1,223 research outputs found

    Floppy aortic graft reconstruction for germ cell tumor invasion of the infrarenal aorta

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    AbstractSignificant aortic invasion by metastatic nonseminomatous germ cell tumors can present difficult problems intraoperatively in attempted curative retroperitoneal lymph node dissection. Aortic replacement with Dacron graft has been a successful method of dealing with this predicament. We describe a new approach of intraoperative floppy aortic graft reconstruction in a young patient with testicular germ cell cancer in whom a 14 cm pseudoaneurysm involving the infrarenal aorta developed after four courses of preoperative chemotherapy. This technique prevents significant lower extremity and pelvic ischemia during resection of the aorta and retroperitoneal tumor while providing the urologic surgeon with excellent exposure and minimal interference from the aortic graft. (J Vasc Surg 2003;37:889-91.

    Qualitative analysis of a Self Administered Motivational Instrument (SAMI): implications for students, teachers and researchers

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    The SAMI (Self Administered Motivational Instrument) is a low-cost intervention that uses motivational interviewing, aspects of the RASI learning-style instrument and analytical decision making to assist students to reflect on approaches to study and motivate change. It is a self-help guide which can be completed within 30 minutes. The impact of the SAMI on deep and strategic approaches to study and student attainment was established earlier (Duffy and Rimmer, 2008). These results were based on a quantitative analysis of data using SPSS and AMOS. Students who completed the SAMI increased their strategic approach to study and had a higher chance of obtaining the top two grades of A or B1 in assessments. Further, a small to moderate effect size of 0.32 was noted in changes in strategic scores on the RASI. The current paper concerns qualitative SAMI information gathered from 88 first-level, pre-registration nursing students studying at a university in the west of Scotland. Their SAMIs were transcribed and a thematic analysis carried out using NVivo, with independent- and multiple checking employed in an effort to ensure reliability and validity. Further, Prochaska and Di Clementes cycle of change and changes in students RASI scores were used to interpret students qualitative responses. Groups of themes were identified and within grouped responses it became apparent that: some students do not want to change; some want to change but cannot; and some make considerable changes to time allocation in relation to study, family, work and social life. It is concluded that while the SAMI is an innovative, cost effective method of encouraging students to think through the process of change in relation to their approach to study, consideration should be given to including a preliminary section that assesses students preparedness for change. Moreover, the results of this current research suggest that a comparison with SAMI material provided by post-registration nurses studying for degrees could Prochaska and Di Clementes reveal substantial differences.CIHRinpress182

    Neutrino masses in the Lepton Number Violating MSSM

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    We consider the most general supersymmetric model with minimal particle content and an additional discrete Z_3 symmetry (instead of R-parity), which allows lepton number violating terms and results in non-zero Majorana neutrino masses. We investigate whether the currently measured values for lepton masses and mixing can be reproduced. We set up a framework in which Lagrangian parameters can be initialised without recourse to assumptions concerning trilinear or bilinear superpotential terms, CP-conservation or intergenerational mixing and analyse in detail the one loop corrections to the neutrino masses. We present scenarios in which the experimental data are reproduced and show the effect varying lepton number violating couplings has on the predicted atmospheric and solar mass^2 differences. We find that with bilinear lepton number violating couplings in the superpotential of the order 1 MeV the atmospheric mass scale can be reproduced. Certain trilinear superpotential couplings, usually, of the order of the electron Yukawa coupling can give rise to either atmospheric or solar mass scales and bilinear supersymmetry breaking terms of the order 0.1 GeV^2 can set the solar mass scale. Further details of our calculation, Lagrangian, Feynman rules and relevant generic loop diagrams, are presented in three Appendices.Comment: 48 pages, 7 figures, v2 references added, typos corrected, published versio

    The pH-responsive behaviour of poly(acrylic acid) in aqueous solution is dependent on molar mass.

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    Fluorescence spectroscopy on a series of aqueous solutions of poly(acrylic acid) containing a luminescent label showed that polymers with molar mass, Mn < 16.5 kDa did not exhibit a pH responsive conformational change, which is typical of higher molar mass poly(acrylic acid). Below this molar mass, polymers remained in an extended conformation, regardless of pH. Above this molar mass, a pH-dependent conformational change was observed. Diffusion-ordered nuclear magnetic resonance spectroscopy confirmed that low molar mass polymers did not undergo a conformational transition, although large molar mass polymers did exhibit pH-dependent diffusion

