given for the drag due to Coulomb collisions on a charged dust grain moving through a plasma. The commonly used Chandrasekhar (1943) result does not include large scattering angles or plasma collective effects. An equation given by Morfill et al. (1980) which does include large scattering angles, is limited to one-dimensional plasma particle motion and can give at least an order of magnitude too much drag. This paper also makes use of an analogy between the drag problem and problems in electrostatics. This analogy permits generalization to any isotropic plasma of an observation made by Chandrasekhar for a Maxwellian, namely, that the drag is independent of the presence or absence of plasma particles moving faster than the grain. Finally, the contribution of plasma collective effects to the drag is studied with the inclusion of large scattering angles.

Large registry analysis to accurately define second malignancy rates and risks in a well-characterized cohort of 744 consecutive multiple myeloma patients followed-up for 25 years

PubMed Central

Engelhardt, Monika; Ihorst, Gabriele; Landgren, Ola; Pantic, Milena; Reinhardt, Heike; Waldschmidt, Johannes; May, Annette M.; Schumacher, Martin; Kleber, Martina; Wäsch, Ralph

2015-01-01

Additional malignancies in multiple myeloma patients after first-line and maintenance treatment have been observed, questioning whether specific risks exist. Second primary malignancies have also gained attention since randomized data showed associations to newer drugs. We have conducted this large registry analysis in 744 consecutive patients and analyzed: 1) frequency and onset of additional malignancies; and 2) second primary malignancy- and myeloma-specific risks. We assessed the frequency of additional malignancies in terms of host-, myeloma- and treatment-specific characteristics. To compare these risks, we estimated cumulative incidence rates for second malignancies and myeloma with Fine and Gray regression models taking into account competing risks. Additional malignancies were found in 118 patients: prior or synchronous malignancies in 63% and subsequent in 37%. Cumulative incidence rates for second malignancies were increased in IgG-myeloma and decreased in bortezomib-treated patients (P<0.05). Cumulative incidence rates for myeloma death were increased with higher stage and age, but decreased in IgG-subtypes and due to anti-myeloma treatment (P<0.05). Cytogenetics in patients acquiring second primary malignancies were predominantly favorable, suggesting that indolent myeloma and long disease latency may allow the manifestation of additional malignancies. An assessment of the Surveillance, Epidemiology, and End Result Program of the National Cancer Institute and our data with long-term follow up of 25 years confirmed a prevalence of second malignancy of 10% at 25 years, whereas death from myeloma decreased from 90% to 83%, respectively. Our important findings widen our knowledge of second malignancies and show that they are of increasing relevance as the prognosis in myeloma improves and mortality rates decrease. PMID:26160877

Human dirofilariasis due to Dirofilaria repens in southern India.

PubMed

Kotigadde, Subbannayya; Ramesh, Sathyavathi Alva; Medappa, Kariyappa Thadiangada

2012-01-01

Dirofilariasis is primarily confined to animals such as dogs, cats, foxes and raccoons. Human dirofilariasis is an accidental zoonotic infection acquired through mosquitoes. Human dirofilariasis due to Dirofilaria repens though endemic in Kerala, reports from Karnataka state are rare. We report a case of solitary subcutaneous dirofilariasis of the eyelid due to D. repens in a 47-year-old woman. She presented with periorbital edema. The swelling was soft, cystic with associated tenderness. A thin, white worm was noticed in the lesion and was removed by traction which was subsequently identified to be D. repens.

Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance.

PubMed

Zolnierczyk, Piotr; Cendrowski, Krzysztof; Sawicki, Wlodzimierz

2015-01-01

This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index - 38), congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic-therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations.

Rolling Moments Due to Rolling and Yaw for Four Wing Models in Rotation

NASA Technical Reports Server (NTRS)

Knight, Montgomery; Wenzinger, Carl J

1932-01-01

This report presents the results of a series of autorotation and torque tests on four different rotating wing systems at various rates of roll and at several angles of yaw. The investigation covered an angle of attack range up to 90 degrees and angles of yaw of 0 degree, 5 degrees, 10 degrees, and 20 degrees. The tests were made in a 5-foot, closed-throat atmospheric wind tunnel. The object of the tests was primarily to determine the effects of various angles of yaw on the rolling moments of the rotating wings up to large angles of attack. It was found that at angles of attack above that of maximum lift the rolling moments on the wings due to yaw (or side slip) from 5 degrees to 20 degrees were roughly of the same magnitude as those due to rolling. There was a wide variation in magnitude of the rolling moment due to yaw angle. The rates and ranges of stable autorotation for the monoplane models were considerably increased by yaw, whereas for an unstaggered biplane they were little affected. The immediate cause of the rolling moment due to yaw is apparently the building up of large loads on the forward wing tip and the reduction of loads on the rearward wing tip.

An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center.

PubMed

MacMillan, Donna; Lewandrowski, Elizabeth; Lewandrowski, Kent

2004-01-01

Utilization of outside reference laboratories for selected laboratory testing is common in the United States. However, relatively little data exist in the literature describing the scope and impact of these services. In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts. A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002. Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002. Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital. The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house. The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory. Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays. Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu. Reference laboratory testing comprises a major component of hospital clinical laboratory services. Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

Eosinophilic ascites due to severe eosinophilic ileitis

PubMed Central

Setia, Namrata; Ghobrial, Peter; Liron, Pantanowitz

2010-01-01

Background: There is a broad etiology for effusion eosinophilia that includes allergic, reactive, infectious, immune, neoplastic, and idiopathic causes. We report and describe the cytomorphologic findings of a rare case of eosinophilic ascites due to severe eosinophilic ileitis. Case Presentation: A 17-year-old male manifested acutely with eosinophilic ascites due to severe biopsy-proven subserosal eosinophilic ileitis. Isolated peritoneal fluid submitted for cytologic evaluation revealed that 65% eosinophils were present in a bloody background. The patient responded to corticosteroids, with complete resolution of his ascites. Conclusion: Eosinophilic gastroenteritis with subserosal involvement should be added to the list of causes for eosinophils in peritoneal fluid. The finding of eosinophilic ascites, with appropriate clinical and laboratory findings, may warrant the need to perform laparoscopic intestinal biopsies to confirm the diagnosis. PMID:20976207

Acute interstitial nephritis due to nicergoline (Sermion).

PubMed

Kim, Mi Jeong; Chang, Jae Hyuck; Lee, Suk Kyeong; Park, Joo Hyun; Choi, Yeong Jin; Yang, Chul Woo; Kim, Yong Soo; Park, Sung Hak; Bang, Byung Kee

2002-01-01

We report a case of acute interstitial nephritis (AIN) due to nicergoline (Sermion). A 50-year-old patient admitted to our hospital for fever and acute renal failure. Before admission, he had been taking nicergoline and bendazac lysine due to retinal vein occlusion at ophthalmologic department. Thereafter, he experienced intermittent fever and skin rash. On admission, clinical symptoms (i.e. arthralgia and fever) and laboratory findings (i.e. eosinophilia and renal failure) suggested AIN, and which was confirmed by pathologic findings on renal biopsy. A lymphocyte transformation test demonstrated a positive result against nicergoline. Treatment was consisted of withdrawal of nicergoline and intravenous methylprednisolone, and his renal function was completely recovered. To our knowledge, this is the first report of nicergoline-associated AIN. Copyright 2002 S. Karger AG, Basel

Climate variability rather than overstocking causes recent large scale cover changes of Tibetan pastures.

PubMed

Lehnert, L W; Wesche, K; Trachte, K; Reudenbach, C; Bendix, J

2016-04-13

The Tibetan Plateau (TP) is a globally important "water tower" that provides water for nearly 40% of the world's population. This supply function is claimed to be threatened by pasture degradation on the TP and the associated loss of water regulation functions. However, neither potential large scale degradation changes nor their drivers are known. Here, we analyse trends in a high-resolution dataset of grassland cover to determine the interactions among vegetation dynamics, climate change and human impacts on the TP. The results reveal that vegetation changes have regionally different triggers: While the vegetation cover has increased since the year 2000 in the north-eastern part of the TP due to an increase in precipitation, it has declined in the central and western parts of the TP due to rising air temperature and declining precipitation. Increasing livestock numbers as a result of land use changes exacerbated the negative trends but were not their exclusive driver. Thus, we conclude that climate variability instead of overgrazing has been the primary cause for large scale vegetation cover changes on the TP since the new millennium. Since areas of positive and negative changes are almost equal in extent, pasture degradation is not generally proceeding.

Climate variability rather than overstocking causes recent large scale cover changes of Tibetan pastures

PubMed Central

Lehnert, L. W.; Wesche, K.; Trachte, K.; Reudenbach, C.; Bendix, J.

2016-01-01

The Tibetan Plateau (TP) is a globally important “water tower” that provides water for nearly 40% of the world’s population. This supply function is claimed to be threatened by pasture degradation on the TP and the associated loss of water regulation functions. However, neither potential large scale degradation changes nor their drivers are known. Here, we analyse trends in a high-resolution dataset of grassland cover to determine the interactions among vegetation dynamics, climate change and human impacts on the TP. The results reveal that vegetation changes have regionally different triggers: While the vegetation cover has increased since the year 2000 in the north-eastern part of the TP due to an increase in precipitation, it has declined in the central and western parts of the TP due to rising air temperature and declining precipitation. Increasing livestock numbers as a result of land use changes exacerbated the negative trends but were not their exclusive driver. Thus, we conclude that climate variability instead of overgrazing has been the primary cause for large scale vegetation cover changes on the TP since the new millennium. Since areas of positive and negative changes are almost equal in extent, pasture degradation is not generally proceeding. PMID:27073126

Climate variability rather than overstocking causes recent large scale cover changes of Tibetan pastures

NASA Astrophysics Data System (ADS)

Lehnert, L. W.; Wesche, K.; Trachte, K.; Reudenbach, C.; Bendix, J.

2016-04-01

The Tibetan Plateau (TP) is a globally important “water tower” that provides water for nearly 40% of the world’s population. This supply function is claimed to be threatened by pasture degradation on the TP and the associated loss of water regulation functions. However, neither potential large scale degradation changes nor their drivers are known. Here, we analyse trends in a high-resolution dataset of grassland cover to determine the interactions among vegetation dynamics, climate change and human impacts on the TP. The results reveal that vegetation changes have regionally different triggers: While the vegetation cover has increased since the year 2000 in the north-eastern part of the TP due to an increase in precipitation, it has declined in the central and western parts of the TP due to rising air temperature and declining precipitation. Increasing livestock numbers as a result of land use changes exacerbated the negative trends but were not their exclusive driver. Thus, we conclude that climate variability instead of overgrazing has been the primary cause for large scale vegetation cover changes on the TP since the new millennium. Since areas of positive and negative changes are almost equal in extent, pasture degradation is not generally proceeding.

Quantifying the burden of disease due to premature mortality in Hong Kong using standard expected years of life lost

PubMed Central

2013-01-01

Background To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010. Methods To estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted. Results In 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were “trachea, bronchus and lung cancers”, “ischaemic heart disease” and “lower respiratory infections” together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong’s standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional

Temporal relationship between depression and dementia – findings from a large community-based 15 year follow-up study

PubMed Central

Li, Ge; Wang, Lucy Y.; Shofer, Jane B.; Thompson, Mary Lou; Peskind, Elaine R.; McCormick, Wayne; Bowen, James D.; Crane, Paul K.; Larson, Eric B.

2012-01-01

Context Late-life depression is associated with increased risk of dementia but the temporal relationship between depression and development of dementia remains unclear. Objectives To examine the association between risk of dementia and 1) baseline depressive symptoms ; 2) past history of depression, particularly early-life (< 50 years) versus late-life depression; and 3) individual domains of the Center for Epidemiologic Studies Depression Scale (CESD). Design A large cohort with initially non-demented participants was followed biennially for up to 15 years for incident dementia. Baseline depressive symptoms were assessed using the 11-item version of CESD (CESD-11), and defined as CESD-11 score ≥ 11. Self-reported history of depression was collected at the baseline interview. Cox proportional hazards regression was used to assess the association between depression and the dementia risk. Setting Population-based cohort drawn from members of Group Health Cooperative in Seattle, Washington. Participants A cohort of 3,410 participants without dementia aged ≥ 65 years. Results Over an average of 7.1 years follow-up, 658 participants (19%) developed dementia. At baseline, 9% of participants had depressive symptoms (CESD-11 ≥ 11) and 21% reported a past history of depression. The adjusted hazard ratio (aHR) for dementia associated with baseline depressive symptoms was 1.71 (95% confidence interval 1.37, 2.13), after adjusting for age-at-entry, gender, education, and wave of enrollment. Compared to participants without depression history, those with late-life depression were at increased dementia risk (aHR =1.46 [1.16, 1.84]), but early-life depression had no association with dementia risk (aHR=1.10 [0.83, 1.47]). Depressed mood (aHR 1.48 [1.25, 1.76]) and perceived performance difficulty (aHR 1.39 [1.15, 1.67]) were independently associated with dementia. Conclusions This study confirmed previous observations of an association between late-life depression and

Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

PubMed

Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

2017-03-01

Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The effects of workplace health promotion on absenteeism and employment costs in a large industrial population.

