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While the care of children and young people affected by neuromuscular disorders focuses on promoting health and aims to avoid hospital admissions, many require a number of admissions throughout their life. Hospital admissions are associated with increased anxiety and can be a traumatic and frightening experience. A review of inpatient care from the carer perspective was undertaken as part of a larger project to evaluate care on the children's medical ward which includes a high dependency unit. The ward staff work closely with the specialist paediatric neuromuscular service in Birmingham Heartlands Hospital. A structured interview was undertaken with a parent or carer after discharge following a hospital admission longer than forty-eight hours; this included elective and emergency admissions. A total of seven full interviews were completed. The cohort included three children affected by Duchenne Muscular Dystrophy, two children affected by Spinal Muscular Atrophy, one affected by Congenital Muscular Dystrophy and one child affected by Quadriplegic Cerebral Palsy. All the children were at a non-ambulatory stage. Specific areas addressed included the admission process, availability of equipment, communication and continuity of care, patient safety and the discharge process. Clear themes were identified highlighting equipment shortages, facilities and space problems, manual handling training needs and communication issues on multiple levels. The results supported the urgent need for a specialised toilet and shower chair which has since been secured. Additional staff training is planned and communication booklets are considered. Planning of care and facilities should prioritise inclusion of all children and young people. Staff should be empowered with the appropriate training, enabling them to deliver best possible care to all young people and families, ensuring their disability is not perceived as a barrier. [ABSTRACT FROM AUTHOR]

The Russian Wheat Aphid ( Diuraphis noxia Kurdjumov, 1913) (RWA) is a serious pest of grain crops and is of considerable concern in South Africa, particularly in terms of barley grown specifically for the brewing industry. This paper highlights the effect of a small (50 ppm) increase in [CO 2 ] on the growth rate of the four South African RWA biotypes on the SABBIErica barley cultivar. Controlled environment experiments revealed that the colony growth rate for RWASA4 was significantly lower than SA1 under ambient conditions as well as significantly lower than SA1, SA2 or SA3 under elevated CO 2 conditions. The unexpected difference suggested an atypical, non-preferential feeding habit on SABBIErica, for RWASA4. The small RWASA4 colonies inflicted similar morphological damage to the significantly larger RWASA1 – RWASA3 biotype populations — indicative of potential hypervirulence under elevated CO 2 . The continuous feeding of RWASA biotypes causes damage to the transport system as well as substantial, catastrophic damage to mesophyll chloroplasts as well as mitochondria within the host plant's leaves. The TEM study revealed evidence of sequential/systematic degeneration of chloroplasts and mitochondria with continued aphid feeding, which we suggest is an indication of potential emergent hypervirulence under elevated CO 2 conditions. [ABSTRACT FROM AUTHOR]

Machine learning techniques can provide powerful tools to detect patterns in multidimensional parameter space. We use K-means - a simple yet powerful unsupervised clustering algorithm which picks out structure in unlabelled data - to study a sample of quasar UV spectra from the Quasar Catalog of the 10th Data Release of the Sloan Digital Sky Survey (SDSS-DR10) of Paris et al. Detecting patterns in large data sets helps us gain insights into the physical conditions and processes giving rise to the observed properties of quasars. We use K-means to find clusters in the parameter space of the equivalent width (EW), the blue- and red-half-width at half-maximum (HWHM) of the Mg II 2800 Å line, the C IV 1549 Å line, and the C III] 1908 Å blend in samples of broad absorption line (BAL) and non-BAL quasars at redshift 1.6-2.1. Using this method, we successfully recover correlations well-known in the UV regime such as the anti-correlation between the EW and blueshift of the C IV emission line and the shape of the ionizing spectra energy distribution (SED) probed by the strength of He n and the Si III]/C III] ratio. We find this to be particularly evident when the properties of C III] are used to find the clusters, while those of Mg n proved to be less strongly correlated with the properties of the other lines in the spectra such as the width of C IV or the Si III]/C III] ratio. We conclude that unsupervised clustering methods (such as K-means) are powerful methods for finding 'natural' binning boundaries in multidimensional data sets and discuss caveats and future work. [ABSTRACT FROM AUTHOR]

We present a photometric catalogue of star cluster candidates in Hickson compact groups (HCGs) 7, 31, 42, 59, and 92, based on observations with the Advanced Camera for Surveys and the Wide Field Camera 3 on the Hubble Space Telescope. The catalogue contains precise cluster positions (right ascension and declination), magnitudes, and colours in the BVI filters. The number of detected sources ranges from 2200 to 5600 per group, from which we construct the high-confidence sample by applying a number of criteria designed to reduce foreground and background contaminants. Furthermore, the high-confidence cluster candidates for each of the 16 galaxies in our sample are split into two subpopulations: one that may contain young star clusters and one that is dominated by globular older clusters. The ratio of young star cluster to globular cluster candidates varies from group to group, from equal numbers to the extreme of HCG 31 which has a ratio of 8 to 1, due to a recent starburst induced by interactions in the group. We find that the number of blue clusters with MV < -9 correlates well with the current star formation rate in an individual galaxy, while the number of globular cluster candidates with MV < -7.8 correlates well (though with large scatter) with the stellar mass. Analyses of the high-confidence sample presented in this paper show that star clusters can be successfully used to infer the gross star formation history of the host groups and therefore determine their placement in a proposed evolutionary sequence for compact galaxy groups. [ABSTRACT FROM AUTHOR]