    Mercury Concentrations in Tropical Resident and Migrant Songbirds on Hispaniola

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    Despite growing concerns over mercury (Hg) exposure to humans and wildlife on a global scale, little is known about Hg bioaccumulation in the New World tropics. From 2005 to 2011, we monitored Hg concentrations in blood of nine avian species occupying a geographic range of tropical wet broadleaf sites on the island of Hispaniola, including eight passerines (two Nearctic- Neotropical migrant and six resident species) and one top order predatory accipiter. Invertivorous songbirds were further differentiated by foraging guild, with six species of groundforagers and two species of foliage-gleaners. Blood Hg concentrations were orders of magnitude higher in birds sampled in central and southern cloud forest sites (1000 – 1800 m elevation) than in northern and northeastern rainforest sites (50 – 500 m elevation), with migratory and resident species both showing 2 – 20 X greater blood Hg concentrations in cloud forests than in rainforests. Within cloud forest sites, ground-foraging species had higher Hg concentrations than foliage-gleaning species. Top order predatory sharp-shinned hawks (Accipiter striatus) had the highest blood Hg concentrations among all species, suggesting that Hg biomagnification is occurring in terrestrial forests of Hispaniola. Two migrant songbird species overwintering on the island had higher blood Hg concentrations than have been recorded on their North American breeding grounds. Future studies should seek to elucidate sources of variation in atmospheric Hg deposition on Hispaniola and to quantify the dynamics of Hg cycling in tropical forest ecosystems, which may differ in important ways from patterns documented in temperate forest ecosystems

    A Psychometric Comparison of the Beck Depression Inventory and the Inventory for Diagnosing Depression in a College Population

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    The relationship between the Beck Depression Inventory (BDI) and the Inventory for Diagnosing Depression (IDD) was evaluated in a college population. The BDI is an established self-report depression instrument. The IDD is a relatively new self-report depression instrument. The IDD was designed to address the BDI's lack of full correspondence with Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.) (DSM-III) through DSM-IV criteria. The two instruments were found to be highly correlated and Cronbach's alpha was found to be high for each instrument. The diagnostic performance of three BDI cutoff scores was found to vary considerably when compared to IDD diagnostic criteria. Implications for selection and use of self-report depression inventories are discussed.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

    The Galactic cosmic ray intensity at the evolving Earth and young exoplanets

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    Cosmic rays may have contributed to the start of life on the Earth. Here, we investigate the evolution of the Galactic cosmic ray spectrum at the Earth from ages t = 0.6−6.0 Gyr. We use a 1D cosmic ray transport model and a 1.5D stellar wind model to derive the evolving wind properties of a solar-type star. At t=1 Gyr, approximately when life is thought to have begun on the Earth, we find that the intensity of ∼GeV Galactic cosmic rays would have been ∼10 times smaller than the present-day value. At lower kinetic energies, Galactic cosmic ray modulation would have been even more severe. More generally, we find that the differential intensity of low-energy Galactic cosmic rays decreases at younger ages and is well described by a broken power law in solar rotation rate. We provide an analytic formula of our Galactic cosmic ray spectra at the Earth’s orbit for different ages. Our model is also applicable to other solar-type stars with exoplanets orbiting at different radii. Specifically, we use our Galactic cosmic ray spectrum at 20 au for t=600 Myr to estimate the penetration of cosmic rays in the atmosphere of HR 2562b, a directly imaged exoplanet orbiting a young solar-type star. We find that the majority of particles <0.1 GeV are attenuated at pressures ≳10−5 bar and thus do not reach altitudes below ∼100 km. Observationally constraining the Galactic cosmic ray spectrum in the atmosphere of a warm Jupiter would in turn help constrain the flux of cosmic rays reaching young Earth-like exoplanets

    Estimating the risk of mortality attributable to recent late HIV diagnosis following admission to the intensive care unit: A single-centre observational cohort study

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    OBJECTIVES: Despite improvements in survival of people with HIV admitted to the intensive care unit (ICU), late diagnosis continues to contribute to in-ICU mortality. We quantify the population attributable fraction (PAF) of in-ICU mortality for recent late diagnosis among people with HIV admitted to a London ICU. METHODS: Index ICU admissions among people with HIV were considered from 2000 to 2019. Recent late diagnosis was a CD4 T-cell count < 350 cells/μL and/or AIDS-defining illness at/within 6 months prior to ICU admission. Univariate comparisons were conducted using Wilcoxon rank-sum/Cochran-Armitage/χ2 /Fisher's exact tests. We used Poisson regression (robust standard errors) to estimate unadjusted/adjusted (age, sex, calendar year of ICU admission) risk ratios (RRs) and regression standardization to estimate the PAF. RESULTS: In all, 207 index admissions were included [median (interquartile range) age: 46 (38-53) years; 72% male]; 58 (28%) had a recent late diagnosis, all of whom had a CD4 count < 350 cells/μL, and 95% had advanced HIV (CD4 count < 200 cells/μL and/or AIDS at admission) as compared with 57% of those who did not have a recent late diagnosis (p < 0.001). In-ICU mortality was 27% (55/207); 38% versus 22% in those who did and did not have a recent late diagnosis, respectively (p = 0.02). Recent late diagnosis was independently associated with increased in-ICU mortality risk (adjusted RR = 1.75) (95% confidence interval: 1.05-2.91), with 17.08% (16.04-18.12%) of deaths being attributable to this. CONCLUSIONS: There is a need for improved public health efforts focused on HIV testing and reporting of late diagnosis to better understand potentially missed opportunities for earlier HIV diagnosis in healthcare services
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