Does small business need a financial fix?

An evaluation of several proposals that would promote additional lending to the small business sector, some through direct government intervention and others by changing existing regulations to promote the market's allocation of credit. The authors argue that market-oriented initiatives are the preferred approach for improving a small-business credit crunch.Small business

Tetralogy of F allot with Complete D i G eorge Syndrome: Report of a Case and a Review of the Literature

Complete D i G eorge syndrome ( CDGS ) has a severe T ‐cell immunodeficiency and is fatal without thymus or bone marrow transplantation. Associated congenital heart disease ( CHD ) further complicates the clinical management. We report an infant with tetralogy of F allot, confluent and hypoplastic pulmonary arteries, right aortic arch, and aberrant left subclavian artery. He was athymic with no CD 3+ T cells. CDGS was diagnosed with 22q11.2 deletion. The patient underwent central aortopulmonary shunt at 12 days of age. The patient died at 5 weeks of age awaiting thymus transplantation. We performed a review of the literature regarding CDGS and CHD . We found 43 cases including conotruncal defects (20) and nonconotruncal defects (23). The overall mortality rate was 67%. Among 30 cases undergoing transplantation (bone marrow 16 and thymus 12, bone marrow + thymus 2), the mortality rate was 53%. The patients with conotruncal defects were more likely to die before transplantation (45% vs. 16%, P =.04). The main cause of death was infection before and after transplantation. We conclude that children with CDGS and CHD have a high mortality. Bone marrow and thymus transplantation can improve the survival, but the overall management of these high risk patients remains challenging.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99054/1/chd694.pd

The impact of urgency of umbilical hernia repair on adverse outcomes in patients with cirrhosis: a population-based cohort study from England

\ua9 2023, The Author(s). Introduction: Umbilical hernia is common in patients with cirrhosis; however, there is a paucity of dedicated studies on postoperative outcomes in this group of patients. This population-based cohort study aimed to determine the outcomes after emergency and elective umbilical hernia repair in patients with cirrhosis. Methods: Two linked electronic healthcare databases from England were used to identify all patients undergoing umbilical hernia repair between January 2000 and December 2017. Patients were grouped into those with and without cirrhosis and stratified by severity into compensated and decompensated cirrhosis. Length of stay, readmission, 90-day case fatality rate and the odds ratio of 90-day postoperative mortality were defined using logistic regression. Results: In total, 22,163 patients who underwent an umbilical hernia repair were included and 297 (1.34%) had cirrhosis. More patients without cirrhosis had an elective procedure, 86% compared with 51% of those with cirrhosis (P < 0.001). In both the elective and emergency settings, patients with cirrhosis had longer hospital length of stay (elective: 0 vs 1 day, emergency: 2 vs 4 days, P < 0.0001) and higher readmission rates (elective: 4.87% vs 11.33%, emergency:11.39% vs 29.25%, P < 0.0001) than those without cirrhosis. The 90-day case fatality rates were 2% and 0.16% in the elective setting, and 19% and 2.96% in the emergency setting in patients with and without cirrhosis respectively. Conclusion: Emergency umbilical hernia repair in patients with cirrhosis is associated with poorer outcomes in terms of length of stay, readmissions and mortality at 90 days

Migration of Interplanetary Dust

We numerically investigate the migration of dust particles with initial orbits close to those of the numbered asteroids, observed trans-Neptunian objects, and Comet Encke. The fraction of silicate asteroidal particles that collided with the Earth during their lifetime varied from 1.1% for 100 micron particles to 0.008% for 1 micron particles. Almost all asteroidal particles with diameter d>4 microns collided with the Sun. The peaks in the migrating asteroidal dust particles' semi-major axis distribution at the n:(n+1) resonances with Earth and Venus and the gaps associated with the 1:1 resonances with these planets are more pronounced for larger particles. The probability of collisions of cometary particles with the Earth is smaller than for asteroidal particles, and this difference is greater for larger particles.Comment: Annals of the New York Academy of Sciences, 15 pages, 8 Figures, submitte

