5,389 research outputs found
Coastal Scenic Quality Assessment of Moroccan Mediterranean Beaches: A Tool for Proper Management
This paper focuses on the study of landscape quality of Moroccan Mediterranean coastal areas, with a view to distinguishing exceptional beaches with high scenic value. The main characteristics of 50 beaches along the studied coast were assessed using a coastal scenic evaluation system based on a set of 26 selected parameters, including physical (18) and human (8) parameters. Each parameter was examined via a five-point rating scale, ranging from presence/absence or poor quality (1) to excellent quality (5). A decision index (D) is afterward obtained and used to classify sites into five classes: Class I: D >= 0.85, which included 9 sites (18%); Class II: 0.85 > D >= 0.65, 10 sites (20%); Class III: 0.65 > D >= 0.40, 8 sites (16%); Class IV: 0.40 > D >= 0.00, 16 sites (32%); and Class V: D < 0.00, 7 sites (14%). The sites of Belyounech 2, Maresdar, El Hwad, and Dalya are the best examples of Class I and represent extremely attractive coastal landscapes. The sites of Ghandouri, Tangier Municipal, M'Diq, Martil, and Tangier Malabata are examples of degraded urban sites that are very unattractive due to high human pressures. Management efforts in Moroccan coastal landscapes can strengthen the control of human activities and improve the scenic value of the sites. Class II beaches, such as Mrisat, Souani, Taourirt, and Sfiha, could improve and upgrade to Class I through litter cleaning and a regular maintenance program. Using the same principle, Class III sites, such as Sidi Amer O Moussa and Sidi Driss, could improve and upgrade to Class II. Indeed, litter and sewage appear as the main factors of degradation of Moroccan coasts, and many excellent beaches are strongly affected by them. This should be a wakeup call to the Moroccan authorities to take urgent and appropriate management measures
BCI for Music Making: Then, Now, and Next
Brain–computer music interfacing (BCMI) is a growing field with a history of experimental applications derived from the cutting edge of BCI research as adapted to music making and performance. BCMI offers some unique possibilities over traditional music making, including applications for emotional music selection and emotionally driven music creation for individuals as communicative aids (either in cases where users might have physical or mental disabilities that otherwise preclude them from taking part in music making or in music therapy cases where emotional communication between a therapist and a patient by means of traditional music making might otherwise be impossible). This chapter presents an overview of BCMI and its uses in such contexts, including existing techniques as they are adapted to musical control, from P300 and SSVEP (steady-state visually evoked potential) in EEG (electroencephalogram) to asymmetry, hybrid systems, and joint fMRI (functional magnetic resonance imaging) studies correlating affective induction (by means of music) with neurophysiological cues. Some suggestions for further work are also volunteered, including the development of collaborative platforms for music performance by means of BCMI
Enhancing mechanical properties of wire + arc additively manufactured INCONEL 718 superalloy through in-process thermomechanical processing
Wire + arc additive manufacture (WAAM) was applied to produce INCONEL 718 superalloy (IN718) components in a layer by layer manner; further, interpass cold rolling was introduced to generate in-process thermomechanical processing effect during the deposition process. Mechanical testing showed that with rolling applied, the strength of the solution plus aging treated WAAM IN718 was improved from 1056 MPa (unrolled) to 1351 MPa (rolled) which met the wrought standard (1276 MPa), and the material anisotropy was eliminated. The unrolled IN718 featured large columnar grains developing along the building direction, with the length and width as large as 11 mm and 0.8 mm respectively; rolling induced plastic deformation triggered a non-uniform recrystallization upon successive depositions, which produced a recrystallized core with small columnar grains and numerous finely equiaxed grains with the grain size of 12.7 μm. The overall strengthening produced by interpass rolling was attributed mostly (76%) to the rolling induced recrystallization which produced grain size reduction strengthening and created larger grain boundary area to allow more precipitation at the grain boundaries, and partially (24%) due to the improved aging response of the recrystallized grain structur
Manganite charge and orbitally ordered and disordered states probed by Fe substitution into Mn site in LnBaMn1.96Fe0.04O5, LnBaMn1.96Fe0.04O6 and LnBaMn1.96Fe0.04O5.5 (Ln=Y, Gd, Sm, Nd, Pr, La)
The layered manganese oxides LnBaMn1.96Fe0.04Oy (Ln=Y, Gd, Sm, Nd, Pr, La)
have been synthesized for y=5, 5.5 and 6. In the oxygen-saturated state (y=6)
they exhibit the charge and orbital order at ambient temperature for Ln=Y, Gd,
Sm, but unordered eg-electronic system for Ln=La,Pr,Nd. Fourfold increase of
quadrupole splitting was observed owing to the charge and orbital ordering.