In a single optical spectrum, the quasar narrow-line region (NLR) reveals low-density, photoionized gas in the host galaxy interstellar medium (ISM), while the immediate vicinity of the central engine generates the accretion disc continuum and broad emission lines. To isolate these two components, we construct a library of high-S/N optical composite spectra created from the Sloan Digital Sky Survey Data Release 7. We divide the sample into bins of continuum luminosity and Hß full width at half-maximum that are used to construct median composites at different redshift steps up to 0.75. We measure the luminosities of the narrow-emission lines [Ne v] γ3427, [Ne iii] γ3870, [O iii] γ5007, and [O ii] γ3728 with ionization potentials (IPs) of 97, 40, 35, and 13.6 eV, respectively. The high IP lines' luminosities show no evidence of increase with redshift consistent with no evolution in the AGN spectral energy distribution or the host galaxy ISM illuminated by the continuum. In contrast, we find that the [O ii] line becomes stronger at higher redshifts, and we interpret this as a consequence of enhanced star formation contributing to the [O ii] emission in host galaxies at higher redshifts. The SFRs estimated from the [O ii] luminosities show a flatter increase with z than non-AGN galaxies given our assumed AGN contribution to the [O ii] luminosity. Finally, we confirm an inverse correlation between the strength of the Fe ii γ4570 complex and both the [O iii] equivalent width (though not the luminosity) and the width of the Hß line as known from the eigenvector 1 correlations. [ABSTRACT FROM AUTHOR]

Many stainless steel crowns ( SSCs) disrupt the occlusion in children, but stabilisation appears to occur within a short period post-placement. The extent and mechanism of these short-term occlusal changes in children are unknown. This study sought to determine whether placement of a SSC changes the maximum intercuspation position ( MIP) in children, whether the MIP returns to normal within 4 weeks and whether local anaesthesia had an effect on the child's ability to achieve MIP. The T-Scan® III was used for the measurement of occlusal contacts. Reliability and reproducibility of the system was determined using a calibration exercise where MIP recordings were taken of eleven children not undergoing any dental treatment. For the main study, the percentage of total occlusal force on each tooth was recorded in 20 children preoperatively, after local anaesthesia, after SSC placement and 4 weeks postoperatively. There was no significant difference in MIP ( P = 0·435) preoperatively and post-administration of local anaesthesia. There was a significant difference between the preoperative force on a tooth and the reading after crown placement ( P = 0·0013, Wilcoxon test). By 4 weeks, there was no significant difference overall between post- SSC placement and the preoperative value for the tooth ( P = 0·3). Administration of local anaesthesia did not affect the ability of a child to attain MIP. Maximum intercuspation position was disturbed by the placement of a SSC in seven of 20 cases. When MIP was disturbed, in most cases, it returned to preoperative status within 4 weeks of crown placement. [ABSTRACT FROM AUTHOR]

The canonical Wnt signalling pathway induces the β-catenin/lymphoid enhancer factor transcription factors. It is activated in various cancers, most characteristically carcinomas, in which it promotes metastatic spread by increasing migration and/or invasion. The Wnt/β-catenin signalling pathway is frequently activated in melanoma, but the presence of β-catenin in the nucleus does not seem to be a sign of aggressiveness in these tumours. We found that, unlike its positive role in stimulating migration and invasion of carcinoma cells, β-catenin signalling decreased the migration of melanocytes and melanoma cell lines. In vivo, β-catenin signalling in melanoblasts reduced the migration of these cells, causing a white belly-spot phenotype. The inhibition by β-catenin of migration was dependent on MITF-M, a key transcription factor of the melanocyte lineage, and CSK, an Src-inhibitor. Despite reducing migration, β-catenin signalling promoted lung metastasis in the NRAS-driven melanoma murine model. Thus, β-catenin may have conflicting roles in the metastatic spread of melanoma, repressing migration while promoting metastasis. These results highlight that metastasis formation requires a series of successful cellular processes, any one of which may not be optimally efficient. [ABSTRACT FROM AUTHOR]

Purpose: To use the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to explore the experiences of women living with self-identified HIV-associated neurocognitive challenges. Method: This interpretive, qualitative study involved key informant interviews with 16 women with self-identified HIV-associated neurocognitive challenges. Data were collected through 60-90 min, in-depth, semi-structured interviews. Thematic analysis was performed using an inductive approach. Theoretical analysis then used the ICF to reconceptualize the data using a disability lens. Results: Participants perceived impairments (e.g. memory loss, difficulty multi-tasking) and participation restrictions (e.g. parenting, work roles) resulting from their neurocognitive challenges as having a larger impact on their daily lives than activity limitations (e.g. difficulty with chores). Participants held contrasting views about parenting: women with children drew strength from parenting whereas women without children worried that parenting could compromise their health. Participation in work and volunteering roles was viewed as integral to managing neurocognitive challenges and health overall. Conclusions: Conceptualizing neurocognitive challenges through a disability lens focuses attention on how impairments interact with other realities in these women's lives. This exploratory study reveals the need for future research exploring perceptions among people living with HIV-associated neurocognitive challenges with attention to aging and among other vulnerable groups. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes an experiment to examine whether a visual warning system can improve detection of moving machine hazards that could result in struck-by or pinning accidents. Thirty-six participants, twelve each in one of three age groups, participated in the study. A visual warning system capable of providing four different modes of warning was installed on a continuous mining machine that is used to mine coal. The speed of detecting various machine movements was recorded with and without the visual warning system. The average speed of detection for forward and reverse machine movements was reduced by 75% when using the flashing mode of the visual warning system. This translated to 0.485 m of machine travel for the fast speed condition of 19.8 m/min, which is significant in the context of the confined spaces of a mine. There were no statistically significant differences among age groups in the ability to detect machine movements for the visual warning modes in this study. The visual warning system shows promise as a safety intervention for reducing struck-by or pinning accidents involving continuous mining machines. The methods and results of this study could be applied to other moving machinery used in mining or other industries where moving machinery poses struck-by or pinning hazards. [Copyright &y& Elsevier]

