Provider Education to Increase Knowledge of Effective Obesity Management in the Prevention of Cancer

Background: Obesity is a chronic disease that can result in the development of myriad related health problems including cancer. Providers lack knowledge of the link between obesity and cancer and often miss critical care encounters to educate patients about evidence-based surgical options for reducing obesity and preventing cancer. Objectives: The objective of this quality improvement project was to increase provider knowledge of surgical options for the treatment of obesity to prevent cancer. Methodology: The project utilized a pre-/post-intervention quality improvement framework to evaluate provider knowledge of the topic at baseline (T0), immediately following an educational program (T1). Knowledge scores were measured using a 20-item test in which all questions were worth one point Results: A total of n = 15 primary care providers agreed to participate in the project including 16(52%) females. Average knowledge scores from pre-intervention, and post-intervention were 7.85 and 18.99. respectively. Results from a Wilcoxon sum rank test indicated that statistically significant changes in scores occurred from baseline to post-intervention (p \u3c .000). Conclusions: The results support the use of an educational intervention to increase provider knowledge of the topic. Increased knowledge should result in changes to practice to improve patient care. Implications: Education should be considered as an opportunity to increase provider knowledge of the use of surgical options to reduce cancer incidence in patients with obesity. Keywords: obesity, cancer, bariatric surgery, education, primary care provide

Selection of benthic habitat by yellow-phase American eels (Anguilla rostrata)

This thesis examines habitat preference of yellow-phase American eels (Anguilla rostrata) and relationships between age and length with that preference. The thesis is comprised of two chapters: (1) an introduction and literature review on American eel life history, their habitat selection, and the study of resource selection, and (2) an experimental study of yellow-phase American eel habitat preference and relationships between preference and age and length. Given widespread habitat alteration of North American rivers, an understanding of the use and selection of habitat is important to conservation and management of the American eel. Yellow-phase American eels are often considered as habitat generalists, in part, because of their occurrence across a wide range of habitat types, but few experimental studies have examined microhabitat selection. In a laboratory experiment, I quantified microhabitat use of small yellow-phase American eels (n = 130, 224--338 mm TL) conditional on five benthic substrate types common to many rivers within the geographic range of the American eel. During nine, 4-day trials replicated with three aquaria, American eels were given a choice to burrow into five equally available benthic substrates: cobble (90--256 mm), gravel (4--16 mm), sand (0.125--1 mm), silt/clay (\u3c 0.0625 mm), and leaf pack. Five American eels were used per aquaria for each trial, and individuals were used one time only. All eels were injected with PIT tags prior to the study, which allowed for determination of lengths and otolith-based ages of each individual following each trial. Leaf pack was selected with a significantly higher probability than other substrates (63 of 130 individuals). However, other substrates were also used (cobble, 21 of 130; silt/clay, 18 of 130; gravel, 16 of 130; and sand, 12 of 130). Length and age covariates were not associated with substrate selection. Selection of leaf pack habitat supports the importance of terrestrial organic material and riparian zones to yellow-phase American eels in riverine systems

Climatic and eustatic controls on the development of a Late Triassic source rock in the Jameson Land Basin, East Greenland

This work was undertaken as part of the continuing work of CASP in East Greenland. The sponsoring companies are thanked for their continued support of this work. Help in the field by T. Kinnaird and useful discussions with A. Whitham are gratefully acknowledged. The reviews of L. Clemmensen and an anonymous reviewer, and the input from S. Jones led to improvements to the original paper.Peer reviewedPostprin

A Kucha\v{r} Hypertime Formalism For Cylindrically Symmetric Spacetimes With Interacting Scalar Fields

The Kucha\v{r} canonical transformation for vacuum geometrodynamics in the presence of cylindrical symmetry is applied to a general non-vacuum case. The resulting constraints are highly non-linear and non-local in the momenta conjugate to the Kucha\v{r} embedding variables. However, it is demonstrated that the constraints can be solved for these momenta and thus the dynamics of cylindrically symmetric models can be cast in a form suitable for the construction of a hypertime functional Schr\"odinger equation.Comment: 5 pages, LaTeX, UBCTP-93-02

Le champ filonien à Zn-(Pb, Cu, As, Hg) du district minier de Fedj Hassène (Nord Ouest de la Tunisie): Minéralogie, Eléments en traces, Isotopes du Soufre et Inclusions Fluides

Le district minier de Fedj Hassène est situé à proximité de la frontière algéro-tunisienne, à 10 Km au sud de la ville de Ghardimaou. Il regroupe plusieurs filons à Pb-Zn, localement accompagnés par des sulfures de Cu, d'As et d'Hg. Les réserves sont estimées à 370.000 t à 10% de Zn et 0,2% de Pb. Les minéralisations remplissent des fractures subparallèles à la faille d'Ain Kohla de direction ESEWNW et des fentes d'extension qui recoupent les calcaires marneux du Turonien moyen. Le filon principal est formé par de la sphalérite massive brune et accessoirement par de la galène et de la barytine. Le minerai peut se présenter sous forme massive ou sous la forme de ciment de brèche. L'association minérale est composée par de la sphalérite, galène, chalcopyrite, pyrite et orpiment. La gangue est formée par de la calcite massive et localement par de la barytine et du quartz. L'analyse des éléments en trace dans la sphalérite révèle des teneurs en poids de 0,84% Fe, 0,14% Cd et 0,02% Mn. L'étude des inclusions fluides dans la calcite et la sphalérite montre l'existence d'un fluide caractérisé par une salinité de l'ordre de 23% poids équiv. NaCl à température décroissante lors de la mise en place des minéralisations (194 °C lors du dépôt de la calcite et 133 °C lors du dépôt de la sphalérite). Ce fluide est caractérisé par une densité comprise entre 1,00 g/cm3 et 1,11 g/cm3 avec une pression de piégeage estimée de 200 bars. La précipitation des sulfures parait être contrôlée par une chute de la température. Les mesures des isotopes du soufre dans la sphalérite donnent des valeurs de δ34S toutes positives et variant dans une gamme très restreinte comprise entre + 4,6‰ et 6,4‰ VCDT (moyenne=5,6‰). Ces valeurs indiquent une origine commune du soufre réduit qui est formé par les processus de ré duction thermique de sulfates. La source des sulfates admet les évaporites triasiques de la région comme reservoir potentiel. Les études géologiques et minéralogiques couplées à la microthermométrie des inclusions fluides et la géochimie des éléments en traces et des isotopes du soufre permettent de classer le gisement filonien de Fedj Hassène dans le groupe des gisements polymétalliques (Pb-Zn-As, Hg) typiques de la zone des nappes de la Tunisie du Nord et de l'Algérie nord-orientale

