Mortality From Postoperative Myocardial Infarction in Nonthoracic Surgical Patients at a Community Hospital

In a 20-month prospective study, 35 patients with postoperative myocardial infarction were identified. All patients referred to cardiologists by nonthoracic surgeons were evaluated for evidence of postoperative myocardial infarction as defined by symptoms, electrocardiographic changes, and cardiac enzyme elevation. Ten of the 35 patients (29%) subsequently died, seven (20%) from the myocardial infarction. Twenty-five of the 35 patients (71%) had preexisting coronary artery disease. Reported experience with patient mortality following postoperative myocardial infarction varies from 28% to 69%. Our patient mortality rate at 29%, though still substantial, is lower than many current reports. Despite close perioperative surveillance of patients with coronary artery disease, the morbidity and mortality remains unacceptably high. Physicians should routinely evaluate the surgical patient thoroughly for cardiac risk

Fish and Wildlife Benefits of the Wildlife Habitat Incentives Program

Th e Wildlife Habitat Incentives Program (WHIP) is a voluntary program that encourages the establishment and enhancement of a wide variety of fish and wildlife habitats of national, state, tribal, or local significance. Through voluntary agreements, the Natural Resources Conservation Service (NRCS) provides financial and technical assistance to participants who installed habitat restoration and management practices. Since 1998, nearly $150 million has been dedicated to the program and over 2.8 million acres involving over 18,000 contracts have been enrolled. A wide range of habitat-enhancement actions are cost-shared through the program, affecting hundreds of target and non-target species. While few quantitative data exist describing how fish and wildlife have responded to terrestrial and aquatic habitats enrolled in the program, the popularity of WHIP among participants and funding partners and anecdotal evidence imply that tangible benefits to target species are being realized. Additional studies are needed to better understand how WHIP projects affect local habitat use by and population response of target and non-target species

Pharmacists in Pharmacovigilance: Can Increased Diagnostic Opportunity in Community Settings Translate to Better Vigilance?

The pharmacy profession has undergone substantial change over the last two to three decades. Whilst medicine supply still remains a central function, pharmacist’s roles and responsibilities have become more clinic and patient focused. In the community (primary care), pharmacists have become important providers of healthcare as Western healthcare policy advocates patient self-care. This has resulted in pharmacists taking on greater responsibility in managing minor illness and the delivery of public health interventions. These roles require pharmacists to more fully use their clinical skills, and often involve diagnosis and therapeutic management. Community pharmacists are now, more than ever before, in a position to identify, record and report medication safety incidents. However, current research suggests that diagnostic ability of community pharmacists is questionable and they infrequently report to local or national schemes. The aim of this paper is to highlight current practice and suggest ways in which community pharmacy can more fully contribute to patient safety

Nonlinear multidimensional cosmological models with form fields: stabilization of extra dimensions and the cosmological constant problem

We consider multidimensional gravitational models with a nonlinear scalar curvature term and form fields in the action functional. In our scenario it is assumed that the higher dimensional spacetime undergoes a spontaneous compactification to a warped product manifold. Particular attention is paid to models with quadratic scalar curvature terms and a Freund-Rubin-like ansatz for solitonic form fields. It is shown that for certain parameter ranges the extra dimensions are stabilized. In particular, stabilization is possible for any sign of the internal space curvature, the bulk cosmological constant and of the effective four-dimensional cosmological constant. Moreover, the effective cosmological constant can satisfy the observable limit on the dark energy density. Finally, we discuss the restrictions on the parameters of the considered nonlinear models and how they follow from the connection between the D-dimensional and the four-dimensional fundamental mass scales.Comment: 21 pages, LaTeX2e, minor changes, improved references, fonts include

