1,445 research outputs found
An overview of barrier winds off southeastern Greenland during the Greenland Flow Distortion experiment
During the Greenland Flow Distortion experiment, barrier flow was observed by an instrumented aircraft on 1, 2, 5 and 6 March 2007 off southeastern Greenland. During this time period the barrier flow increased from a narrow jet, ~15 m s-1, to a jet filling almost the whole of the Denmark Strait with maximum wind speed exceeding 40 m s-1. Dropsonde observations show that the barrier flow was capped by a sharp temperature inversion below mountain height. Below the inversion was a cold and dry jet, with a larger northerly wind component than that of the flow above, which was also warmer and more moist. Thus, the observations indicate two air masses below mountain height: a cold and dry barrier jet of northern origin and, above this, a warmer and moister air mass that was of cyclonic origin. Numerical simulations emphasize the non-stationarity of the Greenland barrier flow and its dependence on the synoptic situation in the Greenland--Iceland region. They show that the barrier jet originated north of the Denmark Strait and was drawn southward by a synoptic-scale cyclone, with the strength and location of the maximum winds highly dependent on the location of the cyclone relative to the orography of Greenland. Experiments without Greenland's orography suggest a ~20 m s-1 enhancement of the low-level peak wind speeds due to the presence of the barrier. Thus, the Greenland barrier flows are not classic geostrophically balanced barrier flows but have a significant ageostrophic component and are precisely controlled by synoptic-scale systems
Warped Riemannian metrics for location-scale models
The present paper shows that warped Riemannian metrics, a class of Riemannian
metrics which play a prominent role in Riemannian geometry, are also of
fundamental importance in information geometry. Precisely, the paper features a
new theorem, which states that the Rao-Fisher information metric of any
location-scale model, defined on a Riemannian manifold, is a warped Riemannian
metric, whenever this model is invariant under the action of some Lie group.
This theorem is a valuable tool in finding the expression of the Rao-Fisher
information metric of location-scale models defined on high-dimensional
Riemannian manifolds. Indeed, a warped Riemannian metric is fully determined by
only two functions of a single variable, irrespective of the dimension of the
underlying Riemannian manifold. Starting from this theorem, several original
contributions are made. The expression of the Rao-Fisher information metric of
the Riemannian Gaussian model is provided, for the first time in the
literature. A generalised definition of the Mahalanobis distance is introduced,
which is applicable to any location-scale model defined on a Riemannian
manifold. The solution of the geodesic equation is obtained, for any Rao-Fisher
information metric defined in terms of warped Riemannian metrics. Finally,
using a mixture of analytical and numerical computations, it is shown that the
parameter space of the von Mises-Fisher model of -dimensional directional
data, when equipped with its Rao-Fisher information metric, becomes a Hadamard
manifold, a simply-connected complete Riemannian manifold of negative sectional
curvature, for . Hopefully, in upcoming work, this will be
proved for any value of .Comment: first version, before submissio
What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?
<p>Abstract</p> <p>Background</p> <p>Optimal treatment gives complete relief of symptoms of many disorders. But even if such treatment is available, some patients have persisting complaints. One disorder, from which the patients should achieve complete relief of symptoms with medical or surgical treatment, is gastroesophageal reflux disease (GERD). Despite the fact that such treatment is cheap, safe and easily available; some patients have persistent complaints after contact with the health services. This study evaluates the causes of treatment failure.</p> <p>Methods</p> <p>Twelve patients with GERD and persistent complaints had a semi-structured interview which focused on the patients' evaluation of treatment failure. The interviews were taped, transcribed and evaluated by 18 physicians, (six general practitioners, six gastroenterologists and six gastrointestinal surgeons) who completed a questionnaire for each patient. The questionnaires were scored, and the relative responsibility for the failure was attributed to the patient, primary care, secondary care and interaction in the health services.</p> <p>Results</p> <p>Failing interaction in the health services was the most important cause of treatment failure, followed by failure in primary care, secondary care and the patient himself; the relative responsibilities were 35%, 28%, 27% and 10% respectively. There was satisfactory agreement about the causes between doctors with different specialities, but significant inter-individual differences between the doctors. The causes of the failures differed between the patients.</p> <p>Conclusions</p> <p>Treatment failure is a complex problem. Inadequate interaction in the health services seems to be important. Improved communication between parts of the health services and with the patients are areas of improvement.</p
A Rasch and factor analysis of the Functional Assessment of Cancer Therapy-General (FACT-G)
