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In this note, we describe a large-scale transition to an active learning format in first-semester calculus at the University of Florida. Student performance and attitudes are compared across traditional lecture and flipped sections. [ABSTRACT FROM AUTHOR]

Reflecting the need to protect concrete structures from deicing salt and freeze-thaw loading, the study introduced in this paper springs from the uncertainty that exists in the benefit of in situ performance of isobutyl silane as a protection material. It is likely that environmental loading and internal moisture at the time of application are the main contributory factors for underperformance. This paper deals with alternative materials—a high-solids silane and an aqueous crystallization solution—operating by a moisture-driven crystallization mechanism rather than demanding a dry application regime. The results demonstrated similar substantial performance reduction of both materials at 0–5% moisture on medium-strength (C25: 25 N/mm2) and high-strength (C40: 40 N/mm2) concrete. There is greater take-up of protection materials by C25 concrete than by C40 concrete, together with greater chloride reduction, indicating that the level of achieved dosing is a significant factor. The similarity between the absorption of water and of the two protection materials relative to initial water content points to a possible basis for predicting achievable dosing of surface-applied protection materials. The crystallization material achieved greater application volume and chloride reduction than the silane material. [ABSTRACT FROM AUTHOR]

Cormorants Phalacrocorax carbo have increased on European freshwaters, creating conflicts with fishing interests. As a result, control measures have been implemented in several countries, although their effect on the English population has yet to be determined. Wetland Bird Survey data was used to derive population growth rates (PGR) of non-coastal Cormorant populations in England. PGR was analysed in relation to control intensity at different scales (5- to 30-km radius) from 2001 to 2009 in order to determine (1) the extent to which control intensity (proportion of the local population shot per winter) was associated with site-level population change, and (2) whether potential effects of control intensity were evident on Special Protection Areas (SPAs). There were no clear differences in PGR when comparing sites which had experienced control versus sites where control had never been carried out. The few significant relationships between control intensity and Cormorant PGR detected were mostly positive, i.e. population growth was associated with higher control intensity. Control intensity was not related to Cormorant numbers in SPAs. Positive associations with control may arise because control is reactive, or because non-lethal effects cause greater dispersal of Cormorants. These results provide no evidence that Cormorant removal at local scales is having an effect on longer term (i.e. year-to-year) population size at a site level. They also suggest that control measures have not affected national population trends, although a better understanding of site use and movements of individual Cormorants needs to be developed at smaller scales (including those due to disturbance caused by control measures) to more fully understand processes at larger scales. Further research is also needed into the extent to which lethal and non-lethal effects of control on Cormorants are having the desired impact on predation rates of fish, and so help resolve the conflict between Cormorants and fisheries. [ABSTRACT FROM AUTHOR]

The Black Grouse Tetrao tetrix is primarily a lekking species, although in some populations solitary display is also common. We analysed data from a 25-year-long survey of an increasing Black Grouse population in the western Italian Alps in order to test whether the numbers of males adopting different tactics conformed to patterns expected, based on the hypothesis that dominant birds occupy the leks and solitary displaying birds are subordinate, and that the tendency for birds to be excluded from leks increases with lek size. Four predictions were made to test this hypothesis: (1) the proportion of solitary males would increase as the overall population increases, (2) there would be a threshold at which there is little or no increase in the size of the lekking population, but continued increase in the population of solitary displaying birds, (3) available lek habitat would be occupied prior to an increase in solitary displaying males, and (4) there would be an increase in the use of less preferred habitat by solitary displaying males as the total population increases. Population trends varied according to display status, in that the lekking population reached an apparent threshold while the number of solitary males continued to increase, and there was an expansion of the range of solitary males into higher altitudes in years when the population was larger. However, there was no increase in the proportion of solitary males as the total population increased. Furthermore, there was no suggestion that suitable lek habitat was limiting, as the number of leks and the mean size of those leks continued to increase throughout the study period. Although two predictions were supported, the precise patterns of trends, and results of additional analyses, suggested that solitary display is more likely to be an alternative rather than a subordinate tactic. Several factors may promote this apparent dual display tactic in Black Grouse, but habitat structure in this and other Alpine populations is likely to be a key influence. [ABSTRACT FROM AUTHOR]