PubMed Central

Bertera, R L

1990-01-01

We evaluated the impact of a comprehensive workplace health promotion program on absences among full-time employees in a large, multi-location, diversified industrial company. A pretest-posttest control group design was used to study 41 intervention sites and 19 control sites with 29,315 and 14,573 hourly employees, respectively. Blue-collar employees at intervention sites experienced an 14.0 percent decline in disability days over two years versus a 5.8 percent decline at control sites. This resulted in a net difference of 11,726 fewer disability days over two years at program sites compared with non-program sites. Savings due to lower disability costs at intervention sites offset program costs in the first year, and provided a return of $2.05 for every dollar invested in the program by the end of the second year. These results suggest that comprehensive workplace health promotion programs can reduce disability days among blue collar employees and provide a good return on investment. PMID:2382748

Years of Potential Life Lost among Heroin Addicts 33 Years after Treatment

PubMed Central

Smyth, Breda; Hoffman, Valerie; Fan, Jing; Hser, Yih-Ing

2007-01-01

Objective To examine premature mortality in terms of years of potential life lost (YPLL) among a cohort of long-term heroin addicts. Method This longitudinal, prospective study followed a cohort of 581 male heroin addicts in California for more than 33 years. In the latest follow-up conducted in 1996/97, 282 subjects (48.5%) were confirmed as deceased by death certificates. YPLL before age 65 years were calculated by causes of death. Ethnic differences in YPLL were assessed among Whites, Hispanics, and African Americans. Results On average, addicts in this cohort lost 18.3 years (SD = 10.7) of potentiallife before age 65. Of the total YPLL for the cohort, 22.3% of the years lost was due to heroin overdose, 14.0% due to chronic liver disease, and 10.2% to accidents. The total YPLL and YPLL by death cause in addict cohort were significant higher than that of US population. The YPLL among African Americans was significantly lower than that among Whites or Hispanics. Conclusion The YPLL among addicts was much higher than that in the national population; within the cohort, premature mortality was higher among Whites and Hispanics compared to African American addicts. PMID:17291577

Electromotive force due to magnetohydrodynamic fluctuations in sheared rotating turbulence

DOE PAGES

Squire, J.; Bhattacharjee, A.

2015-11-02

Here, this article presents a calculation of the mean electromotive force arising from general small-scale magnetohydrodynamical turbulence, within the framework of the second-order correlation approximation. With the goal of improving understanding of the accretion disk dynamo, effects arising through small-scale magnetic fluctuations, velocity gradients, density and turbulence stratification, and rotation, are included. The primary result, which supplements numerical findings, is that an off-diagonal turbulent resistivity due to magnetic fluctuations can produce large-scale dynamo action-the magnetic analog of the "shear-current" effect. In addition, consideration of alpha effects in the stratified regions of disks gives the puzzling result that there is nomore » strong prediction for a sign of alpha, since the effects due to kinetic and magnetic fluctuations, as well as those due to shear and rotation, are each of opposing signs and tend to cancel each other.« less

Multi-Model Simulations of Aerosol and Ozone Radiative Forcing Due to Anthropogenic Emission Changes During the Period 1990-2015

NASA Technical Reports Server (NTRS)

Myhre, Gunnar; Aas, Wenche; Ribu, Cherian; Collins, William; Faluvegi, Gregory S.; Flanner, Mark; Forster, Piers; Hodnebrog, Oivind; Klimont, Zbigniew; Lund, Marianne T.

2017-01-01

Over the past few decades, the geographical distribution of emissions of substances that alter the atmospheric energy balance has changed due to economic growth and air pollution regulations. Here, we show the resulting changes to aerosol and ozone abundances and their radiative forcing using recently updated emission data for the period 1990-2015, as simulated by seven global atmospheric composition models. The models broadly reproduce large-scale changes in surface aerosol and ozone based on observations (e.g. 1 to 3 percent per year in aerosols over the USA and Europe). The global mean radiative forcing due to ozone and aerosol changes over the 1990-2015 period increased by 0.17 plus or minus 0.08 watts per square meter, with approximately one-third due to ozone. This increase is more strongly positive than that reported in IPCC AR5 (Intergovernmental Panel on Climate Change Fifth Assessment Report). The main reasons for the increased positive radiative forcing of aerosols over this period are the substantial reduction of global mean SO2 emissions, which is stronger in the new emission inventory compared to that used in the IPCC analysis, and higher black carbon emissions.

A 10-year ecosystem restoration community of practice tracks large-scale restoration trends

EPA Science Inventory

In 2004, a group of large-scale ecosystem restoration practitioners across the United States convened to start the process of sharing restoration science, management, and best practices under the auspices of a traditional conference umbrella. This forum allowed scientists and dec...

Transurethral lithotripsy with holmium-YAG laser of a large exogenous prostatic calculus.

PubMed

Hasegawa, Masanori; Ohara, Rei; Kanao, Kent; Nakajima, Yosuke

2011-04-01

Prostatic calculi are classified into two types, endogenous and exogenous calculi, based on their origin. Endogenous calculi are commonly observed in elderly men; however, exogenous prostatic calculi are extremely rare. We report here the case of a 51-year-old man who suffered incontinence and pollakiuria with a giant exogenous prostatic calculus almost completely replacing the prostatic tissue. X-rays and computed tomography demonstrated a large calculus of 65 × 58 mm in the small pelvic cavity. The patient underwent a transurethral lithotripsy with a holmium-YAG laser and a total of 85 g of disintegrated stones was retrieved and chemical stone analysis revealed the presence of magnesium ammonium phosphate. The incontinence improved and the voiding volume increased dramatically, and no stone recurrence in the prostatic fossa occurred at the 2 years follow-up. The etiology of this stone formation seemed to be based on some exogenous pathways combined with urinary stasis and chronic urinary infection due to compression fracture of the lumbar vertebra.

[Aortic valve insufficiency due to rupture of the cusp in a patient with multiple trauma].

PubMed

Vidmar, J; Brilej, D; Voga, G; Kovacic, N; Smrkolj, V

2003-06-01

Lesions of the heart valve caused by blunt chest trauma is rare, but when it does occur it can significantly injure the patient. On the basis of autopsy studies, research shows that heart valves are injured in less than 5% of patients who have died due to impact thoracic trauma. Among the heart valves, the aortic valve is the most often lacerated, which has been proved by relevant autopsy and clinical studies. Aortic valve lesions can be the only injury, but it is possible that additional heart or large vessel injuries are also present (myocardial contusion, rupture of the atrial septum, aortic rupture, rupture of the left common carotid artery). The force that causes such an injury is often great and often causes injuries to other organs and organ systems. In a multiple trauma patient, it is very important to specifically look for heart-related injuries because it is possible that they may be overlooked or missed by the surgeon, because of other obvious injuries. We describe the case of a 41-year-old man with multiple trauma who was diagnosed with aortic valve insufficiency due to rupture of the left coronary cusp 6 weeks after a road accident. Valvuloplasty was performed. Seven years later the patient is free of symptoms and is in good physical condition. Echocardiography showed normal dimensions of the heart chambers, a normal thickness of the heart walls, and normal systolic and diastolic function of the left ventricle. Heart valves are morphologically normal, and only an unimportant aortic insufficiency was noticed by echocardiography.

Perceptions of Teachers in Their First Year of School Restructuring: Failure to Make Adequate Yearly Progress

ERIC Educational Resources Information Center

Moser, Sharon

2010-01-01

The 2007-2008 school year marked the first year Florida's Title I schools that did not made Adequate Yearly Progress (AYP) for five consecutive years entered into restructuring as mandated by the "No Child Left Behind Act" of 2001. My study examines the perceptions of teacher entering into their first year of school restructuring due to…

Massive Ischemic Stroke Due to Pulmonary Barotrauma and Cerebral Artery Air Embolism During Commercial Air Travel

PubMed Central

Zarabi, Sara Farshchi; Parotto, Matteo; Katznelson, Rita; Downar, James

2017-01-01

Patient: Male, 65 Final Diagnosis: Air emboli Symptoms: Short of breath Medication: — Clinical Procedure: — Specialty: Anesthesiology Objective: Unusual setting of medical care Background: Air embolism into the systemic arterial circulation secondary to pulmonary barotrauma has rarely been reported. Herein, we report the clinical course of an extremely rare presentation of cerebral air embolism likely due to ruptured pulmonary bullae during commercial air travel. Case Report: A 65-year-old man suddenly became unconscious during an airplane descent. Upon landing, he was immediately transferred to the nearest emergency department where he was intubated for airway protection. His head CT angiogram showed multiple air pockets in the right parietal lobe suspicious for multiple air emboli. His chest CT scan showed multiple large bullae in the left upper and lower lobes as well as diffusely emphysematous lung tissue. After initial stabilization, he underwent emergent hyperbaric oxygen treatment (HBOT) in the multiplace chamber at 2.8 atmospheres. The patient tolerated HBOT well with no complications. However, his neurologic status deteriorated in the following 24 hours due to progression of his cerebral edema and mass effects. The patient’s clinical status was discussed with his family and the decision was made to withdraw life-sustaining measures. He died shortly after withdrawal of life support. Post-mortem examination confirmed the presence of very large bullae in the lungs bilaterally. Conclusions: Spontaneous cerebral air embolism is a possible complication of ruptured pulmonary bullae during air travel. HBOT is well-tolerated and may be used with caution even in the presence of emphysematous bullae. PMID:28607332

Time Discounting and Credit Market Access in a Large-Scale Cash Transfer Programme

PubMed Central

Handa, Sudhanshu; Martorano, Bruno; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha

2017-01-01

Summary Time discounting is thought to influence decision-making in almost every sphere of life, including personal finances, diet, exercise and sexual behavior. In this article we provide evidence on whether a national poverty alleviation program in Kenya can affect inter-temporal decisions. We administered a preferences module as part of a large-scale impact evaluation of the Kenyan Government’s Cash Transfer for Orphans and Vulnerable Children. Four years into the program we find that individuals in the treatment group are only marginally more likely to wait for future money, due in part to the erosion of the value of the transfer by inflation. However among the poorest households for whom the value of transfer is still relatively large we find significant program effects on the propensity to wait. We also find strong program effects among those who have access to credit markets though the program itself does not improve access to credit. PMID:28260842

Time Discounting and Credit Market Access in a Large-Scale Cash Transfer Programme.

PubMed

Handa, Sudhanshu; Martorano, Bruno; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha

2016-06-01

Time discounting is thought to influence decision-making in almost every sphere of life, including personal finances, diet, exercise and sexual behavior. In this article we provide evidence on whether a national poverty alleviation program in Kenya can affect inter-temporal decisions. We administered a preferences module as part of a large-scale impact evaluation of the Kenyan Government's Cash Transfer for Orphans and Vulnerable Children. Four years into the program we find that individuals in the treatment group are only marginally more likely to wait for future money, due in part to the erosion of the value of the transfer by inflation. However among the poorest households for whom the value of transfer is still relatively large we find significant program effects on the propensity to wait. We also find strong program effects among those who have access to credit markets though the program itself does not improve access to credit.

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong

PubMed Central

Lai, Agnes Y.; Mui, Moses W.; Wan, Alice; Stewart, Sunita M.; Yew, Carol; Lam, Tai-hing; Chan, Sophia S.

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong.

PubMed

Lai, Agnes Y; Mui, Moses W; Wan, Alice; Stewart, Sunita M; Yew, Carol; Lam, Tai-Hing; Chan, Sophia S

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the "train-the-trainer" workshop (TTT) for the first large scale, community-based, family intervention projects, entitled "Happy Family Kitchen Project" (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers' competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees' reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example

The 2-Year Cosmetic Outcome of a Randomized Trial Comparing Prone and Supine Whole-Breast Irradiation in Large-Breasted Women

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

Veldeman, Liv, E-mail: liv.veldeman@uzgent.be; Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent; Schiettecatte, Kimberly

Purpose: To report the 2-year cosmetic outcome of a randomized trial comparing prone and supine whole-breast irradiation in large-breasted patients. Methods and Materials: One hundred patients with a (European) cup size ≥C were included. Before and 2 years after radiation therapy, clinical endpoints were scored and digital photographs were taken with the arms alongside the body and with the arms elevated 180°. Three observers rated the photographs using the 4-point Harvard cosmesis scale. Cosmesis was also evaluated with the commercially available Breast Cancer Conservation Treatment.cosmetic results (BCCT.core) software. Results: Two-year follow-up data and photographs were available for 94 patients (47 supine treatedmore » and 47 prone treated). Patient and treatment characteristics were not significantly different between the 2 cohorts. A worsening of color change occurred more frequently in the supine than in the prone cohort (19/46 vs 10/46 patients, respectively, P=.04). Five patients in the prone group (11%) and 12 patients in the supine group (26%) presented with a worse scoring of edema at 2-year follow-up (P=.06). For retraction and fibrosis, no significant differences were found between the 2 cohorts, although scores were generally worse in the supine cohort. The cosmetic scoring by 3 observers did not reveal differences between the prone and supine groups. On the photographs with the hands up, 7 patients in the supine group versus none in the prone group had a worsening of cosmesis of 2 categories using the (BCCT.org) software (P=.02). Conclusion: With a limited follow-up of 2 years, better cosmetic outcome was observed in prone-treated than in supine-treated patients.« less

Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma.

