Previously clinically “silent” adrenal phaeochromocytoma presenting as hypovolemic shock with paradoxical hypertension

No Abstract Keywords: Phaeochromocytoma; Acute abdomen; Rupture; Hypovolemic shoc

A new method for assessing the safety of ships damaged by collisions

The longitudinal strength of a ship decreases with the reduction in its bending moment capacity following a collision accident. This decrease may lead to the total loss of the ship in some cases due to its loss of hull girder strength, particularly when large vessels are involved. Therefore, the damaged ship should be able to reach the closest harbour safely without any catastrophic hull girder collapse. This paper aims to develop a method to predict the hull girder residual strength of double-hull oil tankers by considering probabilistic collision damage scenarios. The collision damage index is defined as the reduction ratio of the vertical hull girder moment of inertia, and the residual strength index is characterised as the reduction ratio of the hull girder ultimate bending moment. Four different as-built double-hull oil tankers (Panamax, Aframax, Suezmax and VLCC) were studied to demonstrate the proposed method and to formulate the collision damage index. The relationships between the residual strength index and the collision damage index are identified in the form of diagrams and linear-type regressions. The produced diagrams and regressions represent a first-cut assessment of a ship’s safety immediately after taking collision damage

Wheat Fertilization with Special Reference to Soil Properties and Groundwater Composition in Heavy Clay Soil from Egypt

Egypt is considered to be a heavy user of chemical fertilizers, especially NPK fertilizers. Thus, sustainable NPK-fertilizer management should be considered to minimize nutrient losses to the environment via volatilization or leaching. Therefore, the objectives of this study were to investigate the effect of different levels of NPK fertilization on some soil chemical properties, the chemical composition of groundwater and the yield and yield components of wheat plant under different treatments of NPK. Field experiments were carried out to study the effect of NPK application on soil properties and groundwater quality as well as wheat yield. Groundwater and soil samples were collected after the first, the third irrigation as well as after harvesting from each treatment for chemical analysis. The highest value of soil salinity was 1.64 dS m-1 after wheat harvesting compared to it before planting (1.13 dS m-1). Values of pH after wheat harvesting ranged from 7.39 to 8.01 (7.67 before planting). Concentration of soluble cations in the ground water after harvesting was higher than it before planting. Concerning soluble salts, Na+ and Cl- was the dominate ions in the soil solution and cation concentration had the descending order: Na+ > Ca++ > Mg++ > K+ and anions had the following order: Cl- > SO4-- > HCO3-. The mean values of available N after wheat harvesting ranged from 8 to 19 mg N kg-1 (38 – 42 mg N kg-1 before planting). The highest value of available phosphorus after wheat harvesting was 11 mg P kg-1 (19.4 mg P kg-1 before planting). Available K ranged from 97 to 204 mg K kg-1 compared to it before planting (160 – 210 mg K kg-1). The balance fertilization of NPK (N80P22K50) gave the highest yield of wheat, improving soil fertility and decrease nutrient leaching to ground water. The grain yield of wheat was highly significant increased with increasing N levels up to 120 kg N acre-1. The highest mean value of grain yield over the two seasons was 3.5 Mg acre-1

Effect of different levels of NPK on wheat crop in North Delta

A balanced fertilization of NPK nutrients leads to increase soil fertility, anti soil nutrients depletion and also decrease nutrients losses to ground water and hence decrease its pollution. Therefore, a field experiment was conducted for two growing seasons on wheat in North Delta, Egypt. Different levels of nitrogen (0, 96, 192 and 288 kg N ha-1), phosphorus (0 and 53 kg P2O5 ha-1) and potassium (0 and 120 kg K2O ha-1) as well as 4 doses of N fertilizer were used. The objective of the present study was to investigate the effect of previous different levels of N, P and K fertilization and N fertilizer splitting on wheat yield and its components as well as uptake of N, P and K by wheat grain under different treatments. The results revealed that yield and its components were significantly affected by graded applied and splitting of N levels. The protein content in wheat grains was increased with increasing N levels up to 288 kg N ha-1 in presence of 53 kg P2O5 ha-1 as well as 120 kg K2O ha-1. The previous treatment recorded the highest values for protein content in wheat grains and total chlorophyll content

Solar-Powered Solutions for the Water and Energy Shortage Problem: The Case Study of Nahr El Bared, Lebanon

Solar power is an effective way to reduce the dependency on conventional fuels and mitigate the water and energy shortage issue. The main aim of the current paper is to assess and compare the techno-economic feasibility of rooftop grid-connected photovoltaic energy systems for generating electricity and generating drinkable water in Nahr El Bared, Lebanon. To this aim, the present paper first reviews previous scientific studies associated with the water resources and energy situation to summarize the current status in Lebanon. According to this review, Lebanon's water resources are highly polluted, domestic and industrial sewage is largely untreated, and intolerable agricultural practices further exacerbate the situation. Furthermore, population and economic growth and the continuous utilization of old power plants have led to an increase in the number of hours of power outages in the country. Accordingly, the proposed project aims to evaluate the viability of using solar energy as an alternative solution to the shortage of water and energy in the country. Secondly, the techno-economic performance of the proposed system in the selected region was evaluated based on the variations in financial parameters using RETScreen Experts software. The results demonstrate that 11770–13451kWh/yr could be generated from the solar system, which can help reduce the energy shortage and generate drinkable water. Furthermore, the investment was found to be economically viable and attractive for investors. This paper concludes that solar energy can be able to solve the energy shortage of electricity, reduce the country's electricity costs, and produce freshwater for drinking and domestic use in the country

