Letter from W[illiam] M. Canby to John Muir, 1897 Oct 24.

[4]Whenever I speak of Alaska and recommend people to go there to see its wonders, that is always the principal inducement I mention.I ask you to believe, my dear Mr. Muir, that I always think of you with the utmost respect and I may truly say admiration; and that in all sincerity I am most truly,Your obliged,Wm M. CanbyI sent your Mountains of California to Mr. Anderson[1]Wilmington DelawareOct. 24th 1897My dear Mr. Muir,Prof. August has written me of the death of your mother-in-law, the dear old lady who so kindly received us when he and I were at your house some years since. I desire to express my sympatny with you and especially with Mrs. Muir at this severance of so tender and close a relation. However circumstances of poor health or suffering may seem to the outside world to make such a change even desirable it is always more or02353 [2]less shocking to affectionate natures and to those who are in near relationship.I have been, since my return, so very busy--indeed hard-worked--that I have not written, as I had intended, to thank you for the past pleasure and profit you gave me during our journey together. When I consider what a plague I was to you and how often and unmercifully--yes and unwarrantably--I let my sense of fun get the better of my discretion in teasing you I wonder at your forbearance. I do assure you that I constantly acknowledge to myself all I[3]owe to you of pleasure and knowledge and constantly feel that one of the best journeys of my life was made what it was by you. But for you I should scarce think of Alaska with a sense of proper knowledge or of the great delight in it which I now have. And so if you will let me I will ask you to think of me as being very grateful to you.I consider it the greatest thing I ever experienced in that I have seen God\u27s hand carving out a country with his icy chisel. The more I think of it the more reverential I become

Letter from William M. Canby to John Muir, 1898 Jul 11.

[letterhead]July 11 1898Dear old streak o\u27lightning on ice,I was delighted to hear from the glacier period once more and to know that you were going to make your escape from Purgatory and merge in the Heavenly forests of the Alleghenies. As to going with you and Sargent I intend to do it - if possible. With yours came a letter from S. asking me to place out a route. re. - and you speak of those woods which I know so well. Well I must say that if Sargent does not know the southeastern woods I do not know any one that does. It has been long since I have seen them. However I will try to map out something.My time of going is between Sept. 12 and Oct. 10 if I really can go. Only one thing that I can now foresee may prevent. I have a niece who has two charming little daughters who is coming to see me this fall and who must consult a [Phila.?] authority in regard to a [lameness?] of me of the children. I must see to this for her and perhaps be with her. I am going to try to find out about her plans and try to arrange. Will02447 the time above mentioned suit you.Have you seen the Luray Caverns or the Natural Bridge? If not do you care to? I should like to have you look for the summit of Salt Pond Mt. in CA and the Roan in N.C. Then I must get into Northern Alabama for a day (at Piedmont).But I will consult with Sargent about this. Be assured that with my kindest regards I am ever yours sincerelyWilliam M. Canb

Porphyry-type gold mineralization of late Neogene age at the Zule volcanic center, Sierra County, California

Online access for this thesis was created in part with support from the Institute of Museum and Library Services (IMLS) administered by the Nevada State Library, Archives and Public Records through the Library Services and Technology Act (LSTA). To obtain high a quality image or document please contact the DeLaMare Library at https://unr.libanswers.com/ or call: 775-784-6945.The volcanic setting, alteration, geochemical characteristics, and association of gold with quartz stockwork, hydrogene iron oxides, and hypersaline fluid inclusions suggest this is a shallowly-exposed porphyry gold system

Does periprocedural anticoagulation management of atrial fibrillation affect the prevalence of silent thromboembolic lesion detected by diffusion cerebral magnetic resonance imaging in patients undergoing radiofrequency atrial fibrillation ablation with open irrigated catheters? Results from a prospective multicenter study

BackgroundSilent cerebral ischemia (SCI) has been reported in 14% of cases after catheter ablation of atrial fibrillation (AF) with radiofrequency (RF) energy and discontinuation of warfarin before AF ablation procedures.ObjectiveThe purpose of this study was to determine whether periprocedural anticoagulation management affects the incidence of SCI after RF ablation using an open irrigated catheter.MethodsConsecutive patients undergoing RF ablation for AF without warfarin discontinuation and receiving heparin bolus before transseptal catheterization (group I, n = 146) were compared with a group of patients who had protocol deviation in terms of maintaining the therapeutic preprocedural international normalized ratio (patients with subtherapeutic INR) and/or failure to receive pretransseptal heparin bolus infusion and/or ≥2 consecutive ACT measurements <300 seconds (noncompliant population, group II, n = 134) and with a group of patients undergoing RF ablation with warfarin discontinuation bridged with low molecular weight heparin (group III, n = 148). All patients underwent preablation and postablation (within 48 hours) diffusion magnetic resonance imaging.ResultsSCI was detected in 2% of patients (3/146) in group I, 7% (10/134) in group II, and 14% (21/148) in group III (P <.001). “Therapeutic INR” was strongly associated with a lower prevalence of postprocedural silent cerebral ischemia (SCI). Multivariable analysis demonstrated nonparoxysmal AF (odds ratio 3.8, 95% confidence interval 1.5–9.7, P = .005) and noncompliance to protocol (odds ratio 2.8, 95% confidence interval 1.5–5.1, P <.001] to be significant predictors of ischemic events.ConclusionStrict adherence to an anticoagulation protocol significantly reduces the prevalence of SCI after catheter ablation of AF with RF energy

The need for illness

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45466/1/11089_2005_Article_BF01845887.pd

Systematic care for caregivers of people with dementia in the ambulatory mental health service: designing a multicentre, cluster, randomized, controlled trial

Contains fulltext : 81435.pdf (publisher's version ) (Open Access)BACKGROUND: Care for people with dementia and their informal caregivers is a challenging aim in healthcare. There is an urgent need for cost-effective support programs that prevent informal caregivers of people with dementia from becoming overburdened, which might result in a delay or decrease of patient institutionalization. For this reason, we have developed the Systematic Care Program for Dementia (SCPD). The SCPD consists of an assessment of caregiver's sense of competence and suggestions on how to deal with competence deficiencies. The efficiency of the SCPD will be evaluated in our study. METHODS AND DESIGN: In our ongoing, cluster, randomized, single-blind, controlled trial, the participants in six mental health services in four regions of the Netherlands have been randomized per service. Professionals of the ambulatory mental health services (psychologists and social psychiatric nurses) have been randomly allocated to either the intervention group or the control group. The study population consists of community-dwelling people with dementia and their informal caregivers (patient-caregiver dyads) coming into the health service. The dyads have been clustered to the professionals. The primary outcome measure is the patient's admission to a nursing home or home for the elderly at 12 months of follow-up. This measure is the most important variable for estimating cost differences between the intervention group and the control group. The secondary outcome measure is the quality of the patient's and caregiver's lives. DISCUSSION: A novelty in the SCPD is the pro-active and systematic approach. The focus on the caregiver's sense of competence is relevant to economical healthcare, since this sense of competence is an important determinant of delay of institutionalization of people with dementia. The SCPD might be able to facilitate this with a relatively small cost investment for caregivers' support, which could result in a major decrease in costs in the management of dementia. Implementation on a national level will be started if the SCPD proves to be efficient. TRIAL REGISTRATION: NCT00147693

Experimental forecasts of El Niño

Experimental forecasts of El Niño events occurring since 1970, made with a deterministic model of the coupled ocean-atmosphere system, indicate that El Niño is generally predictable one or two years ahead. A forecast for 1986 is also presented