2,721 research outputs found

    Family-Centered Early Intervention in North America: Have Home-based Programmes Lived up to their Promise for High-risk Families?

    Get PDF
    While early intervention programming is not new in North America, such programs have gone through a rapid expansion in recent years. This has been motivated by the recognition of the need for timely intervention, the development of a family rather than a child focused practice philosophy and the desire on the part of funding organizations to save money by promoting less expensive programming. This article reviews the various components of early intervention programmes in North America while also questioning aspects of current practice. There is a clear need for family-centered intervention. This should not be in question. However, the fundamental question should not be whether family centered intervention is necessary but rather how can empirical research inform best practices? It is the conclusion of the authors that this will be the key challenge in the coming years

    Effect of ultrafiltration during hemodialysis on hepatic and total-body water: an observational study.

    Get PDF
    Background The hepatic circulation is involved in adaptive systemic responses to circulatory stress. However, it is vulnerable to both chronic hypervolemia and cardiac dysfunction. The influence of hemodialysis (HD) and ultrafiltration (UF) upon liver water content has been understudied. We conducted a detailed pilot study to characterize the effects of HD upon liver water content and stiffness, referenced to peripheral fluid mobilization and total body water. Methods We studied 14 established HD patients without liver disease. Magnetic resonance imaging (MRI) together with ultrasound-based elastography and bioimpedance assessment were employed to measure hepatic water content and stiffness, body composition, and water content in the calf pre- and post-HD. Results Mean UF volume was 8.13 ± 4.4 mL/kg/hr. Fluid removal was accompanied with effective mobilization of peripheral water (measured with MRI within the thigh) from 0.85 ± 0.21 g/mL to 0.83 ± 0.18 g/mL, and reduction in total body water (38.9 ± 9.4 L to 37.4 ± 8.6 L). However, directly-measured liver water content did not decrease (0.57 ± 0.1 mL/g to 0.79 ± 0.3 m L/g). Liver water content and IVC diameter were inversely proportional (r = - 0.57, p = 0.03), a relationship which persisted after dialysis. Conclusions In contrast to the reduced total body water content, liver water content did not decrease post-HD, consistent with a diversion of blood to the hepatic circulation, in those with signs of greater circulatory stress. This novel observation suggests that there is a unique hepatic response to HD with UF and that the liver may play a more important role in intradialytic hypotension and fluid shifts than currently appreciated

    Plasmic Degradation of Crosslinked Fibrin CHARACTERIZATION OF NEW MACROMOLECULAR SOLUBLE COMPLEXES AND A MODEL OF THEIR STRUCTURE

    Get PDF
    A B S T R A C T Crosslinked fibrin was digested by plasmin, and three soluble complexes larger than DD/E were purified and characterized. After gel filtration chromatography, the purified complexes were shown to have molecular weights of 465,000, 703,000, and 850,000, as determined by equilibrium sedimentation. Each of the complexes was dissociated into two or more fragments by SDS-polyacrylamide gel electrophoresis. The structure of these subunit fragments was deduced from determinations of their molecular weights and polypeptide chain composition and from known sites of plasmin cleavage of fibrin. Fragments larger than DD have been identified that contain intact yry crosslinks as well as fragments resulting from cleavages at or near this site. The former include DY (mol wt 247,000), YY (mol wt 285,000), DXD (mol wt 461,000), and YXD (mol wt 500,000); and the latter include fragments XD (mol wt 334,000) and XY (mol wt 391,000). A schematic model was developed to explain the structure of the large noncovalently bound complexes based on their molecular weight and observed component fragments. Our scheme supports the twostranded half-staggered overlap model as the basic unit of fibrin structure, in which each complex consists of fragments from two adjacent complementary antiparallel fibrin strands. The smallest derivative, complex 1, is the DD/E complex; complex 2 contains apposed DY and YD fragments, and complex 3 consists of fragments DXD and YY. Complex 4 is less wellcharacterized, but its intact structure is projected to consist of YXD and DXY fragments from adjacent fibrin strands. Each complex is heterogeneous in subunit composition, reflecting additional plasmin cleavages within and/or adjacent to its theoretical boundaries. Since most ofthe protein initially released into solution from degrading fibrin is as complexes larger than DD/E