This paper summarizes the published evidence and reports from ongoing and completed projects that used Bibliotherapy and Information Prescription to deliver patient care. A literature search was conducted and relevant papers were summarized into: type of study, type of Bibliotherapy, client group and recommendations. In total, 65 papers were considered with 57 reviewed. A survey was also sent to Library Authorities subscribing to national survey standards asking for details about delivery of Information Prescription projects. There were 21 returned surveys. The experiences and recommendations were then summarized. The aim of the paper is to collate the evidence-base of written research and the experience and recommendations of projects into an easy format so that practitioners interested in using Bibliotherapy/Information Prescription/Books on Prescription have an understanding what they are, the extent of the evidence-base to inform practice, and highlight gaps in the research. [ABSTRACT FROM AUTHOR]

Habitat associations of 40 bird species were analysed using data from a survey of 12892 garden sites throughout the United Kingdom between 1995 and 2002. Gradients in 20 garden habitat variables and 25 variables describing the surrounding local habitat were derived from Detrended Correspondence Analysis. The main garden axis explained 13.3% of variation in the data and described a gradient from sites containing and bounded by high levels of vegetation cover to open sites bounded by walls and fences. The main local axis explained 29.9% of variation in the data and described a gradient from rural to urban habitats. Higher probability of occurrence was detected in larger sites in 25 species and in smaller sites in four (urban-associated) species. Many species (22 out of 40) were significantly associated with the local gradient: seven species showed the highest probability of occurrence in sites within more urbanised habitats. Other species were most likely to occur in sites within rural or suburban habitats. Only five species showed a significant association with garden habitat gradient, four of these being most likely to occur in sites with highest vegetation cover. These associations were similar when controlling for garden size and for food provision in gardens. The results imply that the likelihood of many species occurring in gardens is dependent on the surrounding local habitat rather than the garden habitat. However, survey participants were likely to have “bird-friendly” gardens which may have reduced the variation in garden habitat across the sample. An assessment of the representativeness of survey sites is needed to further understand habitat associations of garden birds. [ABSTRACT FROM AUTHOR]

Steel bridges require periodical inspection for possible deterioration and a program of maintenance and restoration tasks in order to prolong their life. Due to the varied size and geometry of bridges, as well as the complexity of all conservation procedures, their environmental impact and hazardous nature, efforts have been made to design an efficient automated facility to carry out these activities. The available tools and systems bear the characteristics leading to a versatile and efficient automated facility; however, there is still room for improvement, as none of the available automated systems provide a solution to the problem of steel bridge maintenance and restoration, which is applicable to a variety of bridge geometries and can attend to the whole of the bridge structure. The purpose of the present research is to gather data relating to tools and systems, critically review them, and identify their range and feasible limitations. The present paper identifies the commonly used inspection and restoration methods, then discusses their operational requirements and suitability for automation, as well as assesses commercially available automated or semi-automated systems. The overall result of the above identifies important parameters and attempts to quantify them. The collection of the data on available systems and tools, and their critical appraisal for any imperfections or inadequacies, serve towards either improvement or an alternative approach, giving a more efficacious end product. This paper would be of interest to researchers working towards general-purpose, steel restoration automated devices. [Copyright &y& Elsevier]

Abstract Patterns of change in distribution (presence/absence) and abundance since the late 1960s were examined in 20 species of farmland bird in southern Britain in predominantly arable (eastern), predominantly mixed (central) and predominantly grassland (western) regions. Comparisons were made between changes in distribution and in abundance to determine whether these measures show similar relationships to environmental change. Local extinctions of selected species and reductions in species richness were significantly greater in the predominantly grassland region. Decreases in abundance were greatest in seven species in the predominantly arable region, two in the mixed region and nine in the grassland region. Changes in distribution and abundance showed consistent patterns in three species, turtle dove Streptopelia turtur L., yellow wagtail Motacilla flava L. and reed bunting Emberiza schoeniclus L. In another four species, grey partridge Perdix perdix L., lapwing Vanellus vanellus L., tree sparrow Passer montanus L. and corn bunting Miliaria calandra L., decreases in abundance were greatest in the arable region, yet declines in distribution were lowest. For other individual species, changes in distribution were too small to draw any conclusions in relation to farm type. We suggest that modern grassland systems are suboptimal habitats compared to arable or mixed agricultural land for many farmland species that occur at relatively low density in the more western, grass-dominated region. Declines in abundance are therefore more likely to lead to local extinction in these areas than in eastern areas where abundance is higher. However, the role of changes in grassland management on bird populations requires further research. It is suggested that conclusions drawn from changes in distribution alone, in the absence of supporting data on changes in abundance, may be misleading where the aim is to assess how large-scale spatial dynamics of populations relate to environmental change. [ABSTRACT FROM AUTHOR]

Presents a question and answer advisory related to the administration of medical care in Great Britain. Treatment for a patient with coronary infarct and mild angina; Association of lobar pneumonia and jaundice; Effect of progestogen on pregnant women.