PubMed

Myers, Regina M; Hill, Brian T; Shaw, Bronwen E; Kim, Soyoung; Millard, Heather R; Battiwalla, Minoo; Majhail, Navneet S; Buchbinder, David; Lazarus, Hillard M; Savani, Bipin N; Flowers, Mary E D; D'Souza, Anita; Ehrhardt, Matthew J; Langston, Amelia; Yared, Jean A; Hayashi, Robert J; Daly, Andrew; Olsson, Richard F; Inamoto, Yoshihiro; Malone, Adriana K; DeFilipp, Zachariah; Margossian, Steven P; Warwick, Anne B; Jaglowski, Samantha; Beitinjaneh, Amer; Fung, Henry; Kasow, Kimberly A; Marks, David I; Reynolds, Jana; Stockerl-Goldstein, Keith; Wirk, Baldeep; Wood, William A; Hamadani, Mehdi; Satwani, Prakash

2018-02-15

Autologous hematopoietic cell transplantation (auto-HCT) is a standard therapy for relapsed classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL); however, long-term outcomes are not well described. This study analyzed survival, nonrelapse mortality, late effects, and subsequent malignant neoplasms (SMNs) in 1617 patients who survived progression-free for ≥2 years after auto-HCT for cHL or DLBCL between 1990 and 2008. The median age at auto-HCT was 40 years; the median follow-up was 10.6 years. The 5-year overall survival rate was 90% (95% confidence interval [CI], 87%-92%) for patients with cHL and 89% (95% CI, 87%-91%) for patients with DLBCL. The risk of late mortality in comparison with the general population was 9.6-fold higher for patients with cHL (standardized mortality ratio [SMR], 9.6) and 3.4-fold higher for patients with DLBCL (SMR, 3.4). Relapse accounted for 44% of late deaths. At least 1 late effect was reported for 9% of the patients. A total of 105 SMNs were confirmed: 44 in the cHL group and 61 in the DLBCL group. According to a multivariate analysis, older age, male sex, a Karnofsky score < 90, total body irradiation (TBI) exposure, and a higher number of lines of chemotherapy before auto-HCT were risk factors for overall mortality in cHL. Risk factors in DLBCL were older age and TBI exposure. A subanalysis of 798 adolescent and young adult patients mirrored the outcomes of the overall study population. Despite generally favorable outcomes, 2-year survivors of auto-HCT for cHL or DLBCL have an excess late-mortality risk in comparison with the general population and experience an assortment of late complications. Cancer 2018;124:816-25. © 2017 American Cancer Society. © 2017 American Cancer Society.

Relevance of Tidal Heating on Large TNOs

NASA Technical Reports Server (NTRS)

Saxena, Prabal; Renaud, Joe P.; Henning, Wade G.; Jutzi, Martin; Hurford, Terry A.

2017-01-01

We examine the relevance of tidal heating for large Trans-Neptunian Objects, with a focus on its potential to melt and maintain layers of subsurface liquid water. Depending on their past orbital evolution, tidal heating may be an important part of the heat budget for a number of discovered and hypothetical TNO systems and may enable formation of, and increased access to, subsurface liquid water. Tidal heating induced by the process of despinning is found to be particularly able to compete with heating due to radionuclide decay in a number of different scenarios. In cases where radiogenic heating alone may establish subsurface conditions for liquid water, we focus on the extent by which tidal activity lifts the depth of such conditions closer to the surface. While it is common for strong tidal heating and long lived tides to be mutually exclusive, we find this is not always the case, and highlight when these two traits occur together. We find cases where TNO systems experience tidal heating that is a significant proportion of, or greater than radiogenic heating for periods ranging from100 s of millions to a billion years. For subsurface oceans that contain a small antifreeze component, tidal heating due to very high initial spin states may enable liquid water to be preserved right up to the present day. Of particular interest is the Eris-Dysnomia system, which in those cases may exhibit extant cryovolcanism.

Relevance of tidal heating on large TNOs

NASA Astrophysics Data System (ADS)

Saxena, Prabal; Renaud, Joe P.; Henning, Wade G.; Jutzi, Martin; Hurford, Terry

2018-03-01

We examine the relevance of tidal heating for large Trans-Neptunian Objects, with a focus on its potential to melt and maintain layers of subsurface liquid water. Depending on their past orbital evolution, tidal heating may be an important part of the heat budget for a number of discovered and hypothetical TNO systems and may enable formation of, and increased access to, subsurface liquid water. Tidal heating induced by the process of despinning is found to be particularly able to compete with heating due to radionuclide decay in a number of different scenarios. In cases where radiogenic heating alone may establish subsurface conditions for liquid water, we focus on the extent by which tidal activity lifts the depth of such conditions closer to the surface. While it is common for strong tidal heating and long lived tides to be mutually exclusive, we find this is not always the case, and highlight when these two traits occur together. We find cases where TNO systems experience tidal heating that is a significant proportion of, or greater than radiogenic heating for periods ranging from100‧s of millions to a billion years. For subsurface oceans that contain a small antifreeze component, tidal heating due to very high initial spin states may enable liquid water to be preserved right up to the present day. Of particular interest is the Eris-Dysnomia system, which in those cases may exhibit extant cryovolcanism.

Seclusion of Students with Disabilities: An Analysis of Due Process Hearings

ERIC Educational Resources Information Center

Connolly, Jennifer F.

2017-01-01

In the last several years, there has been growing concern about the use of seclusion in schools. Little is known about its use, particularly with students with disabilities. This article presents the findings from an analysis of 26 due process hearings taking place nationwide over a 12-year period containing a description of the use of seclusion.…

Sudden onset of artery dissection in a 32-year-old woman with vascular Ehlers-Danlos syndrome due to psychological stress of her mother's death: a case series.

PubMed

Shimoyama, Yuichiro; Umegaki, Osamu; Agui, Tomoyuki; Kadono, Noriko; Minami, Toshiaki

2017-01-01

Patients with vascular Ehlers-Danlos syndrome (EDS) are susceptible to significant vascular complications, such as aortic and visceral arterial ruptures, aneurysms, and dissection. We describe a case of repeated bleeding in a 57-year-old woman and a case of sudden onset of artery dissection in her daughter, both of whom were previously diagnosed with vascular EDS and managed at our institution. A 57-year-old woman was admitted to our emergency department due to sudden onset of left low back pain. Her past history included vascular EDS. An urgent abdominal computed tomography (CT) scan revealed a left-sided retroperitoneal hematoma and left external iliac artery dissection. Stent graft repair was performed. Five hours postoperatively, cardiac arrest occurred and resuscitation attempts failed. The 32-year-old daughter with genetically diagnosed vascular EDS was notified of the death of her mother during the customary end-of-life conference. Six hours after her mother's death, she was admitted to our emergency department due to sudden onset of left low back pain. On examination, she was not in hypovolemic shock, and weak pulses were palpable in the bilateral dorsalis pedis. An urgent abdominal CT scan revealed a right-sided retroperitoneal hematoma around the right external iliac artery and left external iliac artery dissection. She was admitted to the intensive care unit and underwent conservative therapy consisting of bed rest and antihypertensive therapy with nicardipine. She developed no further vascular complications requiring surgical intervention and was discharged on the 21st hospital day. Vascular rupture can be fatal in patients with vascular EDS. This report underscores the importance of strategic management of vascular complications to prevent rupture, and the importance of psychological care for the bereaved family given the hereditary nature of vascular EDS.

Ghost reefs: Nautical charts document large spatial scale of coral reef loss over 240 years

PubMed Central

McClenachan, Loren; O’Connor, Grace; Neal, Benjamin P.; Pandolfi, John M.; Jackson, Jeremy B. C.

2017-01-01

Massive declines in population abundances of marine animals have been documented over century-long time scales. However, analogous loss of spatial extent of habitat-forming organisms is less well known because georeferenced data are rare over long time scales, particularly in subtidal, tropical marine regions. We use high-resolution historical nautical charts to quantify changes to benthic structure over 240 years in the Florida Keys, finding an overall loss of 52% (SE, 6.4%) of the area of the seafloor occupied by corals. We find a strong spatial dimension to this decline; the spatial extent of coral in Florida Bay and nearshore declined by 87.5% (SE, 7.2%) and 68.8% (SE, 7.5%), respectively, whereas that of offshore areas of coral remained largely intact. These estimates add to finer-scale loss in live coral cover exceeding 90% in some locations in recent decades. The near-complete elimination of the spatial coverage of nearshore coral represents an underappreciated spatial component of the shifting baseline syndrome, with important lessons for other species and ecosystems. That is, modern surveys are typically designed to assess change only within the species’ known, extant range. For species ranging from corals to sea turtles, this approach may overlook spatial loss over longer time frames, resulting in both overly optimistic views of their current conservation status and underestimates of their restoration potential. PMID:28913420

Effectiveness of a multifactorial handwashing program to reduce school absenteeism due to acute gastroenteritis.

PubMed

Azor-Martínez, Ernestina; Cobos-Carrascosa, Elena; Gimenez-Sanchez, Francisco; Martínez-López, Jose Miguel; Garrido-Fernández, Pablo; Santisteban-Martínez, Joaquin; Seijas-Vazquez, Maria Luisa; Campos-Fernandez, Maria Amparo; Bonillo-Perales, Antonio

2014-02-01

Acute gastroenteritis (AGE) is one of the most common diseases among children and an important cause of school absenteeism. The aim of this study was to assess the effectiveness of a handwashing program using hand sanitizers for the prevention of school absenteeism due to AGE. A randomized, controlled and open study of a sample of 1341 children between 4 and 12 years of age, attending 5 state schools in Almería (Spain), with an 8-month follow up (academic year). The experimental group (EG) washed their hands with soap and water, complementing this with the use of a hand sanitizer, and the control group (CG) followed the usual handwashing procedure. Absenteeism rates due GI were compared between the 2 groups through the multivariate Poisson regression analysis. Percent days absent in both groups were compared with a Z-test. 446 cases of school absenteeism due to AGE were registered. The school children from the EG had a 36% lower risk of absenteeism due to AGE (IRR: 0.64, 95% confidence interval: 0.52-0.78) and a decrease in absenteeism of 0.13 episodes/child/academic year (0.27 of EG vs 0.40 CG/episodes/child/academic year, P < 0.001). Pupils missed 725 school days due to AGE and absent days was significantly lower in the EG (EG: 0.31%, 95% confidence interval: 0.28-0.35 vs. CG: 0.44%, 95% confidence interval: 0.40-0.48, P < 0.001). The use of hand sanitizer as a complement to handwashing with soap is an efficient measure to reduce absent days and the number of school absenteeism cases due to AGE.

Quantifying alteration of river flow regime by large reservoirs in France

NASA Astrophysics Data System (ADS)

Cipriani, Thomas; Sauquet, Eric

2017-04-01

Reservoirs may highly modify river flow regime. Knowing the alterations is of importance to better understand the biological and physical patterns along the river network. However data are not necessary available to carry out an analysis of modifications at a national scale, e.g. due to industrial interests or to lack of measurements. The objective of this study is to quantify the changes in a set of hydrological indices due to large reservoirs in France combining different data sources. The analysis is based on a comparison between influenced discharges (observed discharges) and natural discharges available from: (i) gauging stations available upstream the dam, (ii) regionalization procedures (Sauquet et al., 2008; Sauquet et Catalogne, 2011; Cipriani et al., 2012), or (iii) historical data free from human influence close to the dam location. The impact of large reservoirs is assessed considering different facets of the river flow regime, including flood quantiles, low flow characteristics, quantiles from the flow duration curve and the twelve mean monthly discharges. The departures from the indice representative of natural conditions quantify the effect of the reservoir management on the river flow regime. The analysis is based on 62 study cases. Results show large spread in terms of impact depending on the purposes of the reservoirs and the season of interest. Results also point out inconsistencies in data (water balance between outflow and inflow, downstream of the dam is not warranted) due to uncertainties in mean monthly discharges and to the imperfect knowledge of inflows and outflows. Lastly, we suggest a typology of hydrological alterations based on the purposes of the reservoirs. Cipriani T., Toilliez T., Sauquet E. (2012). Estimating 10 year return period peak flows and flood durations at ungauged locations in France. La Houille Blanche, 4-5: 5-13, doi : 10.1051/lhb/2012024. Sauquet E., Catalogne C. (2011). Comparison of catchment grouping methods for

Grassland bird communtiy response to large wildfires

USGS Publications Warehouse

Roberts, Anthony J.; Boal, Clint W.; Wester, David B.; Rideout-Hanzak, Sandra; Whitlaw, Heather A.

2012-01-01

We studied breeding season communities of grassland birds on short-grass and mixed-grass prairie sites during the second and third breeding seasons following two large wildfires in March 2006 in the Texas panhandle, USA. There was an apparent temporary shift in avian community composition following the fires due to species-specific shifts associated with life-history traits and vegetation preferences. Species that prefer sparse vegetation and bare ground on short-grass sites, such as Horned Lark (Eremophila alpestris), benefited from wildfires, while others, such as Western Meadowlark (Sturnella neglecta), that prefer more dense vegetation, were negatively impacted. Mixed-grass sites had species-specific shifts in 2007, two breeding seasons after the fires; grassland bird communities on burned plots were similar by 2008 to those on unburned plots. Avian communities appeared to return to pre-burn levels within 3 years following wildfires. Many of the responses in our study of wildfire were similar to those reported following prescribed fires elsewhere. Prescribed fires appear to have similar effects on the avian community despite differences in intensity and environmental conditions during wildfires.

Analysis of capital spending and capital financing among large US nonprofit health systems.

PubMed

Stewart, Louis J

2012-01-01

This article examines the recent trends (2006 to 2009) in capital spending among 25 of the largest nonprofit health systems in the United States and analyzes the financing sources that these large nonprofit health care systems used to fund their capital spending. Total capital spending for these 25 nonprofit health entities exceeded $41 billion for the four-year period of this study. Less than 3 percent of total capital spending resulted in mergers and acquisition activities. Total annual capital spending grew at an average annual rate of 17.6 percent during the first three year of this study's period of analysis. Annual capital spending for 2009 fell by more than 22 percent over prior year's level due to the impact of widespread disruption in US tax-exempt variable rate debt markets. While cash inflow from long-term debt issues was a significant source of capital financing, this study's primary finding was that operating cash flow was the predominant source of capital spending funding. Key words: nonprofit, mergers and acquisitions (M&A), capital spending, capital financing.

A Compulsory Bioethics Module for a Large Final Year Undergraduate Class

ERIC Educational Resources Information Center

Pearce, Roger S.

