Reliability of Standardized Assessment for Adults who are Deafblind

This study assessed the reliability of the interRAI Community Health Assessment (interRAI CHA) and Deafblind Supplement (DbS). The interRAI CHA and DbS represents a multidimensional, standardized assessment instrument for use with adults (18 and older) who are deafblind. The interrater reliability of the instrument was tested through the completion of dual assessments with 44 individuals who were deafblind in the province of Ontario, Canada. Overall, nearly 50% of items had a kappa value of at least 0.60, indicating fair to substantial agreement for these items. Several items related to psychosocial well-being, mood, and sense of involvement had kappa scores of less than 0.40. However, among these items with low kappa values, most (78%) showed at least 70% agreement between the two assessors. The internal consistency of several health subscales, embedded within the assessment, was also very good and ranged from 0.63 to 0.93. The interRAI was also very good and ranged from 0.63 to 0.93. The interRAI CHA and DbS represents a reliable instrument for assessing adults with deafblindness to better understand their needs, abilities, and preferences

Examination of fire scene reconstructions using virtual reality to enhance forensic decision-making. A case study in Scotland.

When attending a crime scene, first responders are responsible for identifying areas of potential interest for subsequent forensic examination. This information is shared with the police, forensic practitioners, and legal authorities during an initial meeting of all interested parties, which in Scotland is known as a forensic strategy meeting. Swift documentation is fundamental to allow practitioners to learn about the scene(s) and to plan investigative strategies, traditionally relying on word-of-mouth briefings using digital photographs, videos, diagrams, and verbal reports. We suggest that these early and critical briefings can be augmented positively by implementing an end-to-end methodology for indoor 3D reconstruction and successive visualisation through immersive Virtual Reality (VR). The main objective of this paper is to provide an integrative documentation tool to enhance the decision-making processes in the early stages of the investigation. Taking a fire scene as an example, we illustrate a framework for rapid spatial data acquisition of the scene that leverages structure-from-motion photogrammetry. We developed a VR framework that enables the exploration of virtual environments on a standalone, low-cost immersive head-mounted display. The system was tested in a two-phased inter-agency fire investigation exercise, where practitioners were asked to produce hypotheses suitable for forensic strategy meetings by (1) examining traditional documentation and then (2) using a VR walkthrough of the same premises. The integration of VR increased the practitioners’ scene comprehension, improved hypotheses formulation with fewer caveats, and enabled participants to sketch the scene, in contrast to the orientation challenges encountered using conventional documentation

A New Sampler for the Collection and Retrieval of Dry Dust Deposition

Atmospheric dust can influence biogeochemical cycles, accelerate snowmelt, and affect air, water quality, and human health. Yet, the bulk of atmospherically transported material remains poorly quantified in terms of total mass fluxes and composition. This lack of information stems in part from the challenges associated with measuring dust deposition. Here we report on the design and efficacy of a new dry deposition sampler (Dry Deposition Sampling Unit (DSU)) and method that quantifies the gravitational flux of dust particles. The sampler can be used alone or within existing networks such as those employed by the National Atmospheric Deposition Program (NADP). Because the samplers are deployed sterile and the use of water to remove trapped dust is not required, this method allows for the recovery of unaltered dry material suitable for subsequent chemical and microbiological analyses. The samplers were tested in the laboratory and at 15 field sites in the western United States. With respect to material retention, sampler performance far exceeded commonly used methods. Retrieval efficiency was \u3e97% in all trials and the sampler effectively preserved grain size distributions during wind exposure experiments. Field tests indicated favorable comparisons to dust-on-snow measurement across sites (r2 0.70, p \u3c 0.05) and within sites to co-located aerosol data (r2 0.57–0.99, p \u3c 0.05). The inclusion of dust deposition and composition monitoring into existing networks increases spatial and temporal understanding of the atmospheric transport on materials and substantively furthers knowledge of the effects of dust on terrestrial ecosystems and human exposure to dust and associated deleterious compounds

Galactic-Centre Gamma Rays in CMSSM Dark Matter Scenarios

We study the production of gamma rays via LSP annihilations in the core of the Galaxy as a possible experimental signature of the constrained minimal supersymmetric extension of the Standard Model (CMSSM), in which supersymmetry-breaking parameters are assumed to be universal at the GUT scale, assuming also that the LSP is the lightest neutralino chi. The part of the CMSSM parameter space that is compatible with the measured astrophysical density of cold dark matter is known to include a stau_1 - chi coannihilation strip, a focus-point strip where chi has an enhanced Higgsino component, and a funnel at large tanb where the annihilation rate is enhanced by the poles of nearby heavy MSSM Higgs bosons, A/H. We calculate the total annihilation rates, the fractions of annihilations into different Standard Model final states and the resulting fluxes of gamma rays for CMSSM scenarios along these strips. We observe that typical annihilation rates are much smaller in the coannihilation strip for tanb = 10 than along the focus-point strip or for tanb = 55, and that the annihilation branching ratios differ greatly between the different dark matter strips. Whereas the current Fermi-LAT data are not sensitive to any of the CMSSM scenarios studied, and the calculated gamma-ray fluxes are probably unobservably low along the coannihilation strip for tanb = 10, we find that substantial portions of the focus-point strips and rapid-annihilation funnel regions could be pressured by several more years of Fermi-LAT data, if understanding of the astrophysical background and/or systematic uncertainties can be improved in parallel.Comment: 33 pages, 12 figures, comments and references added, version to appear in JCA

Diffuse gamma ray constraints on annihilating or decaying Dark Matter after Fermi