Focuses on the micro-Raman spectroscopy study of thin films of YBa...Cu...Co...O...grown by laser ablation. Reference to the growth pressure; Other information on the study.

We report on the epitaxial growth of YSr/sub 2/Cu/sub 2.75/Mo/sub 0.25/O/sub 7-/spl delta// (YSCMO) thin films by pulsed laser ablation, and discuss the superconducting find normal state transport properties of microbridges patterned from such films. To investigate the dopant oxygen mobility of this material, we have used electrical biases applied at near room temperature to induce long range displacement of chain oxygen vacancies in these microbridges. We find that with electromigration, the T/sub c/ of the microbridges can be raised to |60 K. This transition temperature is higher than any previously achieved for this compound, including the T/sub c/'s achieved. As result of extended very high pressure oxygen anneals, or by high pressure in situ measurements. Micro-Raman spectroscopy measurements have been used to examine and characterize the oxygen order in the film before and After electromigration. These measurements indicate that, as suggested by the final T/sub c/ achieved, a very high degree of oxygenation and chain oxygen order can be induced in the microbridge by this process. Thus the as-grown properties of YSCMO appear to be dominated by the low level of oxygenation and the low degree of oxygen homogeneity obtained by normal annealing processes. [ABSTRACT FROM PUBLISHER]

We report on the micro-Raman spectroscopy study of thin films of YBa/sub 2/Cu/sub 3-x/Co/sub x/O/sub 7-/spl delta// grown by laser ablation. Depending on the growth pressure, the films are found to be either homogenous or inhomogeneous on a scale /spl Gt/2 /spl mu/m. In either case the films are, on average, oxygen deficient, but this deficit can be substantially improved, yielding /spl delta/ less than zero in thin film microstructures treated by oxygen electromigration. This indicates that the Co addition to such films impedes, but does not forbid the attainment of a relatively optimal degree of occupancy of the dopant, chain oxygen sites. [ABSTRACT FROM PUBLISHER]

The article discusses the agri-environment schemes and population of farmland birds. Topics mention including the declines in the European farmland biodiversity,entry level scheme (ELS) and Higher Level Scheme (HLS) and most powerful assessment to date in the efficacy of HLS on the population of the birds.

A correction to the article "The dynamics of alternative male mating tactics in a population of Black Grouse Tetrao tetrix in the Italian Alps" that was published in the March 2013 issue is presented.

We present a case of bronchocentric granulomatosis in a woman with no history of asthma who was colonised with Aspergillusfumigatus. A family history of chronic granulomatous disease prompted further testing that demonstrated severely depressed neutrophil oxidant production and gp91(phox) deficiency compatible with the X linked carrier state of chronic granulomatous disease. Only one report of the association of these two rare diseases has previously appeared in the literature. We postulate that an ineffective immune response led to the prolonged colonisation of Afumigatus resulting in a hypersensitivity reaction that was manifest clinically as bronchocentric granulomatosis. [ABSTRACT FROM AUTHOR]

Presents an obituary for John Hamer, former consultant cardiologist at the Saint Bartholomew's Hospital, London, England, who died on November 6, 2003.

An experiment was conducted to examine how the response of dairy cows to a change from twice to three times-daily milking is affected by deficiencies in the dietary supplies of three amino acids, His, Met, and Lys. Six cows were used in a 6 x 6 Latin square with 14-d periods. The three dietary treatments were: grass silage and a cereal-based supplement containing feather meal as the sole protein supplement; the same silage-cereal diet supplying similar amounts of metabolizable and rumen-undegradable protein but with additional amounts of His, Met, and Lys in the form of fish meal; and the fish meal diet with additional metabolizable energy in the form of an additional 2 kg/d of sugar beet pulp. Within each of these dietary treatments, the cows were milked twice and three times daily, making a total of six treatments. When cows were given the feather meal diet, even though dietary metabolizable energy was in considerable excess, a deficiency of specific amino acids prevented any increase in milk yield in response to increasing the frequency of milking from twice to three times daily. In contrast, when cows consumed a similar level of excess metabolizable energy and a similar level of rumen-undegradable protein for which the protein was of better amino acid balance (fish meal), the increased frequency of milking led to increased yield of milk and milk protein. [ABSTRACT FROM AUTHOR]

Studies the effects of changes in dietary amino acid balance on milk yield and mammary function in dairy cows. Method of the study; Results and discussion; Conclusion.

