937 research outputs found
Analysis, Tracing, Characterization and Performance Modeling of Select ASCI Applications for BlueGene/L Using Parallel Discrete Event Simulation
Caltech's Jet Propulsion Laboratory (JPL) and Center for Advanced Computer Architecture (CACR) are conducting application and simulation analyses of Blue Gene/L[1] in order to establish a range of effectiveness of the architecture in performing important classes of computations and to determine the design sensitivity of the global interconnect network in support of real world ASCI application execution
An evaluation of diagnostic equipment which must be purchased by optometry students
This material deals with student\u27s response to a survey as to quality and quantity of their retinoscope, ophthalmoscope, trial lens set and trial frame. Also basic use and features of these instruments are included. Other less expenesive equipment was surveyed to see if students actually possessed it
Placental pathology in an unsuspected case of mucolipidosis type II with secondary hyperparathyroidism in a premature infant
Mucolipidosis type II (MLII, MIM 252500) is a lysosomal storage disorders caused by defects i
Strengthening Democracy by Design: Challenges and Opportunities
In 2014, the Journal of Public Deliberation published an essay, “Democracy by Design,” a framework for a more aspirational, stronger democracy and approach to civic learning. Here, the authors update and reissue Democracy by Design along with a report on the status of the four foundational attributes of a strong democracy, one that is participatory, free and equal, educated and informed, and accountable and justly governed. The authors argue that American democracy faces multiple challenges reflecting declines in democratic norms and practices, for example, growing inequality, weak and unequal civic education, widening polarization, and the rise of undemocratic forces in some segments of American society that are seemingly unchecked by political leaders. Stopping democracy’s decline calls for efforts - some deliberative and some more activist - by both public officials and everyday citizens. Citizen-driven efforts will prevail only if contextualized in broader knowledge and understanding of democracy’s design and health
Descendants of the Jurassic turiasaurs from Iberia found refuge in the Early Cretaceous of western USA
A new, largely complete eusauropod dinosaur with cranial and postcranial elements from two skeletons, Mierasaurus bobyoungi gen. nov., sp. nov. from the lower Yellow Cat Member (Early Cretaceous) of Utah (USA), is the first recognized member of Turiasauria from North America. Moreover, according to our phylogenetic results, Moabosaurus utahensis from the lower Yellow Cat Member of Utah (USA) is also a member of this clade. This group of non-neosauropod eusauropods, which now includes five genera (Losillasaurus, Turiasaurus, Mierasaurus, Moabosaurus and Zby), was previously known only from the Jurassic of Europe. These recent discoveries in Utah suggest that turiasaurs as a lineage survived the Jurassic-Cretaceous extinction boundary and expanded their known range, at least, into western North America. The revised spatiotemporal distribution of turiasaurs is consistent with the presence of a land connection between North America and Europe sometime during the late Tithonian to Valanginian (c.147-133 Ma). Mierasaurus and Moabosaurus are the only non-neosauropod eusauropods known from North America, despite being younger than the classic neosauropods of the Morrison Formation (c.150 Ma)
Use and disclosure of complementary health approaches in US adults with cardiovascular disease
Evidence indicates that use of Complementary Health Approaches (CHAs) is common in
patients with cardiovascular disease (CVD) and has benefits and risks. Yet, disclosure of
CHA use to physicians is not uniformly high. The present study aimed to assess the prevalence
and patterns of CHA use and disclosure in patients with CVD in a nationally
representative US sample. Use of specific CHA modalities and the predictors and reasons
for nondisclosure were examined. In the 2012 National Health Interview Survey, a nationally
representative sample of adults aged 18+ was used, and 12,364 patients who reported
being diagnosed with CVD were analyzed using weighted bivariate and logistic regression.
