The Risk Factors and Clinical Outcomes of Upper Extremity Deep Vein Thrombosis

The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year period. Medical records of 373 consecutive patients who underwent upper extremity venous duplex ultrasound (VDU) examination were retrospectively reviewed. A quarter of the patients screened by VDU (94 of 373) had acute UEDVT; 63% presented with arm swelling or arm pain; 48% had cancer; and 93% had indwelling CVCs. Cancer patients with CVCs were more likely to develop UEDVT (48%). Of the 94 UEDVTs, 16% had concurrent lower extremity DVT. The incidence of objectively confirmed pulmonary embolism (PE) was 9% (8 of 94 patients), and the 1-month mortality rate was 6.4%. The majority of patients (80%) with UEDVT received anticoagulation therapy and 20% were not treated. The most common risk factors for UEDVT were indwelling CVCs and a diagnosis of cancer. The incidence rate of PE and mortality rate from UEDVT were not insignificant at 9% and 6%, respectively. There were no institutional screening protocols for patients at risk of UEDVT associated with CVCs. Future research should focus on risk assessment and management protocols for patients at risk of UEDVT. In addition, a comparison of clinical outcomes associated with the type, size, and duration of catheter placement should be conducted in patients at risk of or diagnosed with UEDVT

Findings from a mixed methods study of an interprofessional faculty development program

Forty faculty members from eight schools participated in a year-long National Faculty Development Program (NFDP) conducted in 2012–2013, aimed at developing faculty knowledge and skills for interprofessional education (IPE). The NFDP included two live conferences. Between conferences, faculty teams implemented self-selected IPE projects at their home institutions and participated in coaching and peer-support conference calls. This paper describes program outcomes. A mixed methods approach was adopted. Data were gathered through online surveys and semi-structured interviews. The study explored whether faculty were satisfied with the program, believed the program was effective in developing knowledge and skills in designing, implementing, and evaluating IPE, and planned to continue newly-implemented IPE and faculty development (FD). Peer support and networking were two of the greatest perceived benefits. Further, this multi-institutional program appears to have facilitated early organizational change by bringing greater contextual understanding to assumptions made at the local level that in turn could influence hidden curricula and networking. These findings may guide program planning for future FD to support IPE

A Comparative Study of Some Pseudorandom Number Generators

We present results of an extensive test program of a group of pseudorandom number generators which are commonly used in the applications of physics, in particular in Monte Carlo simulations. The generators include public domain programs, manufacturer installed routines and a random number sequence produced from physical noise. We start by traditional statistical tests, followed by detailed bit level and visual tests. The computational speed of various algorithms is also scrutinized. Our results allow direct comparisons between the properties of different generators, as well as an assessment of the efficiency of the various test methods. This information provides the best available criterion to choose the best possible generator for a given problem. However, in light of recent problems reported with some of these generators, we also discuss the importance of developing more refined physical tests to find possible correlations not revealed by the present test methods.Comment: University of Helsinki preprint HU-TFT-93-22 (minor changes in Tables 2 and 7, and in the text, correspondingly

Determination of the bond percolation threshold for the Kagome lattice

The hull-gradient method is used to determine the critical threshold for bond percolation on the two-dimensional Kagome lattice (and its dual, the dice lattice). For this system, the hull walk is represented as a self-avoiding trail, or mirror-model trajectory, on the (3,4,6,4)-Archimedean tiling lattice. The result pc = 0.524 405 3(3) (one standard deviation of error) is not consistent with the previously conjectured values.Comment: 10 pages, TeX, Style file iopppt.tex, to be published in J. Phys. A. in August, 199

Quantum value indefiniteness

The indeterministic outcome of a measurement of an individual quantum is certified by the impossibility of the simultaneous, definite, deterministic pre-existence of all conceivable observables from physical conditions of that quantum alone. We discuss possible interpretations and consequences for quantum oracles.Comment: 19 pages, 2 tables, 2 figures; contribution to PC0

Stochasticity of flow through microcirculation as a regulator of oxygen delivery

<p>Abstract</p> <p>Objective</p> <p>Observations of microcirculation reveal that the blood flow is subject to interruptions and resumptions. Accepting that blood randomly stops and resumes, one can show that the randomness could be a powerful means to match oxygen delivery with oxygen demand.</p> <p>Method</p> <p>The ability of the randomness to regulate oxygen delivery is based on two suppositions: (a) the probability for flow to stop does not depend on the time of uninterrupted flow, thus the number of interruptions of flow follows a Poisson distribution; (b) the probability to resume the flow does not depend on the time for flow being interrupted; meaning that time spent by erythrocytes at rest follows an exponential distribution. Thus the distribution of the time to pass an organ is a compound Poisson distribution. The Laplace transform of the given distribution gives the fraction of oxygen that passes the organ.</p> <p>Result</p> <p>Oxygen delivery to the tissues directly depends on characteristics of the irregularity of the flow through microcirculation.</p> <p>Conclusion</p> <p>By variation of vasomotion activity it is possible to change delivery of oxygen to a tissue by up to 8 times.</p

The Extent and Nature of Fluidity in Typologies of Female Sex Work in Southern India: Implications for HIV Prevention Programs

These authors examine the nature and extent of fluidity in defining the typology of female sex work based on the place of solicitation or place of sex or both places together, and whether sex workers belonging to a particular typology are at increased risk of HIV in southern India. Data are drawn from a cross-sectional survey conducted during 2007–2008 among mobile female sex workers (N = 5301) in four Indian states. Findings from this study address an important policy issue: Should programmatic prevention interventions be spread to cover all places of sex work or be focused on a few places that cover a large majority of sex workers? Results indicate that most female sex workers, including those who are usually hard to reach such as those who are mobile or who use homes for soliciting clients or sex, can be reached programmatically multiple times by concentrating on a smaller number of categories, such as street-, lodge-, and brothel-based sex workers

"Contagious Love": A Qualitative Study of the Couple Relationships of Ten AIDS Carriers

The qualitative study in this article portrays the couple relationship among AIDS carriers, based on Sternberg's triangular love theory (involving domains of intimacy, passion and commitment). The central study hypothesis is that certain components of the Sternberg model will be more significant than others among the AIDS carrier population. The study was conducted on ten AIDS carriers aged 21-37 who had experienced a couple relationship. Six men and four women participated; most of them were in a romantic couple relationship of homosexual orientation