Rapid hull collapse strength calculations of double hull oil tankers after collisions

The primary objective of this study is to develop a rapid method for calculating hull collapse strength of double hull oil tankers after collisions. For this purpose, the statistical characteristics of hull girder collapse after collision are studied. Four double hull oil tankers with different size are considered: Panamax, Aframax, Suezmax and Very Large Crude Carrier. A set of 50 credible collision scenarios are selected by a sampling technique associated with the collision hazard identification based on the historical ship collision database. Four parameters, namely vertical collision location, damage penetration, striking ship's bulbous bow height, and striking ship's bulbous bow length are determined as a consequence of the corresponding collision scenario. The intelligent supersize finite element method is used to compute the progressive collapse behaviour of hull girder structures with the collision damages so determined. The residual hull girder strength indices can then be determined and formulated in a closed expression associated with collision damages and ship length. The developed formulations will be useful to quickly calculate the hull collapse strength of double hull oil tankers immediately after collisions

The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

Total mesorectal excision (TME) is considered standard of care for rectal cancer treatment. Failure to remove the mesorectal fat envelope entirely may explain part of observed local and distant recurrences. Several studies suggest quality of the mesorectum after TME surgery as determined by pathological evaluation may influence prognosis. We aimed to determine the prognostic value of the plane of surgery as well as factors influencing the likelihood of a high-quality specimen by reviewing the literature. A pooled meta-analysis of relevant outcome data was performed where appropriate. A muscularis propria resection plane was found to increase the risk of local recurrence (RR 2.72 [95 % CI 1.36 to 5.44]) and overall recurrence (RR 2.00 [95 % CI 1.17 to 3.42]) compared to an (intra)mesorectal plane. Plane of surgery is an important factor in rectal cancer treatment and the documentation by pathologists is essential for the improvement of TME quality and patient outcome

Studying the Underlying Event in Drell-Yan and High Transverse Momentum Jet Production at the Tevatron

We study the underlying event in proton-antiproton collisions by examining the behavior of charged particles (transverse momentum pT > 0.5 GeV/c, pseudorapidity |\eta| < 1) produced in association with large transverse momentum jets (~2.2 fb-1) or with Drell-Yan lepton-pairs (~2.7 fb-1) in the Z-boson mass region (70 < M(pair) < 110 GeV/c2) as measured by CDF at 1.96 TeV center-of-mass energy. We use the direction of the lepton-pair (in Drell-Yan production) or the leading jet (in high-pT jet production) in each event to define three regions of \eta-\phi space; toward, away, and transverse, where \phi is the azimuthal scattering angle. For Drell-Yan production (excluding the leptons) both the toward and transverse regions are very sensitive to the underlying event. In high-pT jet production the transverse region is very sensitive to the underlying event and is separated into a MAX and MIN transverse region, which helps separate the hard component (initial and final-state radiation) from the beam-beam remnant and multiple parton interaction components of the scattering. The data are corrected to the particle level to remove detector effects and are then compared with several QCD Monte-Carlo models. The goal of this analysis is to provide data that can be used to test and improve the QCD Monte-Carlo models of the underlying event that are used to simulate hadron-hadron collisions.Comment: Submitted to Phys.Rev.

Measurement of the W+W−W^+W^- Production Cross Section and Search for Anomalous WWγWW\gamma and WWZWWZ Couplings in ppˉp \bar p Collisions at s=1.96\sqrt{s} = 1.96 TeV

This Letter describes the current most precise measurement of the $W$ boson pair production cross section and most sensitive test of anomalous $WW\gamma$ and $WWZ$ couplings in $p \bar p$ collisions at a center-of-mass energy of 1.96 TeV. The $WW$ candidates are reconstructed from decays containing two charged leptons and two neutrinos, where the charged leptons are either electrons or muons. Using data collected by the CDF II detector from 3.6 fb$^{-1}$ of integrated luminosity, a total of 654 candidate events are observed with an expected background contribution of $320 \pm 47$ events. The measured total cross section is $\sigma (p \bar p \to W^+ W^- + X) = 12.1 \pm 0.9 \textrm{(stat)} ^{+1.6}_{-1.4} \textrm{(syst)}$ pb, which is in good agreement with the standard model prediction. The same data sample is used to place constraints on anomalous $WW\gamma$ and $WWZ$ couplings.Comment: submitted to Phys. Rev. Let

Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial

IMPORTANCE: Secretory phospholipase A2(sPLA2) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA2inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. OBJECTIVE: To determine the effects of sPLA2inhibition with varespladib on cardiovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). INTERVENTIONS: Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy measurewas a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. RESULTS: At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA2inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01130246. Copyright 2014 American Medical Association. All rights reserved