We consider the diffuse gamma ray data from FERMI first year observations and compare them to the gamma ray fluxes predicted by Dark Matter annihilation or decay (both from prompt emission and from Inverse Compton Scattering), for different observation regions of the sky and a range of Dark Matter masses, annihilation/decay channels and Dark Matter galactic profiles. We find that the data exclude large regions of the Dark Matter parameter space not constrained otherwise and discuss possible directions for future improvements. Also, we further constrain Dark Matter interpretations of the e+e- PAMELA/FERMI spectral anomalies, both for the annihilating and the decaying Dark Matter case: under very conservative assumptions, only models producing dominantly mu+mu- and assuming a cored Dark Matter galactic profile can fit the lepton data with masses around 2 TeV.Comment: 16 pages, 4 figures. v2: Matches version published on Nuclear Physics B; discussion on the uncertainties related to magnetic field models added in an appendix, some typos corrected and some references added, conclusions unchange

Current concepts in anterior glenohumeral instability: diagnosis and treatment.

The glenohumeral joint is the most dislocated articulation, accounting for more than 50% of all joint dislocations. The reason behind shoulder instability should be investigated in detail for successful management, and the treatment plan should be individualized for all patients. Several classification systems have been proposed for glenohumeral instability. A physical exam is mandatory no matter what classification system is used. When treating patients with anterior shoulder instability, surgeons need to be aware of the critical size of the bone loss, which is commonly seen. The glenoid track concept was clinically adopted, and the measurement of the glenoid track for surgical decision-making is recommended. Detailed assessment of existing soft tissue injury to the labrum, capsule, glenohumeral ligaments, and rotator cuff is also mandatory as their presence influences the surgical outcome. Rehabilitation, arthroscopic repair techniques, open Bankart procedure, capsular plication, remplissage, Latarjet technique, iliac crest, and other bone grafts offer the surgeon different treatment options according to the type of patient and the lesions to be treated. Three-dimensional (3D) technologies can help to evaluate glenoid and humeral defects. Patient-specific guides are low-cost surgical instruments and can be used in shoulder instability surgery. 3D printing will undoubtedly become an essential tool to achieve the best results in glenohumeral instability surgery

Improvement in Chronic Hepatocerebral Degeneration Following Liver Transplantation

Chronic progressive hepatocerebral degeneration with spastic paraparesis, dementia, dysarthria, ataxia, tremor, and neuropsychiatric symptoms follows long-standing portal-systemic shunting, is associated with structural changes in the central nervous system, and does not respond to conventional therapy for hepatic encephalopathy. A case of advanced chronic liver disease with severe, progressive hepatocerebral degeneration after 23 yr of portal-systemic shunting is reported in whom there was significant objective improvement in intellectual function and in the chronic neurological signs 3 mo after orthotopic liver transplantation and further improvement 12 mo after transplantation

Constraining Dark Matter Properties with Gamma-Rays from the Galactic Center with Fermi-LAT

We study the capabilities of the Fermi-LAT instrument on board of the Fermi mission to constrain particle dark matter properties, as annihilation cross section, mass and branching ratio into dominant annihilation channels, with gamma-ray observations from the galactic center. Besides the prompt gamma-ray flux, we also take into account the contribution from the electrons/positrons produced in dark matter annihilations to the gamma-ray signal via inverse Compton scattering off the interstellar photon background, which turns out to be crucial in the case of dark matter annihilations into mu+mu- and e+e- pairs. We study the signal dependence on different parameters like the region of observation, the density profile, the assumptions for the dark matter model and the uncertainties in the propagation model. We also show the effect of the inclusion of a 20% systematic uncertainty in the gamma-ray background. If Fermi-LAT is able to distinguish a possible dark matter signal from the large gamma-ray background, we show that for dark matter masses below ~200 GeV, Fermi-LAT will likely be able to determine dark matter properties with good accuracy.Comment: 38 pages, 13 figures, 4 tables; to match published versio

Galactic electrons and positrons at the Earth:new estimate of the primary and secondary fluxes

We analyse predictions of the CR lepton fluxes at the Earth of both secondary and primary origins, evaluate the theoretical uncertainties, and determine their level of consistency with respect to the available data. For propagation, we use a relativistic treatment of the energy losses for which we provide useful parameterizations. We compute the secondary components by improving on the method that we derived earlier for positrons. For primaries, we estimate the contributions from astrophysical sources (supernova remnants and pulsars) by considering all known local objects within 2 kpc and a smooth distribution beyond. We find that the electron flux in the energy range 5-30 GeV is well reproduced by a smooth distant distribution of sources with index $\gamma\sim 2.3-2.4$, while local sources dominate the flux at higher energy. For positrons, local pulsars have an important effect above 5-10 GeV. Uncertainties affecting the source modeling and propagation are degenerate and each translates into about one order of magnitude error in terms of local flux. The spectral shape at high energy is weakly correlated with the spectral indices of local sources, but more strongly with the hierarchy in their distance, age and power. Despite the large theoretical errors that we describe, our global and self-consistent analysis can explain all available data without over-tuning the parameters, and therefore without the need to consider any exotic physics. Though a \emph{standard paradigm} of Galactic CRs is well established, our results show that we can hardly talk about any \emph{standard model} of CR leptons, because of the very large theoretical uncertainties. Our analysis provides details about the impact of these uncertainties, thereby sketching a roadmap for future improvements.Comment: 34 pages, 14 figures. V2: few changes, results unchanged; matches the version accepted in Astron. Astrophy