Postoperative nausea and vomiting in facial fracture patients : a randomized and controlled trial on the effect of dexamethasone

Non peer reviewe

Assault-related facial fractures : does the injury mechanism matter?

This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.Peer reviewe

Ammonia as a tracer of chemical equilibrium in the T7.5 dwarf Gliese 570D

We present the first analysis of an optical to mid-infrared spectrum of the T7.5 dwarf Gliese 570D with model atmospheres, synthetic spectra, and brown dwarf evolution sequences. We obtain precise values for the basic parameters of Gl 570D: Teff=800 - 820K, log g (cm/s^2)=5.09 - 5.23, and log L/Lsun= -5.525 to -5.551. The Spitzer IRS spectrum shows prominent features of ammonia (NH3) that can only be fitted by reducing the abundance of NH3 by about one order of magnitude from the value obtained with chemical equilibrium models. We model departures from chemical equilibrium in the atmosphere of Gl 570D by considering the kinetics of nitrogen and carbon chemistry in the presence of vertical mixing. The resulting model spectrum reproduces the data very well.Comment: Accepted for publication in the ApJ. 10 pages, including 3 figure

A Method for Determining the Physical Properties of the Coldest Known Brown Dwarfs

We present a method for measuring the physical parameters of the coldest T-type brown dwarfs using low resolution near infrared spectra. By comparing H_2O- and H_2-sensitive spectral ratios between empirical data and theoretical atmosphere models, and calibrating these ratios to measurements for the well-characterized 2-5 Gyr companion brown dwarf Gliese 570D, we derive estimates of the effective temperatures and surface gravities for 13 mid- and late-type field T dwarfs. We also deduce the first quantitative estimate of subsolar metallicity for the peculiar T dwarf 2MASS 0937+2931. Derived temperatures are consistent with prior estimates based on parallax and bolometric luminosity measurements, and examination of possible systematic effects indicate that the results are robust. Two recently discovered late-type T dwarfs, 2MASS 0939-2448 and 2MASS 1114-2618, both appear to be >50 K cooler than the latest-type T dwarf, 2MASS 0415-0935, and are potentially the coldest and least luminous brown dwarfs currently known. We find that, in general, higher surface gravity T dwarfs have lower effective temperatures and luminosities for a given spectral type, explaining previously observed scatter in the Teff/spectral type relation for these objects. Masses, radii and ages are estimated for the T dwarfs in our sample using the evolutionary models of Burrows et al.; we also determine masses and radii independently for eight T dwarfs with measured luminosities. These two determinations are largely consistent, lending support to the validity of evolutionary models at late ages. Our method is well suited to large samples of faint brown dwarfs, and can ultimately be used to directly measure the substellar mass function and formation history in the Galaxy.Comment: 25 pages, 11 figures, accepted for publication in Ap

Confidence levels and likelihood terms in IPCC reports : a survey of experts from different scientific disciplines

Scientific assessments, such as those by the Intergovernmental Panel on Climate Change (IPCC), inform policymakers and the public about the state of scientific evidence and related uncertainties. We studied how experts from different scientific disciplines who were authors of IPCC reports, interpret the uncertainty language recommended in the Guidance Note for Lead Authors of the IPCC Fifth Assessment Report on Consistent Treatment of Uncertainties. This IPCC guidance note discusses how to use confidence levels to describe the quality of evidence and scientific agreement, as well likelihood terms to describe the probability intervals associated with climate variables. We find that (1) physical science experts were more familiar with the IPCC guidance note than other experts, and they followed it more often; (2) experts' confidence levels increased more with perceptions of evidence than with agreement; (3) experts' estimated probability intervals for climate variables were wider when likelihood terms were presented with "medium confidence" rather than with "high confidence" and when seen in context of IPCC sentences rather than out of context, and were only partly in agreement with the IPCC guidance note. Our findings inform recommendations for communications about scientific evidence, assessments, and related uncertainties.Peer reviewe

Linear instability criteria for ideal fluid flows subject to two subclasses of perturbations

In this paper we examine the linear stability of equilibrium solutions to incompressible Euler's equation in 2- and 3-dimensions. The space of perturbations is split into two classes - those that preserve the topology of vortex lines and those in the corresponding factor space. This classification of perturbations arises naturally from the geometric structure of hydrodynamics; our first class of perturbations is the tangent space to the co-adjoint orbit. Instability criteria for equilibrium solutions are established in the form of lower bounds for the essential spectral radius of the linear evolution operator restricted to each class of perturbation.Comment: 29 page

Gel chromatographic characterization of immunoreactive adrenocorticotropin in patients with ACTH hypersecretion