SNS programming environment user's guide

The computing environment is briefly described for the Supercomputing Network Subsystem (SNS) of the Central Scientific Computing Complex of NASA Langley. The major SNS computers are a CRAY-2, a CRAY Y-MP, a CONVEX C-210, and a CONVEX C-220. The software is described that is common to all of these computers, including: the UNIX operating system, computer graphics, networking utilities, mass storage, and mathematical libraries. Also described is file management, validation, SNS configuration, documentation, and customer services

'The heart of what we do': policies on teaching, learning and assessment in the learning and skills sector

One of the stated aims of government policy in England is to put teaching, training,and learning at the heart of the learning and skills system. This paper provides a critical review of policies on teaching, learning and assessment in the learning and skills sector over the past five years. It draws upon data collected and analysed in the early stages of an ESRC-funded Teaching and Learning Research Programme project. Using evidence from policy sources, we argue that despite policy rhetoric about devolution of responsibility to the 'front line', the dominant 'images' that government has of putting teaching, learning and assessment at the heart of the Learning and Skills Sector involves a narrow concept of learning and skills; an idealisation of learner agency lacking an appreciation of the pivotal role of the learner/tutor relationship and a top-down view of change in which central government agencies are relied on to secure education standards

A systematic review of population-based studies examining outcomes in primary retroperitoneal sarcoma surgery

Retroperitoneal sarcomas (RPS) are rare mesenchymal tumours. Their rarity challenges our ability to understand expected outcomes. The aim of this systematic review was to examine 30-day morbidity and mortality, overall survival rates and prognostic predictors from population-based studies for patients undergoing curative resection for primary RPS. A systematic literature review of EMBASE, MEDLINE, PUBMED and the Cochrane library was performed using PRISMA for population-based studies reporting from nationally registered databases on primary RPS surgical resections in adults. The main outcomes evaluated were 30-day morbidity and mortality and overall survival rates. The use of additional treatment modalities and predictors of overall survival were also examined. Fourteen studies (n = 12 834 patients) reporting from 3 national databases, (Surveillance, Epidemiology and End Results (SEER), the United States National Cancer Database (US NCDB) and the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP)) were analysed. The reported overall 30-day morbidity and mortality were 23% (n = 191/846) and 3% (n = 278/10 181) respectively. Reported use of perioperative radiotherapy was 28%. No study reported loco-regional recurrence rates. Overall reported 5-year survival ranged from 52% to 62%. Independent predictors of overall survival were age of the patient, resection margin, tumour grade and size, histological subtype and receipt of radiotherapy. This review of population-based data demonstrated relatively low 30-day morbidity rates in patients undergoing curative surgical resections for primary RPS. Thirty-day mortality rates were similar to other abdominal tumour groups. There remains a paucity of data reporting recurrence rates, however 5-year survival rates ranged from 52 to 62%

Evaluation of the MODIS LAI product using independent lidar-derived LAI: A case study in mixed conifer forest

This study presents an alternative assessment of the MODIS LAI product for a 58,000 ha evergreen needleleaf forest located in the western Rocky Mountain range in northern Idaho by using lidar data to model (R2=0.86, RMSE=0.76) and map LAI at higher resolution across a large number of MODIS pixels in their entirety. Moderate resolution (30 m) lidar-based LAI estimates were aggregated to the resolution of the 1-km MODIS LAI product and compared to temporally-coincident MODIS retrievals. Differences in the MODIS and lidar-derived values of LAI were grouped and analyzed by several different factors, including MODIS retrieval algorithm, sun/sensor geometry, and sub-pixel heterogeneity in both vegetation and terrain characteristics. Of particular interest is the disparity in the results when MODIS LAI was analyzed according to algorithm retrieval class. We observed relatively good agreement between lidar-derived and MODIS LAI values for pixels retrieved with the main RT algorithm without saturation for LAI LAI≤4. Moreover, for the entire range of LAI values, considerable overestimation of LAI (relative to lidar-derived LAI) occurred when either the main RT with saturation or back-up algorithm retrievals were used to populate the composite product regardless of sub-pixel vegetation structural complexity or sun/sensor geometry. These results are significant because algorithm retrievals based on the main radiative transfer algorithm with or without saturation are characterized as suitable for validation and subsequent ecosystem modeling, yet the magnitude of difference appears to be specific to retrieval quality class and vegetation structural characteristics