Abstract: The current study collected orally-delivered autobiographical narratives from a sample of 44 undergraduate students. Participants were asked to produce both deceptive and non-deceptive versions of their narrative to two specific autobiographical question prompts while standing in front of a video camera. Narratives were then analyzed with Coh-Metrix software on 33 indices of linguistic cohesion. Following a Bonferroni correction for the large number of linguistic variables (p <.002), results indicated that the deceptive narratives contained more explicit action verbs, less linguistic complexity, and less referential coherence (sentences being cohesive with each other). The results support a theory that, in deceptive narratives, there is greater narrative distance between the self that narrates and the self that is narrated about. This suggests that narrative selves are constituted not as autonomous selves, but are subject to processes (e.g., psychological, linguistic, social) that are likely operating on a subconscious level. [Copyright &y& Elsevier]

To elucidate the differences in the pathology of incisional and primary ventral hernias and the outcomes of their laparoscopic repair. An operating room database of all laparoscopic ventral hernias performed between 2001 and 2009 was analyzed retrospectively. Patients were divided into two main groups: Group 1 (incisional hernias) and Group 2 (primary hernias). All P-values < 0.05 were considered to be significant. There were 121 patients in Group 1 (mean age: 60.35 years) and 100 patients in Group 2 (mean age: 51.94 years). There was a significantly higher percentage of females in Group 1 (70 vs. 28%, P < 0.0001). There were significantly more complex hernias (defined as multiple points of weakness on the anterior abdominal wall) in Group 1 (37 vs. 10%, P < 0.0001). A total of 89% of patients required lysis of adhesions in Group 1 as compared with 73% in Group 2 ( P = 0.007). There was a significantly higher percentage of conversions in Group 1 (9%) compared with Group 2 (2%, P = 0.02). The mean mesh size was significantly larger in Group 1 (243.22 vs. 131.46 cm2). The mean length of procedure (LOP) was significantly longer in Group 1 (113.94 min) as compared with Group 2 (70.96 min). The overall morbidity rate was not significantly different between the two groups (23 vs. 16%). The mean length of stay (LOS) was significantly longer for Group 1 (2.2 vs. 0.75 days, P < 0.0001). Finally, 22.3% of the patients in Group 1 were discharged on the same day as compared with 59% of the patients in Group 2 ( P < 0.0001). The LOP and LOS are longer after the laparoscopic repair of incisional than for primary ventral hernias. This disparity should be kept in mind when counseling patients and while designing trials investigating laparoscopic ventral hernia repairs (LVHRs). [ABSTRACT FROM AUTHOR]

Objective To investigate the use of, and willingness to use, the internet for health information purposes in Ireland, with a particular focus on the demographic and mental health of users and non-users. Methods Data from the Health Research Board National Psychological Wellbeing and Distress Survey were analyzed. This telephone survey included 2711 adults aged 18 years and over living in private households in Ireland. Internet use was measured using three items: past use, use specifically for health information, and willingness to use the internet in the future. Current psychological wellbeing was measured using the 12-item General Health Questionnaire. In addition, mental health problems in the previous year were measured. Sociodemographic variables examined included age, gender, employment status, and education. Results Online health-seeking differed significantly by gender, age, employment status, and educational level. A substantial proportion of internet users with poor mental health were found to have searched for health information online. A high willingness to use the internet for health information in the future by non-users was reported. Conclusion This study has shown that those with mental health problems use the internet to search for health information more often than those who have not experienced such problems. It has also shown that there is still a digital divide in terms of online health seeking, which is influenced by age, gender, education, and employment status. These findings highlight the need to address access, technological, psychological, and perceptual issues that may present barriers to the use of online health seeking. [ABSTRACT FROM AUTHOR]

Using the Submillimetre Common-User Bolometer Array on the JCMT, we have carried out a submillimetre (submm) survey of broad absorption-line quasars (BALQs). The sample has been chosen to match, in redshift and optical luminosity, an existing benchmark 850-μm sample of radio-quiet quasars, allowing a direct comparison of the submm properties of BAL quasars relative to the parent radio-quiet population. We reach a submm limit at 850 μm, allowing a more rigorous measure of the submm properties of BAL quasars than previous studies. Our submm photometry complements extensive observations at other wavelengths, in particular X-rays with Chandra and infrared with Spitzer. To compare the 850-μm flux distribution of BALQs with that of the non-BAL quasar benchmark sample, we employ a suite of statistical methods, including survival analysis and a novel Bayesian derivation of the underlying flux distribution. Although there are no strong grounds for rejecting the null hypothesis that BALQs on the whole have the same submm properties as non-BAL quasars, we do find tentative evidence (1–4 per cent significance from a Kolmogorov–Smirnov test and survival analysis) for a dependence of submm flux on the equivalent width of the characteristic C iv BAL. If this effect is real – submm activity is linked to the absorption strength of the outflow – it has implications either for the evolution of active galactic nuclei (AGNs) and their connection with star formation in their host galaxies, or for unification models of AGNs. [ABSTRACT FROM AUTHOR]

Landau-Kleffner syndrome (LKS) is an acquired childhood aphasia associated with paroxysmal bitemporal electroencephalogram (EEG) abnormalities and, sometimes, clinical seizures. We report the case of a female aged 5 years 6 months who presented clinically with apparent hearing loss, deterioration in speech, and seizure activity over 12 days. The female had previous detailed speech/language assessments at 3 to 4 years of age due to articulation delay. LKS was diagnosed on EEG with bitemporal spike and wave activity during sleep. The patient was treated with high dose prednisolone 3mg/kg/day, intensive speech/language therapy, and followed a modified educational program. We recorded a marked regression in receptive and expressive language skills, as well as her speech, language, and cognitive profiles before and during treatment with prednisolone, during an 18-month follow-up period. The patient demonstrated an excellent clinical response highlighting the importance of a multidisciplinary approach to management of LKS. [ABSTRACT FROM AUTHOR]