This is in agreement with the jumplike increase in distortion of the reduced
perovskite-like cell for the charge and orbitally ordered manganites compared
to the unordered ones. Substitution of 2 percents of Mn by Fe suppresses the
temperatures of structural and magnetic transitions by 20 to 50 K. Parameters
of the crystal lattices and the room-temperature M\"{o}ssbauer spectra were
studied on forty samples whose structures were refined within five symmetry
groups: P4/mmm, P4/nmm, Pm-3m, Icma and P2/m. Overwhelming majority of the Fe
species are undifferentiated in the M\"{o}ssbauer spectra for most of the
samples. Such the single-component spectra in the two-site structures are
explained by the preference of Fe towards the site of Mn(III) and by the
segmentation of the charge and orbitally ordered domains.Comment: 8 figures; figures 2 and 3 were revise
Sudden Death and Left Ventricular Involvement in Arrhythmogenic Cardiomyopathy
BACKGROUND: Arrhythmogenic cardiomyopathy (ACM) is an inherited heart muscle disorder characterized by myocardial fibrofatty replacement and an increased risk of sudden cardiac death (SCD). Originally described as a right ventricular disease, ACM is increasingly recognized as a biventricular entity. We evaluated pathological, genetic, and clinical associations in a large SCD cohort. METHODS: We investigated 5205 consecutive cases of SCD referred to a national cardiac pathology center between 1994 and 2018. Hearts and tissue blocks were examined by expert cardiac pathologists. After comprehensive histological evaluation, 202 cases (4%) were diagnosed with ACM. Of these, 15 (7%) were diagnosed antemortem with dilated cardiomyopathy (n=8) or ACM (n=7). Previous symptoms, medical history, circumstances of death, and participation in competitive sport were recorded. Postmortem genetic testing was undertaken in 24 of 202 (12%). Rare genetic variants were classified according to American College of Medical Genetics and Genomics criteria. RESULTS: Of 202 ACM decedents (35.4±13.2 years; 82% male), no previous cardiac symptoms were reported in 157 (78%). Forty-one decedents (41/202; 20%) had been participants in competitive sport. The adjusted odds of dying during physical exertion were higher in men than in women (odds ratio, 4.58; 95% CI, 1.54-13.68; P=0.006) and in competitive athletes in comparison with nonathletes (odds ratio, 16.62; 95% CI, 5.39-51.24; P<0.001). None of the decedents with an antemortem diagnosis of dilated cardiomyopathy fulfilled definite 2010 Task Force criteria. The macroscopic appearance of the heart was normal in 40 of 202 (20%) cases. There was left ventricular histopathologic involvement in 176 of 202 (87%). Isolated right ventricular disease was seen in 13%, isolated left ventricular disease in 17%, and biventricular involvement in 70%. Among whole hearts, the most common areas of fibrofatty infiltration were the left ventricular posterobasal (68%) and anterolateral walls (58%). Postmortem genetic testing yielded pathogenic variants in ACM-related genes in 6 of 24 (25%) decedents. CONCLUSIONS: SCD attributable to ACM affects men predominantly, most commonly occurring during exertion in athletic individuals in the absence of previous reported cardiac symptoms. Left ventricular involvement is observed in the vast majority of SCD cases diagnosed with ACM at autopsy. Current Task Force criteria may fail to diagnose biventricular ACM before death
Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
<p>Abstract</p> <p>Background</p> <p>The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect.</p> <p>Methods</p> <p>A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups.</p> <p>Results</p> <p>85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, <it>P </it>= 0.002). However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use.</p> <p>Conclusions</p> <p>Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.</p
Celecoxib concentration predicts decrease in prostaglandin E2 concentrations in nipple aspirate fluid from high risk women
