Can patients really make an informed choice? An evaluation of the availability of online information about consultant surgeons in the United Kingdom.

Objectives - The National Health Service (NHS) 'Choose and Book' online scheme, which allows patients to select the location and time of hospital appointments, has now been extended to include the option for patients to select a specific consultant to carry out any necessary treatment. The aim of this study was to determine whether there is sufficient online information about consultants or consultant-led teams for patients to make an informed choice regarding a specific consultant. Design - A web-based analysis of the availability of information. Setting - North of England. Participants - Two hundred websites of orthopaedic surgeons. Main outcome measures - The websites were analysed using a bespoke template that took into account recommendations of the 2010 UK Government white paper. Each website was scored in relation to the availability of specific content relating to each surgeon. Results - The majority of websites detailed authorship information (73.2%), level of professional qualification (98.5%) and area of general (73.7%) and specialist (93.3%) interest. However, approximately 50% of websites provided no information in relation to update cycle, involvement in teaching or research and patient satisfaction. Only five (2.6%) of the websites presented death rates, and none indicated morbidity rates. Conclusions - For patients to be able to make informed choices about their healthcare, surgeons need to ensure that sufficient information is available online, according to the identified limitations of the websites investigated in this study

How the Dark Horse Came in: Portland State University Library Acquires Dark Horse Comics Archive

The article reports on the acquisition made by the Portland State University (PSU) on the archives of Dark Horse Comics Inc. The acquisition is done after PSU alumnus and founder of Dark Horse Comics Mark Richardson donated multiple copies of the past issues of their publication and succeeding copies of the publication. The donation is also for the purpose of preserving the publication in the university library. The donated publication is also expected to be used by researchers as a destination resource in popular culture, gender studies, and sequential art. Donating copies to the library, Richardson also expects to create an ideal atmosphere for creative professionals as well as a sense of ownership for Dark Horse creators

Ethernet Performance: Design and Implementation Study

General concepts concerning local area network designs, functions and topologies will be presented. Ethernet as a multipoint bus topology local area network will be presented in detail. The Carrier Sense Multiple Access/Collision Detect (CSMA/CD) method of fairly regulating access to the shared network bus is studied. The Ethernet Network in relation to the Open Systems Interconnect (OSI) is reviewed, but only the layers pertaining to Ethernet are discussed throughout the majority of the paper. The specifications as described by Xerox, Digital and Intel are presented to help the designer understand the network\u27s physical limitations. Analytical models are used to predict performance and actual measured performance studies will be used to make performance assumptions. The performance is studied under varying load conditions. The data gathered concerns both limits imposed on the number of users by the finite bandwidth of the channel and efficient utilization of that channel. In conclusion, design specifications and performance data will be used together to formulate a design methodology for building the most efficient Ethernet network

The GFCAT: a catalog of ultraviolet variables observed by GALEX with sub-minute resolution

We have performed the first systematic search of the full GALEX data archive for astrophysical variability on timescales of seconds to minutes by rebinning data across the whole mission to 30-second time resolution. The result is the GALEX Flare Catalog (GFCAT) which describes 1426 ultraviolet variable sources, including stellar flares, eclipsing binaries, $\delta$ Scuti and RR Lyrae variables, and Active Galactic Nuclei (AGN). Many of these sources have never previously been identified as variable. We have also assembled a table of observations of ultraviolet flares and accompanying statistics and measurements, including energies, and of candidate eclipsing stars. This effort was enabled by a significantly-enhanced version of the gPhoton software for analyzing time-domain GALEX data; this gPhoton2 package is available to support follow-on efforts.Comment: accepted in ApJS; data available as a MAST High Level Science Product via https://dx.doi.org/10.17909/8d57-169

The effects of heat stress on neuromuscular activity during endurance exercise

This study analysed the effect of hot (35 C) and cold (15 C) environments on electromyographic (EMG) signal characteristics, skin and rectal temperatures and heart rate during progressive endurance exercise. Eight healthy subjects performed three successive 15-min rides at 30%, 50% and 70% of their peak sustained power output and then cycled at increasing (15 W/min) work rates to exhaustion in both 35 C and 15 C environments. Skin and rectal temperatures, heart rate and EMG data were measured during the trials. The skin temperatures were higher and the subjects felt more uncomfortable in the hot conditions (Bedford scale) (P<0.01). Rectal temperature was slightly, but not significantly, higher under hot conditions. Heart rate was significantly higher in the hot group (between condition P<0.05). Peak power output (267.4€67.7 W vs. 250.1€61.5 W) and time-toexhaustion (55.7€16.7 min vs. 54.5€17.1 min) (COLD vs. HOT) were not different between conditions. There were no differences in integrated EMG (IEMG) or mean power frequency spectrum between conditions. Rating of perceived exertion increased similarly in both conditions over time. Although the hot conditions increased heart rate and skin temperature, there were no differences in muscle recruitment or maximal performance, which suggests that the thermal stress of 35 C, in combination with exercise, did not impair maximal performance in this study

Caffeine ingestion does not alter performance during a 100-km cycling time-trial performance