Three experiments were carried out to examine responses of milk production to the intravenous infusion of amino acids in dairy cows given diets of grass silage and supplements based on barley, with or without added soyabean meal and ranging in crude protein content from 16 to 19% in dry matter. Particular attention was given to histidine, administered alone or in combination with methionine, lysine and tryptophan. Responses of milk protein secretion to infusion of histidine were seen only when the diet contained a supplement of barley alone. When soyabean meal was included, there were no responses of milk production to infusion of any of the infused amino acids. Calculations suggested that, although histidine remained first-limiting when soya was included in the diet, any response to infusion of histidine was blocked by the rapidly emerging deficiency of another amino acid, probably leucine. The results confirm that, for diets based on grass silage and supplements of cereal only, histidine is first-limiting such that increases of milk protein secretion can be obtained in response to infusion of histidine alone. In assessing the practical significance of this finding, it should be remembered that greater responses in the yield of milk protein can probably be obtained by substituting 1 kg of soyabean meal for 1 kg of cereal, which is likely to be an easier and cheaper option. [ABSTRACT FROM AUTHOR]

Protoplasts were isolated from leaves of Lotus corniculatus and Trifolium repens and from cotyledons of L. corniculatus. These protoplasts divided and produced colonies. The plating efficiency of protoplasts of both species was improved when agarose was used as a supporting medium. Plants were regenerated more regularly and in larger numbers from colonies of L. corniculatus than T. repens. The use of a culture line of T. repens that had been selected for its response in culture markedly increased the proportion of protoplast-derived cultures which regenerated shoots. One regenerant of T. repens (P6) was analysed for morphological and cytological variation. This plant was abnormal and highly aneuploid with a wide range of chromosome numbers. [ABSTRACT FROM AUTHOR]

Purpose: To determine safety and efficacy of intravitreal high-dose ranibizumab in the treatment of active neovascular polypoidal choroidal vasculopathy (PCV).Methods: In this Phase I/II, single-center, randomized, controlled, double-masked study, predominantly non-Asian, previously treated or treatment-naive, male and female adult patients were randomized to receive high-dose (1.0/0.1 ml or 2.0 mg/0.05 ml; n=15) or standard-dose (0.5 mg/0.05 ml; n=5) ranibizumab in 3 monthly loading doses, followed by 9 months of criteria-based, as-needed retreatment. Safety was evaluated by a descriptive analysis of all non-serious and serious adverse events, angiographic assessments, physical examinations, vital signs, ocular examinations, and visual acuity measurements. Visual acuity and anatomic outcomes are described for the high-dose group.Results: Twenty patients (aged 35-76 years; 8 Black, 11 White, 1 Asian) were enrolled. At baseline, in the high-dose group, mean best-corrected visual acuity (BCVA) was 63.5 letters (Snellen equivalent ~20/50), and mean baseline central foveal thickness (CFT) was 253.7 μm. High-dose ranibizumab was generally well tolerated without evidence of ocular or systemic severe adverse events, including arterial thromboembolic events. At month 12, in the high-dose group, the mean overall change from baseline in BCVA was +6.7 letters and in CFT was -49.7 μm.Conclusion: High-dose ranibizumab monotherapy is safe and efficacious for treating patients with PCV. [ABSTRACT FROM AUTHOR]

What is known and objectives Antimicrobial stewardship programmes ( ASPs) have been shown to decrease antimicrobial resistance, reduce hospital-acquired infections and decrease overall antimicrobial expenditures. At St. Joseph Medical Center in Bellingham, WA, a thrice-weekly ASP was initiated in 2010 with the goals of decreasing carbapenem, fluoroquinolone and vancomycin use and tailoring duration of therapy. Methods Antibiotic use per 1000 patient-days and carbapenem, fluoroquinolone and vancomycin use were evaluated pre- and post-implementation of the ASP. Total antimicrobial expenditures were evaluated for the 3 years prior to ASP implementation and three years following implementation. Results and discussion Antimicrobial days of therapy per 1000 patient-days declined by 6·4% after implementation of our ASP. There was a 37% reduction in total antimicrobial expenditures after implementation. Carbapenems, vancomycin and levofloxacin use decreased considerably. Ciprofloxacin use increased during the same time period. What is new and conclusion A thrice-weekly, pharmacist-driven ASP can decrease antimicrobial expenditure, shorten duration of therapy and decrease the utilization of carbapenems, vancomycin and levofloxacin. [ABSTRACT FROM AUTHOR]