<p>Abstract</p> <p>Background</p> <p>Epidemiologic studies suggest that long term low dose celecoxib use significantly lowers breast cancer risk. We previously demonstrated that 400 mg celecoxib taken twice daily for 2 weeks lowered circulating plasma and breast nipple aspirate fluid (NAF) prostaglandin (PG)E<sub>2 </sub>concentrations in post- but not premenopausal high risk women. We hypothesized that circulating concentrations of celecoxib influenced PGE<sub>2 </sub>response, and that plasma levels of the drug are influenced by menopausal status. To address these hypotheses, the aims of the study were to determine: 1) if circulating plasma concentrations of celecoxib correlated with the change in plasma or NAF PGE<sub>2 </sub>concentrations from baseline to end of treatment, and 2) whether menopausal status influenced circulating levels of celecoxib.</p> <p>Methods</p> <p>Matched NAF and plasma were collected from 46 high risk women who were administered celecoxib twice daily for two weeks, 20 subjects receiving 200 mg and 26 subjects 400 mg of the agent. NAF and plasma samples were collected before and 2 weeks after taking celecoxib.</p> <p>Results</p> <p>In women taking 400 mg bid celecoxib, plasma concentrations of the agent correlated inversely with the change in NAF PGE<sub>2 </sub>levels from pre- to posttreatment. Nonsignificant trends toward higher celecoxib levels were observed in post- compared to premenopausal women. There was a significant decrease in NAF but not plasma PGE<sub>2 </sub>concentrations in postmenopausal women who took 400 mg celecoxib (p = 0.03).</p> <p>Conclusion</p> <p>In high risk women taking 400 mg celecoxib twice daily, plasma concentrations of celecoxib correlated with downregulation of PGE<sub>2 </sub>production by breast tissue. Strategies synergistic with celecoxib to downregulate PGE<sub>2 </sub>are of interest, in order to minimize the celecoxib dose required to have an effect.</p
Developing and implementing an integrated delirium prevention system of care:a theory driven, participatory research study
Background: Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence in hospital may be reduced by about a third through a multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it that informed the development of a novel delirium prevention system of care for acute hospital wards. Particular focus of the study was on developing an implementation process aimed at embedding practice change within routine care delivery. Methods: We adopted a participatory action research approach involving staff, volunteers, and patient and carer representatives in three northern NHS Trusts in England. We employed Normalization Process Theory to explore knowledge and ward practices on delirium and delirium prevention. We established a Development Team in each Trust comprising senior and frontline staff from selected wards, and others with a potential role or interest in delirium prevention. Data collection included facilitated workshops, relevant documents/records, qualitative one-to-one interviews and focus groups with multiple stakeholders and observation of ward practices. We used grounded theory strategies in analysing and synthesising data. Results: Awareness of delirium was variable among staff with no attention on delirium prevention at any level; delirium prevention was typically neither understood nor perceived as meaningful. The busy, chaotic and challenging ward life rhythm focused primarily on diagnostics, clinical observations and treatment. Ward practices pertinent to delirium prevention were undertaken inconsistently. Staff welcomed the possibility of volunteers being engaged in delirium prevention work, but existing systems for volunteer support were viewed as a barrier. Our evolving conception of an integrated model of delirium prevention presented major implementation challenges flowing from minimal understanding of delirium prevention and securing engagement of volunteers alongside practice change. The resulting Prevention of Delirium (POD) Programme combines a multi-component delirium prevention and implementation process, incorporating systems and mechanisms to introduce and embed delirium prevention into routine ward practices. Conclusions: Although our substantive interest was in delirium prevention, the conceptual and methodological strategies pursued have implications for implementing and sustaining practice and service improvements more broadly
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