Incidence of Corrective Procedures After Nonoperatively Managed Distal Radius Fractures in the Elderly.

Although the majority distal radius fractures in the elderly are initially managed nonoperatively, the true incidence of subsequent corrective surgery is unknown. The purpose of this study was to determine the incidence and predictors of corrective surgery after conservative management. Methods:ICD-9 and Current Procedural Terminology codes were queried from the Medicare 5% sample to select patients aged 65 years and older undergoing nonsurgical treatment of distal radius fractures with a minimum 5-year follow-up. Rates of subsequent ipsilateral wrist surgery were correlated against patient age, sex, geographic region, and initial closed reduction. Results:Five thousand eighty patients with a mean age of 78.3 years were included. Fifty-five patients (1.1%) had undergone subsequent wrist surgery at a median time of 182 days after injury. The youngest cohort (65 to 69 years) had a significantly higher operation rate (1.9%, P = 0.007) than the oldest cohort (80+ years) (0.5%, P = 0.004). There was no notable difference in corrective procedures between sex, geographic region, and initial closed reduction. Discussion:Once surgical intervention is deemed unnecessary per standard guidelines, the data support successful nonsurgical management in a large majority of patients but highlight a small subset of younger patients who remain at increased risk of requiring additional surgery

Social structure of Lahille’s bottlenose dolphin Tursiops truncatus gephyreus (Cetacea: Delphinidae) off the uruguayan marine coast

Information about the social relations among individuals is essential to de ne and developmanagement plans for a socially structured population. Association data for 25 adult Lahille’s bottlenosedolphins were obtained from 189 photo-identi cation surveys that took place between January 2007 and May2009 in La Coronilla-Cerro Verde and Cabo Polonio, Rocha, Uruguay. Group size averaged 5.22 individuals(SD= 3.77, n= 255). Coe cients of association were calculated using the Half-Weight Index. Most of theassociations were weak (79.7%) and variation of real association indices was greater than would be expected bychance. Thus, the null hypothesis that individuals associated randomly was rejected. Standardized LaggedAssociation Rate analysis also indicated that nonrandom associations between individuals persisted over thestudy period. The exponential decay model that ts best to the data suggested the existence of constantcompanions and casual acquaintances. This study is the rst report about the social structure of the populationof Lahille’s bottlenose dolphin inhabiting the Uruguayan marine coasts. Cerro Verde and Cabo Polonio werethe rst marine protected areas selected by the government of Uruguay. However, information about theecology and behavior of the species in these areas is still insu cient. It is recommended that the results of thisstudy be taken as baseline information to assess the conservation status of this population, as well as for thedevelopment of adequate conservation and management plans.Para una población socialmente estructurada, disponer de información sobre las relaciones sociales entre individuos es esencial para definir y desarrollar planes de manejo. Se obtuvieron datos de asociación para 25 toninas adultas a partir de 189 salidas de foto-identificación, realizadas entre enero 2007 y mayo 2009, en La Coronilla-Cerro Verde y Cabo Polonio, Rocha, Uruguay. El tamaño grupal promedió 5.22 individuos (DS = 3.77, n = 255). Los coeficientes de asociación se calcularon utilizando el Índice de Peso Medio. Las asociaciones fueron mayormente débiles (79.7%) y la variación de los índices de asociación fue mayor que lo esperado por azar. Por tanto, se rechazó la hipótesis nula de que los individuos se asociaron aleatoriamente. El análisis utilizando la Tasa de Asociación con Retardo Estandarizada también indicó que asociaciones no aleatorias persistieron durante el período de estudio. El modelo exponencial que mejor ajusta a los datos sugiere la existencia de compañeros constantes y compañeros casuales. Este estudio reporta por primera vez información sobre la estructura social de la población de toninas que habita la costa marina uruguaya. Cerro Verde y Cabo Polonio fueron las primeras áreas marinas protegidas por el gobierno de Uruguay. Sin embargo, aún es insuficiente la información sobre la ecología y el comportamiento de la especie en estas áreas. Se recomienda que los resultados de este estudio se tomen como información de base para evaluar el estado de conservación de esta población, así como para el desarrollo de planes adecuados de manejo y conservación

