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Introduction Previous studies have shown an association between number of stroke admissions and outcomes. Small hospitals often support more remote areas and we studied national data to determine if an association exists between hospital remoteness and stroke care. Methods Data from the Irish National Audit of Stroke (INAS) on average stroke admissions, adjusted mortality for ischaemic stroke, thrombolysis rate and proportion with door to needle (DTN) ≤45 min were analysed. Hospital remoteness was quantified by distance to the next hospital, nearest neurointerventional centre and location within 10 km of the national motorway network. Results Data for 23 of 24 stroke services were evaluated. Median number of strokes admitted per year was 186 (range 84–497). Nine hospitals (39%) admitted ≥200 stroke patients per year (mean 332). Average adjusted mortality (7.0 vs. 7.3, P  = 0.67 t -test), mean thrombolysis rate (12.1% vs. 9.2%, P  = 0.09) and mean proportion of patients treated ≤45 min (40.4% vs. 31.3%, P  = 0.2) did not differ significantly between higher and lower volume hospitals. Hospitals close to the motorway network (n  = 15) had a higher mean thrombolysis rate (11.9% vs. 7.5%, P  = 0.01 t -test) and proportion DTN ≤45 min (43.7–18.4%, P  < 0.001). Number of stroke admissions did not correlate with mortality (r  = 0.06, P  = 0.78), DTN (r  = 0.12, P  = 0.95) or thrombolysis rate (r  = 0.35, P  = 0.20). Distance to next hospital correlated strongly negatively with DTN (r  = −0.47, P  = 0.02) and thrombolysis rate (−0.43, P  = 0.04). Conclusion Remoteness of hospitals is associated with worse measures of stroke outcome and management. [ABSTRACT FROM AUTHOR]

Humans are exposed to potentially harmful amounts of the neurotoxin monomethylmercury (MMHg) through consumption of marine fish and mammals. However, the pathways of MMHg production and bioaccumulation in the ocean remain elusive. In anaerobic environments, inorganic mercury (Hg) can be methylated to MMHg through an enzymatic pathway involving the hgcAB gene cluster. Recently, hgcA‐like genes have been discovered in oxygenated marine water, suggesting the hgcAB methylation pathway, or a close analog, may also be relevant in the ocean. Using polymerase chain reaction amplification and shotgun metagenomics, we searched for but did not find the hgcAB gene cluster in Arctic Ocean seawater. However, we detected Hg‐cycling genes from the mer operon (including organomercury lyase, merB), and hgcA‐like paralogs (i.e., cdhD) in Arctic Ocean metagenomes. Our analysis of Hg biogeochemistry and marine microbial genomics suggests that various microorganisms and metabolisms, and not just the hgcAB pathway, are important for Hg methylation in the ocean. [ABSTRACT FROM AUTHOR]

Vacuum glazing is an innovative transparent thermal insulator that has applications in high performance windows. Two sheets of glass are separated by an evacuated space maintained by a regular array of support pillars, and the structure is sealed around the edges with solder glass or a metal bond. The evacuated internal gap reduces the heat transfer across the glazing by eliminating air conduction and convection between the glass sheets. This review paper traces the development of vacuum glazing from the initial proposal 100 years ago, to the fi rst reported manufacture in 1989 by the University of Sydney, the subsequent commercialisation of that design in 1996 and recent advances. The various design challenges are discussed along with the innovative ways they were successfully addressed by two research groups. Several key non-technical factors that have been equally important to the commercialisation and acceptance of this new technology are also presented. The future prospects for vacuum glazing are discussed in the context of the growing interest in energy effi cient buildings and higher standards for the thermal performance of windows. [ABSTRACT FROM AUTHOR]

Lentil (Lens culinaris Medic.) is a pulse crop that belongs to the family Leguminosae. Lentils are rich in proteins, have 18 of the 20 amino acids including all 8 essential amino acids and provide a number of essential minerals and vitamins. Thus, lentils occupy an important place in the human diet, especially in developing countries, as a rich source of protein, vitamins and minerals. Although in many developing countries in Asia rice contributes significantly to human daily energy and nutritional requirements, its amino acid profile shows that rice lacks some essential amino acids. Therefore, given their rich composition of amino acids, lentils could act as an ideal supplement for rice-based diets. Although all red lentils are imported, they are the most widely consumed pulse among Sri Lankans. Red lentil consumption levels are significantly greater in the estate sector where the prevalence of under nutrition is high. Thus, this review was undertaken to understand the potential role of lentils in the Sri Lankan diet and how lentils can potentially be utilized to meet the nutritional needs of Sri Lankans. The study was based on an extensive literature review and information obtained through personal interviews with key participants in the red lentil industry of Sri Lanka. It was evident that red lentils are a rich source of nutrients, especially micro-nutrients, but their bioavailability is poor due to the presence of multiple anti-nutritive factors such as protease inhibitors, phenolic compounds and phytates. Although bioavailability of nutrients can be enhanced by changing food processing techniques, fortification and bio-fortification, lentil cooking patterns in Sri Lanka pose difficulties in adopting changed food processing techniques and fortification. Thus, bio-fortification would be the most viable option for enhancing nutrient availability in lentils. Since Sri Lanka does not produce lentils, such initiatives may have to be undertaken in exporting countries or in collaboration with international agricultural research centres. Any strategic investments in breeding new lentil varieties with high bioavailability would provide exporting countries a unique competitive edge in export markets. Such improvements would meet the nutritional needs, not only of Sri Lankans, but also of millions other Asian consumers who face similar nutritional challenges. [ABSTRACT FROM AUTHOR]

