An analysis of the relations, coordination and communication between the national office of the National Association for the Advancement of Colored People and its Massachusetts Chapters

Thesis (M.S.)--Boston Universit

Now You See It, Now You Don\u27t: Using WiFi Notebooks to Turn a Meeting Room Into a Classroom

The Cedar Falls Public Library faced a dilemma: The need for a room to conduct computer- based training was pressing, but space is at a premium. The solution? Use existing public meeting rooms to host classes with cart stored WiFi notebook computers

Point to point protocol connections to CedarNet for Windows 3.x systems

The project allows NEIRLS affiliated libraries to connect with the Internet so that they might use the SILO Locator instead of the CD-ROM based system. Important terms used in the project and paper are defined. The methodology follows the ASSURE approach to analyze the learner, state objectives, select media and materials, utilize materials, require learner participation and to evaluate and revise the project. The project is briefly described and judged to be effective but probably will be soon superseded by advancing technology

Atmospheric circulation of tidally locked exoplanets: II. Dual-band radiative transfer and convective adjustment

Improving upon our purely dynamical work, we present three-dimensional simulations of the atmospheric circulation on Earth-like (exo)planets and hot Jupiters using the Geophysical Fluid Dynamics Laboratory (GFDL)-Princeton Flexible Modelling System (fms). As the first steps away from the dynamical benchmarks of Heng, Menou & Phillipps, we add dual-band radiative transfer and dry convective adjustment schemes to our computational set-up. Our treatment of radiative transfer assumes stellar irradiation to peak at a wavelength shorter than and distinct from that at which the exoplanet re-emits radiation (‘shortwave' versus ‘longwave'), and also uses a two-stream approximation. Convection is mimicked by adjusting unstable lapse rates to the dry adiabat. The bottom of the atmosphere is bounded by a uniform slab with a finite thermal inertia. For our models of hot Jupiter, we include an analytical formalism for calculating temperature-pressure profiles, in radiative equilibrium, which accounts for the effect of collision-induced absorption via a single parameter. We discuss our results within the context of the following: the predicted temperature-pressure profiles and the absence/presence of a temperature inversion; the possible maintenance, via atmospheric circulation, of the putative high-altitude, shortwave absorber expected to produce these inversions; the angular/temporal offset of the hotspot from the substellar point, its robustness to our ignorance of hyperviscosity and hence its utility in distinguishing between different hot Jovian atmospheres; and various zonal-mean flow quantities. Our work bridges the gap between three-dimensional simulations which are purely dynamical and those which incorporate multiband radiative transfer, thus contributing to the construction of a required hierarchy of three-dimensional theoretical model

False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report.

Background: Troponin is a crucial biomarker for the diagnosis of an acute coronary syndrome (ACS). It rises in response to myocardial injury from significant acute myocardial ischaemia caused by obstructive coronary artery disease ['classical' myocardial infarction (MI)]. However, raised levels have also been noted in conditions not recognized as classical ACS. This may include MI with non-obstructed coronary arteries such as takotsubo cardiomyopathy and other acute or chronic conditions such as pulmonary embolus or chronic kidney disease. This is commonly labelled as a 'falsely elevated' troponin although there is some myocardial strain to explain the rise, such as an increase in cardiac oxygen demand. True 'falsely elevated' troponin, characterized by a persistent elevation in the absence of cardiac injury does occur and thought to be secondary to an immunoglobulin-troponin complex (macrotroponin). Case summary: A 53-year-old gentleman with a background of diabetes, hypertension, hypercholesterolaemia, and hepatitis B was admitted with chest pain and persistently elevated cardiac troponin T (cTnT) levels. Investigations revealed unobstructed coronary arteries and a structurally normal, well-functioning heart. Subsequent biochemical analysis found the persistently elevated cTnT secondary to macrotroponin T. Discussion: Macrotroponin, an immunoglobulin-troponin bound complex should be considered as a differential diagnosis when the biochemistry is not reflective of the clinical picture. Early recognition requires effective collaboration with the biochemistry laboratory for accurate diagnosis

Tropical Intraseasonal Variability in Version 3 of the GFDL Atmosphere Model

Tropical intraseasonal variability is examined in version 3 of the Geophysical Fluid Dynamics Laboratory Atmosphere Model (AM3). In contrast to its predecessor AM2, AM3 uses a new treatment of deep and shallow cumulus convection and mesoscale clouds. The AM3 cumulus parameterization is a mass-flux-based scheme but also, unlike that in AM2, incorporates subgrid-scale vertical velocities; these play a key role in cumulus microphysical processes. The AM3 convection scheme allows multiphase water substance produced in deep cumuli to be transported directly into mesoscale clouds, which strongly influence large-scale moisture and radiation fields. The authors examine four AM3 simulations using a control model and three versions with different modifications to the deep convection scheme. In the control AM3, using a convective closure based on CAPE relaxation, both MJO and Kelvin waves are weak relative to those in observations. By modifying the convective closure and trigger assumptions to inhibit deep cumuli, AM3 produces reasonable intraseasonal variability but a degraded mean state. MJO-like disturbances in the modified AM3 propagate eastward at roughly the observed speed in the Indian Ocean but up to 2 times the observed speed in the west Pacific Ocean. Distinct differences in intraseasonal convective organization and propagation exist among the modified AM3 versions. Differences in vertical diabatic heating profiles associated with the MJO are also found. The two AM3 versions with the strongest intraseasonal signals have a more prominent “bottom heavy” heating profile leading the disturbance center and “top heavy” heating profile following the disturbance. The more realistic heating structures are associated with an improved depiction of moisture convergence and intraseasonal convective organization in AM3