Objective: To describe the circumstances surrounding heat related deaths to young children in passenger compartments of motor vehicles. Methods: Cases of heat related deaths to children aged ≤5 years confined in parked vehicles were retrospectively identified using online news accounts from 1 January 1995 to 31 December 2002. A standardized data form was developed to collect information related to the victim, the vehicle and its design features, external temperature, length of time confined, and the responsible adults. Cases were categorized by whether the child gained access to the vehicle or was left by adults. Results: A total of 171 fatalities that met the case criteria were identified. Twenty seven percent (46) were children who gained access to unlocked vehicles and 73% (125) were children who were left by adults. More than a quarter of the adults were aware they were leaving children in the vehicles, while half were unaware or forgot. Forty three percent (54) of deaths to children who were left were associated with childcare: 32 children were left by family members who intended to take them to childcare but forgot and went to work instead; 22 children were left by child care providers or drivers. Conclusions: Many of the deaths reported in this study may have been prevented by keeping cars locked, educating parents, implementing informed child care transportation policies, passing relevant laws, and working with auto and child safely seat manufacturers to build in warnings and other design features. News sources can be useful for obtaining detailed information not otherwise identifiable through standard sources of fatality data. [ABSTRACT FROM AUTHOR]

Two thirds of Americans are considered overweight, while 25% are obese. Obesity is the most common health problem facing U.S. children today, regardless of ethnicity, gender, or socioeconomic status. Lack of preplanning for the hospitalized obese child threatens both patient and caregiver safety, and is becoming a serious consideration in pediatric nursing. Some of the challenges in mobilizing larger children with an eye to preventing caregiver injury and promoting patient safety are explored. Equipment, policy formation, education, and legal considerations are outlined within this context. A case study is presented herein. [ABSTRACT FROM AUTHOR]

After massive weight loss, a patient may be left with a potentially serious new problem: excess abdominal pannus. Here's the latest on corrective surgery and what to teach him about it. [ABSTRACT FROM AUTHOR]

As more patients choose weight-reduction surgery to treat morbid obesity, you're likely to be involved in their care. Here's the skinny on the various options and your role before and after surgery. [ABSTRACT FROM AUTHOR]

Results from coal-exploration drilling in the onshore part of the Port Phillip Basin, Victoria, have established stratigraphic and age correlations of the Lower Miocene Werribee Formation brown coal deposits at Bacchus Marsh to similar brown coals at Altona. The coal deposits occur in a northwest-southeast structural depression (the Parwan Trough) that appears to be a southeast continuation of the Ballan Graben. Recent drilling for potential coal-bed methane in the trough has provided new data on the deeper stratigraphy not penetrated by earlier drilling, including recognition of an Upper Cretaceous to Eocene Yaloak Formation coal-bearing interval, similar to the Anglesea area, Ballan Graben and Lal Lal Basin. Up to 200 m of coal-bearing sediment and minor volcanics underlie the Miocene coal measures. A marine facies transition takes place between the Miocene coal swamps of the Parwan Trough, through barrier sands west of Werribee, to carbonate facies near Geelong. To the south beneath Port Phillip Bay, a similar transition probably occurs between coal swamps of the Parwan Trough and fully marine carbonate environments of the contiguous Sorrento Graben. The palaeogeographical reconstructions suggest a similar coal-to-carbonate facies transition as in the adjacent onshore Gippsland Basin. [ABSTRACT FROM AUTHOR]

A fully cored sequence of Hesse Clay, Port Campbell Limestone and uppermost Gellibrand Marl in the onshore Otway Basin, southeastern Australia, offers new insight into the evolution of the middle Miocene Port Campbell Limestone. The Port Campbell Limestone comprises grey unconsolidated to semi-consolidated and rarely lithified bioclastic muddy carbonate sands in a stack of thin repetitive cycles within cycles of predominantly shoaling-upward character. A glauconitic band with a distinctive mollusc–echinoderm–bryozoan fauna provides a distinctive marker interval in the sequence. In mineralogy, the Port Campbell Limestone is predominantly calcite with traces of remnant aragonite in muddier low-permeability sands, and with dolomitic zones in permeable intervals. The small non-carbonate component of the Port Campbell Limestone is between 3 and 15 wt% and comprises quartz silt with minor clay, feldspar and mica. Dissolution overprints are prominent throughout the carbonate sequence. Three distinct geochemical signatures of provenance are evident in the Port Campbell Limestone sequence, including possible volcanogenic contributions with felsic sources. Foraminifera are common and generally well preserved. Foraminiferal data suggest a depositional transition from outer shelf conditions in the Gellibrand Marl at ca 15 Ma to middle shelf environments in the lower part of the Port Campbell Limestone during the Middle Miocene Climatic Optimum (MMCO) at ca 14.24 Ma. Shallowing after 14 Ma indicates variable paleodepths of <70 m during and following the end of the Middle Miocene Climatic Transition (MMCT) at ca 13.2 Ma when the sequence was emergent for a brief but undetermined period, corresponding with sharp changes in geochemical ratios. Observed cyclicity in these mid-shelfal, cold-water carbonates is strongly correlated with orbital forcings—eccentricity and obliquity. Sedimentation rates determined from cyclostratigraphic analysis indicate 4–6 cm/kyr at the end of the MMCO, diminishing to 1.5–3 cm/kyr during the MMCT and the subsequent accumulation of the Port Campbell Limestone. The Port Campbell Limestone is a stack of thin repetitive depositional cycles within cycles. The cyclicity is strongly correlated with orbital forcings—eccentricity and obliquity—and this is reflected in the geochemistry. Foraminiferal data suggest a depositional transition from outer shelf conditions in the Gellibrand Marl at ca 15 Ma to middle shelf environments in the lower part of the Port Campbell Limestone during the Middle Miocene Climatic Optimum (MMCO) at ca 14.24 Ma. The sequence was emergent for a brief but undetermined period at ca 13.2 Ma, corresponding with sharp changes in geochemical ratios. Three distinct geochemical signatures of provenance are evident in the Port Campbell Limestone sequence, including possible volcanogenic contributions with felsic sources. [ABSTRACT FROM AUTHOR]