We investigated the molecular size of circulating immunoreactive ACTH by gel chromatography in patients with ACTH hypersecretion due to various disorders of the hypothalamic-pituitary-adrenal axis. 4 patients with Addison's disease, 2 with Nelson's syndrome, 4 with Cushing's disease, 6 with the ectopic ACTH syndrome (2 bronchial carcinoma, 1 medullary carcinoma, 1 metastatic islett cell carcinoma, 1 benign bronchial carcinoid and 1 patient with occult ectopic Cushing's syndrome) and 1 patient with hypersecretion of ACTH from a clinically nonfunctioning pituitary adenoma were studied. Analysis of the molecular size of immunoreactive ACTH was performed by gel chromatography on a Sephadex G-75 column (superfine, 100×1.5 cm) equilibrated with 1% formic acid. 2 ml fractions were collected and evaporated to dryness. The ACTH content of the recovered samples was determined by RIA. In Addison's disease, Nelson's syndrome and Cushing's disease the plasma showed a single peak of ACTH immunoreactivity at the expected position of 1–39 ACTH. In the ectopic ACTH syndrome the plasma of 4 patients revealed at chromatography at least one other peak eluting between the void volume and 1–39 ACTH suggestive of a high molecular weight form of ACTH whereas plasma of 2 patients showed only a single ACTH peak at the position of labeled 1–39 ACTH. The patient with a clinically non-functioning pituitary adenoma revealed a gel filtration pattern similar to the patients with ectopic ACTH syndrom and secretion of high molecular weight ACTH. We conclude that secretion of high molecular weight forms of ACTH is not a unique feature of the ectopic ACTH syndrome. It may therefore not serve as a marker of the ectopic Cushing's syndrome in the differential diagnosis of the ACTH dependent Cushing's syndrome. Vice versa, lack of high molecular weight ACTH does not exclude an ectopic source of ACTH secretion as cause of Cushing's syndrome

Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction : a prospective study with 4.9-years follow-up

Purpose The aim of this study was to evaluate the long-term health-related quality of life (HRQoL) of head and neck cancer patients with microvascular surgery. Surgical treatment causes great changes in patient HRQoL. Studies focusing on long-term HRQoL after microvascular reconstruction for head and neck cancer patients are scarce. Methods We conducted a prospective study of 93 patients with head and neck cancer and microvascular reconstruction in Helsinki University Hospital Finland. HRQoL was measured using the 15D instrument at baseline and after a mean 4.9-years follow up. Results were compared with those of an age-standardized general population. Results Of the 93 patients, 61 (66%) were alive after follow-up; of these, 42 (69%) answered the follow-up questionnaire. The median time between surgery and HRQoL assessment was 4.9 years (range 3.7-7.8 years). The mean 15D score of all patients (n = 42) at the 4.9-years follow up was statistically significantly (p = 0.010) and clinically importantly lower than at baseline. The dimensions of "speech" and "usual activities" were significantly impaired at the end of follow up. There was a significant difference at the 4.9-years follow-up in the mean 15D score between patients and the general population (p = 0.014). After follow up, patients were significantly (p <0.05) worse off on the dimensions of "speech," "eating," and "usual activities." Conclusions Long-term HRQoL was significantly reduced in the whole patient cohort. Speech and usual activities were the most affected dimensions in head and neck cancer patients with microvascular reconstruction at the end of the 4.9-years follow up.Peer reviewe

Psychotherapy Dropout: Using the Adolescent Psychotherapy Q-Set to Explore the Early In-Session Process of Short-Term Psychodynamic Psychotherapy

Research suggests that short-term psychodynamic psychotherapy (STPP) is an effective treatment for depression in adolescence, yet treatment dropout is a major concern and what leads to dropout is poorly understood. Whilst studies have begun to explore the role of patient and therapist variables, there is a dearth of research on the actual therapy process and investigation of the interaction between patient and therapist. This study aims to address this paucity through the utilisation of the Adolescent Psychotherapy Q-set (APQ) to examine the early treatment period. The sample includes 69 adolescents aged 16–18 years with major depressive disorder receiving STPP as part of the First Experimental Study of Transference Work–in Teenagers (FEST-IT) trial. Of these, 21 were identified as dropouts and were compared to completers on pre-treatment patient characteristics, symptomatology, functioning, and working alliance. APQ ratings available for an early session from 16 of these drop out cases were analysed to explore the patient-therapist interaction structure. Results from the Q-factor analysis revealed three distinct interaction structures that explained 54.3% of the total variance. The first described a process of mutual trust and collaboration, the second was characterised by patient resistance and emotional detachment, the third by a mismatch and incongruence between therapist and adolescent. Comparison between the three revealed interesting differences which taken together provide further evidence that the reasons why adolescents drop out of therapy vary and are multidimensional in nature

Chemical abundances of planet-host stars: Results for alpha and Fe-group elements

In this paper, we present a study of the abundances of Si, Ca, Sc, Ti, V, Cr, Mn, Co, and Ni in a large set of stars known to harbor giant planets, as well as in a comparison sample of stars not known to have any planet ary-mass companions. We have checked for possible chemical differences between planet hosts and field stars without known planets. Our results show that overall, and for a given value of [Fe/H], the abundance trends for the planet hosts are nearly indistinguishable from those of the field stars. In general, the trends show no discontinuities,and the abundance distributions of stars with giant planets are high [Fe/H] extensions to the curves traced by the field dwarfs without planets. The only elements that might present slight differences between the two groups of stars are V, Mn, and to a lesser extent Ti and Co. We also use the available data to describe galactic chemical evolution trends for the elements studied. When comparing the results with former studies, a few differences emerge for the high [Fe/H] tail of the distribution, a region that is sampled with unprecedented detail in our analysis.Comment: Accepted for publication in Astronomy & Astrophysic