Moving Five-Branes in Low-Energy Heterotic M-Theory

We construct cosmological solutions of four-dimensional effective heterotic M-theory with a moving five-brane and evolving dilaton and T modulus. It is shown that the five-brane generates a transition between two asymptotic rolling-radii solutions. Moreover, the five-brane motion always drives the solutions towards strong coupling asymptotically. We present an explicit example of a negative-time branch solution which ends in a brane collision accompanied by a small-instanton transition. The five-dimensional origin of some of our solutions is also discussed.Comment: 16 pages, Latex, 3 eps figure

Future changes in tropical cyclone activity in the North Indian Ocean projected by high-resolution MRI-AGCMs

Open Access at publisher's web site: http://www.springerlink.com/content/b682734237171631

KLF15 Is a Molecular Link between Endoplasmic Reticulum Stress and Insulin Resistance

Obesity places major demands on the protein folding capacity of the endoplasmic reticulum (ER), resulting in ER stress, a condition that promotes hepatic insulin resistance and steatosis. Here we identify the transcription factor, Kruppel-like factor 15 (KLF15), as an essential mediator of ER stress-induced insulin resistance in the liver. Mice with a targeted deletion of KLF15 exhibit increased hepatic ER stress, inflammation, and JNK activation compared to WT mice; however, KLF15-/- mice are protected against hepatic insulin resistance and fatty liver under high-fat feeding conditions and in response to pharmacological induction of ER stress. The mammalian target of rapamycin complex 1 (mTORC1), a key regulator of cellular energy homeostasis, has been shown to cooperate with ER stress signaling pathways to promote hepatic insulin resistance and lipid accumulation. We find that the uncoupling of ER stress and insulin resistance in KLF15-/- liver is associated with the maintenance of a low energy state characterized by decreased mTORC1 activity, increased AMPK phosphorylation and PGC-1α expression and activation of autophagy, an intracellular degradation process that enhances hepatic insulin sensitivity. Furthermore, in primary hepatocytes, KLF15 deficiency markedly inhibits activation of mTORC1 by amino acids and insulin, suggesting a mechanism by which KLF15 controls mTORC1-mediated insulin resistance. This study establishes KLF15 as an important molecular link between ER stress and insulin action

Transition from suppressed to active convection modulated by a weak-temperature gradient derived large-scale circulation

Numerical simulations are performed to assess the influence of the large-scale circulation on the transition from suppressed to active convection. As a model tool, we used a coupled-column model. It consists of two cloud-resolving models which are fully coupled via a large-scale circulation which is derived from the requirement that the instantaneous domain-mean potential temperature profiles of the two columns remain close to each other. This is known as the weak-temperature gradient approach. The simulations of the transition are initialized from coupled-column simulations over non-uniform surface forcing and the transition is forced within the dry column by changing the local and/or remote surface forcings to uniform surface forcing across the columns. As the strength of the circulation is reduced to zero, moisture is recharged into the dry column and a transition to active convection occurs once the column is sufficiently moistened to sustain deep convection. Direct effects of changing surface forcing occur over the first few days only. Afterward, it is the evolution of the large-scale circulation which systematically modulates the transition. Its contributions are approximately equally divided between the heating and moistening effects. A transition time is defined to summarize the evolution from suppressed to active convection. It is the time when the rain rate within the dry column is halfway to the mean value obtained at equilibrium over uniform surface forcing. The transition time is around twice as long for a transition that is forced remotely compared to a transition that is forced locally. Simulations in which both local and remote surface forcings are changed produce intermediate transition times

"Find Out Exactly What to Think-Next!": Chris Morris, Brass Eye, and Journalistic Authority

This article discusses Chris Morris's fake news TV series Brass Eye (1997, 2001). It concentrates on the ways in which Brass Eye exposed and undermined not only the textual conventions of TV news and current affairs, but also the ways in which the program deployed those textual conventions to highlight and sabotage the cultural authority of public figures who appeared on it. The article first introduces Morris and Brass Eye, before identifying some of the key textual strategies of broadcast news that are satirized in the program, including its mode of address, its music, and its visuals and graphics. It then examines how the program's use of those strategies enables it to exercise the authority of broadcast news to expose the accessed voices of public figures within the show