The Effects of Fire Fighting and On-Scene Rehabilitation on Hemostatis

Fire fighting is a dangerous occupation – in part because firefighters are called upon to perform strenuous physical activity in hot, hostile environments. Each year, approximately 100 firefighters lose their lives in the line of duty and tens of thousands are injured. Over the past 15 years, approximately 45% of line of duty deaths have been attributed to heart attacks and another 650-1,000 firefighters suffer non-fatal heart attacks in the line of duty each year. From 1990 to 2004, the total number of fireground injuries has declined, yet during this same period, the number of cases related to the leading cause of injury - overexertion/strain – remained relatively constant. It is well recognized that fire fighting leads to increased cardiovascular and thermal strain. However, the time course of recovery from fire fighting is not well documented, despite the fact that a large percentage of fire fighting fatalities occur after fire fighting activity. Furthermore, on scene rehabilitation (OSR) has been broadly recommended to mitigate the cardiovascular and thermal strain associated with performing strenuous fire fighting activity, yet the efficacy of different rehabilitation interventions has not been documented. Twenty-five firefighters were recruited to participate in a “within-subjects, repeated measures” study designed to describe the acute effects of fire fighting on a broad array of physiological and psychological measures and several key cardiovascular variables. This study provided the first detailed documentation of the time course of recovery during 2½ hours post-fire fighting. Additionally, we compared two OSR strategies (standard and enhanced) to determine their effectiveness.published or submitted for publicationnot peer reviewe