2009-01-01

The article describes a compulsory bioethics module delivered to [approximately] 120 biology students in their final year. The main intended learning outcome is that students should be able to analyse and reason about bioethical issues. Interactive lectures explain and illustrate bioethics. Underlying principles and example issues are used to…

International Student Adaptation to a U.S. College: A Mixed Methods Exploration of the Impact of a Specialized First-Year Course at a Large Midwestern Institution

ERIC Educational Resources Information Center

Kovtun, Olena

2011-01-01

This mixed methods study assessed a first-year course for international students, entitled the U.S. Education and Culture, at a large Midwestern public institution. The quantitative results indicated that participation in the course improved students' academic skills, psychosocial development, understanding of social diversity in the U.S., use of…

45 CFR 286.280 - When are annual reports due?

Code of Federal Regulations, 2010 CFR

2010-10-01

....280 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF... report required by § 286.275 is due 90 days after the end of the Fiscal Year which it covers. (b) The...

[Mortality due to pesticide poisoning in Colombia, 1998-2011].

PubMed

Chaparro-Narváez, Pablo; Castañeda-Orjuela, Carlos

2015-08-01

Poisoning due to pesticides is an important public health problem worldwide due its morbidity and mortality. In Colombia, there are no exact data on mortality due to pesticide poisoning. To estimate the trend of mortality rate due to pesticide poisoning in Colombia between 1998 and 2011. We carried out a descriptive analysis with the database reports of death as unintentional poisoning, self-inflicted intentional poisoning, aggression with pesticides, and poisoning with non-identified intentionality, population projections between 1998 and 2011, and rurality indexes. Crude and age-adjusted mortality rates were estimated and trends and Spearman coefficients were evaluated. A total of 4,835 deaths were registered (age-adjusted mortality rate of 2.38 deaths per 100,000 people). Mortality rates were higher in rural areas, for self-inflicted intentional poisoning, in men and in age groups between 15 and 39 years old. The trend has been decreasing since 2002. Municipality mortality rates due to unintentional poisoning and aggression correlated significantly with the rurality index in less rural municipalities. Mortality rates due to pesticide poisoning presented a mild decrease between 1998 and 2011. It is necessary to adjust and reinforce the measures conducive to reducing pesticide exposure in order to avoid poisoning and reduce mortality.

Human dirofilariasis due to Dirofilaria repens in southern India

PubMed Central

Kotigadde, Subbannayya; Ramesh, Sathyavathi Alva; Medappa, Kariyappa Thadiangada

2012-01-01

Dirofilariasis is primarily confined to animals such as dogs, cats, foxes and raccoons. Human dirofilariasis is an accidental zoonotic infection acquired through mosquitoes. Human dirofilariasis due to Dirofilaria repens though endemic in Kerala, reports from Karnataka state are rare. We report a case of solitary subcutaneous dirofilariasis of the eyelid due to D. repens in a 47-year-old woman. She presented with periorbital edema. The swelling was soft, cystic with associated tenderness. A thin, white worm was noticed in the lesion and was removed by traction which was subsequently identified to be D. repens. PMID:23508234

The Large Hadron Collider, a personal recollection

NASA Astrophysics Data System (ADS)

Evans, Lyndon

2014-03-01

The construction of the Large Hadron Collider (LHC) has been a massive endeavor spanning almost 30 years from conception to commissioning. Building the machine with the highest possible energy (7 TeV) in the existing LEP tunnel of 27 km circumference and with a tunnel diameter of only 3.8 m has required considerable innovation. The first was the development of an idea first proposed by Bob Palmer at Brookhaven National Laboratory in 1978, where the two rings are integrated into a single magnetic structure. This compact 2-in-1 structure was essential for the LHC due to both the limited space available in the existing Large Electron-Positron collider tunnel and the cost. The second innovation was the bold move to use superfluid helium cooling on a massive scale, which was imposed by the need to achieve a high (8.3 T) magnetic field using an affordable Nb-Ti superconductor. In this article, no attempt is made to give a comprehensive review of the machine design. This can be found in the LHC Design Report [1], which gives a detailed description of the machine as it was built and comprehensive references. A more popular description of the LHC and its detectors can be found in [2]. Instead, this is a more personal account of the project from approval to commissioning, describing some of the main technologies and some of the trials and tribulations encountered in bringing this truly remarkable machine alive.

Tune variations in the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Aquilina, N.; Giovannozzi, M.; Lamont, M.; Sammut, N.; Steinhagen, R.; Todesco, E.; Wenninger, J.

2015-04-01

The horizontal and vertical betatron tunes of the Large Hadron Collider (LHC) mainly depend on the strength of the quadrupole magnets, but are also affected by the quadrupole component in the main dipoles. In case of systematic misalignments, the sextupole component from the main dipoles and sextupole corrector magnets also affect the tunes due to the feed down effect. During the first years of operation of the LHC, the tunes have been routinely measured and corrected through either a feedback or a feed forward system. In this paper, the evolution of the tunes during injection, ramp and flat top are reconstructed from the beam measurements and the settings of the tune feedback loop and of the feed forward corrections. This gives the obtained precision of the magnetic model of the machine with respect to quadrupole and sextupole components. Measurements at the injection plateau show an unexpected large decay whose origin is not understood. This data is discussed together with the time constants and the dependence on previous cycles. We present results of dedicated experiments that show that this effect does not originate from the decay of the main dipole component. During the ramp, the tunes drift by about 0.022. It is shown that this is related to the precision of tracking the quadrupole field in the machine and this effect is reduced to about 0.01 tune units during flat top.

[A five-year-old girl with epilepsy showing forced normalization due to zonisamide].

PubMed

Hirose, Mieko; Yokoyama, Hiroyuki; Haginoya, Kazuhiro; Iinuma, Kazuie

2003-05-01

A case of forced normalization in childhood is presented. When zonisamide was administered to a five-year-old girl with intractable epilepsy, disappearance of seizures was accompanied by severe psychotic episodes such as communication disturbance, personal relationship failure, and stereotyped behavior, which continued after the withdrawal of zonisamide. These symptoms gradually improved by administration of fluvoxamine, however epileptic attacks reappeared. Although most patients with forced normalization are adult and teenager, attention should be paid to this phenomenon as adverse psychotic effects of zonisamide even in young children. Fluvoxamine may be effective for the symptoms.

An Analysis of the Perceptions and Resources of Large University Classes

ERIC Educational Resources Information Center

Cash, Ceilidh Barlow; Letargo, Jessa; Graether, Steffen P.; Jacobs, Shoshanah R.

2017-01-01

Large class learning is a reality that is not exclusive to the first-year experience at midsized, comprehensive universities; upper-year courses have similarly high enrollment, with many class sizes greater than 200 students. Research into the efficacy and deficiencies of large undergraduate classes has been ongoing for more than 100 years, with…

Spurious One-Month and One-Year Periods in Visual Observations of Variable Stars

NASA Astrophysics Data System (ADS)

Percy, J. R.

2015-12-01

Visual observations of variable stars, when time-series analyzed with some algorithms such as DC-DFT in vstar, show spurious periods at or close to one synodic month (29.5306 days), and also at about a year, with an amplitude of typically a few hundredths of a magnitude. The one-year periods have been attributed to the Ceraski effect, which was believed to be a physiological effect of the visual observing process. This paper reports on time-series analysis, using DC-DFT in vstar, of visual observations (and in some cases, V observations) of a large number of stars in the AAVSO International Database, initially to investigate the one-month periods. The results suggest that both the one-month and one-year periods are actually due to aliasing of the stars' very low-frequency variations, though they do not rule out very low-amplitude signals (typically 0.01 to 0.02 magnitude) which may be due to a different process, such as a physiological one. Most or all of these aliasing effects may be avoided by using a different algorithm, which takes explicit account of the window function of the data, and/or by being fully aware of the possible presence of and aliasing by very low-frequency variations.

[Large vessel vasculitides].

PubMed

Morović-Vergles, Jadranka; Puksić, Silva; Gracanin, Ana Gudelj

2013-01-01

Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in young ages. Although all large arteries can be affected, the aorta, subclavian and carotid arteries are most commonly involved. The most common symptoms included upper extremity claudication, hypertension, pain over the carotid arteries (carotidynia), dizziness and visual disturbances. Early diagnosis and treatment has improved the outcome in patients with TA.

Search for Cosmic-Ray Electron and Positron Anisotropies with Seven Years of Fermi Large Area Telescope Data

DOE PAGES

Abdollahi, S.; Ackermann, M.; Ajello, M.; ...

2017-03-01

We present the Large Area Telescope on board the Fermi Gamma-ray Space Telescope that has collected the largest ever sample of high-energy cosmic-ray electron and positron events since the beginning of its operation. Potential anisotropies in the arrival directions of cosmic-ray electrons or positrons could be a signature of the presence of nearby sources. We use almost seven years of data with energies above 42 GeV processed with the Pass 8 reconstruction. The present data sample can probe dipole anisotropies down to a level of 10 -3. We take into account systematic effects that could mimic true anisotropies at thismore » level. We present a detailed study of the event selection optimization of the cosmic-ray electrons and positrons to be used for anisotropy searches. Since no significant anisotropies have been detected on any angular scale, we present upper limits on the dipole anisotropy. Lastly, the present constraints are among the strongest to date probing the presence of nearby young and middle-aged sources.« less

Heart Failure Due to Age-Related Cardiac Amyloid Disease Associated With Wild-Type Transthyretin: A Prospective, Observational Cohort Study

PubMed Central

Connors, Lawreen H.; Sam, Flora; Skinner, Martha; Salinaro, Francesco; Sun, Fangui; Ruberg, Frederick L.; Berk, John L.; Seldin, David C.

2015-01-01

Background Heart failure due to wild-type transthyretin amyloidosis (ATTRwt) is an under-appreciated cause of morbidity and mortality in the aging population. The aims of this study were to examine features of disease and characterize outcomes in a large ATTRwt cohort. Methods and Results Over 20 years, 121 patients with ATTRwt were enrolled in a prospective observational study. Median age at enrollment was 75.6 years (range, 62.6–87.8); 97% of patients were Caucasian. The median survival, measured from biopsy diagnosis, was 46.69 months (95% CI, 41.95–56.77); 78% of deaths were due to cardiac causes. By Kaplan-Meier analysis, 5-year survival was 35.7% (95% CI, 25–46). Impaired functional capacity (mean VO2 max of 13.5 mL/kg/min) and atrial fibrillation (67%) were common clinical features. Multivariate predictors of reduced survival were elevated serum brain natriuretic peptide (BNP, 482 ± 337 pg/mL) and uric acid (8.2 ± 2.6 mg/dL), decreased left ventricular ejection fraction (LVEF, 50% median ranging 10-70%), and increased relative wall thickness (RWT, 0.75 ± 0.19). Conclusions In this series of patients with biopsy-proven ATTRwt amyloidosis, poor functional capacity and atrial arrhythmias were common clinical features. Elevated BNP and uric acid, decreased LVEF, and increased RWT were associated with limited survival of only 35.7% at 5 years for the group as a whole. These data establish the natural history of ATTRwt, provide statistical basis for the design of future interventional clinical trials, and highlight the need for more sensitive diagnostic tests and disease-specific treatments for this disease. PMID:26660282

[A 38-year-old Woman with a Legal and Voluntary Interruption of Pregnancy due to Mental Health Risk. An Unexpected Outcome].

PubMed

Restrepo, Diana; Duque, Marle; Montoya, Laura; Hoyos, Catalina

To describe a case of legal and voluntary interruption of pregnancy due to a mental health risk in the mother. However, the foetus survived and the mother decided to care for the child. Description of the case and a non-systematic review of the relevant literature. A multiparous woman of 38 years with unknown gestational age who requests legal and voluntary interruption of pregnancy. After abortion a male child born of 1050 grams was born, intubated and admitted to intensive care. Subsequently, the mother, without the mental problems that led to abortion, gradually assumed the care of the child. To address this complex case, several aspects are analysed: first, the change of mind of a woman in her desire to be a mother. Second, the disappearance of mental symptoms in the immediate postpartum. Third, the need to review the clinical, ethical and legal foundations of the legal ruling that allows therapeutic abortion in Colombia. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Heritability of metabolic syndrome traits in a large population-based sample[S

PubMed Central

van Dongen, Jenny; Willemsen, Gonneke; Chen, Wei-Min; de Geus, Eco J. C.; Boomsma, Dorret I.

2013-01-01

Heritability estimates of metabolic syndrome traits vary widely across studies. Some studies have suggested that the contribution of genes may vary with age or sex. We estimated the heritability of 11 metabolic syndrome-related traits and height as a function of age and sex in a large population-based sample of twin families (N = 2,792–27,021, for different traits). A moderate-to-high heritability was found for all traits [from H2 = 0.47 (insulin) to H2 = 0.78 (BMI)]. The broad-sense heritability (H2) showed little variation between age groups in women; it differed somewhat more in men (e.g., for glucose, H2 = 0.61 in young females, H2 = 0.56 in older females, H2 = 0.64 in young males, and H2= 0.27 in older males). While nonadditive genetic effects explained little variation in the younger subjects, nonadditive genetic effects became more important at a greater age. Our findings show that in an unselected sample (age range, ∼18–98 years), the genetic contribution to individual differences in metabolic syndrome traits is moderate to large in both sexes and across age. Although the prevalence of the metabolic syndrome has greatly increased in the past decades due to lifestyle changes, our study indicates that most of the variation in metabolic syndrome traits between individuals is due to genetic differences. PMID:23918046

Gravity Shifting Due to Distribution of Momentum in Black Hole and its Relation with Time Flux

NASA Astrophysics Data System (ADS)

Gholibeigian, Hassan; Gholibeygian, Mohammad Hossein

2017-04-01

There are many local convection systems of heat and mass in black holes. These large scale coupled systems including planets and molten masses which generate momentum in black hole and consequently generate coupled gravitational and electromagnetic waves. Therefore black hole's gravity is shifting due to distribution of masses/momentum in its convection systems. Two massive black holes which merged at a distance of 1.3 billion light years far from the Earth, produced different momentum and energy before, during, and after the event in different locations of the black hole. This energy and momentum produced gravitational waves which radiated away and recorded on September 14, 2015 by two detectors of the Laser Interferometry Gravitational Observatories (LIGO) in USA. On the other hand, the nature of time is wavy-like motion of the matter and nature of space is jerky-like motion of the matter. These two natures of space-time can be matched on wave-particle duality in quantum mechanics. And also magnitude of the time for an atom is momentum of its involved fundamental particles [Gholibeigian, adsabs.harvard.edu/abs/2016APS.APR.D1032G]. ∑ ⃗R(mv, σ,τ ) = (pnucleons + pelectrons) In which ⃗Ris time flux, σ&τare space and time coordinates on the string world sheet and p is momentum. Therefore, gravitational waves which travel from black hole to us including different fluxes of time which accompaniment propagated gravitational waves of momentum. As an observable factor, we can look at the 7 milliseconds difference of recorded at the time of arrival of the signals on September 14, 2015 by detector in Livingston before detector in Hanford. This difference of recorded time of signal GW150914 by LIGO cannot be due to warped space-time, because 3002 kilometers distance between two detectors with respect to the 1.3 billion light years (distance of black hole to detectors) is like zero! So, this 7 milliseconds difference between two time's fluxes can be due to

The Influence of Large-Scale Circulation on Fire Outbreaks in the Amazon Region

NASA Astrophysics Data System (ADS)

Pires, L. B. M.; Romao, M.; Freitas, A. C. V.