    Classification of Generalized Symmetries for the Vacuum Einstein Equations

    Full text link
    A generalized symmetry of a system of differential equations is an infinitesimal transformation depending locally upon the fields and their derivatives which carries solutions to solutions. We classify all generalized symmetries of the vacuum Einstein equations in four spacetime dimensions. To begin, we analyze symmetries that can be built from the metric, curvature, and covariant derivatives of the curvature to any order; these are called natural symmetries and are globally defined on any spacetime manifold. We next classify first-order generalized symmetries, that is, symmetries that depend on the metric and its first derivatives. Finally, using results from the classification of natural symmetries, we reduce the classification of all higher-order generalized symmetries to the first-order case. In each case we find that the generalized symmetries are infinitesimal generalized diffeomorphisms and constant metric scalings. There are no non-trivial conservation laws associated with these symmetries. A novel feature of our analysis is the use of a fundamental set of spinorial coordinates on the infinite jet space of Ricci-flat metrics, which are derived from Penrose's ``exact set of fields'' for the vacuum equations.Comment: 57 pages, plain Te

    The Varga Site: A Multicomponent, Stratified Campsite in the Canyonlands of Edwards County, Texas

    Get PDF
    Data recovery excavations at the Varga Site were conducted in two phases during 2002 by archeologists from the Cultural Resources Department of TRC Environmental Corporation’s (TRC’s) Austin office under contract to Texas Department of Transportation (TxDOT) Scientific Service Contract No. 572XXSA004. This mitigation program was necessitated by the proposed reconstruction of the crossing of a Ranch to Market Road over Hackberry Creek, immediately south of the site in northeastern Edwards County. These archeological investigations were conducted as part of the responsibilities of TxDOT under existing federal and state legislation for the protection of cultural resources. Geoarcheological trenching and hand-excavations within the existing 31 m wide road right-of-way of 7- m-wide paved Ranch to Market Road focused on the alluvial fines in the first terrace overlooking Hackberry Creek immediately adjacent to a spring. The southern edge of the terrace contains relatively fine-grained sediments ranging from 15 to 150 centimeter (cm) thick that overlie coarse stream gravels that extend to an unknown depth. The modern ground surface had been impacted by road construction and maintenance activities, as well as by light erosion. Block Excavations were conducted on both sides of the pavement and resulted in the hand-excavations of a total of 207.75 square meters (m2), including 83 m2 (66.2 m3) in Block A on the western side and a 124.75 m2 (38.26 m3) area in Block B on the eastern side. Archeological deposits in the investigated part of the site extend to the southern lip of the first terrace and extend about 50 m to the north. The excavations yielded evidence of a multiple component campsite with three distinct and a fourth less distinct prehistoric components. In Block A, the 100 to 150 cm thick fine-grained sediments yielded four intact cultural components. Block B only targeted the youngest, Toyah component. The fine-grained alluvial sediments that comprise the first terrace contain discrete occupations radiocarbon dated to the Late Prehistoric period Toyah phase (ca. 290 to 660 B.P.), the Late Archaic period (ca. 1,700 to 2,300 B.P.), and the Early Archaic period (ca. 5,200 to 6,300 B.P.). A Middle Archaic period (ca. 3,900 to 4,800 B.P.) component was also recognized, but was not as clearly defined as were the other three components. Krotovina disturbance was relatively extensive in parts of the investigated site area. Nevertheless, the archeological deposits exhibited a high degree of contextual integrity. The Toyah phase component contains a rich assemblage of cultural material (ca. 65,000 pieces), including lithic debitage (ca. 26,000), quantities of highly fragmented bones (ca. 18,700), small burned rocks (ca. 16,000), formal and informal stone tools (ca. 1,850), scattered ceramic sherds (ca. 100), and 11 burned rock features. This component was radiocarbon dated by 14 accepted dates to between 290 and 660 B.P. Preservation was generally good, but mixing and probable overprinting contributed to poor horizontal patterning and an inability to identify discrete activity areas. The Late Archaic period component consists primarily of a large, nearly 6 m diameter lens of burned rock that is interpreted as an incipient burned rock midden with an indistinct central