Application of an isotope-dilution method for determining 90Zr and 90Sr in a 90Sr source material spiked with 86Sr and 92Zr is described. A miniature gas pressurized extraction chromatography (GPEC) system with a column containing Eichrom Sr Resin™ was used for separating the elements so isobaric isotopes could be measured by mass spectrometry. Zirconium was rinsed through the column with 3 M HNO3/trace HF and strontium was eluted with 1% acetic acid. Two mass spectrometric techniques, inductively coupled plasma mass spectrometry (ICP-MS) and thermal ionization mass spectrometry (TIMS), were used for measuring isotope ratios. Data were obtained with 90Sr from a blood-irradiator source. Results from the TIMS measurements gave a decay time of 45.16 ± 0.26 years, and those from the ICP-MS gave 45.24 ± 0.20 years (uncertainties are expanded uncertainty, k = 2). Quadrupole ICP-MS is preferable to TIMS in this application if the ICP-MS data are suitably corrected for non-linearity and mass discrimination. [ABSTRACT FROM AUTHOR]

Supplementation of food to wild birds occurs on an enormous scale worldwide, and is often cited as an exemplar of beneficial human-wildlife interaction. Recently it has been speculated that winter feeding could have negative consequences for future reproduction, for example by enabling low quality individuals to recruit into breeding populations. However, evidence that winter feeding has deleterious impacts on reproductive success is lacking. Here, in a landscape-scale study of blue tits (Cyanistes caeruleus) across multiple years, we show that winter food supplementation reduced breeding performance the following spring. Compared to unfed populations, winter-fed birds produced offspring that weighed less, were smaller, and had lower survival. This impairment was observed in parents that had received fat only, or in combination with vitamin E, suggesting some generality in the mechanism by which supplementary feeding affected reproduction. Our results highlight the potential for deleterious population-level consequences of winter food supplementation on wild birds. [ABSTRACT FROM AUTHOR]

An abstract of the article "Diagnosing an MI: don't trust the monitor!" by D. Tayler, J. Gunn, and D. Chamberlain is presented.

Ecological responses to environmental change are wide-ranging, from alterations in the timing of life-history events to range and population changes. Explaining the variation across species in these responses is essential for identifying vulnerable species and for developing adequate conservation or mitigation strategies. Using population trend data from the UK Breeding Bird Survey, this study examined the association between long-term population trends (1994-2007) and phenological, life-history and resource-use traits of UK passerine species. Phenology, as well as productivity and resource use were significantly associated with long-term population trends. Average laying date and first clutch laying period were key predictors, with higher population growth rates associated with earlier laying dates and longer laying periods. This suggests that flexibility in the duration of reproductive periods buffers species against environmental changes. Average laying period was particularly important for migrant species. Flexibility in laying dates for these species is constrained by their arrival dates; mean change in arrival date over a twenty-five year period strongly predicted population trends amongst migrant species. Besides the key role phenological flexibility plays in buffering population declines, we also showed that more productive, generalist species were less likely to have declining populations than species with specialized habitat requirements, particularly those associated with farmland and urban areas and those reliant on highly seasonal food items (i.e. invertebrate eaters). These results underscore the need for a multi-faceted approach to understanding the mechanisms governing population trends. Additionally, species' sensitivity to environmental change is likely to depend on interactions between species-specific phenology, habitat and resource-use traits. [ABSTRACT FROM AUTHOR]

Aim. To describe the findings from a qualitative study exploring acute care nurses' experiences with patient falls. Background. Patient falls continue to be a problem in acute care settings for nurses at the point of care. Despite the growing body of knowledge related to risk factors and interventions for fall prevention, minimal attention has been given to nurses' perspectives of patient falls. Design. A qualitative descriptive design was used. Method. Focus group discussions were conducted with nurses working on a cross-section of inpatient acute care settings. Audio-taped sessions were transcribed and analysed thematically. Results. Nurses described their experience of falls as 'knowing the patient as safe', an ongoing affirmation that the patient was free from harm. In this focused, narrowly defined and highly specific knowing, nurses employed the key strategies of assessment, monitoring and communicating. Variable conditions influenced whether these strategies were effective in giving nurses the knowledge they needed to keep the patient safe. When strategies failed to provide nurses with knowledge of their patients as safe and patients fell, this created considerable stress for nurses and prompted them to use a range of coping strategies. Conclusion. Knowing the patient as safe has the potential to resolve the tension between patient safety and independence. The critical, often taken for granted, activities used by nurses in this knowing must be expanded to include the meaning falls have for patients and attend to factors beyond nurses control such as environmental redesign and staffing. Relevance to clinical practice. Nurses play an important role in fall prevention through knowing the patient as safe but must be supported through the use of a multi-faceted approach extending from the individual nurse to the institutional level. [ABSTRACT FROM AUTHOR]