Cycling infrastructure for reducing cycling injuries in cyclists

Background: Cycling is an attractive form of transport. It is beneficial to the individual as a form of physical activity that may fit more readily into an individual’s daily routine, such as for cycling to work and to the shops, than other physical activities such as visiting a gym. Cycling is also beneficial to the wider community and the environment as a result of fewer motorised journeys. Cyclists are seen as vulnerable road users who are frequently in close proximity to larger and faster motorised vehicles. Cycling infrastructure aims to make cycling both more convenient and safer for cyclists. This review is needed to guide transport planning. Objectives: To: 1. evaluate the effects of different types of cycling infrastructure on reducing cycling injuries in cyclists, by type of infrastructure; 2. evaluate the effects of cycling infrastructure on reducing the severity of cycling injuries in cyclists; 3. evaluate the effects of cycling infrastructure on reducing cycling injuries in cyclists with respect to age, sex and social group. Search methods: We ran the most recent search on 2nd March 2015. We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE (OvidSP), Embase Classic + Embase(OvidSP), PubMed and 10 other databases. We searched websites, handsearched conference proceedings, screened reference lists of included studies and previously published reviews and contacted relevant organisations. Selection criteria: We included randomised controlled trials, cluster randomised controlled trials, controlled before-after studies, and interrupted time series studies which evaluated the effect of cycling infrastructure (such as cycle lanes, tracks or paths, speed management, roundabout design) on cyclist injury or collision rates. Studies had to include a comparator, that is, either no infrastructure or a different type of infrastructure. We excluded studies that assessed collisions that occurred as a result of competitive cycling. Data collection and analysis: Two review authors examined the titles and abstracts of papers obtained from searches to determine eligibility. Two review authors extracted data from the included trials and assessed the risk of bias. We carried out a meta-analysis using the random-effects model where at least three studies reported the same intervention and outcome. Where there were sufficient studies, as a secondary analysis we accounted for changes in cyclist exposure in the calculation of the rate ratios. We rated the quality of the evidence as ‘high’, ‘moderate’,‘low’ or ‘very low’ according to the GRADE approach for the installation of cycle routes and networks. Main results: We identified 21 studies for inclusion in the review: 20 controlled before-after (CBA) studies and one interrupted time series (ITS) study. These evaluated a range of infrastructure including cycle lanes, advanced stop lines, use of colour, cycle tracks, cycle paths, management of the road network, speed management, cycle routes and networks, roundabout design and packages of measures. No studies reported medically-attended or self-reported injuries. There was no evidence that cycle lanes reduce the rate of cycle collisions (rate ratio 1.21, 95% CI 0.70 to 2.08). Taking into account cycle flow, there was no difference in collisions for cyclists using cycle routes and networks compared with cyclists not using cycle routes and networks (RR 0.40, 95% CI 0.15 to 1.05). There was statistically significant heterogeneity between the studies (I² = 75%, Chi² = 8.00 df = 2, P = 0.02) for the analysis adjusted for cycle flow. We judged the quality of the evidence regarding cycle routes and networks as very low and we are very uncertain about the estimate. These analyses are based on findings from CBA studies. From data presented narratively, the use of 20 mph speed restrictions in urban areas may be effective at reducing cyclist collisions. Redesigning specific parts of cycle routes that may be particularly busy or complex in terms of traffic movement may be beneficial to cyclists in terms of reducing the risk of collision. Generally, the conversion of intersections to roundabouts may increase the number of cycle collisions. In particular, the conversion of intersections to roundabouts with cycle lanes marked as part of the circulating carriageway increased cycle collisions. However, the conversion of intersections with and without signals to roundabouts with cycle paths may reduce the odds of collision. Both continuing a cycle lane across the mouth of a side road with a give way line onto the main road, and cycle tracks, may increase the risk of injury collisions in cyclists. However, these conclusions are uncertain, being based on a narrative review of findings from included studies. There is a lack of evidence that cycle paths or advanced stop lines either reduce or increase injury collisions in cyclists. There is also insufficient evidence to draw any robust conclusions concerning the effect of cycling infrastructure on cycling collisions in terms of severity of injury, sex, age, and level of social deprivation of the casualty. In terms of quality of the evidence, there was little matching of intervention and control sites. In many studies, the comparability of the control area to the intervention site was unclear and few studies provided information on other cycling infrastructures that may be in place in the control and intervention areas. The majority of studies analysed data routinely collected by organisations external to the study team, thus reducing the risk of bias in terms of systematic differences in assessing outcomes between the control and intervention groups. Some authors did not take regression-to-mean effects into account when examining changes in collisions. Longer data collection periods pre- and post-installation would allow for regression-to-mean effects and also seasonal and time trends in traffic volume to be observed. Few studies adjusted cycle collision rates for exposure. Authors’ conclusions: Generally, there is a lack of high quality evidence to be able to draw firm conclusions as to the effect of cycling infrastructure on cycling collisions. There is a lack of rigorous evaluation of cycling infrastructure

A New Probe of the Molecular Gas in Galaxies: Application to M101

Recent studies of nearby spiral galaxies suggest that photodissociation regions (PDRs) are capable of producing much of the observed HI in galaxy disks. In that case, measurements of the HI column density and the far-ultraviolet (FUV) photon flux provide a new probe of the volume density of the local underlying H_2. We develop the method and apply it to the giant Scd spiral M101 (NGC 5457). We find that, after correction for the best-estimate gradient of metallicity in the ISM of M101 and for the extinction of the ultraviolet emission, molecular gas with a narrow range of density from 30-1000 cm^-3 is found near star- forming regions at all radii in the disk of M101 out to a distance of 12' (approximately 26 kpc), close to the photometric limit of R_25 = 13.5'. In this picture, the ISM is virtually all molecular in the inner parts of M101. The strong decrease of the HI column density in the inner disk of the galaxy at R_G < 10 kpc is a consequence of a strong increase in the dust-to-gas ratio there, resulting in an increase of the H_2 formation rate on grains and a corresponding disappearance of hydrogen in its atomic form.Comment: accepted for publication in The Astrophysical Journal (1 August 2000); 29 pages including 20 figures (7 gif); AAS LaTex; contact authors for full resolution versions of gif figure

An Ultraviolet and Near-Infrared View of NGC 4214: A Starbursting Core Embedded in a Low Surface Brightness Disk