A study was conducted to test an online mindfulness and gratitude intervention for self-management of arthritis. It was hypothesized that the intervention would decrease pain anxiety, intensity and interference, fear of movement, and increase pain self-efficacy for a group of self-referred people with arthritis. The intervention consisted of four once-weekly programmes which included animated guides, audio guided mindfulness exercises and a gratitude programme. One hundred and fifty-one people enrolled in the study. Data from 81 people who completed the trial and questionnaires was analysed. Pain anxiety, pain interference, pain intensity, fear of movement and pain self-efficacy were all improved by the intervention as hypothesized. This pilot study lends support to both gratitude and mindfulness being appropriate interventions for physical health conditions and demonstrates how they can be used in combination. Additionally, this shows the potential of online delivery for positive health interventions. [ABSTRACT FROM AUTHOR]

Background: Improved outcomes of laparoscopic Roux-en-Y gastric bypass (LRYGB) have been demonstrated once pratice has moved beyond the learning curve. However, there is no evidence that experience has a favorable impact on the incidence of leaks. This study evaluated the incidence of staple-line leaks as experience accrued in a university-based bariatric surgery program.Methods: Prospectively collected data on our first 200 patients undergoing LRYGB since July 1998 were analyzed. Linear staplers were used to divide the stomach and to create a side-to-side jejunojejunostomy. A side-to-side cardiojejunostomy was created using a 21-mm circular stapler. Patient characteristics, operative data, and outcomes were evaluated chronologically with comparison of outcomes between quartiles.Results: Staple-line leaks developed in 9 (4.5%) of the first 200 patients undergoing LRYGB. Among the 200 patients were 190 women (95%). The median age of the patients was 48 years (ranges, 24-62 years), and their body mass index was 43 kg/m(2) (ranges, 32-59 kg/m(2)). As surgeons' experience increased over time, there was a significant increase in the weight of patients and the percentage of patients with previous abdominal operations. There also was a significant decrease in conversion rates and operative times. Leaks occurred in six patients at the cardiojejunostomy (3%), in two patients jejunojejunostomy (1%), and in one patient at the excluded stomach (0.5%). Of the 50 leaks that occurred in each quartile, there were in the 3 in the 1st quartile, 1 in the 2nd quartile, 2 in the 3rd quartile, 3 in the 4th quartile. The differences were not significant. There was no correlation between the number of LRYGBs, and the occurrence of a leak (p = 0.59 confidence interval -0.13-0.22).Conclusions: The incidence of staple-line leaks appears to be independent of the number of LRYGBs performed. These data suggest that surgeons' experience may not eliminate anastomotic complications experienced by patients undergoing LRYGB. [ABSTRACT FROM AUTHOR]

X-ray binaries (XRBs) are probes of both star formation and stellar mass, but more importantly remain one of the only direct tracers of the compact object population. To investigate the XRB population in M31, we utilized all 121 publicly available observations of M31 totalling over 1 Ms from Chandra's ACIS instrument. We studied 83 star clusters in the bulge using the year 1 star cluster catalogue from the Panchromatic Hubble Andromeda Treasury Survey. We found 15 unique star clusters that matched to 17 X-ray point sources within 1″ (3.8 pc). This population is composed predominantly of globular cluster low-mass XRBs, with one previously unidentified star cluster X-ray source. Star clusters that were brighter and more compact preferentially hosted an X-ray source. Specifically, logistic regression showed that the F475W magnitude was the most important predictor followed by the effective radius, while color (F475W–F814W) was not statistically significant. We also completed a matching analysis of 1566 H II regions and found 10 unique matches to 9 X-ray point sources within 3″ (11 pc). The H II regions hosting X-ray point sources were on average more compact than unmatched H II regions, but logistic regression concluded that neither the radius nor Hα luminosity was a significant predictor. Four matches have no previous classification and thus are high-mass XRB candidates. A stacking analysis of both star clusters and H II regions resulted in non-detections, giving typical upper limits of ≈1032 erg s–1, which probes the quiescent XRB regime. [ABSTRACT FROM AUTHOR]