Objective: To determine whether, in acute non-ST elevation coronary syndrome, the benefit from early invasive coronary intervention compared with a conservative strategy of later symptom-guided intervention varies over time. Methods: In RITA 3 (Randomised Intervention Trial of unstable Angina 3) patients were randomly assigned to coronary angiography (median 2 days after randomisation) and appropriate intervention (n = 895) or to a symptom-guided conservative strategy (n = 915). Results: In the first week patients in both groups were at highest risk of death, myocardial infarction (MI) or refractory angina (incidence rate 40 times higher than in months 5-1 2 of follow up). There were 22 MIs and 6 deaths in the intervention group (largely due to procedure-related events, 14 MIs and 3 deaths) versus 17 MIs and 3 deaths in the conservative group. In the rest of the year there were an additional 12 versus 27 MIs, respectively (treatment-time interaction p = 0.021). Over one year in the intervention group there was a 43% reduction in refractory angina; 22% of patients underwent coronary artery bypass surgery and 35% underwent percutaneous coronary intervention only, which reduced refractory angina but provoked some early MIs; and 43% were still treated medically, mostly because of a favourable initial angiogram. Conclusion: Any intervention policy needs to recognise the high risk of events in the first week and the substantial minority of patients not needing intervention. Intervention may be best targeted at higher risk patients, as the early hazards of the procedure are then offset by reduced subsequent events. [ABSTRACT FROM AUTHOR]

Objective: To report on the effectiveness of an initiative to reduce deaths from sudden cardiac arrest occurring in busy public places. Setting: 110 such places identified from ambulance service data as high risk sites. Patients: 172 members of the public who developed cardiac arrest at these sites between April 2000 and March 2004. 20 592 defibrillator months' use is reported, representing one automated external defibrillator (AED) use every 120 months. Intervention: 681 AEDs were installed; staff present at the sites were trained in basic life support and to use AEDs. Main outcome measures: Initial rhythm detected by AED, restoration of spontaneous circulation, survival to hospital discharge. Results: 172 cases of cardiac arrest were treated by trained lay staff working at the site before the arrival of the emergency services during the period. A shockable rhythm was detected in 135(78%), shocks being administered in 134 an estimated 3-5 minutes after collapse; 38(28.3%) patients subsequently survived to hospital discharge. Spontaneous circulation was restored in five additional patients who received shocks but died later in hospital. In 37 cases no shock was initially indicated; one patient survived after subsequent treatment by paramedics, cardiopulmonary resuscitation having been given soon after collapse. Overall, irrespective of the initial rhythm, 39 patients (22.7%), were discharged alive from hospital. For witnessed arrests of presumed cardiac cause in ventricular fibrillation (an international Utstein comparator) survival was 37 of 124 (29.8%). Conclusions: The use of AEDs by lay people at sites where cardiac arrest commonly occurs is an effective strategy to reduce deaths at these sites. [ABSTRACT FROM AUTHOR]

Prehospital cardiac arrest has been associated with a very poor prognosis. Acute myocardial infarction and massive pulmonary embolism are the underlying causes of out-of-hospital cardiac arrest in 50–70% of patients. Although fibrinolysis is an effective treatment strategy for both myocardial infarction and pulmonary embolism, clinical experience for this therapy performed during resuscitation has been limited owing to the anticipated risk of severe bleeding complications. The TROICA study is planned as one of the largest randomized, double-blind, placebo-controlled trials to assess the efficacy and safety of prehospital thrombolytic therapy in cardiac arrest of presumed cardiac origin. Approximately 1000 patients with cardiac arrest will be randomized at approximately 60 international study centres to receive either a weight-adjusted dose of tenecteplase or placebo after the first dose of a vasopressor. Patients can be included if they are at least 18 years, presenting with a witnessed cardiac arrest of presumed cardiac origin, and if either basic life support had started within 10 min of onset and had been performed up to 10 min or advanced life support is started within 10 min of onset of cardiac arrest. Primary endpoint of the study is the 30-day survival rate, and the coprimary endpoint is hospital admission. Secondary endpoints are the return of spontaneous circulation (ROSC), survival after 24 h, survival to hospital discharge, and neurological performance. Safety endpoints include major bleeding complications and symptomatic intracranial haemorrhage.Eur J Clin Invest 2005; 35 (5): 315 –323 [ABSTRACT FROM AUTHOR]

Examines the influence of amino acid nutrition on the response to milking more frequently, with or without injection of growth hormone on 8 dairy cows. Results for milk production and mammary blood flow from the whole udder; Effects of milking cows three times a day on milk production; Factor which modulated the response to an increase in milking frequency from twice to thrice daily.

