1,851 research outputs found
Thinking About āCompleted Lifeā Euthanasia in the Netherlands from the Generativity Perspective: A Reflexive Exploration
Autonomy and dying: Notes about decision-making and ācompleted lifeā euthanasia in the Netherlands
Prilling of fatty acids as a continuous process for the development of controlled release multiparticulate dosage forms
Recruitment, survival, and parasitism of monarch butterflies (Danaus plexippus) in milkweed gardens and conservation areas
Monarch butterflies (Danaus plexippus) are suffering from declining populations and conservationists have encouraged planting milkweed gardens in urban and suburban landscapes to help offset habitat loss across the breeding range. The effectiveness of gardens as a conservation strategy depends on their ability to attract ovipositing adults and the survival of monarch larvae in these gardens. Larvae are susceptible to a variety of predators as well as to parasitism by a tachinid fly (Lespesia archippivora) and a protozoan parasite (Ophryocystis elektroscirrha) which cause lethal or sublethal effects, yet the severity of these risks in gardens is not well understood. We compared egg abundance and larval survival in traditional conservation areas to gardens that incorporated milkweed to attract monarchs. Additionally, we collected late instar larvae and reared them in the lab to compare parasitism rates between monarch gardens and conservation areas. Both gardens and conservations sites varied widely in recruitment and survival of monarchs and there were no significant differences between the garden and conservation sites. Tachinid fly parasitism ranged from 30% of larvae from conservation sites in 2016 to 55% of larvae from gardens in 2017, but did not differ between the two categories of sites. Parasitism by O. elektroscirrha was detected in fewer than 2% of larvae. The density of milkweed had no effect on the number of monarch eggs in conservation areas or gardens in either year. Milkweed density had no effect on tachinid parasitism in conservation areas but had a significant effect in gardens with lower numbers of milkweed stems increasing tachinid parasitism in 2016. Gardeners planted a variety of species of milkweed and Asclepias syriaca was the most commonly used host plant for monarch larvae (85%). Overall, our results suggest that milkweed gardens have the potential to contribute to successful monarch reproduction. However, the variation among sites and the lack of recruitment from some gardens emphasizes that the realization of this potential contribution will depend on the quality of gardens
Endovascular Treatment of the Descending Thoracic Aorta
AbstractObjectives: to report our initial experience with endovascular stent graft repair of a variety of thoracic aortic pathology.Design: retrospective single center study.Material and methods: between February 2000 and January 2002, endovascular stent graft repair was performed in 26 patients: traumatic aortic isthmus rupture (n=3), Type B dissection (n=11) and descending thoracic aortic aneurysm (n=12). The deployed stent graft systems were AneuRx-Medtronic (n=1), Talent-Medtronic (n=13) and Excluder-Gore (n=12).Results: successful deployment of the stent grafts in the intended position was achieved in all patients. No hospital mortality neither paraplegia were observed. Late, non procedure related, death occurred in four patients (15%). Access artery complications with rupture of the iliac artery occurred in two patients and were managed by iliac-femoral bypass. The left subclavian artery was overstented in seven patients (27%). Only the first patient received a carotido-subclavian bypass. The mean maximal aortic diameter decreased significantly in patients treated for descending thoracic aneurysm. Only one patient had an endoleak type II after 6 months without enlargement of the aneurysm. Complete thrombosis of the thoracic false lumen occurred in all but one patient treated for Type B dissection 6 months postoperatively. Two patients underwent a consecutive stent graft placement, due to a large re-entry tear distal to the first stent graft.Conclusions: endovascular stent graft repair for Type B dissection, descending thoracic aneurysm and aortic isthmus rupture is a promising less-invasive alternative to surgical repair. Further studies are mandatory to determine its long-term efficacy
Associations between rationing of nursing care and inpatient mortality in Swiss hospitals
Objectives To explore the relationship between inpatient mortality and implicit rationing of nursing care, the quality of nurse work environments and the patient-to-nurse staffing ratio in Swiss acute care hospitals. Design Cross-sectional correlational design. Setting Eight Swiss acute care hospitals examined in a survey-based study and 71 comparison institutions. Participants A total of 165 862 discharge abstracts from patients treated in the 8 RICH Nursing Study (the Rationing of Nursing Care in Switzerland Study) hospitals and 760 608 discharge abstracts from patients treated in 71 Swiss acute care hospitals offering similar services and maintaining comparable patient volumes to the RICH Nursing hospitals. Main outcome measures The dependent variable was inpatient mortality. Logistic regression models were used to estimate the effects of the independent hospital-level measures. Results Patients treated in the hospital with the highest rationing level were 51% more likely to die than those in peer institutions (adjusted OR: 1.51, 95% CI: 1.34-1.70). Patients treated in the study hospitals with higher nurse work environment quality ratings had a significantly lower likelihood of death (adjusted OR: 0.80, 95% CI: 0.67-0.97) and those treated in the hospital with the highest measured patient-to-nurse ratio (10:1) had a 37% higher risk of death (adjusted OR: 1.37, 95% CI: 1.24-1.52) than those in comparison institutions. Conclusions Measures of rationing may reflect care conditions that place hospital patients at risk of negative outcomes and thus deserve attention in future hospital outcomes research studie
A Subdomain Method for Mapping the Heterogeneous Mechanical Properties of the Human Posterior Sclera
Although strongly correlated with elevated intraocular pressure, primary open-angle glaucoma (POAG) occurs in normotensive eyes. Mechanical properties of the sclera around the optic nerve head (ONH) may play a role in this disparity. The purpose of this study is to present an automated inverse mechanics based approach to determine the distribution of heterogeneous mechanical properties of the human sclera as derived from its surface deformations arising from pressure inflation experiments. The scleral shell of a 78 year old European Descent male donor eye was utilized to demonstrate the method; the sclera was coated with a speckle pattern on the outer surface and was subjected to inflation pressures of 5, 15, 30, and 45 mmHg. The speckle pattern was imaged at each pressure, and a displacement field was calculated for each pressure step using a previously described sequential digital image correlation (S-DIC) technique. The fiber splay and fiber orientation of the sclera collagen were determined experimentally, and the thickness across the scleral globe was determined using micro CT images. The displacement field from the inflation test was used to calculate the strain and also used as an input for inverse mechanics to determine the heterogeneity of material properties. The scleral geometry was divided into subdomains using the first principal strain. The Holzapfel anisotropic material parameters of matrix and fiber stiffness were estimated within each individual subdomain using an inverse mechanics approach by minimizing the sum of the square of the residuals between the computational and experimental displacement fields. The mean and maximum error in displacement across all subdomains were 8.9 Ā± 3.0 Ī¼m and 13.2 Ī¼m, respectively. The full pressure-inflation forward mechanics experiment was done using subdomain-specific mechanical properties on the entire scleral surface. The proposed approach is effective in determining the distribution of heterogeneous mechanical properties of the human sclera in a user-independent manner. Our research group is currently utilizing this approach to better elucidate how scleral stiffness influences those at high risk for POAG
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