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Correction of tetralogy of Fallot during infancy usually eliminates the risks associated with general anaesthesia. In rare cases of uncorrected defects persisting into adulthood, anaesthetic management during non-cardiac surgery may therefore be challenging. We describe the use of continuous spinal anaesthesia to successfully circumvent the operative risk of major abdominal surgery in an adult patient with uncorrected tetralogy of Fallot.
Diverse theoretical perspectives suggest that place plays an important role in human behavior. One recent perspective proposes that habitual and recursive use of places among humans may be an emergent property of obligate tool use by our species. In this view, the costs of tool use are reduced by preferential occupation of previously occupied places where cultural materials have been discarded. Here we use the model to generate five predictions for ethnographic mobility patterns. We then test the predictions against observations made during one month of coresidence with a residentially mobile Dukha family in the Mongolian Taiga. We show that (1) there is a strong tendency to occupy previously used camps, (2) previously deposited materials are habitually recycled, (3) reoccupation of places transcends kinship, (4) occupational hiatuses can span decades or longer, and (5) the distribution of occupation intensity among camps is highly skewed such that most camps are not intensively reoccupied whereas a few camps experience extremely high reoccupation intensity. These findings complement previous archaeological findings and support the conclusion that the constructed dimensions of human habitats exert a strong influence on mobility patterns in mobile societies.
In order to reveal the mechanism of the negative c-axis expansion in cordierite (4 MgO 4 Al2O3 10 SiO2), the thermal expansion of cordierite containing small amounts of Cs, Li, B, Ge, Sc and Ni-cations was investigated by time-of-flight neutron diffraction at temperatures between 22 and 750°C. The samples were prepared by melting the constituent oxides followed by quenching and devitrification to obtain the hexagonal form (Indialite). Using the neutron powder diffraction data, the atom positions in the space group P6/mcc were refined by Rietveld least squares analyses.
The expansion behavior of the cordierite structure could be explained in terms of the various kinds of constraints and the interatomic bond strengths of the structure. It was found that cordierite doped with Cs-cations shows the largest volume expansion, followed by the Li-doped sample. So-doped cordierite has the lowest volume expansion. All cordierite samples show positive expansion along the a-axis and negative expansion along the c-axis, except the Cs-doped sample which has positive expansion in both directions.
The thermal expansion behavior of pure, Ge-doped and Li-doped hexagonal cordierites with respective compositions: 2MgO 2Al2O3 5Si02 2Mg0 2Al2O3 4Si02 Ge02) and 2MgO (2+x)AL203 (5-2x)Si02 xLi20 with x = .174, was investigated using time-of-flight neutron powder diffraction at temperatures from 22 to 750°C in vacuum. The data were refined in space group P6/mcc using the Rietveld method. The lattice thermal expansion curves of all 3 samples were quite similar. The negative axis expansion is associated with (1)displacement of the T2 cations generally toward the
axis channels and (2) changes in the distortion of the coupled T1/M tetrahedra/octahedra in the structure. Both contributions were present in all 3 samples but the first was more dominant in the Ge doped sample. The nature and origin of the distortions in T1 and M are discussed.
We assess the gas-phase abundances of Si, C, and Fe from our recent measurements of Si++, C++, and Fe++ in the Orion Nebula by expanding on our earlier “blister” models. The Fe++ 22.9 μm line measured with the KAO yields Fe/H ~ 3 × 10−6 - considerably larger than in the diffuse ISM, where relative to solar, Fe/H is down by ~ 100. However, in Orion, Fe/H is still lower than solar by a factor ~ 10. The C and Si abundances are derived from new IUE high dispersion spectra of the C++ 1907, 1909 Å and Si++ 1883, 1892 Å lines. Gas-phase Si/C = 0.016 in the Orion ionized volume and is particularly insensitive to uncertainties in extinction and temperature structure. The solar value is 0.098. Gas-phase C/H = 3 × 10−4 and Si/H = 4.8 × 10−6. Compared to solar, Si is depleted by 0.135 in the ionized region, while C is essentially undepleted. This suggests that most Si and Fe resides in dust grains even in the ionized volume.