2017-12-01

The combination of alterations in land use cover and severe droughts may dramatically increase fire outbreaks. Tropical convection in the Amazon Basin is regulated mainly by large-scale atmospheric systems such as the Walker circulation. Many of the documented drought episodes in the Amazon occurred during intense El Niño events such as those recorded in 1926, 1983, 1997-1998, and 2010. However, not all El Niño events are related to drought in the Amazon. Recent studies have also pointed out the importance of the tropical Atlantic Ocean in the modulation of the Amazonian climate, as observed during the drought episodes in 2005 and 2010. This work investigates the fire outbreak tendency in the Amazon region, and the influence of large-scale circulation on these events. Data from the Fire Program of the Center for Weather Forecasting and Climate Studies (CPTEC/INPE) show a substantial increase in the number of fire outbreaks in the last few years, especially during 2016. However, in the 2017 year a sharp drop in fire outbreaks reaching levels similar to the years prior to 2016 is being noted, already showing a reduction of 54% in relation to the preceding 2016 year. The 2015-2016 period was marked by one of the strongest El Niño in history. This was reflected in the increase of the number of fire outbreaks due to the increase of the drought and temperature elevation period. On the other hand, the 2017 year is being characterized by a condition of neutrality in relation to the El Niño-Southern Oscillation (ENSO) phenomena, and have overall presented positive sea surface temperature (SST) anomalies in the tropical Atlantic. Variations of these systems and their relation to fire outbreaks is demonstrated.

Analysis of driver critical reason and years of driving experience in large truck crashes, analysis brief.

DOT National Transportation Integrated Search

2017-01-01

The 2005 Large Truck Crash Causation Study (LTCCS)i was the first-ever national study to attempt to determine the critical reasons and associated factors that contribute to serious large truck crashes. The LTCCS defines critical reason as the r...

Technologies for Large Data Management in Scientific Computing

NASA Astrophysics Data System (ADS)

Pace, Alberto

2014-01-01

In recent years, intense usage of computing has been the main strategy of investigations in several scientific research projects. The progress in computing technology has opened unprecedented opportunities for systematic collection of experimental data and the associated analysis that were considered impossible only few years ago. This paper focuses on the strategies in use: it reviews the various components that are necessary for an effective solution that ensures the storage, the long term preservation, and the worldwide distribution of large quantities of data that are necessary in a large scientific research project. The paper also mentions several examples of data management solutions used in High Energy Physics for the CERN Large Hadron Collider (LHC) experiments in Geneva, Switzerland which generate more than 30,000 terabytes of data every year that need to be preserved, analyzed, and made available to a community of several tenth of thousands scientists worldwide.

State gun safe storage laws and child mortality due to firearms.

PubMed

Cummings, P; Grossman, D C; Rivara, F P; Koepsell, T D

1997-10-01

Since 1989, several states have passed laws that make gun owners criminally liable if someone is injured because a child gains unsupervised access to a gun. These laws are controversial, and their effect on firearm-related injuries is unknown. To determine if state laws that require safe storage of firearms are associated with a reduction in child mortality due to firearms. An ecological study of firearm mortality from 1979 through 1994. All 50 states and the District of Columbia. All children younger than 15 years. Unintentional deaths, suicides, and homicides due to firearms. Laws that make gun owners responsible for storing firearms in a manner that makes them inaccessible to children were in effect for at least 1 year in 12 states from 1990 through 1994. Among children younger than 15 years, unintentional shooting deaths were reduced by 23% (95% confidence interval, 6%-37%) during the years covered by these laws. This estimate was based on within-state comparisons adjusted for national trends in unintentional firearm-related mortality. Gun-related homicide and suicide showed modest declines, but these were not statistically significant. State safe storage laws intended to make firearms less accessible to children appear to prevent unintentional shooting deaths among children younger than 15 years.

Bayesian hierarchical model for large-scale covariance matrix estimation.

PubMed

Zhu, Dongxiao; Hero, Alfred O

2007-12-01

Many bioinformatics problems implicitly depend on estimating large-scale covariance matrix. The traditional approaches tend to give rise to high variance and low accuracy due to "overfitting." We cast the large-scale covariance matrix estimation problem into the Bayesian hierarchical model framework, and introduce dependency between covariance parameters. We demonstrate the advantages of our approaches over the traditional approaches using simulations and OMICS data analysis.

Large-scale compositional heterogeneity in the Earth's mantle

NASA Astrophysics Data System (ADS)

Ballmer, M.

2017-12-01

Seismic imaging of subducted Farallon and Tethys lithosphere in the lower mantle has been taken as evidence for whole-mantle convection, and efficient mantle mixing. However, cosmochemical constraints point to a lower-mantle composition that has a lower Mg/Si compared to upper-mantle pyrolite. Moreover, geochemical signatures of magmatic rocks indicate the long-term persistence of primordial reservoirs somewhere in the mantle. In this presentation, I establish geodynamic mechanisms for sustaining large-scale (primordial) heterogeneity in the Earth's mantle using numerical models. Mantle flow is controlled by rock density and viscosity. Variations in intrinsic rock density, such as due to heterogeneity in basalt or iron content, can induce layering or partial layering in the mantle. Layering can be sustained in the presence of persistent whole mantle convection due to active "unmixing" of heterogeneity in low-viscosity domains, e.g. in the transition zone or near the core-mantle boundary [1]. On the other hand, lateral variations in intrinsic rock viscosity, such as due to heterogeneity in Mg/Si, can strongly affect the mixing timescales of the mantle. In the extreme case, intrinsically strong rocks may remain unmixed through the age of the Earth, and persist as large-scale domains in the mid-mantle due to focusing of deformation along weak conveyor belts [2]. That large-scale lateral heterogeneity and/or layering can persist in the presence of whole-mantle convection can explain the stagnation of some slabs, as well as the deflection of some plumes, in the mid-mantle. These findings indeed motivate new seismic studies for rigorous testing of model predictions. [1] Ballmer, M. D., N. C. Schmerr, T. Nakagawa, and J. Ritsema (2015), Science Advances, doi:10.1126/sciadv.1500815. [2] Ballmer, M. D., C. Houser, J. W. Hernlund, R. Wentzcovitch, and K. Hirose (2017), Nature Geoscience, doi:10.1038/ngeo2898.

Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance

PubMed Central

Zolnierczyk, Piotr; Cendrowski, Krzysztof; Sawicki, Wlodzimierz

2015-01-01

This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index – 38), congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic–therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations. PMID:25999768

Celestial bodies macroscopic movement is due to the radiation

NASA Astrophysics Data System (ADS)

Yongquan, Han

2016-03-01

The star is radiate, also as the planet. In fact, all the real objects are radiate, but the strength of the radiation is different. Radiation will reduce the quality of the object, but time is not long enough to reduce the mass of the subject, so it is difficult for us to observe. Due to the large object lifecycle, to study the changing rule of the object, we must consider the radiation on the quality of the celestial bodies, and the outer space radiate particles' motion, also consider objects interact with objects of radiation. The reason Celestial bodies moves is that the radiation of those Celestial bodies Interact with each other, Celestial bodies macroscopic movement is due to the radiation. The earth's rotation and revolution is a measure of the survive ability. Author: hanyongquan TEL: 15611860790

[Mortality due to traffic injuries and its impact on life expectancy: a comparison between Mexico and Spain].

PubMed

González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Cabrera-Pivaral, Carlos Enrique

2015-09-01

To determine the impact of mortality due to motor vehicle traffic injuries (MVTI) compared with other causes of death on life expectancy in Mexico and Spain during the three-year periods 2000-2002 and 2010-2012 and the weight of the different age groups in years of life expectancy lost (YLEL) due to this cause. Based on official death and population data, abridged life tables in Mexico and Spain were constructed for the three-year periods studied. Temporary life expectancy and YLEL for persons aged 15 to 75 years were calculated by selected causes (MVTI, diabetes mellitus, malignant neoplasms and ischemic heart diseases) and age groups in each three-year period. In Spain, YLEL decreased in both sexes from all the causes studied, especially MVTI; this reduction was greater in the younger ages. In addition, temporary life expectancy increased. In Mexico, YLEL due to MVTI increased in men, mainly in young people, and remained unchanged among women. Temporary life expectancy declined in men but increased slightly among women. The reduction in YLEL due to MVTI in Spain has contributed to increased life expectancy. By contrast, the increase in YLEL due to MVTI among Mexican men has contributed to the decline in male life expectancy. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

A Bayesian Estimate of the CMB-Large-scale Structure Cross-correlation

NASA Astrophysics Data System (ADS)

Moura-Santos, E.; Carvalho, F. C.; Penna-Lima, M.; Novaes, C. P.; Wuensche, C. A.

2016-08-01

Evidences for late-time acceleration of the universe are provided by multiple probes, such as Type Ia supernovae, the cosmic microwave background (CMB), and large-scale structure (LSS). In this work, we focus on the integrated Sachs-Wolfe (ISW) effect, I.e., secondary CMB fluctuations generated by evolving gravitational potentials due to the transition between, e.g., the matter and dark energy (DE) dominated phases. Therefore, assuming a flat universe, DE properties can be inferred from ISW detections. We present a Bayesian approach to compute the CMB-LSS cross-correlation signal. The method is based on the estimate of the likelihood for measuring a combined set consisting of a CMB temperature and galaxy contrast maps, provided that we have some information on the statistical properties of the fluctuations affecting these maps. The likelihood is estimated by a sampling algorithm, therefore avoiding the computationally demanding techniques of direct evaluation in either pixel or harmonic space. As local tracers of the matter distribution at large scales, we used the Two Micron All Sky Survey galaxy catalog and, for the CMB temperature fluctuations, the ninth-year data release of the Wilkinson Microwave Anisotropy Probe (WMAP9). The results show a dominance of cosmic variance over the weak recovered signal, due mainly to the shallowness of the catalog used, with systematics associated with the sampling algorithm playing a secondary role as sources of uncertainty. When combined with other complementary probes, the method presented in this paper is expected to be a useful tool to late-time acceleration studies in cosmology.

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.

PubMed

Albayrak, Ilknur; Bağcacı, Sinan; Sallı, Ali; Kucuksen, Sami; Uğurlu, Hatice

2013-09-01

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity.

PubMed

Sens, Florence; Bacchetta, Justine; Rabeyrin, Maud; Juillard, Laurent

2016-07-07

We report a case of a 37-year-old man with Maturity Onset Diabetes of the Youth (MODY) type 5, admitted for an episode of cholestasis and a simultaneous acute kidney injury (AKI). Chronic liver disease was due to a mutation in the transcription factor 2 (TCF2) gene, thus highlighting the need for a close liver follow-up in these patients. AKI was attributed to a cholemic nephropathy based on the following rationale: (1) alternative diagnoses were actively ruled out; (2) the onset of AKI coincided with the onset of severe hyperbilirubinaemia; (3) renal pathology showed large bile tubular casts and a marked tubular necrosis and (4) creatinine serum dramatically decreased when bilirubin levels improved after the first sessions of extracorporeal albumin dialysis (ECAD), thus suggesting its role in renal recovery. Even though cholestasis can precipitate renal injury, the diagnosis of cholemic nephropathy could require a renal biopsy at times. Future studies should confirm the benefits of ECAD in cholemic nephropathy. 2016 BMJ Publishing Group Ltd.

The Long-Term Clinical Outcomes Following Autogenous Bone Grafting for Large-Volume Defects of the Knee

PubMed Central

Delano, Mark; Spector, Myron; Pittsley, Andrew; Gottschalk, Alexander

2014-01-01

Objective: We report the long-term clinical outcomes of patients who underwent autogenous bone grafting of large-volume osteochondral defects of the knee due to osteochondritis dessicans (OCD) and osteonecrosis (ON). This is the companion report to one previous published on the biological response. We hypothesized that these grafts would integrate with host bone and the articular surface would form fibrocartilage providing an enduring clinical benefit. Design: Three groups (patients/knees) were studied: OCD without a fragment (n = 12/13), OCD with a partial fragment (n = 14/16), and ON (n = 25/26). Twenty-five of 52 patients were available for clinical follow-up between 12 and 21 years. Electronic medical records provided comparison clinical information. In addition, there were plain film radiographs, MRIs, plus repeat arthroscopy and biopsy on 14 patients. Results: Autogenous bone grafts integrated with the host bone. MRI showed soft tissue covering all the grafts at long-term follow-up. Biopsy showed initial surface fibrocartilage that subsequently converted to fibrocartilage and hyaline cartilage at 20 years. OCD patients had better clinical outcomes than ON patients. No OCD patients were asymptomatic at anytime following surgery. Half of the ON patients came to total knee replacement within 10 years. Conclusions: Autogenous bone grafting provides an alternative biological matrix to fill large-volume defects in the knee as a singular solution integrating with host bone and providing an enduring articular cartilage surface. The procedure is best suited for those with OCD. The treatment for large-volume articular defects by this method remains salvage in nature and palliative in outcome. PMID:26069688

Biotic homogenization of three insect groups due to urbanization.