BACKGROUND: Although the Functional Assessment of Cancer Therapy – General questionnaire (FACT-G) has been validated few studies have explored the factor structure of the instrument, in particular using non-sample dependent measurement techniques, such as Rasch Models. Furthermore, few studies have explored the relationship between item fit to the Rasch Model and clinical utility. The aim of this study was to investigate the dimensionality and measurement properties of the FACT-G with Rasch Models and Factor analysis. METHODS: A factor analysis and Rasch analysis (Partial Credit Model) was carried out on the FACT-G completed by a heterogeneous sample of cancer patients (n = 465). For the Rasch analysis item fit (infit mean squares ≥ 1.30), dimensionality and item invariance were assessed. The impact of removing misfitting items on the clinical utility of the subscales and FACT-G total scale was also assessed. RESULTS: The factor analysis demonstrated a four factor structure of the FACT-G which broadly corresponded to the four subscales of the instrument. Internal consistency for these four scales was very good (Cronbach's alpha 0.72 – 0.85). The Rasch analysis demonstrated that each of the subscales and the FACT-G total scale had misfitting items (infit means square ≥ 1.30). All these scales with the exception of the Social & Family Well-being Scale (SFWB) were unidimensional. When misfitting items were removed, the effect sizes and the clinical utility of the instrument were maintained for the subscales and the total FACT-G scores. CONCLUSION: The results of the traditional factor analysis and Rasch analysis of the FACT-G broadly agreed. Caution should be exercised when utilising the Social & Family Well-being scale and further work is required to determine whether this scale is best represented by two factors. Additionally, removing misfitting items from scales should be performed alongside an assessment of the impact on clinical utility
The bashful and the boastful : prestigious leaders and social change in Mesolithic Societies
The creation and maintenance of influential leaders and authorities is one of the key themes of archaeological and historical enquiry. However the social dynamics of authorities and leaders in the Mesolithic remains a largely unexplored area of study. The role and influence of authorities can be remarkably different in different situations yet they exist in all societies and in almost all social contexts from playgrounds to parliaments. Here we explore the literature on the dynamics of authority creation, maintenance and contestation in egalitarian societies, and discuss the implications for our interpretation and understanding of the formation of authorities and leaders and changing social relationships within the Mesolithic
Long-term outcomes among older patients following nonmyeloablative conditioning and allogeneic hematopoietic cell transplantation for advanced hematologic malignancies.
A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation
<p>Abstract</p> <p>Introduction</p> <p>The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path.</p> <p>Material and methods</p> <p>To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v<sub>0 </sub>= 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity.</p> <p>Results</p> <p>The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity.</p> <p>Discussion</p> <p>Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures.</p
Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system
Primary headaches such as migraine are among the most prevalent neurological disorders, affecting up to one-fifth of the adult population. The scientific work in the last decade has unraveled much of the pathophysiological background of migraine, which is now considered to be a neurovascular disorder. It has been discovered that the trigemino-cerebrovascular system plays a key role in migraine headache pathophysiology by releasing the potent vasodilator calcitonin gene-related peptide (CGRP). This neuropeptide is released in parallel with the pain and its concentration correlates well with the intensity of the headache. The development of drugs of the triptan class has provided relief for the acute attacks but at the cost of, mainly cardiovascular, side effects. Thus, the intention to improve treatment led to the development of small CGRP receptor antagonists such as olcegepant (BIBN4096BS) and MK-0974 that alleviate the acute migraine attack without acute side events. The purpose of this review is to give a short overview of the pathological background of migraine headache and to illustrate the mechanisms behind the actions of triptans and the promising CGRP receptor blockers
Evaluation of zona pellucida birefringence intensity during in vitro maturation of oocytes from stimulated cycles
Background: This study evaluated whether there is a relationship between the zona pellucida birefringence (ZP-BF) intensity and the nuclear (NM) and cytoplasmic (CM) in vitro maturation of human oocytes from stimulated cycles.Results: The ZP-BF was evaluated under an inverted microscope with a polarizing optical system and was scored as high/positive (when the ZP image presented a uniform and intense birefringence) or low/negative (when the image presented moderate and heterogeneous birefringence). CM was analyzed by evaluating the distribution of cortical granules (CGs) throughout the ooplasm by immunofluorescence staining. CM was classified as: complete, when CG was localized in the periphery; incomplete, when oocytes presented a cluster of CGs in the center; or in transition, when oocytes had both in clusters throughout cytoplasm and distributed in a layer in the cytoplasm periphery Nuclear maturation: From a total of 83 germinal vesicle (GV) stage oocytes, 58 of oocytes (69.9%) reached NM at the metaphase II stage. From these 58 oocytes matured in vitro, the high/positively scoring ZP-BF was presented in 82.7% of oocytes at the GV stage, in 75.8% of oocytes when at the metaphase I, and in 82.7% when oocytes reached MII. No relationship was observed between NM and ZP-BF positive/negative scores (P = 0.55). These variables had a low Pearson's correlation coefficient (r = 0.081). Cytoplasmic maturation: A total of 85 in vitro-matured MII oocytes were fixed for CM evaluation. Forty-nine oocytes of them (57.6%) showed the complete CM, 30 (61.2%) presented a high/positively scoring ZP-BF and 19 (38.8%) had a low/negatively scoring ZP-BF. From 36 oocytes (42.3%) with incomplete CM, 18 (50%) presented a high/positively scoring ZPBF and 18 (50%) had a low/negatively scoring ZP-BF. No relationship was observed between CM and ZP-BF positive/negative scores (P = 0.42). These variables had a low Pearson's correlation coefficient (r = 0.11).Conclusions: The current study demonstrated an absence of relationship between ZP-BF high/positive or low/negative score and nuclear and cytoplasmic in vitro maturation of oocytes from stimulation cycles
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