A stratospheric sudden warming (SSW) is a dynamical phenomenon of the wintertime stratosphere caused by the interaction between planetary Rossby waves propagating from the troposphere and the stratospheric zonal-mean flow. While the effects of SSW events are seen predominantly in high latitudes, they can also produce significant changes in middle and low latitude temperature and winds. In this study we quantify the middle and low latitude effects of SSW events on temperature and zonal-mean winds using a composite of SSW events between 1988 and 2010 simulated with the specified dynamics version of the Whole Atmosphere Community Climate Model (WACCM). The temperature and wind responses seen in the tropics also extend into the low latitudes in the other hemisphere. There is variability in observed zonal-mean winds and temperature depending on the observing location within the displaced or split polar vortex and propagation direction of the planetary waves. The propagation of planetary waves show that they originate in mid-high latitudes and propagate upward and equatorward into the mid-latitude middle atmosphere where they produce westward forcing reaching peak values of ~60- 70ms-1 day-1. These propagation paths in the lower latitude stratosphere appear to depend on the phase of the quasibiennial oscillation (QBO). During the easterly phase of the QBO, waves originating at high latitudes propagate across the equator, while in the westerly phase of the QBO, the planetary waves break at ~20-25° N and there is no propagation across the equator. The propagation of planetary waves across the equator during the easterly phase of the QBO reduces the tropical upwelling and poleward flow in the upper stratosphere. [ABSTRACT FROM AUTHOR]

The integration and mandatory study of research method courses by university students is a global phenomenon. However, students demonstrate apprehension and disinterest in research methods courses. Consequently, this study investigated the interplay among research methods anxiety, positive disposition toward research, perception of usefulness, self-efficacy, and academic effort in research. Paper-and-pencil questionnaires were used to collect data from a convenience sample of 636 technical university students in Ghana. Based on partial least squares structural equation modeling results, research anxiety reduces students' self-beliefs (β = −0.172; t = 2.729; p =.000) and negatively affects perception of research usefulness (β = −0.172; t = 2.729; p =.000). A positive disposition towards research enhances students' academic efforts in research (β = 0.919; t = 3.308; p = 0.001). Furthermore, self-efficacy drives students' efforts (β = −0.172; t = 2.729; p =.000), enhances positive disposition toward research (β = 0.191; t = 3.308; p =.001) and perception of research usefulness among students (β = 0.224; t = 3.064; p =.002). Students' perception of research usefulness mediates the relationship between anxiety and effort in research (β = −0.075; t = 3.653; p =.000), positive research disposition and effort (β = −0.056; t = 2.519; p =.012) as well as research self-efficacy and effort in studies (β = 0.083; t = 3.02; p =.003). [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Children with Alagille syndrome often have complex forms of congenital heart defects with the majority having peripheral pulmonary artery stenosis (PPAS) and pulmonary valve atresia (PA) or pulmonary valve stenosis. Children with Alagille syndrome also have variable amounts of liver dysfunction. The purpose of this study was to evaluate the impact of liver dysfunction on outcomes in children with Alagille syndrome undergoing congenital heart surgery. METHODS This was a retrospective review of 69 patients with Alagille syndrome who underwent congenital heart surgery at our institution. The underlying diagnoses included PPAS (n  = 29), tetralogy of Fallot with PPAS (n  = 14), tetralogy with PA (n  = 3), PA with ventricular septal defect and major aortopulmonary collateral arteries (n  = 21) and one each with D-transposition and supravalvar aortic stenosis. RESULTS The median age at surgery was 16 months (range 0–228 months). Procedures performed included PPAS repair (n  = 43), tetralogy with PA repair (n  = 3), unifocalization procedures (n  = 21) and other (n  = 2). Forty-two (61%) patients had mild or no liver dysfunction, while 26 (38%) had moderate or severe liver dysfunction. The median cardiopulmonary bypass time was 345 min (341 with liver dysfunction, 345 without liver dysfunction). There were a total of 8 operative (12%) deaths and 3 late (4%) deaths. Six operative and 2 late deaths occurred in patients with liver dysfunction (combined 30.7%) versus 2 operative and 1 late death (combined 7.1%) for patients without liver dysfunction (P  < 0.05). CONCLUSIONS These results suggest that liver dysfunction has a profound impact on survival in children with Alagille syndrome undergoing congenital heart surgery. [ABSTRACT FROM AUTHOR]

We describe the VISTA Science Archive (VSA) and its first public release of data from five of the six VISTA public surveys. The VSA exists to support the VISTA surveys through their lifecycle: the VISTA Public Survey consortia can use it during their quality control assessment of survey data products before submission to the ESO Science Archive Facility (ESO SAF); it supports their exploitation of survey data prior to its publication through the ESO SAF; and, subsequently, it provides the wider community with survey science exploitation tools that complement the data product repository functionality of the ESO SAF. This paper has been written in conjunction with the first public release of public survey data through the VSA and is designed to help its users understand the data products available and how the functionality of the VSA supports their varied science goals. We describe the design of the database and outline the database-driven curation processes that take data from nightly pipeline-processed and calibrated FITS files to create science-ready survey datasets. Much of this design, and the codebase implementing it, derives from our earlier WFCAM Science Archive (WSA), so this paper concentrates on the VISTA-specific aspects and on improvements made to the system in the light of experience gained in operating the WSA. [ABSTRACT FROM AUTHOR]

