55 research outputs found
Pulmonary Dysfunction in Patients with Femoral Shaft Fracture Treated with Intramedullary Nailing
Background: This study was undertaken to determine whether alveolar dead space increases during intramedullary nailing of femoral shaft fractures and whether alveolar dead space predicts postoperative pulmonary dysfunction in patients undergoing intramedullary nailing of a femoral shaft fracture.
Methods: All patients with a femoral shaft fracture were prospectively enrolled in the study unless there was evidence of acute myocardial infarction, shock, or heart failure. Arterial blood gases were measured at three consecutive time-periods after induction of general anesthesia: before intramedullary nailing and ten and thirty minutes after intramedullary nailing. The end-tidal carbon-dioxide level, minute ventilation, positive end‐expiratory pressure, and percent of inspired and expired inhalation agent were recorded simultaneously with the blood-gas measurement. Postoperatively, all subjects were monitored for evidence of pulmonary dysfunction, defined as the need for mechanical ventilation or supplemental oxygen (at a fraction of inspired oxygen of >40%) in the presence of clinical signs of a respiratory rate of >20 breaths/min or the use of accessory muscles of respiration.
Results: Seventy‐four patients with a total of eighty femoral shaft fractures completed the study. Fifty fractures (62.5%) underwent nailing after reaming, and thirty fractures (37.5%) underwent nailing with minimal or no reaming. The mean alveolar dead-space measurements before canal opening and at ten and thirty minutes after canal opening were 14.5%, 15.8%, and 15.2% in the total series of seventy‐four patients (general linear model, p = 0.2) and 20.5%, 22.7%, and 24.2% in the twenty patients with postoperative pulmonary dysfunction (general linear model, p = 0.05). Of the twenty‐one patients with an alveolar dead-space measurement of >20% thirty minutes after nailing, sixteen had postoperative pulmonary dysfunction. According to univariate and multivariate analysis, the alveolar dead-space measurement was strongly associated with postoperative pulmonary dysfunction.
Conclusions: According to our data, intramedullary nailing of femoral shaft fractures did not significantly increase alveolar dead space, and the amount of alveolar dead space can predict which patients will have pulmonary dysfunction postoperatively
Examining the Factor Structure of the Home Mathematics Environment to Delineate Its Role in Predicting Preschool Numeracy, Mathematical Language, and Spatial Skills
A growing body of evidence suggests that the ways in which parents and preschool children interact in terms of home-based mathematics activities (i.e., the home mathematics environment; HME) is related to children’s mathematics development (e.g., primarily numeracy skills and spatial skills); however, this body of evidence is mixed with some research supporting the relation and others finding null effects. Importantly, few studies have explicitly examined the factor structure of the HME and contrasted multiple hypothesized models. To develop more precise models of how the HME supports children’s mathematics development, the structure of the HME needs to be examined and linked to mathematics performance. The purpose of this study was to extend prior work by replicating the factor structure of the HME (as one general HME factor and three specific factors of direct numeracy, indirect numeracy, and spatial) and using those factors to predict direct assessments of children’s numeracy, mathematical language, and spatial skills. It was hypothesized that the general HME factor would be related to each direct assessment, the direct numeracy factor would be related to both numeracy and mathematical language, and the spatial factor would be related to spatial skills. Using a sample of 129 preschool children (M age = 4.71 years, SD = 0.55; 46.5% female), a series of confirmatory factor analyses were conducted. Results diverged somewhat from prior work as the best fitting model was a bifactor model with a general HME factor and two specific factors (one that combined direct and indirect numeracy activities and another of spatial activities) rather than three specific factors as had previously been found. Further, structural equation modeling analyses suggested that, in contrast to expectations, only the direct + indirect numeracy factor was a significant predictor of direct child assessments when accounting for age, sex, and parental education. These findings provide evidence that a bifactor model is important in understanding the structure of the HME, but only one specific factor is related to children’s outcomes. Delineating the structure of the HME, and how specific facets of the HME relate to children’s mathematics skills, provides a strong foundation for understanding and enhancing the mechanisms that support mathematics development
