Growth of collisional orogens from small and cold to large and hot - inferences from geodynamic models

It is well documented that the interplay between crustal thickening and surface processes determines growth of continent‐continent collision orogens from small and cold to large and hot. Additionally, studies have demonstrated that the structural style of a mountain belt is strongly influenced by inherited (extensional) structures, the pattern of erosion and deposition, as well as the distribution of shallow detachment horizons. However, the factors controlling distribution of shortening and variable structural style as a function of convergence and surface process efficiency remain less explored. We use a 2D upper‐mantle scale plane‐strain thermo‐mechanical model (FANTOM) coupled to a planform, mass conserving surface‐process model (Fastscape), to investigate the long‐term evolution of mountain belts and the influence of lithospheric pull, extensional inheritance, surface processes efficiency, and decoupling between thin‐and thick‐skinned tectonics. We establish an evolutionary shortening distribution for orogenic growth from a mono‐vergent wedge to an orogenic plateau, and find that internal crustal loading is the main factor controlling the large scale evolution, while lithospheric pull modulates the plate driving force for orogenesis. Limited foreland‐basin filling and minor exhumation of the orogen core are characteristic for low surface‐process efficiency, while thick foreland‐basin fill, and profound exhumation of the orogen core are characteristic for high surface‐process efficiency. Utilizing a force balance analysis, we show how inherited structures, surface processes, and decoupling between thin‐and thick‐skinned deformation influence structural style during orogenic growth. Finally, we present a comparison of our generic modeling results with natural systems, with a particular focus on the Pyrenees, Alps, and Himalaya‐Tibet

Reliability, Validity, and Interpretation of the Dependence Scale in Mild to Moderately Severe Alzheimer's Disease

INTRODUCTION: The Dependence Scale (DS) was designed to measure dependence on others among patients with Alzheimer's disease (AD). The objectives of this research were primarily to strengthen the psychometric evidence for the use of the DS in AD studies. METHODS: Patients with mild to moderately severe AD were examined in 3 study databases. Within each data set, internal consistency, validity, and responsiveness were examined, and structural equation models were fit. RESULTS: The DS has strong psychometric properties. The DS scores differed significantly across known groups and demonstrated moderate to strong correlations with measures hypothesized to be related to dependence (|r| >/= .31). Structural equation modeling supported the validity of the DS concept. An anchor-based DS responder definition to interpret a treatment benefit over time was identified. DISCUSSION: The DS is a reliable, valid, and interpretable measure of dependence associated with AD and is shown to be related to--but provides information distinct from--cognition, functioning, and behavior

The MD Anderson Symptom Inventory (MDASI) survey discloses persistent moderate to high-level symptoms in cancer survivors

cancer survivorship care; patient reported outcomeshttps://openworks.mdanderson.org/acif24/1006/thumbnail.jp

Anterior fundoplication at the time of congenital diaphragmatic hernia repair

The loss of normal anatomic barriers in neonates with congenital diaphragmatic hernia (CDH) can predispose children to gastroesophageal reflux (GER). In an attempt to improve post-operative feeding, we have added a modified anterior fundoplication to restore natural gastric and esophageal positioning. The institutional review board of both participating centers approved this study. Between 1997 and 2008, 13 neonates with high-risk anatomy underwent repair of CDH combined with an anterior fundoplication (Boix-Ochoa). The anatomic indications for concomitant fundoplication were absence of an intra-abdominal esophagus, an obtuse angle of His, and a small, vertically oriented stomach. Ten patients survived to discharge and eight were on full oral nourishment. One required partial gastrostomy feedings for an improving oral aversion and quickly progressed to full oral feedings. One patient with chromosomal anomalies and swallowing dysfunction remained on long-term bolus gastrostomy feedings. Two with progressive symptoms of GER and failure to thrive required conversion to a 360° wrap after 18 months of medical management. This was performed in conjunction with a planned, staged muscle flap reconstruction in one patient. There were no complications related to the fundoplication. Anatomic predictors of severe GER can be efficiently countered at the time of CDH repair. A modified fundoplication should be considered in the operative management of high-risk infants

The use of insulin declines as patients live farther from their source of care: results of a survey of adults with type 2 diabetes

BACKGROUND: Although most diabetic patients do not achieve good physiologic control, patients who live closer to their source of primary care tend to have better glycemic control than those who live farther away. We sought to assess the role of travel burden as a barrier to the use of insulin in adults with diabetes METHODS: 781 adults receiving primary care for type 2 diabetes were recruited from the Vermont Diabetes Information System. They completed postal surveys and were interviewed at home. Travel burden was estimated as the shortest possible driving distance from the patient's home to the site of primary care. Medication use, age, sex, race, marital status, education, health insurance, duration of diabetes, and frequency of care were self-reported. Body mass index was measured by a trained field interviewer. Glycemic control was measured by the glycosolated hemoglobin A1C assay. RESULTS: Driving distance was significantly associated with insulin use, controlling for the covariates and potential confounders. The odds ratio for using insulin associated with each kilometer of driving distance was 0.97 (95% confidence interval 0.95, 0.99; P = 0.01). The odds ratio for using insulin for those living within 10 km (compared to those with greater driving distances) was 2.29 (1.35, 3.88; P = 0.02). DISCUSSION: Adults with type 2 diabetes who live farther from their source of primary care are significantly less likely to use insulin. This association is not due to confounding by age, sex, race, education, income, health insurance, body mass index, duration of diabetes, use of oral agents, glycemic control, or frequency of care, and may be responsible for the poorer physiologic control noted among patients with greater travel burdens

Biomedical imaging research opportunities workshop IV: A white paper

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134967/1/mp5838.pd