The effects of block scheduling on students with learning disabilities

The purpose of this study was to determine the effects that block scheduling has on students with learning disabilities, specifically high school students. In retrospect, the surveys offered a comparison between the regular students and the learning disabled. Staff surveys provided insights to areas that need to be addressed relating specifically to the learning disabled student and block scheduling. Surveys were distributed to 64 learning disabled students, 60 regular education students, and 38 staff members. The surveys were designed to elicit their opinions about block scheduling and how it has had an effect on the students\u27 learning. It was determined that the learning disabled students had a difficult time keeping up with the workload and obtaining assistance when needed. Regular education students stated similar problems. Both groups of students preferred block periods when class time was utilized appropriately. Staff surveys brought the issues of being prepared to work with learning disabled students in the mainstream classroom and the absentee rate for both populations on block days. The staff had an equal distribution of responses to their preference to block scheduling

Aprotinin reduces blood loss in off-pump coronary artery bypass (OPCAB) surgery

Objective: Effects of aprotinin in off-pump coronary artery bypass (OPCAB) surgery have not yet been described. This study analyses hemostasiologic changes and potential benefit in OPCAB patients treated with aprotinin. Methods: In a prospective, double-blind, randomized study 47 patients undergoing OPCAB surgery were investigated. Patients received either aprotinin (2×106 KIU loading dose and 0.5×106 KIU/h during surgery, n=22) or saline solution (control, n=25). Activated clotting time was adjusted to a target of 250 s intraoperatively. Blood samples were taken up to 18 h postoperatively: complete hematologic and hemostasiologic parameters including fibrinopeptide A (FPA) and D-dimer in a subgroup of 31 patients were analyzed. Blood loss, blood transfusion and other clinical data were collected. Results: Both groups showed comparable demographic and intraoperative variables. Forty-one (87%) patients of the whole study group received aspirin within 7 days prior to surgery. Number of grafts per patient were comparable (2.9±1.0 [mean±SD] in the aprotinin group and 2.8±1.2 in control, P=0.83). Blood loss during the first 18 h in intensive care unit was significantly reduced in patients treated with aprotinin (median [25th-75th percentiles]: 500 [395-755] ml vs. 930 [800-1170] ml, P<0.001). Postoperatively only two patients (10%) in the aprotinin group received packed red blood cells, whereas eight (35%) in the control group (P=0.07). Perioperatively FPA levels reflecting thrombin generation were elevated in both groups. The increase in D-dimer levels after surgery was significantly inhibited in the aprotinin group (P<0.001). Early clinical outcome was similar in both groups. Conclusions: Aprotinin significantly reduces blood loss in patients undergoing OPCAB surgery. Inhibition of enhanced fibrinolysis can be observed. FPA generation during and after OPCAB surgery seems not to be influenced by aprotini

Aprotinin reduces blood loss in off-pump coronary artery bypass (OPCAB) surgery

Objective: Effects of aprotinin in off-pump coronary artery bypass (OPCAB) surgery have not yet been described. This study analyses hemostasiologic changes and potential benefit in OPCAB patients treated with aprotinin. Methods: In a prospective, double-blind, randomized study 47 patients undergoing OPCAB surgery were investigated. Patients received either aprotinin (2×10 superscript 6 KIU loading dose and 0.5×10 superscript 6 KIU/h during surgery, n=22) or saline solution (control, n=25). Activated clotting time was adjusted to a target of 250 s intraoperatively. Blood samples were taken up to 18 h postoperatively: complete hematologic and hemostasiologic parameters including fibrinopeptide A (FPA) and D-dimer in a subgroup of 31 patients were analyzed. Blood loss, blood transfusion and other clinical data were collected. Results: Both groups showed comparable demographic and intraoperative variables. Forty-one (87%) patients of the whole study group received aspirin within 7 days prior to surgery. Number of grafts per patient were comparable (2.9±1.0 [mean±SD] in the aprotinin group and 2.8±1.2 in control, P=0.83). Blood loss during the first 18 h in intensive care unit was significantly reduced in patients treated with aprotinin (median [25th–75th percentiles]: 500 [395–755] ml vs. 930 [800–1170] ml, P<0.001). Postoperatively only two patients (10%) in the aprotinin group received packed red blood cells, whereas eight (35%) in the control group (P=0.07). Perioperatively FPA levels reflecting thrombin generation were elevated in both groups. The increase in D-dimer levels after surgery was significantly inhibited in the aprotinin group (P<0.001). Early clinical outcome was similar in both groups. Conclusions: Aprotinin significantly reduces blood loss in patients undergoing OPCAB surgery. Inhibition of enhanced fibrinolysis can be observed. FPA generation during and after OPCAB surgery seems not to be influenced by aprotinin

