684 research outputs found
Гидронимия верховьев Дона
В публикации (носящей пробный характер) представлен фрагмент первой части каталога названий всех водных объектов бассейна реки Дон - от его истоков до устья его правого притока р. Таболы.У публікації наводиться гідромінікон верхів'їв Дону від його початку до гирла правої притоки Таболи, а також суміжні географічні назви з однаковою лексичною базою. Подається велика кількість синхронних і діахронних варіантів і дублетів цих назв.The article investigates hydronymicon of upper reaches of the Don from its beginning of river head of the Tabola and adjacent geographical names with the equal lexical base. The great number of synchronous and diachronous variants and duplicates of these names is adduce
From model to radar variables: a new forward polarimetric radar operator for COSMO
In this work, a new forward
polarimetric radar operator for the COSMO numerical weather prediction (NWP)
model is proposed. This operator is able to simulate measurements of radar
reflectivity at horizontal polarization, differential reflectivity as well as
specific differential phase shift and Doppler variables for ground based or
spaceborne radar scans from atmospheric conditions simulated by COSMO. The
operator includes a new Doppler scheme, which allows estimation of the full
Doppler spectrum, as well a melting scheme which allows representing the very
specific polarimetric signature of melting hydrometeors. In addition, the
operator is adapted to both the operational one-moment microphysical scheme
of COSMO and its more advanced two-moment scheme. The parameters of the
relationships between the microphysical and scattering properties of the
various hydrometeors are derived either from the literature or, in the case
of graupel and aggregates, from observations collected in Switzerland. The
operator is evaluated by comparing the simulated fields of radar observables
with observations from the Swiss operational radar network, from a high
resolution X-band research radar and from the dual-frequency precipitation
radar of the Global Precipitation Measurement satellite (GPM-DPR). This
evaluation shows that the operator is able to simulate an accurate Doppler
spectrum and accurate radial velocities as well as realistic distributions of
polarimetric variables in the liquid phase. In the solid phase, the simulated
reflectivities agree relatively well with radar observations, but the
simulated differential reflectivity and specific differential phase shift
upon propagation tend to be underestimated. This radar operator makes it
possible to compare directly radar observations from various sources with
COSMO simulations and as such is a valuable tool to evaluate and test the
microphysical parameterizations of the model.</p
Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain.
Validated clinician outcome scores are considered less associated with psychosocial factors than patient-reported outcome measurements (PROMs). This belief may lead to misconceptions if both instruments are related to similar factors.
We asked: In patients with chronic shoulder pain, what biopsychosocial factors are associated (1) with PROMs, and (2) with clinician-rated outcome measurements?
All new patients between the ages of 18 and 65 with chronic shoulder pain from a unilateral shoulder injury admitted to a Swiss rehabilitation teaching hospital between May 2012 and January 2015 were screened for potential contributing biopsychosocial factors. During the study period, 314 patients were screened, and after applying prespecified criteria, 158 patients were evaluated. The median symptom duration was 9 months (interquartile range, 5.5-15 months), and 72% of the patients (114 patients) had rotator cuff tears, most of which were work injuries (59%, 93 patients) and were followed for a mean of 31.6 days (SD, 7.5 days). Exclusion criteria were concomitant injuries in another location, major or minor upper limb neuropathy, and inability to understand the validated available versions of PROMs. The PROMs were the DASH, the Brief Pain Inventory, and the Patient Global Impression of Change, before and after treatment (physiotherapy, cognitive therapy and vocational training). The Constant-Murley score was used as a clinician-rated outcome measurement. Statistical models were used to estimate associations between biopsychosocial factors and outcomes.
Greater disability on the DASH was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.64; 95% CI, 0.25-1.03; p = 0.002) and social factors (language, professional qualification combined coefficient, -6.15; 95% CI, -11.09 to -1.22; p = 0.015). Greater pain on the Brief Pain Inventory was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.076; 95% CI, 0.021-0.13; p = 0.006). Poorer impression of change was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia coefficient, 0.93; 95% CI, 0.87-0.99; p = 0.026) and social factors (education, language, and professional qualification coefficient, 6.67; 95% CI, 2.77-16.10; p < 0.001). Worse clinician-rated outcome was associated only with psychological factors (Hospital Anxiety and Depression Scale (depression only), Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia combined coefficient, -0.35; 95% CI, -0.58 to -0.12; p = 0.003).
Depressive symptoms and catastrophizing appear to be key factors influencing PROMs and clinician-rated outcomes. This study suggests revisiting the Constant-Murley score.
Level III, prognostic study
Acute traumatic aortic rupture: early stent-graft repair
Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakag
Multiple Arterial Macroaneurysms in Acquired Coats' Disease in an Adult - A Case Report.
Multiple arterial macroaneurysms in acquired Coats' disease in an adult - a case repor
Social inclusion and valued roles : a supportive framework
The aim of this paper is to examine the concepts of social exclusion, social inclusion and their relevance to health, well-being and valued social roles. The article presents a framework, based on Social Role Valorization (SRV), which was developed initially to support and sustain socially valued roles for those who are, or are at risk of, being devalued within our society. The framework incorporates these principles and can be used by health professionals across a range of practice, as a legitimate starting point from which to support the acquisition of socially valued roles which are integral to inclusio
Electrocardiographic alterations during intravascular application of three different test doses of bupivacaine and epinephrine: experimental study in neonatal pigs
Background Origin of electrocardiographic (ECG) alterations during intravascular injection of local anaesthetic solutions is controversial. The aim of this study was to elucidate whether epinephrine, bupivacaine or their combination is responsible for ECG alteration. Methods Forty-five piglets were randomized into three groups. After induction of general anaesthesia using sevoflurane and peripheral venous cannulation, the trachea was intubated, the lungs were artificially ventilated, and anaesthesia was maintained by sevoflurane. Under steady state 0.2 ml kg−1 and after 10 min 0.4 ml kg−1 of one of the following three test solutions was administered i.v.: bupivacaine 0.125% (Group 1), bupivacaine 0.125%+epinephrine 1:200 000 (Group 2), and plain epinephrine 1:200 000 (Group 3). The ECG was analysed for alterations in heart rate and T-elevation. Results After injection of 0.2 or 0.4 ml kg−1 test solution, an increase in heart rate of at least 10% was found in none of Group 1 and in all of Groups 2 and 3. After application of 0.2 ml kg−1 test solution, T-elevation was found in 7% of Group 1 and in 93% of Groups 2 and 3. The injection of 0.4 ml kg−1 revealed a T-elevation in 27%, 100%, and 100%, respectively, in Groups 1, 2, and 3. Conclusions This animal model demonstrated that increases in heart rate and T-elevation in the ECG during i.v. application of a common test dose (0.2 ml kg−1) of bupivacaine are caused by epinephrine addition. Whether higher doses of bupivacaine alone can cause similar ECG changes or not requires further studie
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