PubMed

Knop, Eva

2016-01-01

Cities are growing rapidly, thereby expected to cause a large-scale global biotic homogenization. Evidence for the homogenization hypothesis is mostly derived from plants and birds, whereas arthropods have so far been neglected. Here, I tested the homogenization hypothesis with three insect indicator groups, namely true bugs, leafhoppers, and beetles. In particular, I was interested whether insect species community composition differs between urban and rural areas, whether they are more similar between cities than between rural areas, and whether the found pattern is explained by true species turnover, species diversity gradients and geographic distance, by non-native or specialist species, respectively. I analyzed insect species communities sampled on birch trees in a total of six Swiss cities and six rural areas nearby. In all indicator groups, urban and rural community composition was significantly dissimilar due to native species turnover. Further, for bug and leafhopper communities, I found evidence for large-scale homogenization due to urbanization, which was driven by reduced species turnover of specialist species in cities. Species turnover of beetle communities was similar between cities and rural areas. Interestingly, when specialist species of beetles were excluded from the analyses, cities were more dissimilar than rural areas, suggesting biotic differentiation of beetle communities in cities. Non-native species did not affect species turnover of the insect groups. However, given non-native arthropod species are increasing rapidly, their homogenizing effect might be detected more often in future. Overall, the results show that urbanization has a negative large-scale impact on the diversity specialist species of the investigated insect groups. Specific measures in cities targeted at increasing the persistence of specialist species typical for the respective biogeographic region could help to stop the loss of biodiversity. © 2015 John Wiley & Sons Ltd.

Hospitalization of older adults due to ambulatory care sensitive conditions

PubMed Central

Marques, Aline Pinto; Montilla, Dalia Elena Romero; de Almeida, Wanessa da Silva; de Andrade, Carla Lourenço Tavares

2014-01-01

OBJECTIVE To analyze the temporal evolution of the hospitalization of older adults due to ambulatory care sensitive conditions according to their structure, magnitude and causes. METHODS Cross-sectional study based on data from the Hospital Information System of the Brazilian Unified Health System and from the Primary Care Information System, referring to people aged 60 to 74 years living in the state of Rio de Janeiro, Souhteastern Brazil. The proportion and rate of hospitalizations due to ambulatory care sensitive conditions were calculated, both the global rate and, according to diagnoses, the most prevalent ones. The coverage of the Family Health Strategy and the number of medical consultations attended by older adults in primary care were estimated. To analyze the indicators’ impact on hospitalizations, a linear correlation test was used. RESULTS We found an intense reduction in hospitalizations due to ambulatory care sensitive conditions for all causes and age groups. Heart failure, cerebrovascular diseases and chronic obstructive pulmonary diseases concentrated 50.0% of the hospitalizations. Adults older than 69 years had a higher risk of hospitalization due to one of these causes. We observed a higher risk of hospitalization among men. A negative correlation was found between the hospitalizations and the indicators of access to primary care. CONCLUSIONS Primary healthcare in the state of Rio de Janeiro has been significantly impacting the hospital morbidity of the older population. Studies of hospitalizations due to ambulatory care sensitive conditions can aid the identification of the main causes that are sensitive to the intervention of the health services, in order to indicate which actions are more effective to reduce hospitalizations and to increase the population’s quality of life. PMID:25372173

Pneumonia due to Enterobacter cancerogenus infection.

PubMed

Demir, Tülin; Baran, Gamze; Buyukguclu, Tuncay; Sezgin, Fikriye Milletli; Kaymaz, Haci

2014-11-01

Enterobacter cancerogenus (formerly known as CDC Enteric Group 19; synonym with Enterobacter taylorae) has rarely been associated with human infections, and little is known regarding the epidemiology and clinical significance of this organism. We describe a community-acquired pneumonia case in a 44-year-old female due to E. cancerogenus. Identification and antimicrobial susceptibility of the microorganism was performed by the automatized VITEK 2 Compact system (bioMerieux, France). The clinical case suggests that E. cancerogenus is a potentially pathogenic microorganism in determined circumstances; underlying diseases such as bronchial asthma, empiric antibiotic treatment, wounds, diagnostic, or therapeutic instruments.

Gunshot wounds to the scrotum: a large single-institutional 20-year experience.

PubMed

Simhan, Jay; Rothman, Jason; Canter, Daniel; Reyes, Jose M; Jaffe, William I; Pontari, Michel A; Doumanian, Leo R; Mydlo, Jack H

2012-06-01

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Penetrating trauma to the scrotum often requires operative intervention, with testicular salvage only possible when enough testicular tissue can be re-approximated in the traumatic setting. The present report represents the largest series of gunshot wound trauma to the scrotum in the literature. Further, it validates recommendations of the European Association of Urology guidelines on urological trauma that advocate operative intervention due to minimal rates of patient morbidity and the inherent limitations of scrotal ultrasonography in discerning testicular compromise. To report our 20-year experience of gunshot wounds (GSWs) to the scrotum and outline the management of this traumatic injury. We queried our institutional database for patients presenting with GSWs to the scrotum between 1985 and 2006. All patients underwent the standard trauma evaluation upon presentation, including physical examination of the external genitalia. Management was dictated by the presence or absence of a penetrating injury to the scrotum and associated traumatic injuries. Nonoperative and operative management of traumatic injury to the scrotum were used. Testicular salvage was performed when anatomically feasible. If testicular salvage was not feasible, an orchiectomy was performed. Scrotal exploration was performed in 91 (94%) patients while six (6%) patients were treated nonoperatively. Testicular injury was found in 44 (48%) patients undergoing exploration, six (7%) of whom had bilateral testicular injuries, which gave a total of 50 injured testicles. Of the injured testicles, 24 (48%) could not be salvaged and required orchiectomy, while 26 (52%) were debrided and repaired. The most common associated genitourinary (GU) injuries were to the corpora cavernosum (n= 20 [21%]) and urethra (n= 10 [10%]). Soft tissue injury of the extremities occurred in 54 patients (56

The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil.

PubMed

Ferrer, Glênio César Nunes; da Silva, Rosemeri Maurici; Ferrer, Kelian Tenfen; Traebert, Jefferson

2014-01-01

To estimate the burden of disease due to tuberculosis in the state of Santa Catarina, Brazil, in 2009. This was an epidemiological study with an ecological design. Data on tuberculosis incidence and mortality were collected from specific Brazilian National Ministry of Health databases. The burden of disease due to tuberculosis was based on the calculation of disability-adjusted life years (DALYs). The DALYs were estimated by adding the years of life lost (YLLs) and years lived with disability (YLDs). Absolute values were transformed into rates per 100,000 population. The rates were calculated by gender, age group, and health care macroregion. The burden of disease due to tuberculosis was 5,644.27 DALYs (92.25 DALYs/100,000 population), YLLs and YLDs respectively accounting for 78.77% and 21.23% of that total. The highest rates were found in males in the 30-44 and 45-59 year age brackets, although that was not true in every health care macroregion. Overall, the highest estimated burden was in the Planalto Norte macroregion (179.56 DALYs/100,000 population), followed by the Nordeste macroregion (167.07 DALYs/100,000 population). In the majority of the health care macroregions of Santa Catarina, the burden of disease due to tuberculosis was concentrated in adult males, the level of that concentration varying among the various macroregions.

The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil*, **

PubMed Central

Ferrer, Glênio César Nunes; da Silva, Rosemeri Maurici; Ferrer, Kelian Tenfen; Traebert, Jefferson

2014-01-01

OBJECTIVE: To estimate the burden of disease due to tuberculosis in the state of Santa Catarina, Brazil, in 2009. METHODS: This was an epidemiological study with an ecological design. Data on tuberculosis incidence and mortality were collected from specific Brazilian National Ministry of Health databases. The burden of disease due to tuberculosis was based on the calculation of disability-adjusted life years (DALYs). The DALYs were estimated by adding the years of life lost (YLLs) and years lived with disability (YLDs). Absolute values were transformed into rates per 100,000 population. The rates were calculated by gender, age group, and health care macroregion. RESULTS: The burden of disease due to tuberculosis was 5,644.27 DALYs (92.25 DALYs/100,000 population), YLLs and YLDs respectively accounting for 78.77% and 21.23% of that total. The highest rates were found in males in the 30-44 and 45-59 year age brackets, although that was not true in every health care macroregion. Overall, the highest estimated burden was in the Planalto Norte macroregion (179.56 DALYs/100,000 population), followed by the Nordeste macroregion (167.07 DALYs/100,000 population). CONCLUSIONS: In the majority of the health care macroregions of Santa Catarina, the burden of disease due to tuberculosis was concentrated in adult males, the level of that concentration varying among the various macroregions. PMID:24626271

The solution of large multi-dimensional Poisson problems

NASA Technical Reports Server (NTRS)

Stone, H. S.

1974-01-01

The Buneman algorithm for solving Poisson problems can be adapted to solve large Poisson problems on computers with a rotating drum memory so that the computation is done with very little time lost due to rotational latency of the drum.

Use of large-scale acoustic monitoring to assess anthropogenic pressures on Orthoptera communities.

PubMed

Penone, Caterina; Le Viol, Isabelle; Pellissier, Vincent; Julien, Jean-François; Bas, Yves; Kerbiriou, Christian

2013-10-01

Biodiversity monitoring at large spatial and temporal scales is greatly needed in the context of global changes. Although insects are a species-rich group and are important for ecosystem functioning, they have been largely neglected in conservation studies and policies, mainly due to technical and methodological constraints. Sound detection, a nondestructive method, is easily applied within a citizen-science framework and could be an interesting solution for insect monitoring. However, it has not yet been tested at a large scale. We assessed the value of a citizen-science program in which Orthoptera species (Tettigoniidae) were monitored acoustically along roads. We used Bayesian model-averaging analyses to test whether we could detect widely known patterns of anthropogenic effects on insects, such as the negative effects of urbanization or intensive agriculture on Orthoptera populations and communities. We also examined site-abundance correlations between years and estimated the biases in species detection to evaluate and improve the protocol. Urbanization and intensive agricultural landscapes negatively affected Orthoptera species richness, diversity, and abundance. This finding is consistent with results of previous studies of Orthoptera, vertebrates, carabids, and butterflies. The average mass of communities decreased as urbanization increased. The dispersal ability of communities increased as the percentage of agricultural land and, to a lesser extent, urban area increased. Despite changes in abundances over time, we found significant correlations between yearly abundances. We identified biases linked to the protocol (e.g., car speed or temperature) that can be accounted for ease in analyses. We argue that acoustic monitoring of Orthoptera along roads offers several advantages for assessing Orthoptera biodiversity at large spatial and temporal extents, particularly in a citizen science framework. © 2013 Society for Conservation Biology.

High Fidelity Simulations of Large-Scale Wireless Networks

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

Onunkwo, Uzoma; Benz, Zachary

The worldwide proliferation of wireless connected devices continues to accelerate. There are 10s of billions of wireless links across the planet with an additional explosion of new wireless usage anticipated as the Internet of Things develops. Wireless technologies do not only provide convenience for mobile applications, but are also extremely cost-effective to deploy. Thus, this trend towards wireless connectivity will only continue and Sandia must develop the necessary simulation technology to proactively analyze the associated emerging vulnerabilities. Wireless networks are marked by mobility and proximity-based connectivity. The de facto standard for exploratory studies of wireless networks is discrete event simulationsmore » (DES). However, the simulation of large-scale wireless networks is extremely difficult due to prohibitively large turnaround time. A path forward is to expedite simulations with parallel discrete event simulation (PDES) techniques. The mobility and distance-based connectivity associated with wireless simulations, however, typically doom PDES and fail to scale (e.g., OPNET and ns-3 simulators). We propose a PDES-based tool aimed at reducing the communication overhead between processors. The proposed solution will use light-weight processes to dynamically distribute computation workload while mitigating communication overhead associated with synchronizations. This work is vital to the analytics and validation capabilities of simulation and emulation at Sandia. We have years of experience in Sandia’s simulation and emulation projects (e.g., MINIMEGA and FIREWHEEL). Sandia’s current highly-regarded capabilities in large-scale emulations have focused on wired networks, where two assumptions prevent scalable wireless studies: (a) the connections between objects are mostly static and (b) the nodes have fixed locations.« less

Large impacts and the evolution of Venus; an atmosphere/mantle coupled model.