During the Astro-2 Spacelab mission in 1995 March, the Ultraviolet Imaging Telescope (UIT) obtained far-UV (λ = 1500 A) imagery of the nearby Sm/Im galaxy NGC 4214. The UIT images have a spatial resolution of ~3'' and a limiting surface brightness, μ1500 > 25 mag arcsec-2, permitting detailed investigation of the intensity and spatial distribution of the young, high-mass stellar component. These data provide the first far-UV imagery covering the full spatial extent of NGC 4214. Comparison with a corresponding I-band image reveals the presence of a starbursting core embedded in an extensive low surface brightness disk. In the far-UV (FUV), NGC 4214 is resolved into several components: a luminous, central knot; an inner region (r 2.5 kpc) with ~15 resolved sources embedded in bright, diffuse emission; and a population of fainter knots extending to the edge of the optically defined disk (r ≈ 5 kpc). The FUV light, which traces recent massive star formation, is observed to be more centrally concentrated than the I-band light, which traces the global stellar population. The FUV radial light profile is remarkably well represented by an R1/4 law, providing evidence that the centrally concentrated massive star formation in NGC 4214 is the result of an interaction, possibly a tidal encounter, with a dwarf companion(s). The brightest FUV source produces ~8% of the global FUV luminosity. This unresolved source, corresponding to the Wolf-Rayet knot described by Sargent & Filippenko, is located at the center of the FUV light distribution, giving NGC 4214 an active galactic nucleus-like morphology. Another strong source is present in the I band, located 19'' west, 10'' north of the central starburst knot, with no FUV counterpart. The I-band source may be the previously unrecognized nucleus of NGC 4214 or an evolved star cluster with an age greater than ~200 Myr. The global star formation rate derived from the total FUV flux is consistent with rates derived using data at other wavelengths and lends support to the scenario of roughly constant star formation during the last few hundred million years at a level significantly enhanced relative to the lifetime averaged star formation rate. The hybrid disk/starburst-irregular morphology evident in NGC 4214 emphasizes the danger of classifying galaxies based on their high surface brightness components at any particular wavelength

UIT Astro-2 Observations of NGC 4449

The bright Magellanic irregular galaxy NGC 4449 was observed by the Ultraviolet Imaging Telescope (UIT) during the Astro-2 Spacelab mission in March, 1995. Far ultraviolet (FUV) images at a spatial resolution of ~3 arcsec show bright star-forming knots that are consistent with the general optical morphology of the galaxy and are often coincident with bright H II regions. Comparison of FUV with H-alpha shows that in a few regions, sequential star formation may have occurred over the last few Myr. The bright star forming complexes in NGC 4449 are superposed on a smooth, diffuse FUV background that may be associated with the H-alpha "froth."Comment: 4 pages, Latex with AIP proceedings macros, 2 EPS figures. To appear in proceedings of U. Maryland October Astrophysics Conf., 1996, AIP pu

Prospectus, September 30, 1981

SENATORS ELECTED; News In Brief; PC enrollment sets records; Join new Com Club; Parkland extends to area; Choirs sing; Computer linked to aid Chanute growth; Women, meet your auto; Ski Club picks new officers; New art exhibit is reviewed; Best news is no news; ISO elects new officers; Use coupons and \u27garbage\u27 to save on shopping; Mark gives us his various thoughts and views; Be aware and be safe; Go Grape at Grape Expectations; Newhart does better on sit-com; Classifieds; Shelter reaches capacity; Neil Simon has another hit; Butts sets record; Cross country team improving more each meet; DuPage Invitational Summary; Belushi stars in new movie; Volleyball team evens up their record; Sign up for offered seminars; Clinton steps back in timehttps://spark.parkland.edu/prospectus_1981/1011/thumbnail.jp

Anomalies in T cell function are associated with individuals at risk of mycobacterium abscessus complex infection