University Strategic Planning: A Process for Change in a Principal Preparation Program

This study describes a strategic planning process used for developing an educational leadership program that prepares principals for leading 21st century schools. The plan is based on recommendations received from the External reviewers representing Southern Association of Colleges and Schools, the Texas Education Agency, survey responses received from former students currently serving in school leadership positions, and focus group forums. Recommendations received were used to develop a strategic plan that resulted in a more rigorous and accessible, field-based program to better prepare school leaders

The use of cosmic muons in detecting heterogeneities in large volumes

The muon intensity attenuation method to detect heterogeneities in large matter volumes is analyzed. Approximate analytical expressions to estimate the collection time and the signal to noise ratio, are proposed and validated by Monte Carlo simulations. Important parameters, including point spread function and coordinate reconstruction uncertainty are also estimated using Monte Carlo simulations.Comment: 8 pages, 11 figures, submetted to NIM

Polyelectrolyte Multilayering on a Charged Planar Surface

The adsorption of highly \textit{oppositely} charged flexible polyelectrolytes (PEs) on a charged planar substrate is investigated by means of Monte Carlo (MC) simulations. We study in detail the equilibrium structure of the first few PE layers. The influence of the chain length and of a (extra) non-electrostatic short range attraction between the polycations and the negatively charged substrate is considered. We show that the stability as well as the microstructure of the PE layers are especially sensitive to the strength of this latter interaction. Qualitative agreement is reached with some recent experiments.Comment: 28 pages; 11 (main) Figs - Revtex4 - Higher resolution Figs can be obtained upon request. To appear in Macromolecule

Overview of Hybrid Ventilation Control System and Full Scale Monitoring

Mix-mode or hybrid ventilation systems have been previously shown to reduce cooling and ventilation energy consumption. This paper presents a case study of a new ten story 83,700 ft² (7,780 m²) office building in downtown Tokyo with a hybrid ventilation system that uses only 1.7% of the building footprint for ventilation shafts. The control system design is presented as an example of balancing the comfort expectations of multiple tenants in a mix-mode system. On-site measurements are presented from a three week commissioning project to show: modest temperature differences within the occupied zone with a maximum difference of 1.5 °F (0.83 °C), large differences of up to 6.1 °F (3.4 °C) between the measured outdoor temperature in the control system and the actual inlet temperature for the natural ventilation system, the importance of smooth integration of various design teams, and the use of low-power fans, 1.2-0.60 hp (900-450 W), that leverage the low pressure drop through the building when natural driving forces are insufficient for pure natural ventilation. Practical lessons learned from the design and commissioning of the building are also shared.Hulic Co., Ltd

A Predictor-Informed Multi-Subject Bayesian Approach for Dynamic Functional Connectivity

Time Varying Functional Connectivity (TVFC) investigates how the interactions among brain regions vary over the course of an fMRI experiment. The transitions between different individual connectivity states can be modulated by changes in underlying physiological mechanisms that drive functional network dynamics, e.g., changes in attention or cognitive effort as measured by pupil dilation. In this paper, we develop a multi-subject Bayesian framework for estimating dynamic functional networks as a function of time-varying exogenous physiological covariates that are simultaneously recorded in each subject during the fMRI experiment. More specifically, we consider a dynamic Gaussian graphical model approach, where a non-homogeneous hidden Markov model is employed to classify the fMRI time series into latent neurological states, borrowing strength over the entire time course of the experiment. The state-transition probabilities are assumed to vary over time and across subjects, as a function of the underlying covariates, allowing for the estimation of recurrent connectivity patterns and the sharing of networks among the subjects. Our modeling approach further assumes sparsity in the network structures, via shrinkage priors. We achieve edge selection in the estimated graph structures, by introducing a multi-comparison procedure for shrinkage-based inferences with Bayesian false discovery rate control. We apply our modeling framework on a resting-state experiment where fMRI data have been collected concurrently with pupillometry measurements, leading us to assess the heterogeneity of the effects of changes in pupil dilation, previously linked to changes in norepinephrine-containing locus coeruleus, on the subjects' propensity to change connectivity states