NASA Astrophysics Data System (ADS)

Gillmann, Cedric; Tackley, Paul; Golabek, Gregor

2014-05-01

We investigate the evolution of atmosphere and surface conditions on Venus through a coupled model of mantle/atmosphere evolution by including meteoritic impacts mechanisms. Our main focuses are mechanisms that deplete or replenish the atmosphere: volcanic degassing, atmospheric escape and impacts. The coupling is obtained using feedback of the atmosphere on the mantle evolution. Atmospheric escape modeling involves two different aspects: hydrodynamic escape (dominant during the first few hundred million years) and non-thermal escape mechanisms as observed by the ASPERA instrument. Post 4 Ga escape is low. The atmosphere is replenished by volcanic degassing, using an adapted version of the StagYY mantle dynamics model (Armann and Tackley, 2012) and including episodic lithospheric overturn. Volatile fluxes are estimated for different mantle compositions and partitioning ratios. The evolving surface temperature is calculated from CO2 and water in the atmosphere with a gray radiative-convective atmosphere model. This surface temperature in turn acts as a boundary condition for the mantle dynamics model and has an influence on the convection, volcanism and subsequent degassing. We take into account the effects of meteorites in our simulations by adapting each relevant part of the model. They can bring volatiles as well as erode the atmosphere. Mantle dynamics are modified since the impact itself can also bring large amounts of energy to the mantle. A 2D distribution of the thermal anomaly due to the impact is used and can lead to melting. Volatile evolution due to impacts (especially the large ones) is heavily debated so we test a broad range of impactor parameters (size, velocity, timing) and test different assumptions related to impact erosion going from large eroding power (Ahrens 1993) to recent parameterization (Shuvalov, 2009, 2010). We are able to produce models leading to present-day-like conditions through episodic volcanic activity consistent with Venus

Meta-ethnography 25 years on: challenges and insights for synthesising a large number of qualitative studies.

PubMed

Toye, Francine; Seers, Kate; Allcock, Nick; Briggs, Michelle; Carr, Eloise; Barker, Karen

2014-06-21

Studies that systematically search for and synthesise qualitative research are becoming more evident in health care, and they can make an important contribution to patient care. Our team was funded to complete a meta-ethnography of patients' experience of chronic musculoskeletal pain. It has been 25 years since Noblit and Hare published their core text on meta-ethnography, and the current health research environment brings additional challenges to researchers aiming to synthesise qualitative research. Noblit and Hare propose seven stages of meta-ethnography which take the researcher from formulating a research idea to expressing the findings. These stages are not discrete but form part of an iterative research process. We aimed to build on the methods of Noblit and Hare and explore the challenges of including a large number of qualitative studies into a qualitative systematic review. These challenges hinge upon epistemological and practical issues to be considered alongside expectations about what determines high quality research. This paper describes our method and explores these challenges. Central to our method was the process of collaborative interpretation of concepts and the decision to exclude original material where we could not decipher a concept. We use excerpts from our research team's reflexive statements to illustrate the development of our methods.

Approaches to the Management of Large Classes. Lancaster-Leeds Language Learning in Large Classes Research Project. Report, No. 11.

ERIC Educational Resources Information Center

Coleman, Hywel

Various approaches to the management of large classes identified in the literature are categorized, with information drawn especially from earlier findings of the Lancaster-Leeds Language Learning in Large Classes Research Project. The discussion makes use of sources appearing during the last 150 years, but emphasizes the period since 1960. Three…

Searching for Dark Matter Annihilation from Milky Way Dwarf Spheroidal Galaxies with Six Years of Fermi Large Area Telescope Data.

PubMed

Ackermann, M; Albert, A; Anderson, B; Atwood, W B; Baldini, L; Barbiellini, G; Bastieri, D; Bechtol, K; Bellazzini, R; Bissaldi, E; Blandford, R D; Bloom, E D; Bonino, R; Bottacini, E; Brandt, T J; Bregeon, J; Bruel, P; Buehler, R; Caliandro, G A; Cameron, R A; Caputo, R; Caragiulo, M; Caraveo, P A; Cecchi, C; Charles, E; Chekhtman, A; Chiang, J; Chiaro, G; Ciprini, S; Claus, R; Cohen-Tanugi, J; Conrad, J; Cuoco, A; Cutini, S; D'Ammando, F; de Angelis, A; de Palma, F; Desiante, R; Digel, S W; Di Venere, L; Drell, P S; Drlica-Wagner, A; Essig, R; Favuzzi, C; Fegan, S J; Ferrara, E C; Focke, W B; Franckowiak, A; Fukazawa, Y; Funk, S; Fusco, P; Gargano, F; Gasparrini, D; Giglietto, N; Giordano, F; Giroletti, M; Glanzman, T; Godfrey, G; Gomez-Vargas, G A; Grenier, I A; Guiriec, S; Gustafsson, M; Hays, E; Hewitt, J W; Horan, D; Jogler, T; Jóhannesson, G; Kuss, M; Larsson, S; Latronico, L; Li, J; Li, L; Llena Garde, M; Longo, F; Loparco, F; Lubrano, P; Malyshev, D; Mayer, M; Mazziotta, M N; McEnery, J E; Meyer, M; Michelson, P F; Mizuno, T; Moiseev, A A; Monzani, M E; Morselli, A; Murgia, S; Nuss, E; Ohsugi, T; Orienti, M; Orlando, E; Ormes, J F; Paneque, D; Perkins, J S; Pesce-Rollins, M; Piron, F; Pivato, G; Porter, T A; Rainò, S; Rando, R; Razzano, M; Reimer, A; Reimer, O; Ritz, S; Sánchez-Conde, M; Schulz, A; Sehgal, N; Sgrò, C; Siskind, E J; Spada, F; Spandre, G; Spinelli, P; Strigari, L; Tajima, H; Takahashi, H; Thayer, J B; Tibaldo, L; Torres, D F; Troja, E; Vianello, G; Werner, M; Winer, B L; Wood, K S; Wood, M; Zaharijas, G; Zimmer, S

2015-12-04

The dwarf spheroidal satellite galaxies (dSphs) of the Milky Way are some of the most dark matter (DM) dominated objects known. We report on γ-ray observations of Milky Way dSphs based on six years of Fermi Large Area Telescope data processed with the new Pass8 event-level analysis. None of the dSphs are significantly detected in γ rays, and we present upper limits on the DM annihilation cross section from a combined analysis of 15 dSphs. These constraints are among the strongest and most robust to date and lie below the canonical thermal relic cross section for DM of mass ≲100  GeV annihilating via quark and τ-lepton channels.

20 years of mass balances on the Piloto glacier, Las Cuevas river basin, Mendoza, Argentina

NASA Astrophysics Data System (ADS)

Leiva, J. C.; Cabrera, G. A.; Lenzano, L. E.

2007-10-01

Climatic changes of the 20th century have altered the water cycle in the Andean basins of central Argentina. The most visible change is seen in the mountain glaciers, with loss of part of their mass due to decreasing thickness and a substantial recession in the last 100 years. This paper briefly describes the results of glacier mass balance research since 1979 in the Piloto Glacier at the Cajón del Rubio, in the headwaters of Las Cuevas River, presenting new results for the period 1997-2003. Very large interannual variability of net annual specific balance is evident, due largely to variations in winter snow accumulation, with a maximum net annual value of + 151 cm w.e. and a minimum value of - 230 cm w.e. Wet El Niño years are normally associated with positive net annual balances, while dry La Niña years generally result in negative balances. Within the 24-year period, 67% of the years show negative net annual specific balances, with a cumulative mass balance loss of - 10.50 m water equivalent (w.e.). Except for exceptions normally related to El Niño events, a general decreasing trend of winter snow accumulation is evident in the record, particularly after 1992, which has a strong effect in the overall negative mass balance values. The glacier contribution to Las Cuevas River runoff is analysed based on the Punta de Vacas River gauge station for a hypothetical year without snow precipitation (YWSP), when the snowmelt component is zero. Extremely dry years similar to a YWSP have occurred in 1968-1969, 1969-1970 and 1996-1997. The Punta de Vacas gauge station is located 62 km downstream from Piloto Glacier, and the basin contains 3.0% of uncovered glacier ice and 3.7% of debris-covered ice. The total glacier contribution to Las Cuevas River discharge is calculated as 82 ± 8% during extremely dry years. If glacier wastage continues at the present trend as observed during the last 2 decades, it will severely affect the water resources in the arid central Andes of

[Results and evaluation of 3 years of a large scale mammography program in the Ariana area of Tunisia].

PubMed

Bouchlaka, A; Ben Abdallah, M; Ben Aissa, R; Zaanouni, E; Kribi, L; Smida, S; M'barek, F; Ben Hamida, A; Boussen, H; Gueddana, N

2009-07-01

To asses and analyse the results of 3 years large scale mammography screening of breast cancer in Ariana state in Tunisia. This program, managed by the Family and Population National Office, was addressing to women aged from 49 to 69 years old residing in a area with adds up a population of 459 700 inhabitants including 52,729 women in the target age population. The screening was including a breast clinical examination and a mammography with two incidences face and external profile. The women was invited at their residence or were sensitized in the reproductive health centers, care and base health centers or by a close relation which heard of the program. An enlightened assent was submitted to the women who wished to profit from the screening. In three years, 9093 mammography were carried out of which 8244 were retained in the analyses, that is to say a rate participation of 9.6%. The rate of women recalled for suspect test was of 18.1% and it was of 13.1% among women of more than 50 years. The rate of practiced surgical biopsies was of 0.5% and the positive predictive value was of 45.5%. The average time between the date of screening and the result of the screening was 9.7 days, more important in the event of tests requiring a complementary assessment (61.7 days). On the whole 40 cancers were detected by the program, that is to say a rough rate of detected cancers, of 4.9 per thousand, in conformity with the recommendations. The percentage of invasive cancers < or = 10 mm was of 24.3 whereas percentages of in situ cancers and of cancers without ganglionic invasion were respectively of 7.7% and of 50.0%. The weakness of our study lay primarily in the rate of participation which remained weak. The methodology adopted for the sensitizing of the women is proven not very effective and did not allow inviting all eligible women. Results of the study are encouraging in spite of its limited impact and made it possible to detect an important rate of cancers of which cancers

The effect of sea-water intrusion due to the large scale construction in a coastal region

NASA Astrophysics Data System (ADS)

Hyun, S.; Jin, S.; Woo, N. C.; Lee, J.; Lee, H.; Kim, Y.

2010-12-01

This study was carried out for estimating the seawater intrusion at the disturbed aquifer by a large scale construction when building a power plant in a coastal region, located in southeastern part of the Korean peninsula. Groundwater sampling and vertical profiling of electrical conductivity(EC) for 8 monitoring wells were carried. EC profiling results shows that maximum EC for PW-5, 6 and 7 is over 40 mS/cm, for PZ-1, 3, 4 and 8 is 18.76, 4.46, 26.16, 21.42 mS/cm and for PZ-2 is 0.79 mS/cm,respectively. Chemical composition of water samples shows that water types of Na-Cl for PZ-5, 6, and 7 (excavated and backfilled area), Na-Cl-SO4 for PZ-4 and PZ-8, Na-Ca-Mg-Cl for PZ-1, Ca-Na-SO4-Cl for PZ-2, and Mg-Ca-Na-SO4 for PZ-3. In addition, the bivariate plot of SO4/Cl(meq ratios) and SO4(mmol/L) indicates that PZ-4, 5, 6, 7 and 8 appear to be seawater, PZ-1 is located at mixing zone between freshwater and seawater, and PZ-2 is freshwater. However, based on the high SO42- level and (HCO3-/Sum anions} ratio less than 0.8, groundwater at PZ-3 seems to show the gypsum dissolution. The gypsum dissolution was attributed to the effect of sea-water intrusion on ageing of lean concrete that was used for backfill around the PZ-3. Key words : large scale construction, EC profiling, hydrochemistry, sea-water intrusion, concrete ageing Acknowledgement This study has been carried out under the Nuclear R&D Program [No. 2010-0001070] supported by the Ministry of Education, Science and Technology, Republic of Korea.

Massive malignant pleural effusion due to lung adenocarcinoma in 13-year-old boy.

PubMed

Afghani, Reza; Hajimohammadi, Amir; Azarhoush, Ramin; Kazemi-Nejad, Vahideh; Yari, Behrouz; Rezapour Esfahani, Mona

2016-05-01

A 13-year-old boy with no risk factors for lung cancer presented with a massive left-sided pleural effusion and a mediastinal shift on chest radiography and computed tomography. A chest tube drained bloody pleural fluid with an exudative pattern. A pleural biopsy and wedge biopsy of the left lower lobe revealed mucinous adenocarcinoma in the left lower lobe wedge biopsy and metastatic adenocarcinoma in the pleural biopsy. The patient is currently undergoing chemotherapy. Radiotherapy is planned after shrinkage of the tumor. Adenocarcinoma of the lung is very rarely seen in teenagers or children, especially in the absence of risk factors. © The Author(s) 2016.

A large high-efficiency multi-layered Micromegas thermal neutron detector

NASA Astrophysics Data System (ADS)

Tsiledakis, G.; Delbart, A.; Desforge, D.; Giomataris, I.; Menelle, A.; Papaevangelou, T.

2017-09-01

Due to the so-called 3He shortage crisis, many detection techniques used nowadays for thermal neutrons are based on alternative converters. Thin films of 10B or 10B4C are used to convert neutrons into ionizing particles which are subsequently detected in gas proportional counters, but only for small or medium sensitive areas so far. The micro-pattern gaseous detector Micromegas has been developed for several years in Saclay and is used in a wide variety of neutron experiments combining high accuracy, high rate capability, excellent timing properties and robustness. We propose here a large high-efficiency Micromegas-based neutron detector with several 10B4C thin layers mounted inside the gas volume for thermal neutron detection. The principle and the fabrication of a single detector unit prototype with overall dimension of ~ 15 × 15 cm2 and a flexibility of modifying the number of layers of 10B4C neutron converters are described and simulated results are reported, demonstrating that typically five 10B4C layers of 1-2 μm thickness can lead to a detection efficiency of 20-40% for thermal neutrons and a spatial resolution of sub-mm. The design is well adapted to large sizes making possible the construction of a mosaic of several such detector units with a large area coverage and a high detection efficiency, showing the good potential of this novel technique.

Is mudflow in Sidoarjo, East Java due to the pumping mechanism of hot air bubbles? : Laboratory simulations and field observations

NASA Astrophysics Data System (ADS)

Nurhandoko, Bagus Endar B.

