Novel, congenital iliac arterial anatomy: Absent common iliac arteries and left internal iliac artery.

Congenital anomalies of the iliac arterial system are rare and can be associated with ischemia. With an increase in vascular imaging and interventions, such anomalies are likely to be encountered with greater frequency. We present the case of a 25-year-old female who was incidentally found to have absence of the common iliac arteries bilaterally and the left internal iliac artery, a constellation not previously reported in the literature. We present relevant imaging findings, review embryonic vascular development, and discuss potential clinical implications

Clarification of the circulatory patho-physiology of anaesthesia - Implications for high-risk surgical patients

AbstractThe paper examines the effects of anaesthesia on circulatory physiology and their implications regarding improvement in perioperative anaesthetic management. Changes to current anaesthetic practice, recommended recently, such as the use of flow monitoring in high risk patients, are already beginning to have an impact in reducing complications but not mortality [1]. Better understanding of the patho-physiology should help improve management even further. Analysis of selected individual clinical trials has been used to illustrate particular areas of patho-physiology and how changes in practice have improved outcome. There is physiological support for the importance of achieving an appropriate rate of oxygen delivery (DO2), particularly following induction of anaesthesia. It is suggested that ensuring adequate DO2 during anaesthesia will avoid development of oxygen debt and hence obviate the need to induce a high, compensatory, DO2 in the post-operative period. In contrast to the usual assumptions underlying strategies requiring a global increase in blood flow [1] by a stroke volume near maximization strategy, blood flow control actually resides entirely at the tissues not at the heart. This is important as the starting point for understanding failed circulatory control as indicated by ‘volume dependency’. Local adjustments in blood flow at each individual organ – auto-regulation – normally ensure the appropriate local rate of oxygen supply, i.e. local DO2. Inadequate blood volume leads to impairment of the regulation of blood flow, particularly in the individual tissues with least capable auto-regulatory capability. As demonstrated by many studies, inadequate blood flow first occurs in the gut, brain and kidney. The inadequate blood volume which occurs with induction of anaesthesia is not due to blood volume loss, but probably results from redistribution due to veno-dilation. The increase in venous capacity renders the existing blood volume inadequate to maintain venous return and pre-load. Blood volume shifted to the veins will, necessarily, also reduce the arterial volume. As a result stroke volume and cardiac output fall below normal with little or no change in peripheral resistance. The resulting pre-load dependency is often successfully treated with colloid infusion and, in some studies, ‘inotropic’ agents, particularly in the immediate post-operative phase. Treatment during the earliest stage of anaesthesia can avoid the build up of oxygen debt and may be supplemented by drugs which maintain or restore venous tone, such as phenylephrine; an alternative to volume expansion. Interpretation of circulatory patho-physiology during anaesthesia confirms the need to sustain appropriate oxygen delivery. It also supports reduction or even elimination of supplementary crystalloid maintenance infusion, supposedly to replace the “mythical” third space loss. As a rational evidence base for future research it should allow for further improvements in anaesthetic management

On the anatomy of a chain shift

Phonological chain shifts have been the focus of many theoretical, developmental, and clinical concerns. This paper considers an overlooked property of the problem by focusing on the typological properties of the widely attested ‘s > θ > f’ chain shift involving the processes of Labialization and Dentalization in early phonological development. Findings are reported from a cross-sectional study of 234 children (ages 3 years; 0 months–7;9) with functional (nonorganic) phonological delays. The results reveal some unexpected gaps in the predicted interactions of these processes and are brought to bear on the evaluation of recent optimality theoretic proposals for the characterization of phonological interactions. A developmental modification to the theory is proposed that has the desired effect of precluding certain early-stage grammars. The proposal is further evaluated against the facts of another widely cited developmental chain shift known as the ‘puzzle > puddle > pickle’ problem (Smith 1973).National Institutes of Health DC00433, RR7031K, DC00076, DC001694 (PI: Gierut

Southern expansion of the brown alga Colpomenia peregrina Sauvageau (Scytosiphonales) in the Northwest Atlantic Ocean

Blackler first recorded Colpomenia peregrina in the Northwest Atlantic based on collections from Nova Scotia, Canada. Five decades later we found large quantities of C. peregrina in Maine, USA, even though it was absent during earlier floristic studies in this region. Thus, C. peregrina has undergone a rapid southern expansion along the Northwest Atlantic coast. While the causes of such an expansion are unknown, it could have a major effect on both shellfish cultivation and native seaweeds within New England because of competitive interactions and increased drag

14C-Cobalamin Absorption from Endogenously Labeled Chicken Eggs Assessed in Humans Using Accelerator Mass Spectrometry.