Application of multireflection grazing incidence method for stress measurements in polished Al–Mg alloy and CrN coating

Multi-reflection grazing incidence geometry, referred to as MGIXD, characterized by a small and constant incidence angle, was applied to measure low surface stresses in very thin layers of Al–Mg alloy and CrN coating. These two materials were selected in order to deal with the low and high levels of residual stress, respectively. The influence of different mechanical treatments on residual stresses was studied for Al–Mg samples. It was found that both rolling and mechanical polishing influence the distribution and amplitude of residual stress in surface layers. In the case of CrN coating, a very high compressive stress was generated during the deposition process. The stress distributions determined by the MGIXD method is in good agreement with the classic sin2 technique results for all studied samples. In performing stress measurements for a powder sample, it was found that the application of the Göbel mirror in the incident beam strongly reduces statistical and misalignment errors. Additionally, the root mean square values of the third order lattice strain within diffracting grains were determined

Investigation of plastic deformation heterogeneities in duplex steel by EBSD

An EBSD analysis of a duplex steel (austeno-ferritic) deformed in tension up to fracture is presented. The main purpose of the paper is to describe, qualitatively and quantitatively, the differences in the behavior of the two phases during plastic deformation. In order to do so, several topological maps are measured on the deformed state using the electron backscatter diffraction technique. Distributions of grain size, misorientation, image quality factor and texture are then analyzed in detail.International audienceAn EBSD analysis of a duplex steel (austeno-ferritic) deformed in tension up to fracture is presented. The main purpose of the paper is to describe, qualitatively and quantitatively, the differences in the behavior of the two phases during plastic deformation. In order to do so, several topological maps are measured on the deformed state using the electron backscatter diffraction technique. Distributions of grain size, misorientation, image quality factor and texture are then analyzed in detail

Trace element contamination in the mine-affected stream sediments of Oued Rarai in north-western Tunisia. A river basin scale assessment

High-quality and accurate environmental investigations are essential for the evaluation of contamination and subsequent decision-making processes. A combination of environmental geochemical indices, multivariate analyses and geographic information system approach was successfully used to assess contamination status and source apportionment of trace elements (Ag, As, Cd, Cr, Cu, Hg, Ni, Pb, Sb, V and Zn) in surface stream sediments from the Oued Rarai basin in north-western Tunisia, containing various metal and metalloid ores. The contamination level reported in this study indicates a non-negligible potential ecological risk, mainly related to sediment transport along the river. Antimony (concentrations ranged from 0.02 to 297 mg kg−1 and Igeo > 5), arsenic (from 0.5 to 1490 mg kg−1 and Igeo > 5), lead (from 2.9 to 5150 mg kg−1 and Igeo > 5) mercury (from 0.05 to 54.4 mg kg−1 and Igeo > 5) and silver (from 0.05 to 9.4 mg kg−1 and Igeo > 5) showed the most crucial contamination. Besides, potential ecological risk index values were maximum for arsenic with a median of 302, indicating a very high to serious ecological risk (> 160). Results from correlation analysis and principal component analysis revealed three main geochemical associations related to lithologic, tectonic and anthropogenic sources. V, Cr and Cu mainly originated from natural bedrock and soil. Ag and Cd were more controlled by both natural and mining enrichments. Mercury and Pb were mostly influenced by the ancient ore-related activities at the Oued Rarai site and north-east–south-west trending faults. Finally, Sb, As, Ni and Zn were largely controlled by the siliciclastic continental Neogene sequences. Finally, the physical and chemical dynamics of the watershed system, lithological properties, mineralisation, tectonic settings and mobilisation of subsurface sediments largely controlled both concentrations and spatial patterns of trace elements in the study basin. These results need to be considered in the strategies of suitable environmental management at former and current mining sites in north-western Tunisia

An innovative solution for earthquake resistance hybrid steel –concrete systems with replaceable dissipative steel links

In this work innovative hybrid coupled shear walls (HCSW) are considered, their design is discussed, their efficiency and limitations evaluated by means of nonlinear static (pushover) analysis. Different numbers of storeys, wall geometries and design assumptions are studied in order to give an overview of situations of interest in European seismic prone areas. The design of an experimental test regarding the performance of the connection of a seismic link embedded in a concrete shear wall is presented. This study is part of a larger research project named INNO-HYCO (INNOvative HYbrid and COmposite steel-concrete structural solutions for building in seismic area) funded by the European Commission

Broadly peak power and pulse width tunable dissipative soliton resonance generation in Figure-of-Eight fiber laser

We experimentally demonstrate a broadlytunable dissipative soliton resonancedual-amplifier figure-of-eight fiber laseremission.The peak power is tuned continuously from 8.8to 41.4Wby the first amplifier andpulse width from 84 to 416 nsby the second one