Time-dependent changes in pulmonary surfactant function and composition in acute respiratory distress syndrome due to pneumonia or aspiration

BACKGROUND: Alterations to pulmonary surfactant composition have been encountered in the Acute Respiratory Distress Syndrome (ARDS). However, only few data are available regarding the time-course and duration of surfactant changes in ARDS patients, although this information may largely influence the optimum design of clinical trials addressing surfactant replacement therapy. We therefore examined the time-course of surfactant changes in 15 patients with direct ARDS (pneumonia, aspiration) over the first 8 days after onset of mechanical ventilation. METHODS: Three consecutive bronchoalveolar lavages (BAL) were performed shortly after intubation (T0), and four days (T1) and eight days (T2) after intubation. Fifteen healthy volunteers served as controls. Phospholipid-to-protein ratio in BAL fluids, phospholipid class profiles, phosphatidylcholine (PC) molecular species, surfactant proteins (SP)-A, -B, -C, -D, and relative content and surface tension properties of large surfactant aggregates (LA) were assessed. RESULTS: At T0, a severe and highly significant reduction in SP-A, SP-B and SP-C, the LA fraction, PC and phosphatidylglycerol (PG) percentages, and dipalmitoylation of PC (DPPC) was encountered. Surface activity of the LA fraction was greatly impaired. Over time, significant improvements were encountered especially in view of LA content, DPPC, PG and SP-A, but minimum surface tension of LA was not fully restored (15 mN/m at T2). A highly significant correlation was observed between PaO(2)/FiO(2 )and minimum surface tension (r = -0.83; p < 0.001), SP-C (r = 0.64; p < 0.001), and DPPC (r = 0.59; p = 0.003). Outcome analysis revealed that non-survivors had even more unfavourable surfactant properties as compared to survivors. CONCLUSION: We concluded that a profound impairment of pulmonary surfactant composition and function occurs in the very early stage of the disease and only gradually resolves over time. These observations may explain why former surfactant replacement studies with a short treatment duration failed to improve outcome and may help to establish optimal composition and duration of surfactant administration in future surfactant replacement studies in acute lung injury

Flood Protection by Forests in Alpine Watersheds: Lessons Learned from Austrian Case Studies

This chapter highlights the influence of mountain forests on runoff patterns in alpine catchments. We discuss the forest impact at different spatial scales and bridge to the requirements for an integrated natural hazard risk management, which considers forest as an efficient protection measure against floods and other water-related natural hazards. We present results from a wide range of research studies from Austria, which all reveal the runoff-reducing effect of forest vegetation in small and medium-size catchments ( 100 km2), e.g., by reducing surface runoff and delaying interflow, but above all by stabilising slopes and therefore reducing bedload transport during major runoff events. To avoid that forests become a hazard due to enhanced driftwood release, managing of steep riparian slopes for a permanent forest cover (“Dauerbestockung”) is a basic prerequisite. Often protective effects of forests are impaired by man-made impacts like dense forest road networks, insensitive use (e.g., false design of skid roads, compacting machinery, forest operations during adverse weather on wet and saturated soils), and delayed or omitted reforestation and regeneration. Flood risk management in mountain regions should include Ecosystem-based Disaster Risk Reduction measures, with particular emphasis on sustainable and climate change-adapted management of protective forests. This will require integral and catchment-based approaches such as comprehensive management concepts coordinated with spatial planning, and verifiable, practicable and correspondingly adapted legal guidelines as well as appropriate funding of protective forest research to close the existing knowledge gaps

Lung Cancer Screening with Submillisievert Chest CT: Potential Pitfalls of Pulmonary Findings in Different Readers with Various Experience Levels