Traditionally, the bioavailability of vitamin B-12 (B12) from in vivo labeled foods was determined by labeling the vitamin with radiocobalt (57Co, 58Co or 60Co). This required use of penetrating radioactivity and sometimes used higher doses of B12 than the physiological limit of B12 absorption. The aim of this study was to determine the bioavailability and absorbed B12 from chicken eggs endogenously labeled with 14C-B12 using accelerator mass spectrometry (AMS). 14C-B12 was injected intramuscularly into hens to produce eggs enriched in vivo with the 14C labeled vitamin. The eggs, which provided 1.4 to 2.6 μg of B12 (~1.1 kBq) per serving, were scrambled, cooked and fed to 10 human volunteers. Baseline and post-ingestion blood, urine and stool samples were collected over a one-week period and assessed for 14C-B12 content using AMS. Bioavailability ranged from 13.2 to 57.7% (mean 30.2 ± 16.4%). Difference among subjects was explained by dose of B12, with percent bioavailability from 2.6 μg only half that from 1.4 μg. The total amount of B12 absorbed was limited to 0.5-0.8 μg (mean 0.55 ± 0.19 μg B12) and was relatively unaffected by the amount consumed. The use of 14C-B12 offers the only currently available method for quantifying B12 absorption in humans, including food cobalamin absorption. An egg is confirmed as a good source of B12, supplying approximately 20% of the average adult daily requirement (RDA for adults = 2.4 μg/day)

Spatial Database For Intersections

Deciding which intersections in the state of Kentucky warrant safety improvements requires a comprehensive inventory with information on every intersection in the public roadway network. The Kentucky Transportation Cabinet (KYTC) had previously catalogued only those intersections where state-maintained roadways met. However, this inventory did not account for intersections between state- and locally-maintained routes, nor was it designed to accommodate regular updates. As such, the Kentucky Transportation Center (KTC) at the University of Kentucky developed a methodology to create and maintain a full inventory of every intersection in the state. The database contains precise location information as well as several safety and operational attributes for each point of an intersection. By replicating the topology factors used in the Highway Safety Manual (HSM), the research team categorized every intersection type, and developed. Safety Performance Functions (SPF) for each intersection type. The SPFs were used to rank each intersection. It is anticipated that this project’s deliverables will be used to increase KYTC’s ability to effectively allocate funds to maintain and improve intersection safety. Making the database available to expert users will allow continuous improvements. In the future, AADT data and traffic control information could be included

On the interaction of Velar Fronting and Labial Harmony

This article documents the typological occurrence and interactions of two seemingly independent error patterns, namely Velar Fronting and Labial Harmony, in a cross-sectional investigation of the sound systems of 235 children with phonological delays (ages 3;0 to 7;9). The results revealed that the occurrence of Labial Harmony depends on the occurrence of Velar Fronting, and that, when these processes co-occurred, all three predicted types of interactions were attested. A constrained version of Optimality Theory is put forward that offers a unified explanation for the implicational relationship between these error patterns and their observed interactions. The findings are compared with the results from other studies and are considered for their theoretical and clinical implicationsNational Institutes of Health DC00433, RR7031K, DC00076, DC001694 (PI: Gierut)This is an Accepted Manuscript of an article published by Taylor & Francis in Clinical Linguistics & Phonetics on March 2011, available online: http://wwww.tandfonline.com/10.3109/02699206.2010.522300

Kentucky Traffic Collision Facts 2016

KENTUCKY’S TRAFFIC COLLISION FACTS report is based on collision reports submitted to the Kentucky State Police Records Branch. As required by Kentucky Revised Statutes 189.635, “every law enforcement agency whose officers investigate a vehicle accident of which a report must be made...shall file a report of the accident...within ten days after investigation of the accident upon forms supplied by the bureau.” The stated purpose of this requirement is to utilize data on traffic collisions for such purposes as will improve the traffic safety program in the Commonwealth. Data contained in this report are based solely on the observations and judgements of the state and local police officers who investigated each collision. The collision data is contained in an automatic system (Collision Report Analysis for Safer Highways) (CRASH). This system has edit checks for accuracy. Computer tabulations and summaries are again checked for accuracy before information is released or disseminated. It is hoped that the detailed information presented in this report will, in fact, “improve the traffic safety program within the Commonwealth.