\u3ci\u3eMycobacterium bovis \u3c/i\u3ein Coyotes from Michigan
During a survey for tuberculosis in wild carnivores and omnivores, Mycobacteriurn bovis was cultured from pooled lymph nodes of three adult female coyotes (Canis latrans) harvested by hunters in Michigan (USA). No gross or histologic lesions suggestive of tuberculosis were seen in these animals. One coyote was taken from Montmorency county and two coyotes from Alcona county located in the northeastern portion of Michigan’s Lower Peninsula where free-ranging white-tailed deer (Odocoileus virginianus) have been found infected with bovine tuberculosis. It is thought that these coyotes became infected with M. bovis through the consumption of tuberculous deer. Other species included in the survey were the opossum (Didelphis virginiana), raccoon (Procyon lotor), red fox (Vulpes vulpes), bobcat (Felis rufus), and badger (Taxidea taxus)
Bovine Tuberculosis in Free-Ranging Carnivores from Michigan
During a survey of carnivores and omnivores for bovine tuberculosis conducted in Michigan (USA) since 1996, Mycobacterium bovis was cultured from lymph nodes pooled from six coyotes (Canis latrans) (four adult female, two adult male), two adult male raccoons (Procyon lotor), one adult male red fox (Vulpes vulpes), and one 1.5-yr-old male black bear (Ursus americanus). One adult, male bobcat (Felis rufus) with histologic lesions suggestive of tuberculosis was negative on culture but positive for organisms belonging to the Mycobacterium tuberculosis complex when tested by polymerase chain reaction. All the tuberculous animals were taken from three adjoining counties where M. bovis is known to be endemic in the free-ranging white-tailed deer (Odocoileus virginianus) population. There were two coyotes, one raccoon, one red fox, and one bobcat infected in Alpena county. Montmorency County had two coyotes and one raccoon with M. bovis. Two coyotes and a bear were infected from Alcona County. These free-ranging carnivores/omnivores probably became infected with M. bovis through consumption of tuberculous deer. Other species included in the survey were opossum (Didelphis virginiana), gray fox (Urocyon cinereoargenteus), and badger (Taxidea taxus); these were negative for M. bovis
Environmental and farm management factors associated with tuberculosis on cattle farms in northeastern Michigan
TRY plant trait database – enhanced coverage and open access
Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives
Are American Homeowners Locked into Their Houses? The Impact of Housing Market Conditions on State-to-State Migration
Measurement of jet fragmentation in Pb+Pb and collisions at TeV with the ATLAS detector at the LHC
Bovine Tuberculosis in Michigan Wildlife and Livestock
Since 1994, the state of Michigan has recognized a problem with bovine tuberculosis (TB), caused by Mycobacterium bovis, in wild white-tailed deer from a 12-county area in northeastern Lower Michigan. A total of 65,000 free-ranging deer have been tested, and 340 have been found to be positive for M. bovis. The disease has been found in other wildlife species, and, in 1998, in domestic cattle, where to date 13 beef cattle and 2 dairy cattle herds have been diagnosed with bovine TB. Unfortunately, the situation is unique in that there have never been reports of self-sustaining bovine TB in a wild, free-ranging cervid population in North America. Scientists, biologists, epidemiologists, and veterinarians who have studied this situation have concluded that the most logical theory is that high deer densities and the focal concentration caused by baiting (the practice of hunting deer over feed) and feeding are the factors most likely responsible for the establishment of self-sustaining TB in free-ranging Michigan deer. Baiting and feeding have been banned since 1998 in counties where the disease has been found. In addition, the deer herd has been reduced by 50% in the endemic area with the use of unlimited antlerless permits. The measures of apparent TB prevalence have been decreased by half since 1997, providing hopeful preliminary evidence that eradication strategies are succeeding
M1051 Gastroenterologists' Experience with the Physicians Quality Reporting Initiative (PQRI): A Demonstration Project
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