Rayleigh and resonance lidar observations were made during the Turbopause experiment at Poker Flat Research Range, Chatanika Alaska (65° N, 147° W) over a 10 h period on the night of 17-18 February 2009. The lidar observations revealed the presence of a strong mesospheric inversion layer (MIL) at 74 km that formed during the observations and was present for over 6 h. The MIL had a maximum temperature of 251 K, amplitude of 27±7 K, a depth of 3.0 km, and overlying lapse rate of 9.4±0.3Kkm-1. The MIL was located at the lower edge of the mesospheric sodium layer. During this coincidence the lower edge of the sodium layer was lowered by 2 km to 74 km and the bottomside scale height of the sodium increased from 1 km to 15 km. The structure of the MIL and sodium are analyzed in terms of vertical diffusive transport. The analysis yields a lower bound for the eddy diffusion coefficient of 430m2 s-1 and the energy dissipation rate of 2.2mWkg-1 at 76-77 km. This value of the eddy diffusion coefficient, determined from naturally occurring variations in mesospheric temperatures and the sodium layer, is significantly larger than those reported for mean winter values in the Arctic but similar to individual values reported in regions of convective instability by other techniques. [ABSTRACT FROM AUTHOR]

Background: Comparison of complete genomes of Bacteria and Archaea shows that gene content varies considerably and that genomes evolve quite rapidly via gene duplication and deletion and horizontal gene transfer. We analyze a diverse set of 92 Bacteria and 79 Archaea in order to investigate the processes governing the origin and evolution of families of related genes within genomes. Results: Genes were clustered into related groups using similarity criteria derived from BLAST. Most clusters contained genes from only one or a small number of genomes, and relatively few core clusters were found that spanned all genomes. Gene clusters found in larger numbers of genomes tended to have larger numbers of genes per genome; however, clusters with unusually large numbers of genes per genome were found among both narrowly and widely distributed clusters. Larger genomes were found to have larger mean gene family sizes and a greater proportion of families of very large size. We used a model of birth, death, and innovation to predict the distribution of gene family sizes. The key parameter is r, the ratio of duplications to deletions. It was found that the model can give a good fit to the observed distribution only if there are several classes of genes with different values of r. The preferred model in most cases had three classes of genes. Conclusions: There appears to be a rapid rate of origination of new gene families within individual genomes. Most of these gene families are deleted before they spread to large numbers of genomes, which suggests that they may not be generally beneficial to the organisms. The family size distribution is best described by a large fraction of families that tend to have only one or two genes and a small fraction of families of multi-copy genes that are highly prone to duplication. Larger families occur more frequently in larger genomes, indicating higher r in these genomes, possibly due to a greater tolerance for non-beneficial gene duplicates. The smallest genomes contain very few multi-copy families, suggesting a high rate of deletion of all but the most beneficial genes in these genomes. [ABSTRACT FROM AUTHOR]

Background Venous thromboembolism (VTE) predominantly afflicts surgical and medical patients in an acute hospital setting. Responsibility for VTE risk assessment and appropriate prophylaxis to prevent this major health burden rests with a variety of clinical staff. All too frequently, however, patients do not undergo VTE risk assessment on admission. This is regardless of the fact that a number are at risk for VTE, receive no prophylaxis and unknowingly are at risk of serious adverse events including death. Objective The broad aims of this paper is to provide evidence based information on VTE and to report on the rate of appropriate VTE prophylaxis pre and post nursing educational sessions. Setting This paper describes a nurse led initiative undertaken at a tertiary level acute care facility in Queensland. Subjects A clinical audit was conducted on 2,063 hospitalised inpatients Primary argument Nurses who are empowered through evidence based education sessions can take responsibility for VTE risk assessment of all admitted patients and ensure appropriate VTE prophylaxis is provided. The rates for appropriate prophylaxis in admitted patients at risk of VTE increased from 27% to 85% (p< 0.0001). Through appropriate prophylaxis of patients at risk of VTE, the incidence of VTE will be significantly reduced. Conclusions Nurses who are committed to VTE risk assessment and prophylaxis have the ability to contribute significantly to the reduction of VTE and its subsequent complications. [ABSTRACT FROM AUTHOR]

We present a description of the design and usage of a new synoptic pipeline and data base model for time series photometry in the VISTA Data Flow System (VDFS). All UK Infra-Red Telescope Wide Field Camera (UKIRT) data and most of the VISTA main survey data will be processed and archived by the VDFS. Much of these data are multi-epoch, useful for finding moving and variable objects. Our new data base design allows the users to easily find rare objects of these types amongst the huge volume of data being produced by modern survey telescopes. Its effectiveness is demonstrated through examples using Data Release 5 of the UKIRT Deep Infrared Sky Survey (UKIDSS-Deep Extragalactic Survey (DXS) and the Wide Field Camera standard star data. The synoptic pipeline provides additional quality control and calibration to these data in the process of generating accurate light curves. We find that per cent of stars and per cent of galaxies in the UKIDSS-DXS with mag are variable with amplitudes mag. [ABSTRACT FROM AUTHOR]