2015-09-01

Extraordinary mudflow has happened in Sidoarjo, East Java, Indonesia since 2006. This mud comes from the giant crater that is located close to the BJP - 01. Thousands of homes have been submerged due to mudflow. Till today this giant mud crater is still has great strength despite the mud flowing over 8 years. This is a very rare phenomenon in the world. This mud flow mechanism raises big questions, because it has been going on for years, naturally the mudflow will stop by itself because the pressure should be reduced. This research evaluates all aspects of integrated observations, laboratory tests and field observations since the beginning of this ongoing mudflow. Laboratory tests were done by providing hot air bubbles into the fluid inside the inverted funnel showed that the fluid can flow with a high altitude. It is due to the mechanism of buoyant force from air bubbles to the water where the contrast density of the water and the air is quite large. Quantity of air bubbles provides direct effect to the debit of fluid flow. Direct observation in the field, in 2006 and 2007, with TIMNAS and LPPM ITB showed the large number of air bubbles on the surface of the mud craters. Temperature observation on the surface of mud crater is around 98 degree C whereas at greater depth shows the temperature is increasingly rising. This strengthens the hypothesis or proves that the mud pumping mechanism comes from buoyant force of hot air bubbles. Inversion gravity images show that the deep subsurface of main crater is close to volcanic layers or root of Arjuna mountain. Based on the simulation laboratory and field observation data, it can be concluded that the geothermal factor plays a key role in the mudflow mechanism.

[Current epidemiological status of causes of disease among patients with liver disease hospitalized in Department of Infectious Diseases in a large general hospital within the past 20 years].

PubMed

Zhao, R H; Ma, K; Hu, J; Chen, C X; Qi, J Y

2018-02-20

Objective: To investigate the causes of disease among patients with liver disease hospitalized in Department of Infectious Diseases in our hospital and the changes in such causes within the past 20 years. Methods: A retrospective analysis was performed for the clinical data of 7570 patients who were admitted to our hospital from January 1995 to December 2015. The chi-square test was used for the statistical analysis of constituent ratio. Results: Of all 7570 patients with liver disease, 4930 (65.13%) had viral hepatitis, 332 (4.39%) had immune disease, 215 (2.84%) had drug-induced liver injury, 192 (2.54%) had fatty liver disease, 88 (1.16%) had schistosome-induced liver disease, 160 (2.11%) had inherited metabolic diseases, and 20 (0.13%) had vascular disease; 689 (9.1%) still had no clear cause of disease at discharge. The proportion of patients with viral hepatitis was 77.61% in the first 10 years and 59.19% in the last 10 years ( P < 0.01). As for liver disease caused by hepatotropic virus, there were significant increases in the proportion of patients with hepatitis C or hepatitis E from the first to the last 10 years (hepatitis C: 2.24% vs 15.56%, P < 0.01; hepatitis E: 18.61% vs 23.07%, P < 0.05), while there were significant reductions in the proportion of patients with hepatitis B (68.14% vs 60.01%, P < 0.05) or hepatitis A (10.7% vs 1.36%, P < 0.05). The proportion of patients with immune diseases was 0.82% in the first 10 years and 6.08% in the last 10 years ( P < 0.01). There were also certain changes in the proportion of patients with liver disease caused by other reasons. Conclusion: There is a large proportion of patients with viral hepatitis among patients with liver disease hospitalized in Department of Infectious Diseases in a large general hospital, especially hepatitis B and E caused by hepatotropic virus. There is a certain change in the epidemiology of liver disease within the past 20 years, with a reduction in the proportion of patients with

Large space structures testing

NASA Technical Reports Server (NTRS)

Waites, Henry; Worley, H. Eugene

1987-01-01

There is considerable interest in the development of testing concepts and facilities that accurately simulate the pathologies believed to exist in future spacecraft. Both the Government and Industry have participated in the development of facilities over the past several years. The progress and problems associated with the development of the Large Space Structure Test Facility at the Marshall Flight Center are presented. This facility was in existence for a number of years and its utilization has run the gamut from total in-house involvement, third party contractor testing, to the mutual participation of other goverment agencies in joint endeavors.

[Severe generalized dystonia due to postradiotherapy cerebral calcifications].

PubMed

Chanson, J-B; Anheim, M; Lagha-Boukbiza, O; Fleury, M; Sellal, F; Tranchant, C

2008-05-01

Cerebral calcifications are a cause of secondary dystonia and may be an uncommon complication of radiotherapy. We report a very severe case of generalized dystonia due to postradiotherapy basal ganglia calcifications. An 8-year-old girl received 53 grays radiotherapy after surgery for craniopharyngioma. One year later she developed generalized dystonia. Computed tomography showed bilateral basal ganglia calcifications, especially of the lenticular nuclei. Pharmacological treatment with tetrabenazine, clonazepam and trihexiphenydile allowed a very limited improvement of dystonia; the course was complicated by dystonic storms and decompensations resulting from the iatrogenous panhypopituitarism. This case illustrates a severe complication of cranial irradiation which should be considered in the indications of this treatment, especially for children.

Recurrent mycobacterial osteomyelitis. Report of a case due to Mycobacterium avium-intracellulare-scrofulaceum complex and BCG vaccination.

PubMed

Solheim, L F; Kjelsberg, F

1982-01-01

A 28-year-old man suffering from recurrent mycobacterial osteomyelitis during several years is reported. Eight years old he had a Mycobacterium scrofulaceum infection in his right calcaneus. A serious infection with multiple foci of osteomyelitis occurred after BCG vaccination at the age of 14 years and 11 years later multifocal lesions of osteomyelitis due to Mycobacterium avium-intracellulare-scrofulaceum complex appeared. The special clinical problems due to the relative or complete resistence of these organisms to antituberculous drugs are emphasized. The mainstays of treatment are surgical revision and drainage with prolonged and intensive multiple drug therapy.

Cognitive Trajectory Changes Over 20 Years Before Dementia Diagnosis: A Large Cohort Study.

PubMed

Li, Ge; Larson, Eric B; Shofer, Jane B; Crane, Paul K; Gibbons, Laura E; McCormick, Wayne; Bowen, James D; Thompson, Mary Lou

2017-12-01

Longitudinal studies have shown an increase in cognitive decline many years before clinical diagnosis of dementia. We sought to estimate changes, relative to "normal" aging, in the trajectory of scores on a global cognitive function test-the Cognitive Abilities Screening Instrument (CASI). A prospective cohort study. Community-dwelling members of a U.S. health maintenance organization. Individuals aged 65 and older who had no dementia diagnosis at baseline and had at least two visits with valid CASI test score (N = 4,315). Average longitudinal trajectories, including changes in trajectory before clinical diagnosis in those who would be diagnosed with dementia, were estimated for CASI item response theory (IRT) scores. The impact of sex, education level, and APOE genotype on cognitive trajectories was assessed. Increased cognitive decline relative to "normal" aging was evident in CASI IRT at least 10 years before clinical diagnosis. Male gender, lower education, and presence of ≥1 APOE ε4 alleles were associated with lower average IRT scores. In those who would be diagnosed with dementia, a trajectory change point was estimated at an average of 3.1 years (95% confidence interval 3.0-3.2) before clinical diagnosis, after which cognitive decline appeared to accelerate. The change point did not differ by sex, education level, or APOE ε4 genotype. There were subtle differences in trajectory slopes by sex and APOE ε4 genotype, but not by education. Decline in average global cognitive function was evident at least 10 years before clinical diagnosis of dementia. The decline accelerated about 3 years before clinical diagnosis. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Large natural geophysical events: planetary planning

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

Knox, J.B.; Smith, J.V.

1984-09-01

Geological and geophysical data suggest that during the evolution of the earth and its species, that there have been many mass extinctions due to large impacts from comets and large asteroids, and major volcanic events. Today, technology has developed to the stage where we can begin to consider protective measures for the planet. Evidence of the ecological disruption and frequency of these major events is presented. Surveillance and warning systems are most critical to develop wherein sufficient lead times for warnings exist so that appropriate interventions could be designed. The long term research undergirding these warning systems, implementation, and proofmore » testing is rich in opportunities for collaboration for peace.« less

Diffuse large B-cell lymphoma: 10 years' real-world clinical experience with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone.

PubMed

Horvat, Matej; Zadnik, Vesna; Južnič Šetina, Tanja; Boltežar, Lučka; Pahole Goličnik, Jana; Novaković, Srdjan; Jezeršek Novaković, Barbara

2018-03-01

Treatment with rituximab plus a regimen of cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) for patients with diffuse large B-cell lymphoma (DLBCL) has proven efficacy in clinical trials. The present study investigated its application in clinical practice. This single-center, retrospective database analysis included patients with DLBCL treated at the Slovenian Institute of Oncology Ljubljana between 2004 and 2013. Overall survival (OS) and progression-free survival (PFS) were assessed according to International Prognostic Index (IPI) and revised IPI (R-IPI) categories. Overall, 573 patients with DLBCL were included in the study (median follow-up, 45.3 months; range, 0.1-143.0). Patients were categorized as IPI 'low' (n=170; 30%), 'low-intermediate' (n=134; 23%), 'high-intermediate' (n=129; 23%) and 'high' (n=140; 24%) risk. R-IPI groups were indicated with 'very good' (n=59; 10%), 'good' (n=245; 43%) and 'poor' (n=269; 47%) prognosis. Ten-year OS and PFS rates were 51 and 72%, respectively; median OS was 124 months and median PFS was not reached. Ten-year OS rates were 80 and 87% in low-risk and 'very good' prognosis groups, respectively, and 30 and 37% in high-risk and poor prognosis patients, respectively. This analysis of patients with DLBCL indicated that many patients treated with R-CHOP and R-CHOP-like regimens in the real-world setting have excellent outcomes.

Groundwater resources vulnerability due to melting glaciers in the Talgar alluvian fan, northern Tien-Shan

NASA Astrophysics Data System (ADS)

Saks, Tomas; Timuhins, Andrejs; Sennikovs, Juris; Ibraimov, Vitaliy; Sotnikov, Evgeniy; Salybekova, Valentina; Rahimov, Timur; Popovs, Konrads

2017-04-01

Alluvial fans on the mountain slopes in Central Asia are an important source of the groundwater, due to there capacity of storing large quantities of the fresh groundwater and due to the fact that most urban centres are situated in the mountainous terrain or along mountain slopes. The groundwater resources in the alluvial fans are replenished by the infiltration from the rivers, which drain the mountain catchments and by infiltration from the precipitation, and released on there lower reaches as a series of seasonal springs or infiltrated into the lower lying aquifers. The rivers with there catchments in the mountainous terrain are fed by the precipitation (with the peak in May-June due to snow melt) and glacier melt. The glacier meltwater constitutes up to 90% of the river runoff in July-August, due to peak in glacier melt and low precipitation, providing much needed freshwater for agriculture in the dry season. In this study an attempt to quantify the importance of the glacier meltwater on the groundwater resources through groundwater modelling in the Talgar alluvial fan, Ili-Alatau mountain range has been performed. The results suggest that glacier meltwater is a substantial portion of the groundwater resources in the Talgar alluvial fan, with up to 30m drop of the groundwater level, if the glaciers disappear, endangering existing groundwater supply. The transient simulations suggest that disappearance of the glaciers and highly variable annual precipitation would result in highly fluctuating groundwater levels, as well as disappearance of most of the springs at the foot of the alluvial fan. These results are especially relevant for the northern Tien-Shan, where glaciers have been rapidly retreating over last 50 years, and some of the glaciers could disappear in next decades.

Human meningitis due to Streptococcus suis in Lomé, Togo: a case report.

PubMed

Prince-David, Mireille; Salou, Mounerou; Marois-Créhan, Corinne; Assogba, Komi; Plainvert, Céline; Balogou, Koffi A; Poyart, Claire; Tazi, Asmaa

2016-11-08

Streptococcus suis is a zoonotic pathogen which represents the leading cause of meningitis in Southeast Asia and an emerging pathogen in the Western world, the main risk factor for infection being contact with pigs. In Africa, the prevalence of S. suis infections in swine and humans is largely unrecognized, with only one recent report of a limited case series. We describe a human case of meningitis due to S. suis in a 32-year-old man living in Togo. The patient had no particular medical history and no risk factors for immunodeficiency but reported regular contact with pork products. Using specific immunological and molecular methods, we characterized the isolate as S. suis serotype 2, ST1, one the most prevalent and virulent clone worldwide. The outcome was favorable after one week of adapted antibiotic therapy but the patient was left with severe hearing disorders. This work highlights the emergence of this pathogen in Africa and reinforces the need for accurate epidemiological and surveillance studies of S. suis infections and for educating clinicians and exposed groups in non-endemic countries.

Angelman syndrome due to paternal uniparental disomy of chromosome 15: A milder phenotype?

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

Bottani, A.; Robinson, W.P.; DeLoizer-Blanchet, C.D.

1994-05-15

The Angelman syndrome (AS) is a neurological disorder characterized by severe mental retardation, absent speech, seizures, gait disturbances, and a typical age-dependent facial phenotype. Most cases are due to an interstitial deletion on the maternally inherited chromosome 15, in the critical region q11-q13. Rare cases also result from paternal uniparental disomy of chromosome 15. In a group of 14 patients with sporadic AS diagnosed in Switzerland, we found 2 unrelated females with paternal isodisomy for the entire chromosome 15. Their phenotypes were milder than usually seen in this syndrome: one girl did not show the typical AS facial changes; bothmore » patients had late-onset mild seizures; as they grow older, they had largely undisturbed gross motor functions, in particular no severe ataxia. Both girls were born to older fathers (45 and 43 years old, respectively). The apparent association of a relatively milder phenotype in AS with paternal uniparental disomy will have to be confirmed by detailed clinical descriptions of further patients. 25 refs., 2 figs., 1 tab.« less

The HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year): design of a large prospective cohort study.

PubMed