17,172 research outputs found

    The Achilles tendon total rupture score : a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures

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    Background The Achilles tendon Total Rupture Score was developed by a research group in 2007 in response to the need for a patient reported outcome measure for this patient population. Beyond this original development paper, no further validation studies have been published. Consequently the purpose of this study was to evaluate internal consistency, convergent validity and responsiveness of this newly developed patient reported outcome measure within patients who have sustained an isolated acute Achilles tendon rupture. Methods Sixty-four eligible patients with an acute rupture of their Achilles tendon completed the Achilles tendon Total Rupture Score alongside two further patient reported outcome measures (Disability Rating Index and EQ 5D). These were completed at baseline, six weeks, three months, six months and nine months post injury. The Achilles tendon Total Rupture Score was evaluated for internal consistency, using Cronbach's alpha, convergent validity, through correlation analysis and responsiveness, by analysing floor and ceiling effects and calculating its relative efficiency in comparison to the Disability Rating Index and EQ 5D scores. Results The Achilles tendon Total Rupture Score demonstrated high internal consistency (Cronbachs alpha > 0.8) and correlated significantly (p < 0.001) with the Disability Rating Index at five time points (pre-injury, six weeks, three, six and nine months) with correlation coefficients between -0.5 and -0.9. However, the confidence intervals were wide. Furthermore, the ability of the new score to detect clinically important changes over time (responsiveness) was shown to be greater than the Disability Rating Index and EQ 5D. Conclusions A universally accepted outcome measure is imperative to allow comparisons to be made across practice. This is the first study to evaluate aspects of validity of this newly developed outcome measure, outside of the developing centre. The ATRS demonstrated high internal consistency and responsiveness, with limited convergent validity. This research provides further support for the use of this outcome measure, however further research is required to advocate its universal use in patients with acute Achilles tendon ruptures. Such areas include inter-rater reliability and research to determine the minimally clinically important difference between scores

    The Future of Nuclear Power After Fukushima

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    http://web.mit.edu/ceepr/www/publications/workingpapers.htmlThis paper analyzes the impact of the Fukushima accident on the future of nuclear power around the world. We begin with a discussion of the ‘but for’ baseline and the much discussed ‘nuclear renaissance.’ Our pre-Fukushima benchmark for growth in nuclear generation in the U.S. and other developed countries is much more modest than many bullish forecasts of a big renaissance in new capacity may have suggested. For at least the next decade in developed countries, it is composed primarily of life extensions for many existing reactors, modest uprates of existing reactors as their licenses are extended, and modest levels of new construction. The majority of forecasted new construction is centered in China, Russia and the former states of the FSU, India and South Korea. In analyzing the impact of Fukushima, we break the effect down into two categories: the impact on existing plants, and the impact on the construction of new units. In both cases, we argue that the accident at Fukushima will contribute to a reduction in future trends in the expansion of nuclear energy, but at this time these effects appear to be quite modest at the global level

    The 1977 surface ozone study of eastern Virginia

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    Data were collected by primarily twelve ground stations positioned throughout the eastern shore - tidewater area of Virginia and North Carolina. From an analysis of the ozone and wind data, certain trends were found such as the existence of a bias in ozone concentrations between stations and a linear correlation between average ozone concentration and latitude. In addition, higher ozone levels were found with surface winds from certain preferred directions at the various sites. The results, however, do not substantiate ozone or ozone precursor transport

    The influence of flow discharge variations on the morphodynamics of a diffluence-confluence unit on a large river: Impacts of discharge variation on a diffluence-confluence unit