We present the case of a 39-year-old white man with a Myobacterium avium-intracellulare pulmonary infection found to have a CD4+ count of 172 cells/mm3 and diagnosed subsequently with idiopathic CD4+ lymphopenia (ICL). After receiving clathromycin for 4 months with minimal improvement, the patient was started on pegylated subcutaneous interleukin (IL)-2 at 600 000 units daily. Later, he received incrementally higher pegylated IL-2 doses until he reached a maintenance dose 3 months later of 11 million units weekly divided into three equal doses. After 5 months of therapy, the patient's chronic cough resolved completely, sputum cultures became negative for Myobacterium avium-intracellulare and the CD4+ T cell count increased to 553 cells/mm3. After 35 months of well-tolerated IL-2 treatments and no recurrence of any opportunistic infections, IL-2 treatment was stopped. CD4+ counts 6 and 9 months after discontinuing IL-2 treatment were 596 and 378 cells/mm3 respectively, and he remains asymptomatic. This report supports IL-2 treatment for ICL-associated opportunistic infections as a safe and potentially efficacious treatment option, especially when combined with more traditional treatment regimens. [ABSTRACT FROM AUTHOR]

Agricultural cooperatives are often viewed as appropriate vehicles to facilitate vertical coordination with, or horizontal integration between, small farmers who would otherwise be excluded from value-adding opportunities and discerning markets. In South Africa, renewed interest in development-oriented cooperatives saw the introduction of a new Cooperatives Act in 2005, along will support measures dedicated to 'emerging' cooperatives. This paper contends that the architects of the new Act discounted important trends in international legislation that would have made development-oriented cooperatives more versatile and given their members better access to capital and expertise through equity partnerships with private agribusiness firms. It is concluded that the new Act should be amended to admit non-patron investors as members, and to allow for nonredeemable and hence appreciable and tradable shares. Such innovations are emerging internationally, usually with a cap on non-patron voting power. [ABSTRACT FROM AUTHOR]

We describe the WFCAM Science Archive, which is the primary point of access for users of data from the wide-field infrared camera WFCAM on the United Kingdom Infrared Telescope (UKIRT), especially science catalogue products from the UKIRT Infrared Deep Sky Survey. We describe the database design with emphasis on those aspects of the system that enable users to fully exploit the survey data sets in a variety of different ways. We give details of the database-driven curation applications that take data from the standard nightly pipeline-processed and calibrated files for the production of science-ready survey data sets. We describe the fundamentals of querying relational databases with a set of astronomy usage examples, and illustrate the results. [ABSTRACT FROM AUTHOR]

A systematic review was performed to evaluate the clinical effectiveness of docetaxel in combination with prednisolone (docetaxel is licensed in the UK for use in combination with prednisone or prednisolone for the treatment of patients with metastatic hormone-refractory prostate cancer. Prednisone is not used in the UK, but it is reasonable to use docetaxel plus prednisone data in this review of docetaxel plus prednisolone) for the treatment of metastatic hormone-refractory prostate cancer. A scoping search identified a trial of docetaxel plus prednisone vs mitoxantrone plus prednisone, but did not identify any trials comparing docetaxel plus prednisolone/prednisone with any other treatments. Therefore, we considered additional indirect evidence that would enable a comparison of docetaxel plus prednisolone/prednisone with other chemotherapy regimens and active supportive care. Systematic searching (upto April 2005) identified seven randomised controlled trials. One large well-conducted trial assessed docetaxel plus prednisone vs mitoxantrone plus prednisone; this showed statistically significant improvements with 3-weekly docetaxel in terms of overall survival, quality of life, pain response and PSA decline. Two other chemotherapy regimens that included docetaxel with estramustine also showed improved outcomes in comparison with mitoxantrone plus prednisone. Three trials that compared mitoxantrone plus corticosteroids with corticosteroids alone were identified and their results for overall survival combined, which showed very little difference between the two groups. The addition of clodronate to mitoxantrone plus prednisone showed no significant differences in comparison with mitoxantrone plus prednisone alone. The evidence suggests that chemotherapy regimens containing 3-weekly docetaxel are superior to mitoxantrone or corticosteroids alone. [ABSTRACT FROM AUTHOR]

Abstract: An active control strategy for vibration control of structures using ATMDs is proposed. The control strategy incorporates the minimax criteria for shaping the frequency response function (FRF) of the structure–TMD system and the bang–bang control law with a control force applied to a TMD. In the control scheme, the control law using bang–bang control is obtained by minimising the time derivative of a Lyapunov function of the open-loop structural system [Wu Z, Soong TT. Modified bang–bang control law for structural control implementation. Journal of Engineering Mechanics 1996;122(8):771–7] and is used to control the ATMD. In addition, the corresponding FRF for the coupled structure–ATMD system is reshaped by changing the tuning parameter of the TMD (when there is no control force applied), such that peaks in the FRF of the structure are equal in magnitude. When the active control is ineffective or is turned off, the damper system acts as a passive TMD. The proposed strategy is compared to another conventional control strategy, the Linear Quadratic Controller (LQC) applied to the structure–TMD system and the advantages are highlighted. The system is examined under harmonic and random excitations. [Copyright &y& Elsevier]

