Estimation of stature from the foot and its segments in a sub-adult female population of North India

<p>Abstract</p> <p>Background</p> <p>Establishing personal identity is one of the main concerns in forensic investigations. Estimation of stature forms a basic domain of the investigation process in unknown and co-mingled human remains in forensic anthropology case work. The objective of the present study was to set up standards for estimation of stature from the foot and its segments in a sub-adult female population.</p> <p>Methods</p> <p>The sample for the study constituted 149 young females from the Northern part of India. The participants were aged between 13 and 18 years. Besides stature, seven anthropometric measurements that included length of the foot from each toe (T1, T2, T3, T4, and T5 respectively), foot breadth at ball (BBAL) and foot breadth at heel (BHEL) were measured on both feet in each participant using standard methods and techniques.</p> <p>Results</p> <p>The results indicated that statistically significant differences (p < 0.05) between left and right feet occur in both the foot breadth measurements (BBAL and BHEL). Foot length measurements (T1 to T5 lengths) did not show any statistically significant bilateral asymmetry. The correlation between stature and all the foot measurements was found to be positive and statistically significant (<it>p-value </it>< 0.001). Linear regression models and multiple regression models were derived for estimation of stature from the measurements of the foot. The present study indicates that anthropometric measurements of foot and its segments are valuable in the estimation of stature. Foot length measurements estimate stature with greater accuracy when compared to foot breadth measurements.</p> <p>Conclusions</p> <p>The present study concluded that foot measurements have a strong relationship with stature in the sub-adult female population of North India. Hence, the stature of an individual can be successfully estimated from the foot and its segments using different regression models derived in the study. The regression models derived in the study may be applied successfully for the estimation of stature in sub-adult females, whenever foot remains are brought for forensic examination. Stepwise multiple regression models tend to estimate stature more accurately than linear regression models in female sub-adults.</p

Relapse prevention for addictive behaviors

The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Pedestal structure and stability in high-performance plasmas on Alcator C-Mod

Thesis: Sc. D., Massachusetts Institute of Technology, Department of Nuclear Science and Engineering, 2014.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student-submitted PDF version of thesis.Includes bibliographical references.High-performance operation in tokamaks is characterized by the formation of a pedestal, a region of suppressed transport and steep gradients in density, temperature, and pressure near the plasma edge. The pedestal height is strongly correlated with overall fusion performance, as a substantial pedestal supports the elevated core pressure necessary for the desired fusion reaction rate and power density. However, stationary operation requires some relaxation of the particle transport barrier, to avoid the accumulation of impurities (e. g., helium "fusion ash," plasmafacing surface materials) in the plasma. Moreover, the formation of the pedestal introduces an additional constraint: the steep gradients act as a source of free energy for Edge-Localized Mode (ELM) instabilities, which on ITER- or reactor-scale devices can drive large, explosive bursts of particle and energy transport leading to unacceptable levels of heat loading and erosion damage to plasma-facing materials. As such, the suppression, mitigation, or avoidance of large ELMs is the subject of much current research. In light of this, a firm physical understanding of the pedestal structure and stability against the ELM trigger is essential for the extrapolation of high-performance regimes to large-scale operation, particularly in operating scenarios lacking large, deleterious ELMs. This thesis focuses on the I-mode, a novel high-performance regime pioneered on the Alcator C-Mod tokamak. I-mode is unique among high-performance regimes in that it appears to decouple energy and particle transport, reaching H-mode levels of energy confinement with the accompanying temperature pedestal while maintaining a L-mode-like density profile and particle transport. I-mode exhibits three attractive properties for a reactor regime: (1) I-mode appears to be inherently free of large ELMs, avoiding the need for externally-applied ELM control. (2) The lack of a particle transport barrier maintains the desired level of impurity flushing from the plasma, avoiding excessive radiative losses. (3) Energy confinement in I-mode presents minimal degradation with input heating power, contrary to that found in H-mode. This thesis presents the results from a combined empirical and computational study of the pedestal on C-Mod. Analysis methods are first implemented in ELMy H-mode base cases on CMod -- in particular, the EPED model based on the combined constraints from peeling-ballooning MHD instability and kinetic-ballooning turbulence is tested on C-Mod. Empirical results in ELMy H-mode are consistent with the physics assumptions used in EPED, with the pedestal pressure gradient constrained by [delta]p ~ I2/p expected from the ballooning stability limit. To lowestorder approximation, ELMy H-mode pedestals are limited in [beta]p,ped, with the attainable beta set by shaping -- within this limit, an inverse relationship between pedestal density and temperature is seen. The pedestal width is found to be described by the scaling [delta][psi] = G[beta] 1/2 / p.ped expected from the KBM limit, where G([nu],[epsilon], ...) is a weakly varying function with hGi = 0.0857. No systematic secondary scalings with field, gyroradius, shaping, or collisionality are observed. The EPED model, based on these assumptions, correctly predicts the pressure pedestal width and height to within a systematic ~20% uncertainty. Empirical scalings in I-mode highlight the operational differences from conventional H-modes. The temperature and pressure pedestal exhibit a positive trend with current, similar to H-mode (although I-mode pedestal temperature typically exceeds that found in comparable H-modes) -- however, the temperature and pressure respond significantly more strongly to heating power, with Te ... The I-mode density profile is set largely independently of the temperature pedestal (unlike ELMy H-mode), controlled by operator fueling. Given sufficient heating power to maintain a consistent ..., temperature pedestals are matched across a range of fueling levels. This indicates a path to readier access and increased performance in Imode, with the mode accessed at moderate density and power, after which the pedestal pressure is elevated with matched increases in fueling and heating power. Global performance metrics in I-mode are competitive with H-mode results on C-Mod, and are consistent with the weak degradation of energy confinement with heating power. I-mode pedestals are also examined against the physics basis for the EPED model. Peelingballooning MHD stability is calculated using the ELITE code, finding the I-mode pedestal to be strongly stable to the MHD modes associated with the ELM trigger. Similarly, modeling of the KBM using the infinite-n ballooning mode calculated in BALOO as a surrogate for the threshold indicates that the I-mode pedestal is stable to kinetic-ballooning turbulence, consistent with the observed lack of a trend in the pedestal width with [beta]p,ped. This is found to be the case even in I-modes exhibiting small, transient ELM-like events. The majority of these events are triggered by the sawtooth heat pulse reaching the edge, and do not negatively perturb the temperature pedestal -- it is proposed, then, that these events are not true peeling-ballooning-driven ELMs, but rather are an ionization front in the SOL driven by the sawtooth heat pulse. There are transient ELM events showing the characteristic temperature pedestal crash indicating a true ELM -- the steady I-mode pedestals around these isolated events are also modeled to be P-B and KBM stable, although more detailed modeling of these events is ongoing.by John Reel Walk, Jr.Sc. D

Low-energy confinement- to high-energy confinement-mode transition and momentum confinement in Alcator C-Mod plasmas

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Physics, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 63-64).Using a spatially-resolving x-ray spectrometer system, toroidal impurity rotation in Alcator C-Mod plasmas was measured. The propagation of the rotational velocity from the edge to the core of the plasma column was measured during the L- to H-mode transition. Momentum transport was measured in both Ohmic and ICRF-heated discharges, which produced EDA and ELM-free H-modes. The momentum transport was modeled by a simplified diffusion model, in which momentum diffusivity was substantially higher than neoclassically predicted values.by John Reel Walk, Jr.S.B

Prescribers' knowledge of and sources of information for potential drug-drug interactions: A postal survey of US prescribers

10.2165/00002018-200831060-00007Drug Safety316525-536DRSA