We combine James Webb Space Telescope (JWST) and Hubble Space Telescope imaging with Atacama Large Millimeter Array CO(2–1) spectroscopy to study the highly turbulent multiphase intergalactic medium (IGM) in Stephan's Quintet on 25–150 pc scales. Previous Spitzer observations revealed luminous H2 line cooling across a 45 kpc-long filament, created by a giant shock wave, following the collision with an intruder galaxy, NGC 7318b. We demonstrate that the Mid-Infrared Instrument/F1000W/F770W filters are dominated by 0–0 S(3) H2 and a combination of polycyclic aromatic hydrocarbon and 0–0 S(5) H2 emission. These observations reveal the dissipation of kinetic energy as massive clouds experience collisions, interactions, and likely destruction/recycling within different phases of the IGM. In 1 kpc-scaled structure, warm H2 was seen to form a triangular-shaped head and tail of compressed and stripped gas behind a narrow shell of cold H2. In another region, two cold molecular clumps with very different velocities are connected by an arrow-shaped stream of warm, probably shocked, H2 suggesting a cloud–cloud collision is occurring. In both regions, a high warm-to-cold molecular gas fraction indicates that the cold clouds are being disrupted and converted into warm gas. We also map gas associated with an apparently forming dwarf galaxy. We suggest that the primary mechanism for exciting strong mid-IR H2 lines throughout Stephan's Quintet is through a fog of warm gas created by the shattering of denser cold molecular clouds and mixing/recycling in the post-shocked gas. A full picture of the diverse kinematics and excitation of the warm H2 will require future JWST mid-IR spectroscopy. The current observations reveal the rich variety of ways that different gas phases can interact with one another. [ABSTRACT FROM AUTHOR]

The effects of the finite Larmor radius on the generation of zonal flows by the four-wave modulational instability are investigated using an extended form of the Hasegawa-Mima equation. Growth rates of the zonal mode are quantified using analytical predictions from a four-mode truncated model, as well as from direct numerical simulation of the nonlinear extended Hasegawa-Mima equation. We not only consider purely zonal flows but also examine the generic oblique case and show that, for small Larmor radii, off-axis modes may become dominant. We find a key parameter Mρ which characterises the behaviour of the system due to changes in the Larmor radius. We find that, similarly to previous results obtained by changing the driving wave amplitude, two separate dynamical regimes can be accessed. These correspond to oscillatory energy transfer between zonal flows and a driving wave and the fully saturated zonal flow. [ABSTRACT FROM AUTHOR]

The article underscores the value of injury research advocacy. It states that the Society for the Advancement of Violence and Prevention (SAVIR) has described advocacy for injury prevention research as one of its priorities. Relative to this, various activities are being planned to educate the members of SAVIR, to enhance their skills, and facilitate their participation in advocacy initiatives.

Quasars at z ≳ 1 most often have redshifts measured from rest-frame ultraviolet emission lines. One of the most common such lines, C iv λ 1549, shows blueshifts up to ≈5000 km s−1 and in rare cases even higher. This blueshifting results in highly uncertain redshifts when compared to redshift determinations from rest-frame optical emission lines, e.g., from the narrow [O iii ] λ 5007 feature. We present spectroscopic measurements for 260 sources at 1.55 ≲ z ≲ 3.50 having −28.0 ≲ M i ≲ − 30.0 mag from the Gemini Near Infrared Spectrograph–Distant Quasar Survey (GNIRS-DQS) catalog, augmenting the previous iteration, which contained 226 of the 260 sources whose measurements are improved upon in this work. We obtain reliable systemic redshifts based on [O iii ] λ 5007 for a subset of 121 sources, which we use to calibrate prescriptions for correcting UV-based redshifts. These prescriptions are based on a regression analysis involving C iv full-width-at-half-maximum intensity and equivalent width, along with the UV continuum luminosity at a rest-frame wavelength of 1350 Å. Applying these corrections can improve the accuracy and the precision in the C iv -based redshift by up to ∼850 km s−1 and ∼150 km s−1, respectively, which correspond to ∼8.5 and ∼1.5 Mpc in comoving distance at z = 2.5. Our prescriptions also improve the accuracy of the best available multifeature redshift determination algorithm by ∼100 km s−1, indicating that the spectroscopic properties of the C iv emission line can provide robust redshift estimates for high-redshift quasars. We discuss the prospects of our prescriptions for cosmological and quasar studies utilizing upcoming large spectroscopic surveys. [ABSTRACT FROM AUTHOR]

Weak emission-line quasars (WLQs) are a subset of type 1 quasars that exhibit extremely weak Ly α + N v λ 1240 and/or C iv λ 1549 emission lines. We investigate the relationship between emission-line properties and accretion rate for a sample of 230 "ordinary" type 1 quasars and 18 WLQs at z < 0.5 and 1.5 < z < 3.5 that have rest-frame ultraviolet and optical spectral measurements. We apply a correction to the H β -based black hole mass (M BH) estimates of these quasars using the strength of the optical Fe ii emission. We confirm previous findings that WLQs' M BH values are overestimated by up to an order of magnitude using the traditional broad-emission-line region size–luminosity relation. With this M BH correction, we find a significant correlation between H β -based Eddington luminosity ratios and a combination of the rest-frame C iv equivalent width and C iv blueshift with respect to the systemic redshift. This correlation holds for both ordinary quasars and WLQs, which suggests that the two-dimensional C iv parameter space can serve as an indicator of accretion rate in all type 1 quasars across a wide range of spectral properties. [ABSTRACT FROM AUTHOR]

The Russian Wheat Aphid ( Diuraphis noxia , RWA) negatively impacts commercially grown barley and wheat in South Africa. Climate change, the attendant rise in [CO 2 ], and the appearance of new RWA biotypes have the potential to induce severe crop yield loss in agriculturally important wheat and barley cultivars. This study presents data showing changes in relative aphid population numbers, concurrently with assessments of plant damage under controlled environmental conditions, under ambient and elevated (450 ppm) [CO 2 ]. Extensive structural damage to the vascular tissue and disruption to the transport systems were revealed using light, fluorescence and electron microscopy. This, coupled with biotype population studies, demonstrated that RWA has the capacity to inflict severe, potentially permanent damage to vegetative small grain plants. Furthermore, some currently ‘resistant’ cultivars may well lose resistance as a direct result of increasing atmospheric [CO 2 ]. A small (50 ppm) increase in atmospheric [CO 2 ] may result in increased aphid population numbers, potentially serious plant damage and, by implication, a potentially negative impact on yield, as increased aphid density per plant leads to an accelerated disruption of the assimilate and transpiration transport pathways. These outcomes pose a direct threat to the commercial small grain industry of South Africa and by extension, to other small grain production areas elsewhere. [ABSTRACT FROM AUTHOR]

Reports on the study describing diabetes management in the family. Roles played by family members in the treatment of diabetes.

