1,728 research outputs found

    The association between preoperative anaemia and surgical mortality and morbidity in South African surgical patients

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    Background: In high-income countries, preoperative anaemia has been associated with poor postoperative outcomes. To date, no large study has investigated this association in South Africa. The demographics of South African surgical patients differ from those of the European and Northern American surgical patients where the preoperative anaemia data are derived. These associations between preoperative anaemia and postoperative outcomes are therefore not necessarily transferable to South African surgical patients. Objectives: The primary objective was to determine the association between preoperative anaemia and in-hospital mortality in South African adult noncardiac, non-obstetric patients. The secondary objectives were to describe the association between preoperative anaemia and i) critical care admission, and ii) length of hospital stay, and to describe the prevalence of preoperative anaemia in adult South African surgical patients. Methods: We performed a secondary analysis of the South African Surgical Outcomes Study (SASOS) – a large, prospective, observational study of patients undergoing in-patient noncardiac, non-obstetric surgery at 50 hospitals across South Africa over a one-week period. To determine whether preoperative anaemia is independently associated with mortality or admission to critical care following surgery, we conducted a multivariate logistic regression analysis, which included all the independent predictors of mortality and admission to critical care identified in the original SASOS model. Results: The prevalence of preoperative anaemia was 1727/3610 (47.8%). Preoperative anaemia was independently associated with in-hospital mortality (odds ratio (OR) 1.66, 95% confidence interval (CI) 1.06-2.60, p=0.028) and admission to critical care (OR 1.49, 95% CI 1.08-2.05, p=0.015). Conclusion: Almost 50% of patients undergoing surgery at government-funded hospitals in South Africa had preoperative anaemia, which was independently associated with postoperative mortality and critical care admission. These numbers indicate a significant perioperative risk, with a clear opportunity for quality improvement programmes which may improve surgical outcomes. Long waiting lists for elective surgery allow time for assessment and correction of anaemia preoperatively. With a high proportion of patients presenting for urgent or emergency surgery, it behoves perioperative clinicians in all specialities to educate themselves in the principles of patient blood management

    The impact of structure on the electrical transport properties of nitrogen-doped carbon microspheres

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    A thesis submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy. April 2016.Chemical vapour deposition was used to synthesise four carbon microspheres (CMS) samples. Introduction of acetonitrile in different quantities produced spheres of differing nitrogen concentration. The structure of the spheres was investigated using Raman spectroscopy, scanning electron microscopy and X-ray photoelectron spectroscopy techniques. The Raman investigation revealed a decrease in average graphitic flake size which forms the surface layers of the spheres with nitrogen incorporation. XPS showed that increased nitrogen doping caused a larger proportion of pyridinic nitrogen, which process likely restricts the growth of the crystallite flakes detected with the Raman technique. Microscopy revealed spheres with differing morphologies which did not correlated with the level of nitrogen doping. Electron paramagnetic resonance techniques were employed to investigate the impact of nitrogen doping on the spin system of the samples. Electrical transport and Hall effect data were collected with an automated experiment station purpose built for this work. Samples displayed semiconducting behaviour at low temperatures which was ascribed to fluctuation assisted tunnelling. At higher temperatures all four samples display a transition to metallic behaviour. Models for conduction, which were tested but ultimately rejected, include variable range hopping in all its dimensional forms, Efros-Shklovskii VRH and weak localisation. A comparison of the conduction results and the structural information showed the conductivity to be more closely affected by the structure of the spheres than the overall doping level. A case is made for the dominant conduction mechanism being determined by the intersphere rather than the intrasphere conduction. This research shows that creating carbon microspheres with specific electrical properties requires control of the structure induced during synthesis. Nitrogen doping alone does not determine the final physical and electrical transport properties.LG201

    A new temnospondyl record from the Upper Triassic of Argentina

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    The Brachyopoidea is a group of Mesozoic temnospondyls with flat, parabolic skulls that were recently reviewed and considered to include Brachyopoidea and Chigutisauridae (Warren and Marsicano, 2000; Yates and Warren, 2000, Damiani and Kitching, 2003). Brachyopids have been recorded from several different localities both in Gondwana (excluding South America) and Laurasia (Warren and Marsicano, 2000) during the Early-Middle Triassic. After the Middle Triassic, they areabsent from the fossil record for several million years until they are recorded in the Middle-Late Jurassic of China (Dong, 1985) and Mongolia (Shishkin, 1991). In contrast, chigutisaurid temnospondyls appear to be restricted to Gondwana. They are known from the Lower Triassic, Lower Jurassic and Lower Cretaceous of Australia (Warren, 1981; Warren and Hutchinson, 1983; Warren et al., 1997), the Upper Triassic of Argentina (Bonaparte, 1975; Marsicano, 1993, 1999) and India (Sengupta, 1995), and from the Upper Triassic and Lower Jurassic of South Africa (Warren and Damiani, 1999). This paper describes a new temnospondyl specimen consisting of an incomplete left mandible, preserved from the symphysis to the level of the anterior coronoid, found in strata assigned to the Late Triassic Cacheuta Formation at the Potrerillos locality in western Argentina (Marsicano et al., 2000). The mandible is here considered to be a putative brachyopid and, therefore, it would be the first occurrence of this group in South America and the youngest for Gondwana. Abbreviations-MCNAM-PV, Museo de Ciencias Naturales y Antropológicas Juan Cornelio Moyano of Mendoza (Argentina), paleovertebrados collection; UCMP, University of California Museum of Paleontology, Berkeley (USA).Fil: Marsicano, Claudia Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentin

    The impact of structure on the electrical transport properties of nitrogen-doped carbon microspheres

    Get PDF
    A thesis submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy. April 2016.Chemical vapour deposition was used to synthesise four carbon microspheres (CMS) samples. Introduction of acetonitrile in different quantities produced spheres of differing nitrogen concentration. The structure of the spheres was investigated using Raman spectroscopy, scanning electron microscopy and X-ray photoelectron spectroscopy techniques. The Raman investigation revealed a decrease in average graphitic flake size which forms the surface layers of the spheres with nitrogen incorporation. XPS showed that increased nitrogen doping caused a larger proportion of pyridinic nitrogen, which process likely restricts the growth of the crystallite flakes detected with the Raman technique. Microscopy revealed spheres with differing morphologies which did not correlated with the level of nitrogen doping. Electron paramagnetic resonance techniques were employed to investigate the impact of nitrogen doping on the spin system of the samples. Electrical transport and Hall effect data were collected with an automated experiment station purpose built for this work. Samples displayed semiconducting behaviour at low temperatures which was ascribed to fluctuation assisted tunnelling. At higher temperatures all four samples display a transition to metallic behaviour. Models for conduction, which were tested but ultimately rejected, include variable range hopping in all its dimensional forms, Efros-Shklovskii VRH and weak localisation. A comparison of the conduction results and the structural information showed the conductivity to be more closely affected by the structure of the spheres than the overall doping level. A case is made for the dominant conduction mechanism being determined by the intersphere rather than the intrasphere conduction. This research shows that creating carbon microspheres with specific electrical properties requires control of the structure induced during synthesis. Nitrogen doping alone does not determine the final physical and electrical transport properties.LG201

    Moving Beyond Free: A College Affordability Compact for the Next Generation

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    Free college programs have proliferated at the state and local levels over the past decade, focused primarily on the nation’s community colleges. President Biden’s $1.8 trillion American Families Plan includes funding to make community college tuition free for participating states, and the idea of federally supported tuition-free four-year public college education is also back in the spotlight. It is easy to see why: “free college” fits on a bumper sticker, and it offers a simple message that signals to low-income families and first-generation students that achieving a valuable postsecondary credential is possible for them. This can lead families to prioritize education earlier, in the middle school years, when young people are developing the skills needed to succeed in high school and college. It can also support the growing number of adult learners by reducing one big uncertainty about the cost of returning to pursue a college degree. Making a public college education tuition-free can indeed enhance access and covering non-tuition costs of college can also aid in completion..

    Mandibles of mastodonsaurid temnospondyls from the Upper Permian-Lower Triassic of Uruguay

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    Partially preserved temnospondyl mandibles from the Late Permian–Early Triassic Buena Vista Formation of Uruguay are referred to the basal stereospondyl taxon Mastodonsauridae. These represent the earliest known members of this group for South America. In most cases, this assignment was based on the characteristic morphology of the postglenoid (= postarticular) area of the lower jaw together with the presence of a hamate process. Comparisons with basal masto−donsaurids indicate that the Uruguayan specimens are phenetically similar to Gondwanan and Laurasian Early Triassic taxa, such as Watsonisuchus, Wetlugasarus, and Parotosuchus. Nevertherless, they display some characters which have not previously been described in Mesozoic temnospondyls. The Permo−Triassic Uruguayan mastodonsaurids support a Gondwanan origin for the group, an event which probably occurred sometime during the latest Permian.Fil: Piñeiro, Graciela. Departamento de Evolución de Cuencas, Sección Bioestratigrafía y Paleo-ecología, Facultad de Ciencias,; UruguayFil: Marsicano, Claudia Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Damiani, Ross. Staatliches Museum für Naturkunde Stuttgart; Alemani

    Exploring the Relationship of Enrollment in IDR to Borrower Demographics and Financial Outcomes

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    As federal policymakers consider changes to income-driven repayment (IDR) schemes, research examining the characteristics and financial behaviors of student loan borrowers participating in IDR is necessary. Using the nationally representative Survey of Consumer Finances, we examined the demographics of IDR enrollment. Counter to expectations, low-income borrowers, and borrowers with high debt-to-income ratios are less likely to enroll in IDR. Conditional on having a large amount of debt, married women of color are likely to enroll in IDR programs. Findings concerning IDR participation may be highly sensitive to how groups are defined and what covariates are in models. IDR participation does not predict engagement in other financial behaviors such as retirement savings or homeownership
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