Analyses revealed that 34.75% of patients with CVD had used CHA in the previous
year. Women, those with higher education and income, who had functional limitations, greater
mental distress, and healthier lifestyles were significantly more likely to use CHA. Nonvitamin,
nonmineral supplements was the most prevalent CHA used (19.22%). Rates of nondisclosure
were highest among younger and better educated CHA users. In patients with CVD
who did not disclose CHA use to their physician (33.67%), 45.51% said the reason was because
physician did not ask; 8.75% said the reason was because they were not using CHA at the
time. In conclusion, over 1/3 of patients with CVD used CHA in the previous year, and
nonvitamin, nonmineral supplements were the most commonly used modality. The findings
underscore the importance of provider-initiated communication about CHA use in patients
with CVD to minimize the potentially harmful consequences of nondisclosure
The effect of hospital factors on mortality rates after abdominal aortic aneurysm repair
BackgroundPatient factors that contribute to mortality from abdominal aortic aneurysm (AAA) repair have been previously described, but few studies have delineated the hospital factors that may be associated with an increase in patient mortality after AAA. This study used a large national database to identify hospital factors that affect mortality rates after open repair (OAR) and endovascular AAA repair (EVAR) of elective and ruptured AAA.MethodsA retrospective analysis was completed using the Nationwide Inpatient Sample from 1998 to 2011. International Classification of Disease, Ninth Revision codes were used to identify patients who underwent elective or ruptured AAA repair by OAR or EVAR. The association between mortality and hospital covariates, including ownership, bed size, region, and individual hospital volume for these patients was statistically delineated by analysis of variance, χ2, and Mann-Kendall trend analysis.ResultsA total of 128,232 patients were identified over the 14-year period, of which 88.5% were elective procedures and 11.5% were performed acutely for rupture. Most hospitals that complete elective OAR do between one and 50 cases, with mortality between 0% and 40%. Hospitals with mortality >40% uniformly complete fewer than five elective OAR cases annually and fall in the bottom 2.5% of all hospitals for mortality. Most hospitals that complete elective EVAR do between one and 70 cases, with mortality between 0% and 13%. Hospitals with mortality >13% uniformly complete fewer than eight elective EVAR cases annually and fall in the bottom 2.5% of all hospitals for mortality. The majority of hospitals that complete OAR or EVAR for ruptured AAA have between 0% to 100% for mortality, indicative of the high mortality risk associated with rupture.ConclusionsHospitals that complete fewer than five OARs or eight EVARs annually have significantly greater mortality compared with their counterparts. Improved implementation of best practices, more detailed informed consent to include hospital mortality data, and better regional access to health care may improve survival after elective AAA repair
Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms
ObjectiveHybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.MethodsAll patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.6% male) were identified. One hundred thirty-two bypasses were constructed (median 4 per patient) using either polyester (30), thin-walled polytetrafluoroethylene (ePTFE, 100) or saphenous vein (2). Follow-up computed tomography (CT) imaging was routinely performed at 1 and 6 months, and annually thereafter.ResultsOf the 37 patients with one follow-up CT, 20 (54.1%) were found to have fluid collections. The natural history of the 17 patients with collections and further follow-up imaging was variable, with 2 resolving, 6 stable, and 9 enlarging. Two patients with collections developed evidence of graft infection requiring reoperation. Two patients with enlarging sterile collections required evacuation for symptoms. By multivariate analysis, both preoperative creatinine (P = .005) and number of bypasses constructed (P = .04) independently correlated with the development of a fluid collection.ConclusionsPostoperative fluid collections following hybrid debranching procedures identified in this series represent a unique complication not previously described. The subsequent clinical course of these fluid collections is variable and ranges from benign to frank graft infection and relate both to patient factors, as well as specific operative strategies. Longer-term studies with more robust numbers of patient numbers are warranted to determine whether this complication may limit the long-term durability of this procedure
Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms
ObjectiveHybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.MethodsAll patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.6% male) were identified. One hundred thirty-two bypasses were constructed (median 4 per patient) using either polyester (30), thin-walled polytetrafluoroethylene (ePTFE, 100) or saphenous vein (2). Follow-up computed tomography (CT) imaging was routinely performed at 1 and 6 months, and annually thereafter.ResultsOf the 37 patients with one follow-up CT, 20 (54.1%) were found to have fluid collections. The natural history of the 17 patients with collections and further follow-up imaging was variable, with 2 resolving, 6 stable, and 9 enlarging. Two patients with collections developed evidence of graft infection requiring reoperation. Two patients with enlarging sterile collections required evacuation for symptoms. By multivariate analysis, both preoperative creatinine (P = .005) and number of bypasses constructed (P = .04) independently correlated with the development of a fluid collection.ConclusionsPostoperative fluid collections following hybrid debranching procedures identified in this series represent a unique complication not previously described. The subsequent clinical course of these fluid collections is variable and ranges from benign to frank graft infection and relate both to patient factors, as well as specific operative strategies. Longer-term studies with more robust numbers of patient numbers are warranted to determine whether this complication may limit the long-term durability of this procedure
A New Basal Sauropod Dinosaur from the Middle Jurassic of Niger and the Early Evolution of Sauropoda
The early evolution of sauropod dinosaurs is poorly understood because of a highly incomplete fossil record. New discoveries of Early and Middle Jurassic sauropods have a great potential to lead to a better understanding of early sauropod evolution and to reevaluate the patterns of sauropod diversification.A new sauropod from the Middle Jurassic of Niger, Spinophorosaurus nigerensis n. gen. et sp., is the most complete basal sauropod currently known. The taxon shares many anatomical characters with Middle Jurassic East Asian sauropods, while it is strongly dissimilar to Lower and Middle Jurassic South American and Indian forms. A possible explanation for this pattern is a separation of Laurasian and South Gondwanan Middle Jurassic sauropod faunas by geographic barriers. Integration of phylogenetic analyses and paleogeographic data reveals congruence between early sauropod evolution and hypotheses about Jurassic paleoclimate and phytogeography.Spinophorosaurus demonstrates that many putatively derived characters of Middle Jurassic East Asian sauropods are plesiomorphic for eusauropods, while South Gondwanan eusauropods may represent a specialized line. The anatomy of Spinophorosaurus indicates that key innovations in Jurassic sauropod evolution might have taken place in North Africa, an area close to the equator with summer-wet climate at that time. Jurassic climatic zones and phytogeography possibly controlled early sauropod diversification
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