Purpose To assess the interreader variability of submillisievert CT for lung cancer screening in radiologists with various experience levels. Method Six radiologists with different degrees of clinical experience in radiology (range, 1-15 years), rated 100 submillisievert CT chest studies as either negative screening finding (no nodules, benign nodules, nodules 10 mm). Each radiologist interpreted scans randomly ordered and reading time was recorded. Interobserver agreement was assessed with ak statistic. Reasons for differences in nodule classification were analysed on a case-by-case basis. Reading time was correlated with reader experience using Pearson correlation (r). Results The overall interobserver agreement between all readers was moderate (k = 0.454; p < 0.001). In 57 patients, all radiologists agreed on the differentiation of negative and indeterminate/positive finding. In 64 cases disagreement between readers led to different nodule classification. In 8 cases some readers rated the nodule as benign, whereas others scored the case as positive. Overall, disagreement in nodule classification was mostly due to failure in identification of target lesion (n = 40), different lesion measurement (n = 44) or different classification (n = 26). Mean overall reading time per scan was of 2 min 2 s (range: 7s-7 min 45 s) and correlated with reader-experience (r =-0.824). Conclusions Our study showed substantial interobserver variability for the detection and classification of pulmonary nodules in submillisievert CT. This highlights the importance for careful standardisation of screening programs with the objective of harmonizing efforts of involved radiologists across different institutions by defining and assuring quality standards

Comparative proteome analysis of lung tissue from patients with idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP) and organ donors

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Influence of Canopy Disturbances on Runoff and Landslide Disposition after Heavy Rainfall Events

As protective forests have a major control function on runoff and erosion, they directly affect the risk from hydrogeomorphic processes such as sediment transport processes or debris flows. In this context, future scenarios of climate-related canopy disturbances and their influence on the protective effect remain, however, an unsolved problem. With the individual-based forest landscape and disturbance model iLand, an ensemble of forest landscape simulations was carried out and the effects of future changes in natural disturbance regimes were evaluated. To determine peak runoff, hydrological simulations have been conducted, using the conceptual hydrological model ZEMOKOST as well as the deterministic model GEOtop. Effects of forest disturbances on hillslope stability were investigated, based on a modified Coulomb landslide model. Our results suggest no influence of the disturbance regime on the runoff. The climate-related increase in the frequency of disturbances is not reflected in increased runoff during the period under consideration. Contrary, slope stability analyses indicate that the availability of shallow landslides in steep forested torrent catchments might be decreased by the occurrence of disturbances – especially for a warm and dry climate projection. Canopy disturbances seem to accelerate the adaptation of tree species to future climate conditions, which is likely to be accompanied by a change in root systems away from flat roots that currently predominate in torrential catchments. In terms of managing the protective effect of forests against shallow landslides, such natural disturbances can thus be considered as positive interventions in the existing forest ecosystem by promoting natural succession

Altered fibrin clot structure and dysregulated fibrinolysis contribute to thrombosis risk in severe COVID-19

The high incidence of thrombotic events suggests a possible role of the contact system pathway in COVID-19 pathology. Here, we demonstrate altered levels of factor XII (FXII) and its activation products in critically ill COVID-19 patients in comparison to patients with severe acute respiratory distress syndrome due to influenza virus (ARDS-influenza). Compatible with this data, we report rapid consumption of FXII in COVID-19, but not in ARDS-influenza, plasma. Interestingly, the lag phase in fibrin formation, triggered by the FXII activator kaolin, was not prolonged in COVID-19 as opposed to ARDS-influenza. Using confocal and electron microscopy, we showed that increased FXII activation rate, in conjunction with elevated fibrinogen levels, triggers formation of fibrinolysis-resistant, compact clots with thin fibers and small pores in COVID-19. Accordingly, clot lysis was markedly impaired in COVID-19 as opposed to ARDS-infleunza subjects. Dysregulatated fibrinolytic system, as evidenced by elevated levels of thrombin-activatable fibrinolysis inhibitor, tissue-plasminogen activator, and plasminogen activator inhibitor-1 in COVID-19 potentiated this effect. Analysis of lung tissue sections revealed wide-spread extra- and intra-vascular compact fibrin deposits in COVID-19 patients. Together, compact fibrin network structure and dysregulated fibrinolysis may collectively contribute to high incidence of thrombotic events in COVID-19