To evaluate outcome measures in a cardiology unit, patient satisfaction was measured. Patients consistently related problems in two areas: pain management and the waiting period before their procedure. After a major system change, patient satisfaction increased 16% and 29% respectively. [ABSTRACT FROM AUTHOR]

Today's patients want to be well-informed consumers of health care. A resource center can help. [ABSTRACT FROM AUTHOR]

Background This study explored the synergistic relationship between stigma, self-esteem and social support, as predictors of depressive symptomology in parents of children with disabilities (e.g. Autism and Down syndrome). Method One hundred and seventy-three parents (115 parents of children with disabilities and 58 control parents) completed measures of perceived stigma, self-esteem, social support and depressive symptoms. Results Parents of children with disabilities reported more depressive symptomology; additionally, stigma, self-esteem and social support were associated with depressive symptomology. Moreover, the association between stigma and depressive symptomology was mediated by self-esteem, i.e. parents who reported higher stigma were lower on self-esteem and more depressed. Further, this path varied as a function of emotional support. Conclusion Results highlight the need for tailored interventions that offer parents effective strategies in dealing with stigma through social support and self-esteem. [ABSTRACT FROM AUTHOR]

We utilize recent NuSTAR observations (co-added depth ≈55â€"120 ks) of PG 1001+054, PG 1254+047, and PHL 1811 to constrain their hard X-ray (≳5 keV) weakness and spectral shapes and thus to investigate the nature of their extreme X-ray weakness. These quasars showed very weak soft X-ray emission, and they were proposed to be intrinsically X-ray weak, with the X-ray coronae producing weak continuum emission relative to their optical/UV emission. However, the new observations suggest an alternative explanation. The NuSTAR 3â€"24 keV spectral shapes for PG 1001+054 and PHL 1811 are likely flat (effective power-law photon indices Î" eff = 1.0 âˆ' 0.6 + 0.5 and Î" eff = 1.4 âˆ' 0.7 + 0.8 , respectively), while the shape is nominal for PG 1254+047 (Î"eff = 1.8 ± 0.3). PG 1001+054 and PHL 1811 are significantly weak at hard X-ray energies (by factors of ≈26â€"74 at rest-frame 8 keV) compared to the expectations from their optical/UV emission, while PG 1254+047 is only hard X-ray weak by a factor of ≈3. We suggest that X-ray obscuration is present in all three quasars. We propose that, as an alternative to the intrinsic X-ray weakness + X-ray obscuration scenario, the soft and hard X-ray weakness of these quasars can be uniformly explained under an obscuration-only scenario. This model provides adequate descriptions of the multiepoch soft and hard X-ray data of these quasars, with variable column density and leaked fraction of the partial covering absorber. We suggest that the absorber is the clumpy dust-free wind launched from the accretion disk. These quasars probably have super-Eddington accretion rates that drive powerful and high-density winds. [ABSTRACT FROM AUTHOR]

An integral part of the unified model for active galactic nuclei (AGNs) is an axisymmetric obscuring medium, which is commonly depicted as a torus of gas and dust surrounding the central engine. However, a robust, dynamical model of the torus is required in order to understand the fundamental physics of AGNs and interpret their observational signatures. Here, we explore self-similar, dusty disk winds, driven by both magnetocentrifugal forces and radiation pressure, as an explanation for the torus. Using these models, we make predictions of AGN infrared (IR) spectral energy distributions from 2 to 100 μm by varying parameters such as the viewing angle (from i = 0° to 90°), the base column density of the wind (from NH, 0 = 1023 to 1025 cm-2), the Eddington ratio (from L/LEdd = 0.01 to 0.1), the black hole mass (from MBH = 108 to 109 M⊙), and the amount of power in the input spectrum emitted in the X-ray relative to that emitted in the UV/optical (from αox = 1.1 to 2.1).We find that models with NH, 0 = 1025 cm-2, L/LEdd = 0.1, and MBH ≥108 M⊙ are able to adequately approximate the general shape and amount of power expected in the IR as observed in a composite of optically luminous Sloan Digital Sky Survey quasars. The effect of varying the relative power coming out in X-rays relative to the UV is a change in the emission below ~5μm from the hottest dust grains; this arises from the differing contributions to heating and acceleration of UV and X-ray photons. We see mass outflows ranging from ~1 to 4 M⊙ yr-1, terminal velocities ranging from ~1900 to 8000 km s-1, and kinetic luminosities ranging from ~1 x 1042 to 8 x 1043 erg s-1. Further development of this model holds promise for using specific features of observed IR spectra in AGNs to infer fundamental physical parameters of the systems. [ABSTRACT FROM AUTHOR]

In this paper we describe a graph-theoretical approach for pattern discovery that is especially useful in epidemiological research when applied to case-control studies involving categorical features such as genotypes and exposures. Whereas existing approaches are limited to exploring relationships among two or three factors, or deal with thousands of genes but are unable to isolate interactions among individual genes, we focus on interactions among tens of genes. We present a pattern discovery algorithm that finds associations among multiple factors, such as genetic and environmental factors, and groups of individuals (cases and controls) in a clinical survey. To validate our approach and to demonstrate its effectiveness, we applied it to a selection of synthetic data sets that were devised to emulate the situations encountered in epidemiological studies involving common diseases with suspected associations involving multiple factors that could include inherited genotypes, somatic genotypes, demographic characteristics, or exposures. The results of this experiment show that it is possible to identify the effects of multiple factors in moderate-size surveys (involving hundreds of individuals) even when the number of factors is greater than three. [ABSTRACT FROM AUTHOR]