The article comments on the importance of Stephan Fuchs' 'Against Essentialism' for general theory in sociology. Stephan Fuchs's Against Essentialism is the most important work of general theory that has appeared in the last 10 years or more. It is grand theory on the level with Luhmann, Habermas, and Giddens, encompassing society, culture, knowledge, and philosophy, it is general theory both in the sense of giving a framework for all of sociology and in the sense that the word "theory" is now used in humanistic and especially literary fields, the orienting perspective on what cultural knowledge consists in. On issues of culture, Fuchs neatly uncovers essentialist assumptions that vitiate Habermas, Bourdieu, and others. Fuchs marshals the evidence of conversational analysis to show how arguments, business meetings, and casual talk actually take place, and how consensus is constructed as a statement to outsiders rather than an accurate description of what actually happened in the social encounter. Fuchs defends a version of sociological realism against both absolutists and postmodernists. Firm realities are neither impossible nor everywhere; it is a mistake on the postmodernist/deconstructionist side to make the distinction between essences and lack of essences into an absolute contrast, forcing one to make a choice. it is a continuum, and again social networks determine where and when these kinds of realities or relativisms exist. Monopoly and hegemony, too, are not absolutes; these too are historically varying constructions.

ABSTRACT The variability in the infrared to millimetre emission from microquasar GRS 1915+105 is believed to be dominated by the system's relativistic jet. In this paper we develop a time-dependent version of the jet emission model of Blandford & Königl and apply it to the oscillations in the infrared and millimetre emission from GRS 1915+105 observed recently by Fender & Pooley. The resulting model provides a reasonable description of the observed flux oscillations from GRS 1915+105. From a fit of the observed time lag between the flux peaks in the infrared and millimetre emission together with the flux normalization, we were able to determine the model parameters for the GRS 1915+105 jet. We find that to achieve the observed flux levels with the model requires an unphysically large electron density within the jet. We therefore conclude that the Blandford & Königl model cannot explain these observations, either because it does not provide the correct description of the emission from microquasar jets, or because the observed emission variations do not originate in the jet. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the alcohol use of women in various non-European ethnic groups in the U.S. Review of related literature; Characteristics of the participants; Methodology; Findings and conclusion.

Examines whether the use of psychoactive drugs enhance individuals' ability to produce creative works. Findings that only the expected effects of alcohol contributes to the creative process; Conclusion that the pharmacological effect of alcohol does not enhance one's creativity; Implications for measuring creativity and the possible motivation to use drugs for creative effect.

Mammary gland mononuclear cells (MGM) were compared with peripheral blood mononuclear cells (PBM) for their ability to proliferate in response to phytohaemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM), and to produce interleukin-2 (IL-2) when cultured with Con A. MGM proliferative responses to all three mitogens were at a level only just above background. Following removal of adherent cells by passage of the MGM population over Sephadex G10, their ability to proliferate increased but these responses were still significantly lower (P < 0.001) than those of PBM. Mammary secretions from non-lactating cows and colostrum, but not milk, were found to suppress the proliferative responses to PHA and Con A of PBM following a 24-hr preincubation period. There was no difference in IL-2 production in response to Con A by Sephadex G10-treated MGM and PBM, and dry-cow secretions had no effect on IL-2 production. [ABSTRACT FROM AUTHOR]

Presents a computer simulation of a one-dimensional particle migration by local hopping of Chandrasekhar type with no local bias. Concept of local particle traffic; Cases of reflecting and absorbing boundaries; Specification and evaluation of the hopping model.

A double-blind trial ot the effect of transfer factor on multiple sclerosis patients was carried out. In a series of fifty-six multiple sclerosis patients treated with monthly injections of either transfer factor or placebo for 1 year, no beneficial effect of transfer factor was noted. In addition, none of the immunological and serological parameters studied (measles migration inhibition, measles HI titre or CSF immunoglobulin) changed as a result of transfer factor therapy. Histocompatibility typing and CSF IgG/TP ratios were correlated with the disease activity. Of interest was the finding that the presence of the DW2 antigen, when unassociated with HLA-B7 antigen, appeared to correlate with the mildest form of disease activity. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine if the presence of a pericardial effusion is associated with adverse outcomes among children admitted with juvenile idiopathic arthritis. Patients and methods: The multicenter, retrospective cohort study was conducted with 4,332 patients (1,554 males, 2,778 females; median age: 12 years; IQR, 7, 15 years) using the Pediatric Health Information System. Data from hospital admissions between January 1, 2004, and September 15, 2015, were obtained for patients with an International Disease Classification, Ninth Revision code for juvenile idiopathic arthritis. Pericardial effusion was the primary predictor variable; the outcomes of interest were length of stay, hospital costs, and readmission within 90 days. Multivariate models were created to evaluate associations between pericardial effusion and adverse outcomes. We also analyzed factors associated with increased odds of having pericardial effusion in juvenile idiopathic arthritis. Results: One hundred twenty (3%) patients had a code for pericardial effusion. Children with pericardial effusion had a longer median length of stay (7 days (IQR 3-12) vs. 3 days (IQR 2-6), p<0.001), higher median costs ($17,688 (IQR 8,657-40,623) vs. $8,456 (IQR 4,865-16,302), p<0.001), and greater rates of readmission (22% vs. 15%, p=0.045). Multivariate analysis demonstrated no significant association between pericardial effusion and outcomes of interest. Black race and male sex were associated with increased odds of having pericardial effusion. Conclusion: Pericardial effusion is rare among children admitted with juvenile idiopathic arthritis but is associated with significant morbidity; its presence may be a marker of disease severity. Black children and males admitted with juvenile idiopathic arthritis warrant special consideration and may benefit from screening echocardiography. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of HER2 status is critical for selecting patients who will benefit from trastuzumab therapy. There is still no consensus regarding the optimal method to assess HER2 status. Computerized image analysis has been shown to provide a more accurate and objective way for quantification of HER2 expression by IHC than manual evaluation. It has been suggested that the use of image analysis may help to resolve some of the discrepancies between IHC and FISH assay. We compared the results of HER2 expression by IHC using automated image analysis with fluorescent in situ hybridization (FISH) assay. Design: Testing for HER2 expression by IHC and FISH was performed on 2853 specimens at UT Southwestern Medical Center between the years 2002 to 2011. Quantification of IHC HER2 expression was done by image analysis and scored as positive (>2.0), borderline (1.5 to 2.0) and negative. (<1.5). The PathVysion kit was used for FISH assay to evaluate HER2 amplification. Ratios >2.0, 1.8 to 2.0 and <1.8 were defined positive, borderline and negative amplification respectively. [ABSTRACT FROM AUTHOR]