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    © 2017 The Authors. Earth Surface Processes and Landforms published by John Wiley & Sons Ltd. Bifurcations are key geomorphological nodes in anabranching and braided fluvial channels, controlling local bed morphology, the routing of sediment and water, and ultimately defining the stability of their associated diffluence–confluence unit. Recently, numerical modelling of bifurcations has focused on the relationship between flow conditions and the partitioning of sediment between the bifurcate channels. Herein, we report on field observations spanning September 2013 to July 2014 of the three-dimensional flow structure, bed morphological change and partitioning of both flow discharge and suspended sediment through a large diffluence–confluence unit on the Mekong River, Cambodia, across a range of flow stages (from 13 500 to 27 000 m 3 s −1 ). Analysis of discharge and sediment load throughout the diffluence–confluence unit reveals that during the highest flows (Q = 27 000 m 3 s −1 ), the downstream island complex is a net sink of sediment (losing 2600 ± 2000 kg s −1 between the diffluence and confluence), whereas during the rising limb (Q = 19 500 m 3 s −1 ) and falling limb flows (Q = 13 500 m 3 s −1 ) the sediment balance is in quasi-equilibrium. We show that the discharge asymmetry of the bifurcation varies with discharge and highlight that the influence of upstream curvature-induced water surface slope and bed morphological change may be first-order controls on bifurcation configuration. Comparison of our field data to existing bifurcation stability diagrams reveals that during lower (rising and falling limb) flow the bifurcation may be classified as unstable, yet transitions to a stable condition at high flows. However, over the long term (1959–2013) aerial imagery reveals the diffluence–confluence unit to be fairly stable. We propose, therefore, that the long-term stability of the bifurcation, as well as the larger channel planform and morphology of the diffluence–confluence unit, may be controlled by the dominant sediment transport regime of the system. © 2017 The Authors. Earth Surface Processes and Landforms published by John Wiley & Sons Ltd

    Detection of lithium in nearby young late-M dwarfs

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    Late M-type dwarfs in the solar neighborhood include a mixture of very low-mass stars and brown dwarfs which is difficult to disentangle due to the lack of constraints on their age such as trigonometric parallax, lithium detection and space velocity. We search for young brown dwarf candidates among a sample of 28 nearby late-M dwarfs with spectral types between M5.0 and M9.0, and we also search for debris disks around three of them. Based on theoretical models, we used the color IJI-J, the JJ-band absolute magnitude and the detection of the Li I 6708 A˚\AA doublet line as a strong constraint to estimate masses and ages of our targets. For the search of debris disks, we observed three targets at submillimeter wavelength of 850 μ\mum. We report here the first clear detections of lithium absorption in four targets and a marginal detection in one target. Our mass estimates indicate that two of them are young brown dwarfs, two are young brown dwarf candidates and one is a young very low-mass star. The closest young field brown dwarf in our sample at only \sim15 pc is an excellent benchmark for further studying physical properties of brown dwarfs in the range 100-150 Myr. We did not detect any debris disks around three late-M dwarfs, and we estimated upper limits to the dust mass of debris disks around them.Comment: 10 pages, 5 figures, accepted for publication in Astronomy and Astrophysic

    Protein Nutrition of Southern Plains Small Mammals: Immune Response to Variation in Maternal and Offspring Dietary Nitrogen

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    Maternal nutrition during pregnancy and postnatal offspring nutrition may influence offspring traits. We investigated the effects of maternal and post weaning offspring dietary nitrogen on immune function and hematology in two species of rodent: the hispid cotton rat (Sigmodon hispidus), a primarily herbivorous rodent, and the fulvous harvest mouse (Reithrodontomys fulvescens), an omnivore. These two species responded differently to the same levels of treatment, with cotton rats primarily influenced by maternal diet and harvest mice by post weaning offspring diet. Cotton rats born to mothers on high-nitrogen diets had lower values of mean corpuscle volume and hemoglobin and greater concentrations of serum immunoglobulins. Spleen size, cell-mediated immune response, and the number of splenocytes and thymic platelets were lower in cotton rats born to mothers on low- and high-nitrogen diets. High-nitrogen offspring diet increased kidney and liver mass in cotton rats. Harvest mice had increased kidney mass on high-nitrogen maternal diets; however, changes in offspring diet after weaning reduced hematological parameters in individuals fed low nitrogen diets. Body length was also affected, with harvest mice born to mothers fed low- and high-nitrogen diets having shorter lengths. Splenocyte cellular activity was greater in offspring born to mothers on high-nitrogen diets in both species
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