In this paper we describe the use of a multi-segment conductivity probe for measuring conductivity as a function of height and time in a foam phase. Relationships between the conductivity ratio (ratio of conductivity in a foam to conductivity in the bulk liquid) and the liquid hold-up in the foam have been described previously by a number of researchers. If conductivity measurements from the multi-segment probe could be interpreted in terms of liquid hold-up in the foam this would provide valuable information about the physical nature of foam in, for example, a fermentation process, in which foams are known to have a number of adverse effects. Conductivity ratios have been determined for two multi-segment probes (one measures over a rectangular section of foam central to a cylindrical vessel, whilst the other measures over a disk like slice of foam). Liquid hold-up was measured using a specially designed column, which allows selected sections of foam (corresponding to segments on the foam probe) to be collected and weighed for determination of liquid content. A range of solutions and process parameters were used to generate foams with a range of structures and liquid hold-ups. At low values of liquid hold-up (<0.04), the conductivity ratios could be predicted well by Lemlich’s equation, which assumes that all the liquid is in the Plateau borders irrespective of process conditions (although there was a concentration dependence for the two BSA concentrations considered). At higher values of liquid hold-up, data were generally better predicted by an equation, which is an interpolation between Lemlich’s equation (valid in the dry limit) and Maxwell’s equation (valid for higher liquid hold-ups). These results should be useful in allowing prediction of dynamic changes in liquid hold-up as a function of foam height from conductivity ratios determined using a mutli-segment conductivity probe similar to the fermenter probe described here, in fermentation processes. [Copyright &y& Elsevier]

The Pliocene and Pleistocene sediments of the Gippsland shelf are dominated by mixed carbonates and siliciclastics. From a detailed stratigraphic study that combines conventional marine geology techniques with magnetic imagery, the Late Neogene tectonic and eustatic history can be interpreted and correlated to the onshore section. Stratigraphic analyses of eight oil and gasfield foundation bores drilled to 150 m below the seabed revealed three principal facies types: (i) Facies A is fine-grained limestone and limey marl deeper than 50 m below the seabed, of Late Pliocene age (nannofossil zones CN11–12); (ii) Facies B is a fine–coarse pebble quartz–carbonate sand that occurs 10–50 m below the seabed in the inner shelf, grading down into Facies A in wells in the outer shelf, and is of Early–Middle Pleistocene age (nannofossil subzones CN13a-14b: ca 1.95–0.26 Ma); and (iii) discontinuous horizons of Facies C composed of carbonate-poor carbonaceous and micaceous fine quartz sand occurring 10–50 m below the seabed. The sparse benthic foraminifers in Facies C are inner shelf or Gippsland (euryhaline) Lakes forms. Holocene sands dominate the upper 1.5–2.5 m of the Gippsland shelf and disconformably overlie cemented limestones with aragonite dissolution, indicating previous exposure to meteoric water. Nannofossil dating of the limestones indicates ages within subzone CN14b (dated between ca 0.26 and 0.47 Ma). Airborne magnetic imaging across the Gippsland shelf and onshore provides details of buried magnetic palaeoriver channels and barrier systems. The river systems trend south-southeast from the Snowy, Tambo, Mitchell, Avon, Macalister and Latrobe Rivers across the shelf. Sparker seismic surveys show the magnetic palaeochannels as seismic ‘smudges’ 20–40 m below the seabed. They appear to correspond to Facies C lenses (i.e. are Early to Middle Pleistocene features). Magnetic palaeobarrier... [ABSTRACT FROM AUTHOR]

New mapping at Anglesea coal mine, and coal resource and deep groundwater drilling have provided new perspectives on the economically important Eastern View Group coal-bearing sedimentary succession in the onshore Torquay Basin. In the Anglesea Syncline, the upper 35 m-thick brown-coal seam of the Eastern View Group is overlain by a low-angle unconformity. Units overlying the coal seams include high-energy, cross-cutting sand channels of the Boonah Formation and lower energy channel and interchannel systems of the overlying Salt Creek and Anglesea Formations. The mine section can be correlated from borehole data with the Eastern View Group and Demons Bluff Group exposed in coastal cliff sections along the adjacent Anglesea to Torquay coast. Recently drilled coal and groundwater exploration bores provide new data on the extent of the coal measures in the Anglesea area, and details of the underlying Tertiary succession that include typical Otway Basin units such as the Pember Mudstone and Pebble Point Formations. The stratigraphy below the coal measures suggests that the Otway Ranges were not present during Palaeogene times. The rank of the brown coals on and around the Otway Ranges is higher than any other Tertiary coals in onshore Victoria, and they preserve similar patterns of rank distribution to the high-rank black coals in the underlying Lower Cretaceous Otway Group. Evidence for large overburden thicknesses is lacking, and the high ranks may have been augmented by higher than normal geothermal gradients in the Early Tertiary. Comparisons between the observed depositional cycles, sequence–stratigraphic cycles, and worldwide coastal onlap curves suggest that the observed disconformity boundaries are sequence boundaries that provide a chronostratigraphic framework. Sequences present may include TB4.1–4.5 in the overburden units, and TB 2.4–3.6 in the coal-bearing interval. [ABSTRACT FROM AUTHOR]