Discusses an abstract of "Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20,536 people with cerebrovascular disease or other high-risk conditions," by R. Collins et al published in a 2004 issue of "Lancet" journal.

Introduction Stroke is a leading cause of morbidity. Current guidelines advise maximum of 4.5 hours post symptom onset for thrombolysis, and 24 hours for thrombectomy. (1) Delay between symptom onset and treatment is associated with an inferior outcome. Thrombolysis is available in 27 Irish centers. Average rate of thrombolysis is 11%. (3) Fewer than half of stroke patients arrived in hospital within three hours of symptom onset in 2019. (4) Median door-to-needle time is 48 minutes. Method FAST calls in Tallaght University Hospital, from 2/7/19–1/7/21, were included in this analysis (n = 594). Results 160 FAST calls took place pre-Covid (20/month), and 434 post-Covid (27.12/month). Time of symptom onset was recorded in 390 cases. Time patients last seen well was known in 185 cases, unknown time of onset in 19. After review by the stroke clinician, FAST imaging was obtained in 78% of cases (n = 464). Of these, 34 cases of FAST imaging were performed for inpatients. Average time from registration to CT was 35:24 minutes pre covid, and 45:52 minutes post. 9.7% of patients were thrombolysed. The median door-to-needle time was 41 minutes pre-Covid(n = 21, 2.625/month), and 54 minutes after (n = 37, 2.3/month). Thrombectomy was performed in 46 cases. 222 patients were diagnosed with an ischaemic stroke, 50 had TIA and 48 had haemorrhagic strokes. Other diagnoses included migraine (6.7%, n = 40), seizures (6.7%, n = 40) and Bells Palsy (3.7%, n = 22). 55% (n = 330) of cases were registered to ED with FAST call between the hours of 9 am-5 pm. 27% (n = 161) of cases occurred during the night shift. Conclusion The median door-to-needle times were below national median pre-Covid, and longer post-pandemic, with an increase in the rate of presentation in the same time-frame. This report highlights the effect of the pandemic on time-critical patient interventions in stroke and the need to stratify services to respond to structural challenges. [ABSTRACT FROM AUTHOR]

In the United States, fractions are an important part of the middle school curriculum, yet many middle school students struggle with fraction concepts. Teachers also have difficulty with the conceptual understanding needed to teach fractions and rely on textbooks when making instructional decisions. This reliance on textbooks, the idea that teaching and learning of fractions is a complex process, and that fraction understanding is the foundation for later topics such as proportionality, algebra, and probability, makes it important to examine the variation in presentation of fraction concepts in U. S. textbooks, especially the difference between traditional and standards-based curricula. The purpose of this study is to determine if differences exist in the presentation of fractions in conventional and standards-based textbooks and how these differences align with the recommendations of National Council of Teachers of Mathematics, Common Core State Standards, and the research on the teaching and learning of fractions. [ABSTRACT FROM AUTHOR]

Nursing home (NH) residents represent the frailest group of older people, and providing gerontologically attuned care that addresses these frailties is often a challenge within the emergency department (ED). This study sought to prospectively profile acutely unwell NH residents in order to clarify some of the challenges of providing emergency care to this group. Over an 18-week period, we prospectively reviewed all NH residents presenting to the ED of an urban university teaching hospital. Relevant data were retrieved by direct physician review (as part of a comprehensive geriatric assessment in the ED), collateral history from NH staff and primary carers, and review of electronic records. There were 155 ED visits by 116 NH residents. Their mean age was 80.3 (±9.6) years. High pre-morbid levels of dependency were reflected by a mean Barthel Index of 34.1 (±20) and almost two-thirds had a pre-existing diagnosis of dementia. One-third of visits were during ‘normal’ working hours. Patients were reviewed by their regular NH doctor pre-transfer for 36% of visits. Using accepted international criteria, over half of the visits were deemed ‘potentially preventable’. Unwell NH residents have complex medical needs. The decision to refer these patients to the ED is often made by ‘out of hours’ general practitioners and their initial care in the ED is directed by physicians with limited experience in geriatric medicine. Most referrals to the ED are potentially preventable but this would require enhancements to the package of care available in NHs. [ABSTRACT FROM AUTHOR]