The role of adult social care in the prevention of intensive health and care needs: a scoping review

Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs. Implications: Greater investment in research in this field will help policy makers and families target scarce resources and invest in the most effective prevention services. We emphasise the impact of prevention services can take several years to realise, which must be reflected in research design and social care funding

Fungicidal effect of volatile oils from Eucalyptus citriodora and its major constituent citronellal

A study was undertaken to explore the effect of volatile oils fromEucalyptus citriodora and its major constituent citronellal against two well-known rice pathogens, Rhizoctonia solani and Helminthosporium oryzae. The radial growth and dry weight of both the test fungi were drastically reduced in response to the volatile oils. A complete inhibition of R. solani and H. oryzae was observed at 10 and 20 ppm, respectively. Citronellal alone was found to be more effective than eucalypt oils. Based on the study, it was concluded that eucalypt volatile oils have potential for the suppression of phytopathogenic fungi

Polonium-210 poisoning: a first-hand account

Background: Polonium-210 (210Po) gained widespread notoriety after the poisoning and subsequent death of Mr Alexander Litvinenko in London, UK, in 2006. Exposure to 210Po resulted initially in a clinical course that was indistinguishable from infection or exposure to chemical toxins, such as thallium. Methods: A 43-year-old man presented to his local hospital with acute abdominal pain, diarrhoea, and vomiting, and was admitted to the hospital because of dehydration and persistent gastrointestinal symptoms. He was initially diagnosed with gastroenteritis and treated with antibiotics. Clostridium difficile toxin was subsequently detected in his stools, which is when he first raised the possibility of being poisoned and revealed his background and former identity, having been admitted under a new identity with which he had been provided on being granted asylum in the UK. Within 6 days, the patient had developed thrombocytopenia and neutropenia, which was initially thought to be drug induced. By 2 weeks, in addition to bone marrow failure, he had evidence of alopecia and mucositis. Thallium poisoning was suspected and investigated but ultimately dismissed because blood levels of thallium, although raised, were lower than toxic concentrations. The patient continued to deteriorate and within 3 weeks had developed multiple organ failure requiring ventilation, haemofiltration, and cardiac support, associated with a drop in consciousness. On the 23rd day after he first became ill, he suffered a pulseless electrical activity cardiorespiratory arrest from which he could not be resuscitated and was pronounced dead. Findings: Urine analysis using gamma-ray spectroscopy on day 22 showed a characteristic 803 keV photon emission, raising the possibility of 210Po poisoning. Results of confirmatory analysis that became available after the patient's death established the presence of 210Po at concentrations about 109-times higher than normal background levels. Post-mortem tissue analyses showed autolysis and retention of 210Po at lethal doses in several organs. On the basis of the measured amounts and tissue distribution of 210Po, it was estimated that the patient had ingested several 1000 million becquerels (a few GBq), probably as a soluble salt (eg, chloride), which delivered very high and fatal radiation doses over a period of a few days. Interpretation: Early symptoms of 210Po poisoning are indistinguishable from those of a wide range of chemical toxins. Hence, the diagnosis can be delayed and even missed without a high degree of suspicion. Although body surface scanning with a standard Geiger counter was unable to detect the radiation emitted by 210Po, an atypical clinical course prompted active consideration of poisoning with radioactive material, with the diagnosis ultimately being made with gamma-ray spectroscopy of a urine sample

Mind the gap: avoiding paravalvular leak using computer simulation in bicuspid transcatheter aortic valve replacement-a case report.

Background: Transcatheter aortic valve replacement (TAVR) is becoming increasingly prevalent worldwide and is now more common than surgical aortic valve replacement. It is expanding into all patient subsets including younger and lower risk patients. Bicuspid aortic valve (BAV) accounts for a significant proportion of TAVR, but due to heterogenous anatomy, it is of increased complexity. One of the greatest challenges in BAV is the selection of the correct TAVR size. Transcatheter aortic valve replacement sizing is based upon computed tomography-derived annular measurements. There are a number of sizing algorithms for BAV based upon anatomical characteristics, often yielding different results. This is noted especially when a patient falls near the borderline between two valve sizes, an anatomical grey zone. Complementary to the algorithm approach is the use of pre-procedural patient-specific computer simulation using finite-element modelling. Case summary: An 86-year-old female was treated for heart failure secondary to severe and calcific BAV aortic stenosis with TAVR. Due to anatomical difficulty and grey-zone valve sizing, we demonstrate the use of pre-procedural patient-specific computer simulation with the novel Medtronic Evolut PRO+ platform to achieve a good result. Discussion: Using patient-specific computer simulation, we were able to safely select the valve and the deployment height and then accurately predict the result in a difficult, severely calcified BAV. In addition to improving outcome, this allows for patient-specific, tailored discussion to occur at heart team meetings