This study analyzed the effect of caffeine ingestion on performance during a repeated-measures, 100-km, laboratory cycling time trial that included bouts of 1- and 4-km high intensity epochs (HIE). Eight highly trained cyclists participated in 3 separate trials - placebo ingestion before exercise with a placebo carbohydrate solution and placebo tablets during exercise (Pl), or placebo ingestion before exercise with a 7% carbohydrate drink and placebo tablets during exercise (Cho), or caffeine tablet ingestion before and during exercise with 7% carbohydrate (Caf). Placebo (twice) or 6 mg · kg-1 caffeine was ingested 60 min prior to starting 1 of the 3 cycling trials, during which subjects ingested either additional placebos or a caffeine maintenance dose of 0.33 mg · kg-1 every 15 min to trial completion. The 100-km time trial consisted of five 1-km HIE after 10, 32, 52, 72, and 99 km, as well as four 4-km HIE after 20, 40, 60, and 80 km. Subjects were instructed to complete the time trial and all HIE as fast as possible. Plasma (caffeine) was significantly higher during Caf (0.43 ± 0.56 and 1.11 ± 1.78 mM pre vs. post Pl; and 47.32 ± 12.01 and 72.43 ± 29.08 mM pre vs. post Caf). Average power, HIE time to completion, and 100-km time to completion were not different between trials. Mean heart rates during both the 1-km HIE (184.0 ± 9.8 Caf; 177.0 ± 5.8 Pl; 177.4 ± 8.9 Cho) and 4-km HIE (181.7 ± 5.7 Caf; 174.3 ± 7.2 Pl; 175.6 ± 7.6 Cho;p less than .05) was higher in Caf than in the other groups. No significant differences were found between groups for either EMG amplitude (IEMG) or mean power frequency spectrum (MPFS). IEMG activity and performance were not different between groups but were both higher in the 1-km HIE, indicating the absence of peripheral fatigue and the presence of a centrally-regulated pacing strategy that is not altered by caffeine ingestion. Caffeine may be without ergogenic benefit during endurance exercise in which the athlete begins exercise with a defined, predetermined goal measured as speed or distance

The effect of selective beta1-blockade on EMG signal characteristics during progressive endurance exercise

This study analysed the effect of selective b1- blockade on neuromuscular recruitment characteristics during progressive endurance exercise. Ten healthy subjects ingested a selective b1-blocker, acebutolol (200 mg b.d.), for 7 days (for one of two cycling trials), with a 10-day wash-out period between trials. On the last day of acebutolol ingestion subjects performed three successive 15-min rides at 30%, 50% and 70% of their peak power output and then cycled at increasing (15 W min-1) work rates to exhaustion. Force output, heart rate, submaximal V_O2, rate of perceived exertion (RPE), electromyographic (EMG) data and blood lactate were captured during the cycling activity. Peak work rate [270 (111) W vs 197 (75) W, CON vs BETA, P<0.01], time to exhaustion [49.7 (23.2) min vs 40.3 (23.7) min, CON vs BETA, P <0.05] and heart rate [mean, for the full ride 135.5 (38.3) beats min-1 vs 111.5 (30.0) beats min-1 CON vs BETA, P <0.05] were significantly lower for the group who ingested b1-blockade (BETA) compared to the control group (CON). Although not significant, submaximal V_O2 was reduced in BETA during the ride, while RPE was significantly higher during the ride for BETA (P <0.01). Mean integrated electromyography was higher in the BETA group although these differences were not significant. Mean power frequency values of the BETA group showed a significant (P <0.05) shift to the upper end of the spectrum in comparison to the control group. Lactate values [11.7 (3.5) mmol.l-1 vs 7.1 (4.1) mmol.l-1 CON vs BETA] were significantly lower (P <0.05) at exhaustion in BETA. Significant reductions in cycling performance were found when subjects ingested b1- blockers. This study has shown significant shifts to the upper end of the EMG frequency spectrum after b1- blocker ingestion, which could be caused by a change in neuromuscular recruitment strategy to compensate for the impaired submaximal exercise performance

Prostate Brachytherapy Seed Migration to the Heart Seen on Cardiovascular Computed Tomographic Angiography

Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell. They can embolize through the venous system to the lungs or heart and subsequently be detected by cardiovascular computed tomography. Cardiovascular imagers should be aware of the appearance of migrated seeds, as their presence in the chest is generally benign, so that unnecessary worry and testing are avoided. We report a case of a patient who underwent brachytherapy for prostate cancer and developed a therapeutic seeds embolus to the right ventricle

EMG amplitude in maximal and submaximal exercise is dependent on signal capture rate

This study analysed the effect of different electromyographic (EMG) capture rates during maximal voluntary contraction, submaximal and maximal dynamic cycling activity on EMG amplitude and signal characteristics. Ten healthy subjects participated in this study. Peak power output (PPO) and maximal isometric force output (MVC) were measured, followed by a progressive cycle ride on a cycle ergometer. Electromyographic (EMG) data were simultaneously captured during the MVC and cycling activities at frequencies of 32, 64, 128, 256, 512, 1024 and 1984 Hz. Significant differences in amplitude were found (p < 0.01) between MVC, submaximal (SUB) and maximal cycling activities (PWATT) for all capture rates. Asymptote values for IEMG amplitude occurred at EMG capture rates of 1604 ± 235.6 Hz during MVC, 503.1 ± 236.2 Hz during PWATT and 326.2 ± 105.4 Hz during SUB cycling activity and were significantly different (p < 0.01). No significant differences were found for force/EMG ratios between PWATT and MVC at 1984 Hz capture rates (3.8 ± 1.7 N/V vs 2.5 ± 0.9 N/V) while significant differences occurred at 32 Hz capture rate (6.2 ± 3.8 vs 16.0 ± 8.0; p < 0.01). Low correlations were found between EMG activity captured at 1984 Hz during PWATT and lean thigh volume (r = 0.36) and MVC (r = 0.32). Asymptote values found on this study suggest that data captured below 326 Hz for SUB, 503 Hz for PWATT and 1604 Hz for MVC are not reliable. Therefore apparatus capturing EMG data at low frequencies from these values cannot be used for quantitative data analyses