The increasing global incidence and prevalence of non-tuberculous mycobacteria (NTM) infection is of growing concern. New evidence of person-to-person transmission of multidrug-resistant NTM adds to the global concern. The reason why certain individuals are at risk of NTM infections is unknown. Using high definition flow cytometry, we studied the immune profiles of two groups that are at risk of Mycobacterium abscessus complex infection and matched controls. The first group was cystic fibrosis (CF) patients and the second group was elderly individuals. CF individuals with active M. abscessus complex infection or a history of M. abscessus complex infection exhibited a unique surface T cell phenotype with a marked global deficiency in TNFa production during mitogen stimulation. Importantly, immune-based signatures were identified that appeared to predict at baseline the subset of CF individuals who were at risk of M. abscessus complex infection. In contrast, elderly individuals with M. abscessus complex infection exhibited a separate T cell phenotype underlined by the presence of exhaustion markers and dysregulation in type 1 cytokine release during mitogen stimulation. Collectively, these data suggest an association between T cell signatures and individuals at risk of M. abscessus complex infection, however, validation of these immune anomalies as robust biomarkers will require analysis on larger patient cohorts

High-density lipoprotein subclasses are a potential intermediary between alcohol intake and reduced risk of cardiovascular disease: The Rancho Bernardo Study

We conducted a cross-sectional study of NMR-derived HDL subclasses and alcohol intake among 2171 community-dwelling older adults with a large proportion of daily or near-daily alcohol consumers (44 %). We aimed to assess whether, in addition to increasing total HDL, alcohol may induce a beneficial shift in HDL particle size distribution. Participants were categorised based on reported alcohol intake (g per week) and on frequency (none, < 3 times/week, 3-4 times/week, ≥ 5 times/week). The association between alcohol intake and lipoprotein fractions was examined using sex-specific linear regression models adjusted for age, BMI, diabetes, current smoking, exercise and hormone therapy in women. There was a stepwise gradient with the highest weekly alcohol consumption associated with the highest total HDL size and greatest number of medium and large HDL particles, as well as higher total HDL concentrations (all P < 0.001); total small HDL did not differ. Alcohol-HDL size associations were similar in both sexes and did not differ by use of hormone replacement therapy in women. In conclusion, regular alcohol consumers had a higher number and percentage of large HDL particles than non-drinkers. These results suggest that one way that alcohol may decrease CVD is through potentially favourable changes in lipoprotein subclass composition

Early observed transient prostate-specific antigen elevations on a pilot study of external beam radiation therapy and fractionated MRI guided High Dose Rate brachytherapy boost

PURPOSE: To report early observation of transient PSA elevations on this pilot study of external beam radiation therapy and magnetic resonance imaging (MRI) guided high dose rate (HDR) brachytherapy boost. MATERIALS AND METHODS: Eleven patients with intermediate-risk and high-risk localized prostate cancer received MRI guided HDR brachytherapy (10.5 Gy each fraction) before and after a course of external beam radiotherapy (46 Gy). Two patients continued on hormones during follow-up and were censored for this analysis. Four patients discontinued hormone therapy after RT. Five patients did not receive hormones. PSA bounce is defined as a rise in PSA values with a subsequent fall below the nadir value or to below 20% of the maximum PSA level. Six previously published definitions of biochemical failure to distinguish true failure from were tested: definition 1, rise >0.2 ng/mL; definition 2, rise >0.4 ng/mL; definition 3, rise >35% of previous value; definition 4, ASTRO defined guidelines, definition 5 nadir + 2 ng/ml, and definition 6, nadir + 3 ng/ml. RESULTS: Median follow-up was 24 months (range 18–36 mo). During follow-up, the incidence of transient PSA elevation was: 55% for definition 1, 44% for definition 2, 55% for definition 3, 33% for definition 4, 11% for definition 5, and 11% for definition 6. CONCLUSION: We observed a substantial incidence of transient elevations in PSA following combined external beam radiation and HDR brachytherapy for prostate cancer. Such elevations seem to be self-limited and should not trigger initiation of salvage therapies. No definition of failure was completely predictive