An analysis of the energy, spatial character, and temporal evolution of electron beams and hard x rays from 0.9 to 1.0 MA high-Z X pinches is presented. Experimental results from Ti, Fe, Mo, and W X pinches show that X pinches are an effective source of hard x rays with energies greater than 30 keV. Electron beams with energies up to 2 MeV higher than the applied anode-cathode voltage are generated along the pinch axis before the maximum current is reached. The beams have diameters of about 3 mm and generate bursts of hard x rays with sizes between 1 and 2 mm and total time durations of up to 150 ns. The measured 100-500 keV x-ray distribution is spectrally anisotropic. Hard x-ray synchrotron radiation in the side-on direction is proposed as a possible explanation of this anisotropy. [ABSTRACT FROM AUTHOR]

The presence of collimated 1.5-2.0 MeV electron beams in 0.9-1.0 MA high-Z X-pinch plasmas leads to the generation of an anisotropic hard x-ray radiation (more than 50-100 keV) in the crossing point of the wires, with a 1-2 mm size source and a time duration of 100-150 ns. The side-on measured electron temperature is higher than the end-on. Introducing of a synchrotron radiation in a side-on direction is used for the explanation of the phenomenon. The new results of time-resolved 0.16-10 keV x-ray imaging and spectroscopic study of the development of jets and hot spots in X-pinches are presented. The plasma parameters varied significantly for consecutive x-ray bursts (hot spots) during the same X-pinch discharge. A minimum duration of x-ray pulses was 1.1 ns. The x-ray energy output was up to 10-11 kJ, and a maximum power can reach up to 3 × 10[sup 11] W. The X-pinch coupled with the x-ray glass-capillary converter for collecting and focusing of x rays can generate soft x-ray energy density up to (1-10) J/cm², and the flux density up to (1-5) × 10[sup 9] W/cm². The 1 MA X-pinch can be used as a possible hard and soft x-ray backlighter and a soft x-ray source for material science and microelectronics research. [ABSTRACT FROM AUTHOR]

Background: Current guidelines suggest that, for patients at moderate risk of death from unstable coronary-artery disease, either an interventional strategy (angiography followed by revascularisation) or a conservative strategy (ischaemia-driven or symptom-driven angiography) is appropriate. We aimed to test the hypothesis that an interventional strategy is better than a conservative strategy in such patients.Methods: We did a randomised multicentre trial of 1810 patients with non-ST-elevation acute coronary syndromes (mean age 62 years, 38% women). Patients were assigned an early intervention or conservative strategy. The antithrombin agent in both groups was enoxaparin. The co-primary endpoints were a combined rate of death, non-fatal myocardial infarction, or refractory angina at 4 months; and a combined rate of death or non-fatal myocardial infarction at 1 year. Analysis was by intention to treat.Findings: At 4 months, 86 (9.6%) of 895 patients in the intervention group had died or had a myocardial infarction or refractory angina, compared with 133 (14.5%) of 915 patients in the conservative group (risk ratio 0.66, 95% CI 0.51-0.85, p=0.001). This difference was mainly due to a halving of refractory angina in the intervention group. Death or myocardial infarction was similar in both treatment groups at 1 year (68 [7.6%] vs 76 [8.3%], respectively; risk ratio 0.91, 95% CI 0.67-1.25, p=0.58). Symptoms of angina were improved and use of antianginal medications significantly reduced with the interventional strategy (p<0.0001).Interpretation: In patients presenting with unstable coronary-artery disease, an interventional strategy is preferable to a conservative strategy, mainly because of the halving of refractory or severe angina, and with no increased risk of death or myocardial infarction. [ABSTRACT FROM AUTHOR]

