Storm Damage - Floating Culverts

A review of buoyancy issues culverts experience due to blockage. Includes discussion of blockage due to floating debris and issues with multiple culverts. Provides information on characteristics that help to determine if a culvert has floated

Storm Damage - Murphy\u27s Law

Examination of a disastrous event that required 4 coinciding occurrences happening that individually would likely have resulted in minor or no damage

Storm Damage - SR-57 June 2008

A review of the impact of the White River leaving its watershed and destroying a box culvert under SR-57 in Greene County, IN. Includes discussion about impact of illegal levee, and photos and discussion on contraction scour

Prevalence, correlates, and prognosis of peripheral artery disease in rural ecuador-rationale, protocol, and phase I results of a population-based survey: an atahualpa project-ancillary study

Background. Little is known on the prevalence of peripheral artery disease (PAD) in developing countries. Study design. Population-based study in Atahualpa. In Phase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. In Phase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. In Phase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes. Results. During Phase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). A poor cardiovascular health status was noticed in 464 (70%) persons of which 27 (4%) had a stroke and 14 (2%) had ischemic heart disease. Forty-four subjects (7%) had suspected symptomatic PAD and 170 (26%) had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD. Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region

Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS

Time-lapse imaging of human preimplantation IVF embryos has enabled objective algorithms based on novel observations of development (morphokinetics) to be used for clinical selection of embryos. Embryo aneuploidy, a major cause of IVF failure, has been correlated with specific morphokinetic variables used previously to develop an aneuploidy risk classification model. The purpose of this study was to evaluate the effectiveness and potential impact of this model for unselected IVF patients without biopsy and preimplantation genetic screening (PGS). Embryo outcomes – no implantation, fetal heart beat (FHB) and live birth (LB) – of 88 transferred blastocysts were compared according to calculated aneuploidy risk classes (low, medium, high). A significant difference was seen for FHB (P < 0.0001) and LB (P < 0.01) rates between embryos classified as low and medium risk. Within the low-risk class, relative increases of 74% and 56%, compared with rates for all blastocysts, were observed for FHB and LB respectively. The area under the receiver operating characteristic curve was 0.75 for FHB and 0.74 for LB. This study demonstrates the clinical relevance of the aneuploidy risk classification model and introduces a novel, non-invasive method of embryo selection to yield higher implantation and live birth rates without PGS. The largest single cause of failure of the human embryo to implant, and of early miscarriage, is aneuploidy (errors in numbers of chromosomes of the early (preimplantation) human embryo). More than half of human embryos are believed to be affected by aneuploidy and many must be unwittingly transferred following IVF, resulting in failed implantation, miscarriage or the birth of a baby with a related disorder. It is not possible for embryologists in IVF laboratories to identify aneuploid embryos under the microscope; however, our studies with time-lapse incubation in conjunction with preimplantation genetic screening (PGS) of IVF embryos have allowed us to develop and publish a model that rates each embryo based on its developmental patterns (morphokinetics) as being at low, medium or high risk of aneuploidy. PGS, whilst very effective, requires expensive technology and expertise, is not widely available and requires the embryo to undergo biopsy (removal of cell(s)). In this study, we tested the aneuploidy risk classification model on embryos with a known outcome and, importantly, on those embryos resulting in a live birth. This demonstrated how the model has the potential to greatly enhance IVF outcome without biopsy and PGS. By using such unique, non-invasive and specifically designed embryo selection models, we can now make more informed choices in order to select the most viable embryo to transfer, with the lowest risk of aneuploidy. Selection of an embryo classified as low risk has improved the relative chance of a live birth by 56% over conventional embryo selection

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

Background. Information on the association between earlobe crease (ELC) and peripheral artery disease is limited. We assessed this association in community-dwelling older adults. Study Design. A total of 294 Atahualpa residents aged ≥60 years were enrolled. ELC were visually identified by two raters. The ankle-brachial index (ABI), used as a surrogate of peripheral artery disease, was categorized using American Heart Association criteria. Using logistic regression and probability models, adjusted for demographics and cardiovascular risk factors, we assessed the relationship between ELC and abnormal ABI determinations, as well as the influence of age on this association. Results. ELC was identified in 141 (48%) individuals, and abnormal ABI determination was carried out in 56 (19%). The association between ELC and abnormal ABI was nonsignificant in logistic regression and probability models with individuals stratified according to their median age. Conclusions. The association between ELC and abnormal ABI determinations is probably attenuated by the high prevalence of both conditions in older persons. ELC might not be useful for identifying candidates for ABI determination

sj-docx-1-jpc-10.1177_21501319241228123 – Supplemental material for The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities

Supplemental material, sj-docx-1-jpc-10.1177_21501319241228123 for The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities by Oscar H. Del Brutto, Robertino M. Mera, Denisse A. Rumbea and Mark J. Sedler in Journal of Primary Care & Community Health</p

Hand grip strength before and after SARS-CoV-2 infection in community-dwelling older adults.

To assess the association between SARS-CoV-2 infection and decreased hand grip strength (HGS). Longitudinal population-based study. Community-dwelling older adults (aged ≥60 years) living in a rural Ecuadorian village struck by the SARS-CoV-2 pandemic. Of 282 enrolled individuals, 254 (90%) finished the study. HGS was measured 3 months before (January 2020) and 9 months after the introduction of the virus into the population (January 2021). SARS-CoV-2 antibody testing was performed in two rounds: in May-June (early) and September-November (late), 2020. An independent association between SARS-CoV-2 infection and HGS decline was assessed by fitting linear mixed models for longitudinal data. Changes in HGS scores in SARS-CoV-2 seropositive subjects, according to the time elapsed since seroconversion, were compared with those who remained seronegative. Overall, 149 (59%) individuals became seropositive for SARS-CoV-2. The mean HGS (in kg) was 25.3 ± 8.3 at baseline and 23.7 ± 8.1 at follow-up (p = 0.028), with 140 individuals having >5% HGS decline between both measurements. The follow-up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p 5% HGS decline between both measurements. The follow-up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p 5% HGS decline at the time of the follow-up than those with later, i.e., more recent, infections. This study shows an independent deleterious impact of SARS-CoV-2 on HGS that is more marked among individuals with infections that occurred more than 8 months before follow-up HGS. Results suggest the possibility of chronic damage to skeletal muscles by SARS-CoV-2