Wild harvesting has taken place over millennia in Africa. However urbanization and cash economies have effectively altered harvesting from being cultural, traditional, and subsistence activities that are part of a rural norm, to being a subculture of commonly illicit activities located primarily within the urban, cash-based, informal economy. This paper focuses on Cape Town, South Africa where high levels of poverty and extensive population growth have led to a rapidly growing informal industry based on the cultural, subsistence, and entrepreneurial harvesting and consumption of products obtained from the local natural environment. Through a process of literature reviews, database analysis, and key informant interviews, a compendium of harvested species was developed, illustrating the breadth of illicit harvesting of products from nature reserves, public open space, and other commonage within the City. The compendium records 448 locally occurring species (198 animals and 250 plants) that are extracted for medicinal, energy, ornamental, sustenance, nursery, and other uses. The sustainability of harvesting is questionable; nearly 70% of all harvested flora and 100% of all collected fauna are either killed or reproductively harmed through the harvesting processes. Furthermore, for the 183 indigenous flora species currently recorded on the International Union for Conservation of Nature (IUCN) Red List, 28% (51) hold assessments ranging from Declining through to Critically Endangered. With respect to the more poorly assessed fauna (46 spp.), approximately 24% (11) have Declining or Threatened status. [ABSTRACT FROM AUTHOR]

Molybdenum thin films were deposited by rf and dc magnetron sputtering and their properties analyzed with regards to their potential application as a back contact for CIGS solar cells. It is shown that both types of films tend to transition from tensile to compressive strain when the deposition pressure increases, while the conductivity and the grain size decreas. The nucleation of the films characterized by in situ and real time spectroscopic ellipsometry shows that both films follow a Volmer-Weber growth, with a higher surface roughness and lower deposition rate for the rf deposited films. The electronic relaxation time was then extracted as a function of bulk layer thickness for rf and dc films by fitting each dielectric function to a Drude free-electron model combined with a broad Lorentz oscillator. The values were fitted to a conical growth mode and demonstrated that the rf-deposited films have already smaller grains than the dc films when the bulk layer thickness is 30 nm. [ABSTRACT FROM AUTHOR]

Some people are adept at using discrete emotion categories (anxious, angry, sad) to capture their felt experience; other people merely communicate how good or bad they feel. We theorized that people who are better at describing their emotions might be less likely to self-medicate with alcohol. During a 3-week period, 106 underage social drinkers used handheld computers to self-monitor alcohol intake. From participants’ reported experiences during random prompts, we created an individual difference measure of emotion differentiation. Results from a 30-day timeline follow-back revealed that people with intense negative emotions consumed less alcohol if they were better at describing emotions and less reliant on global descriptions. Results from ecological momentary assessment procedures revealed that people with intense negative emotions prior to drinking episodes consumed less alcohol if they were better at describing emotions. These findings provide support for a novel methodology and dimension for understanding the influence of emotions on substance-use patterns. [ABSTRACT FROM PUBLISHER]

The article focuses on tracking of the volcano ash cloud during the eruption of Mt. Augustine Volcano in southern Alaska. It provides information on the report of the Alaska Volcano Observatory (AVO), the office responsible for the monitoring of the 100 active volcanoes in the Northern Pacific. It talks on the ash dispersion model Puff developed by the University of Alaska Fairbanks (UAF), and Geophysical Institute (GI) at AVO to allow forecasters to predict the movement of volcanic ash clouds, and warn aircraft of potential hazards. Observations based on satellite data on the movement of ash clouds in the neighboring place of Mt. Augustine and across Alaska are also provided.

The authors reflect on the use of visual representations in helping middle school students understand mathematics focusing on fractions. It notes that students learning and ideas on mathematical communication are supported by these representations, which help them organize their thinking and make connections among mathematical concepts. According to the authors, teachers should introduced their students to a variety of representations that can take full advantage of the benefits of each form.

The Arctic Marine Biodiversity Observing Network monitors biological assemblages on taxonomic scales ranging from microbes to seabirds on the eastern Chukchi Sea shelf to improve understanding of their responses to changing environmental conditions, including climate change. Here, we compare two years, 2015 and 2017, the latter characterized by a much larger spatial extent of warmer, more saline Pacific waters within the study region. These environmental differences were associated with changes in the taxonomic diversity and species composition of eight different assemblages. Impacts included decreases in the diversity and abundance of benthic species and increases in the diversity and abundance of zooplankton and demersal fish. These observations are consistent with the expected patterns of borealization, a term that describes changes from polar to more southern or boreal conditions and that have been observed on other Arctic inflow shelves where there is communication with the global ocean. A decoupling of the seabird assemblage from other assemblages in 2017 suggests that seabirds were unable to fully adjust to changing prey conditions in 2017. Pronounced differences in the taxonomic composition and a substantial decline in taxonomic diversity of bacteria and protists in 2017 remain unexplained but suggest that these microbes are highly susceptible to changing conditions. Continued warming of the Chukchi Sea will likely result in further borealization, with differential impacts on pelagic and benthic communities. [ABSTRACT FROM AUTHOR]

Presents the results of a randomized trial on the prophylactic daily aspirin among males in Great Britain. Analysis on the efficacy of aspirin in reducing stroke, myocardial infarction and other vascular conditions; Significance of migraine and musculoskeletal pain in the control and treated group; Correlation between the disabling stroke and the established value of antiplatelet treatment.