Summary: Background: Current guidelines suggest that, for patients at moderate risk of death from unstable coronary-artery disease, either an interventional strategy (angiography followed by revascularisation) or a conservative strategy (ischaemia-driven or symptom-driven angiography) is appropriate. We aimed to test the hypothesis that an interventional strategy is better than a conservative strategy in such patients. Methods: We did a randomised multicentre trial of 1810 patients with non-ST-elevation acute coronary syndromes (mean age 62 years, 38% women). Patients were assigned an early intervention or conservative strategy. The antithrombin agent in both groups was enoxaparin. The co-primary endpoints were a combined rate of death, non-fatal myocardial infarction, or refractory angina at 4 months; and a combined rate of death or non-fatal myocardial infarction at 1 year. Analysis was by intention to treat. Findings: At 4 months, 86 (9.6%) of 895 patients in the intervention group had died or had a myocardial infarction or refractory angina, compared with 133 (14.5%) of 915 patients in the conservative group (risk ratio 0.66, 95% CI 0.51-0.85, p=0.001). This difference was mainly due to a halving of refractory angina in the intervention group. Death or myocardial infarction was similar in both treatment groups at 1 year (68 [7.6%] vs 76 [8.3%], respectively; risk ratio 0.91, 95% CI 0.67-1.25, p=0.58). Symptoms of angina were improved and use of antianginal medications significantly reduced with the interventional strategy (p<0.0001). Interpretation: In patients presenting with unstable coronary-artery disease, an interventional strategy is preferable to a conservative strategy, mainly because of the halving of refractory or severe angina, and with no increased risk of death or myocardial infarction. [ABSTRACT FROM AUTHOR]

A wide variety of x-ray and extreme ultraviolet (EUV) diagnostics are being developed to study z-pinch plasmas at the Nevada Terawatt Facility at the University of Nevada, Reno. Time-resolved x-ray/EUV imaging and spectroscopy, x-ray polarization spectroscopy, and backlighting will be employed to measure profiles of plasma temperature, density, flow, and charge state, and to investigate electron distribution functions and magnetic fields. The instruments are state-of-the-art applications of glass capillary converters (GCC), multilayer mirrors (MLM), and crystals. New devices include: a novel GCC-based two-dimensional imaging spectrometer, a six-channel crystal/MLM spectrometer (“polychromator”) with a transmission grating spectrometer, and two sets of x-ray/EUV polarimeters/spectrometers. An x-pinch backlighter is under development. X-ray polarimeter/spectrometer, a survey spectrometer, a multichannel time-gated x-ray pinhole camera, and filtered fast x-ray diodes have observed the structure of Ti and Fe x pinches driven by a 0.9 MA current. X-ray yield and pulse duration depend sensitively on the wire load. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Cidofovir, a nucleoside analog antiviral agent, has been used with moderate success in the treatment of juvenile laryngeal papillomatosis (JLP) by direct intralesional injection. We report the first case where IV cidofovir was used successfully to treat a rare but lethal multicystic lung disease complicating JLP. A 35-year-old woman with a history of JLP requiring multiple laser ablations of laryngeal papillomata each year presented with hemoptysis and was found on CT scan to have bilateral, multiple pulmonary nodules and cysts. The results of BAL fluid analysis demonstrated no evidence of malignancy, and cultures were negative for fungi and mycobacteria. Molecular DNA typing of a biopsy specimen obtained from a laryngeal papilloma confirmed infection with human papilloma virus type 11. She received 12 months of treatment with IV cidofovir followed by 9 months of combined treatmentwith IV cidofovir and subcutaneous interferon-alpha-2A. This therapeutic regime resulted in a markedly decreased requirement for surgical removal of laryngeal papillomata, and CT scanning documented the regression of the lesions in the lung parenchyma that persisted after the discontinuation of therapy. The results of this case demonstrate that cidofovir may be used successfully to treat JLP-related lung disease and suggest that further studies are warranted. [ABSTRACT FROM AUTHOR]

Examines the treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex. Cause of acute transmural myocardial infarction; Cineangiographic evidence of reperfusion; Role of thrombolytic agents.

Focuses on several medical research. Discussions on chest physiotherapy; Evaluations on the preregistration for general practice; Descriptions on the adverse effects of inhaled corticosteroids.

Epithelioid haemangioendothelioma (EHE) is a rare vascular tumour of intermediate behaviour. It can arise from various sites including the liver, spleen, pleura, or lung. Cutaneous EHE can be primary or secondary. This report describes the case of a 51 year old man who presented with a history of dry cough, shortness of breath, and pleural effusion, and who developed two cutaneous nodules in the anterior abdominal wall a few weeks later. lie had a previous history of asbestos exposure. Computed tomography scan showed a left sided pleural effusion and nodular pleural mass. Histology of both the pleural and cutaneous. lesions was compatible with EHE. Electron microscopic examination demonstrated the presence of Weibel-Palade bodies. The patient underwent elliptical excision of the metastatic cutaneous nodules after decortication of the primary pleural tumour and adjuvant treatment. A few reports have described metastasis of intrathoracic EHE to the skin. Despite treatment with interferon, the patient developed more cutaneous lesions two years after the initial diagnosis. Even though the tumour has the classic light histological and ultrastructural features of EHE, it behaved in an aggressive manner. [ABSTRACT FROM AUTHOR]