pit oven. This feature was associated with a buried A horizon and exhibited a high degree of stratigraphic integrity. However, beyond the ill-defined boundaries of this burned rock feature, limited lithic debitage assemblage (ca. 1,800), a few mussel shell fragments, five isolated burned rock features, scattered burned rocks, and occasional chipped stone tools (ca. 30) totaling less than 6,000 pieces. Identified dart point styles associated with this midden include Frio, Marcos, Ensor, Castroville, and Edgewood. This component was radiocarbon dated by 11 accepted dates to a 600-year period between 1,700 and 2,310 B.P. The Middle Archaic component was not well-defined, but definitely present and dispersed below the Late Archaic component and above the Early Archaic component. These materials were vertically distributed over a 20 to 40 cm thick zone that lacked completely sterile levels or visible breaks in the stratigraphy between the other cultural events. Lithic debitage (ca. 4,400) dominates the recovered assemblage (ca. 6,000), with limited burned rocks (ca. 3,000), a few formal chipped stone tools (ca. 25), and moderate frequency of vertebrate remains (100 g) also present. Two poorly organized burned rock features were also identified and documented. Five Early Triangular projectile points and one Carrizo point fragment occurred within this component. Two wood charcoal assays and one radiocarbon date on a deer bone directly date this Middle Archaic component to ca. 900-radiocarbon year period between 3,910 and 4,820 B.P. These three absolute dates are stratigraphically in order compared to the radiocarbon dates from the cultural components above and below. The Early Archaic component was defined by quantities of dense cultural debris (ca. 135,000) within a roughly 30 cm thick zone directly on top and mixed into coarse river gravels and below the Middle Archaic component. The cultural material varied in depth from a shallow 50 cm below datum (bd) at the north end to a much deeper 120 cmbd in the southern end of Block A. The recovery of a robust assemblage of dart points (170 specimens) that consisted of Group 2—Early Corner-Notched, Bandy, Martindale, Gower, and Merrell dart points indicates that this zone represents many occupations that occurred over a relatively broad time frame. The dart points were associated with a diverse tool assemblage (ca. 1,300). Organic preservation was poor in this lower stratum, but occasional fragments of animal bone, plant seeds, and wood charcoal were recovered. Fifteen organic samples of diverse materials yielded radiocarbon dates that document a minimum use period of 1,080-radiocarbon years from 5,200 B.P. to 6,280 B.P. Greater insight and understanding of each of these four components represented was made possible through the employment of numerous technical analyses, including the radiocarbon dating of 66 samples, six optically stimulated luminescence dates, use-wear analysis and organic residue identifications on 156 stone specimens, petrographic analyses on 18 pottery and one local sediment samples, pollen and phytolith analyses on 25 paired samples, instrumental neutron activation analysis on 261 chert samples and 18 pottery sherds, fatty acid composition on eight pottery sherds and 94 burned rocks, stable carbon and nitrogen analyses on 112 samples, macrobotanical analyses on 44 float and 75 individual charcoal samples, and granulometric and compositional studies on 10 sediment samples. The combined results have contributed significantly to a greater understanding of the Varga Site as a whole and documented specific information concerning the behaviors of the people who occupied the site. These and other technical analyses are urged for other excavated sites in the future to continue to broaden our understanding of the human behaviors at specific sites and throughout the broader region. This will add to a growing database that will foster a better understanding of prehistoric lifeways across Texas

    High Elmo1 expression aggravates and low Elmo1 expression prevents diabetic nephropathy

    Get PDF
    About one-third of patients with type 1 diabetes mellitus develop nephropathy, which often progresses to end-stage renal diseases. The present study demonstrates that below-normal Elmo1 expression in mice ameliorates the albuminuria and glomerular histological changes resulting from long-standing type 1 diabetes, whereas above-normal Elmo1 expression makes both worse. Increasing Elmo1 expression leads to aggravation of oxidative stress markers and enhances the expression of fibrogenic genes. Suppressing Elmo1 action in human patients could be a promising option for treating/preventing the progressive deterioration of renal function in diabetes
    • …
    corecore