The first axenic synthesis of morphologically typical ericoid mycorrhizas of the Epacridaceae has been achieved in micropropagated Epacris impressa Labill. with eight fungi isolated from roots of two epacrid species, E. impressa and Astyoloma pinifolium (R.Br.) Benth. Mycorrhizal synthesis has also been achieved between E. impressa and both Hymenoscyphus ericae (Read) Korf and Kernan and Oidiodendron griseum Robak, recognized endophytes of Ericaceae, suggesting that the endophytes of the Epacridaceae and Ericaceae are capable of cross-infection. Infection rate of epidermal cells on hair roots varied from 3 77% infection and the density of hyphal coils varied widely. This synthesis makes possible studies of the roles of these endophytes in the Epacridaceae and comparison with their roles in the Ericaceae. [ABSTRACT FROM AUTHOR]

Ready access to health research studies is becoming more important as researchers, and their funders, seek to maximize the opportunities for scientific innovation and health improvements. Large-scale population-based prospective studies are particularly useful for multidisciplinary research into the causes, treatment and prevention of many different diseases. UK Biobank has been established as an open-access resource for public health research, with the intention of making the data as widely available as possible in an equitable and transparent manner. Access to UK Biobank's unique breadth of phenotypic and genetic data has attracted researchers worldwide from across academia and industry. As a consequence, it has enabled scientists to perform world-leading collaborative research. Moreover, open access to an already deeply characterized cohort has encouraged both public and private sector investment in further enhancements to make UK Biobank an unparalleled resource for public health research and an exemplar for the development of open-access approaches for other studies. [ABSTRACT FROM AUTHOR]

Employee deviance and time theft is an expensive and pervasive workplace problem. Research indicates that a primary reason employees engage in deviant behaviour is the perception of injustice often associated with psychological contract breach (i.e., broken promises). This study used a rodent model to mimic said experience of broken promises and then examined the subsequent neurophysiological changes that lead to the display of deviant behaviours. Specifically, we generated a psychological contract using a 3 choice serial reaction task, then broke the promise, and finally examined deviant behaviours and neurological correlates. After the broken promise, rats had elevated levels of corticosterone and testosterone, engaged in riskier behaviour, and were more aggressive. The most prominent changes in gene expression were associated with serotonin and stress, and were found in the nucleus accumbens. This study highlights the value of pre-clinical models in the investigation of the theoretical tenants of industrial and organizational psychology. [ABSTRACT FROM AUTHOR]

Background: Greater numbers of older patients are accessing hospital services. Specialist geriatric input at presentation may improve outcomes for at-risk patients. The Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI) frailty measure, developed for use in the community, has also been used in the emergency department (ED). Aim: To measure frailty, review its prevalence in older patients presenting to ED and compare characteristics and outcomes of frail patients with their non-frail counterparts. Design: Patient characteristics were recorded using symphony® electronic data systems. SHARE-FI assessed frailty. Cognition, delirium and 6 and 12 months outcomes were reviewed. Methods: A prospective cohort study was completed of those aged≥70 presenting to ED over 24h, 7 days a week. Results: Almost half of 198 participants (46.7%, 93/198) were classified as frail, but this was not associated with a significant difference in mortality rates (OR 0.89, 95% CI 0.58-1.38, P=0.614) or being alive at home at 12 months (OR 1.07, 95% CI 0.72-1.57, P=0.745). Older patients were more likely to die (OR 2.34, 95% CI 1.30-4.21, P=0.004) and less likely to be alive at home at 12 months (OR 0.49, 95% CI 0.23-0.83, P=0.009). Patients with dementia (OR 0.24, P=0.005) and on ≥5 medications (OR 0.37, 95% CI 0.16-.87, P=0.022) had a lower likelihood of being alive at home at 12 months. Conclusions: Almost half of the sample cohort was frail. Older age was a better predictor of adverse outcomes than frailty as categorized by the SHARE-FI. SHARE-FI has limited predictability when used as a frailty screening instrument in the ED. [ABSTRACT FROM AUTHOR]

Background Across our province, post-radiotherapy (rt) handover notes are sent to family physicians (fps) after rt. Based on previous fp feedback, we created a revised post-radiotherapy handover note with more information requested by fps. The purpose of this study was to determine whether the revised handover note improved the note as a communication aid. Methods Potential common and rare treatment side effects, oncologist contact information, and treatment intent were added to the revised handover note. Both versions were sent alongside a questionnaire to fps. Paired t-tests were carried out to compare satisfaction differences. Results There was a response rate of 37% for the questionnaires. Significantly greater clarity in the following categories was observed: responsibility for patient follow-up (mean score improvement of 1.2 on a 7-point Likert scale, p < 0.001), follow-up schedule (1.1, p < 0.001) as well as how and when to contact the oncologist (1.4, p = 0.001). Family physicians were also more content with how the institute transitioned care back to them (1.5, p = 0.012). Overall, fps were generally satisfied with the content of the revised post-rt handover note and noted improvement over the previous version. The frequency of investigations and institute supports initiated such as counselling services were suggested further additions. Conclusions The inclusion of potential treatment side effects, oncologist contact information, treatment intent and a well-laid out follow-up schedule were essential information needed by fps for an effective post-rt completion note. With these additions, the revised post-rt handover note showed significant improvement. [ABSTRACT FROM AUTHOR]