414 research outputs found

    Catalytic surface effects on space thermal protection system during Earth entry of flights STS-2 through STS-5

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    An on going orbiter experiment catalytic surface effects experiment being conducted on the Space Shuttle is discussed. The catalytic surface effects experiment was peformed on four of the five flights of Columbia. Temperature time histories and distributions along the midfuselage and wing of the orbiter were used to determine the surface catalytic efficiency of the baseline high temperature reusable surface insulation. Correlation parameters are shown that allow the comparison of all flight data with predictions from the design and surface emittance decreased as a result of contaminants during the five flights of the Space Shuttle

    Salt intake, stroke, and cardiovascular disease : meta-analysis of prospective studies

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    Objective: To assess the relation between the level of habitual salt intake and stroke or total cardiovascular disease outcome. Design: Systematic review and meta-analysis of prospective studies published 1966-2008. Data sources: Medline (1966-2008), Embase (from 1988), AMED (from 1985), CINAHL (from 1982), Psychinfo (from 1985), and the Cochrane Library. Review methods: For each study, relative risks and 95% confidence intervals were extracted and pooled with a random effect model, weighting for the inverse of the variance. Heterogeneity, publication bias, subgroup, and meta-regression analyses were performed. Criteria for inclusion were prospective adult population study, assessment of salt intake as baseline exposure, assessment of either stroke or total cardiovascular disease as outcome, follow-up of at least three years, indication of number of participants exposed and number of events across different salt intake categories. Results: There were 19 independent cohort samples from 13 studies, with 177 025 participants (follow-up 3.5-19 years) and over 11 000 vascular events. Higher salt intake was associated with greater risk of stroke (pooled relative risk 1.23, 95% confidence interval 1.06 to 1.43; P=0.007) and cardiovascular disease (1.14, 0.99 to 1.32; P=0.07), with no significant evidence of publication bias. For cardiovascular disease, sensitivity analysis showed that the exclusion of a single study led to a pooled estimate of 1.17 (1.02 to 1.34; P=0.02). The associations observed were greater the larger the difference in sodium intake and the longer the follow-up. Conclusions: High salt intake is associated with significantly increased risk of stroke and total cardiovascular disease. Because of imprecision in measurement of salt intake, these effect sizes are likely to be underestimated. These results support the role of a substantial population reduction in salt intake for the prevention of cardiovascular disease

    An updated flora of selmunett (St. Paul's Island) including mosses and lichens

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    A survey of four visits in Selmunett (Gzejjer ta' San Pawl) resulted in a number of new records comprising 23 lichens, 2 mosses and 20 higher plants. Five of these species are protected, amongst which Plocama calabrica is very rare whereas Parietaria cretica, a critical species only recorded from Selmunett in the Maltese islands, has been rediscovered after not being sighted for about 15 years and was suspected of having become extinct. Records resulting from this survey are compared with those from previous records or surveys between 1927 and 2012. These are examined critically, identifying possible misidenti cations as well as establishing their status, thus producing a final update of the florula of Selmunett.peer-reviewe

    Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study

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    Objective: The aim of this retrospective longitudinal naturalistic study was to evaluate the effects of maintenance lithium treatment on parathyroid hormone (PTH) and calcium levels. Methods: A retrospective longitudinal naturalistic study design was used. Data were collected from the database of a tertiary psychiatric center covering the years 2010\u20132014. Included were bipolar patients who had never been exposed to lithium and had lithium started, and who had PTH, and total and ionized calcium levels available before and during lithium treatment. Paired t-tests were used to analyze changes in PTH and calcium levels. Linear regressions were per- formed, with mean lithium level and duration of lithium exposure as independent variables and change in PTH levels as dependent variable. Results: A total 31 patients were included. The mean duration of lithium treatment was 18.6\ub111.4 months. PTH levels significantly increased during lithium treatment (+13.55\ub114.20 pg/mL); the rate of hyperparathyroidism was 12.9%. Neither total nor ionized calcium increased from baseline to follow-up; none of our patients developed hypercalcemia. Linear regressions analyses did not show an effect of duration of lithium exposure or mean lithium level on PTH levels. Conclusion: Lithium-associated stimulation of parathyroid function is more common than assumed to date. Among parameters to be evaluated prior to lithium implementation, calcium and PTH should be added

    A Curriculum for Enhancing Physician Teaching Skills: The Value of Physician-Educator Partnerships

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    Developing as a physician requires an enormous amount of complex training, and quality of instruction greatly affects training outcomes. But while physicians are expected to teach trainees within the clinic, they often do not receive formal training in effective instructional practices. Providing faculty development programs is one way that institutions can help physicians develop teaching skills, but these programs often are developed without the input of educational specialists and not based in educational theory. In this methodology paper, we describe a 5-module curriculum that was developed in a cross-disciplinary collaboration between instructional designers and physician faculty. By merging educational and medical expertise and using adult learning theory with the Charlotte-Danielson educational framework, an essentials for clinical teaching educational endorsement program (ECTEEP) was created as a feature of the institutional curriculum within a large, urban teaching hospital. Here we describe how the program was developed through a physician-educator partnership, outline the program\u27s key content, and highlight essential aspects of successful implementation. The ECTEEP incorporates active learning approaches within an abbreviated format, distilling 5 critical aspects of effective teaching that are relevant to the clinical environment: cultural humility and safe learning environments, instruction practices for engaging learners, instruction and assessment strategies, receiving and giving feedback, and mentorship and coaching. A central feature of the program is that facilitators actively model the teaching behaviors they are conveying, which underscores the critical importance of facilitator preparation and skill. Our curriculum is offered here as a basic template for institutions that may want to establish a program for enhancing physician teaching skill
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