We apply a 2-D, axisymmetric code for modeling H II regions (Rubin Ap. J. 287, 653, 1984) to observations of the Orion Nebula. The model solves for the ionization and thermal structure and radiative transfer for the quasi-equilibrium volume. Assuming that the Orion Nebula is viewed face-on (along the symmetry axis) and that the geometry/density distribution is plane parallel with an exponential density gradient perpendicular to the slab, we use a x2 minimization technique to best fit the radio continuum maps. The best fit to the Schraml and Mezger map (Astrophys. J. 156, 269, 1969) has a density at the star of ∼1800 cm−3, a scale height of ∼0.23 pc, and ∼1.5x1049 ionizing photons s−1 so that ∼ 1/3 of the ionizing photons from the exciting source are escaping the nebula through the frontal density-bounded direction. Our model for Orion requires circular symmetry in the plane of the sky; nonsymmetrical features such as the ionization bar toward the SE cannot be reproduced. Further modeling that compares with line observations has been delayed to incorporate the important role played by recombinations in populating low-lying [O II] levels (Rubin 1985, Astrophys. J., submitted).
Using in situ data from 2011 and 2013, we evaluate the ability of CryoSat-2 (CS-2) to retrieve sea-ice freeboard over fast ice in McMurdo Sound. This provides the first systematic validation of CS-2 in the coastal Antarctic and offers insight into the assumptions currently used to process CS-2 data. European Space Agency Level 2 (ESAL2) data are compared with results of a Waveform Fitting (WfF) procedure and a Threshold-First-Maximum-Retracker-Algorithm employed at 40% (TFMRA40). A supervised freeboard retrieval procedure is used to reduce errors associated with sea surface height identification and radar velocity in snow. We find ESAL2 freeboards located between the ice and snow freeboard rather than the frequently assumed snow/ice interface. WfF is within 0.04 m of the ice freeboard but is influenced by variable snow conditions causing increased radar backscatter from the air/snow interface. Given such snow conditions and additional uncertainties in sea surface height identification, a positive bias of 0.14 m away from the ice freeboard is observed. TFMRA40 freeboards are within 0.03 m of the snow freeboard. The separation of freeboard estimates is primarily driven by the different assumptions of each retracker, although waveform alteration by variations in snow properties and surface roughness is evident. Techniques are amended where necessary, and automatic freeboard retrieval procedures for ESAL2, WfF and TFMRA40 are presented. CS-2 detects annual fast-ice freeboard trends using all three automatic procedures that are in line with known sea-ice growth rates in the region.
To evaluate changes in outpatient fluoroquinolone (FQ) and nitrofurantoin (NFT) use and resistance among E. coli isolates after a change in institutional guidance to use NFT over FQs for acute uncomplicated cystitis.
We compared 2 time periods: January 2003–June 2007 when FQs were recommended as first-line therapy, and July 2007–December 2012, when NFT was recommended. The main outcomes were changes in FQ and NFT use and FQ- and NFT-resistant E. coli by time-series analysis.
Overall, 5,714 adults treated for acute cystitis and 11,367 outpatient E. coli isolates were included in the analysis. After the change in prescribing guidance, there was an immediate 26% (95% CI, 20%–32%) decrease in FQ use (P<.001), and a nonsignificant 6% (95% CI, −2% to 15%) increase in NFT use (P=.12); these changes were sustained over the postintervention period. Oral cephalosporin use also increased during the postintervention period. There was a significant decrease in FQ-resistant E. coli of −0.4% per quarter (95% CI, −0.6% to −0.1%; P=.004) between the pre- and postintervention periods; however, a change in the trend of NFT-resistant E. coli was not observed.
In an integrated healthcare system, a change in institutional guidance for acute uncomplicated cystitis was associated with a reduction in FQ use, which may have contributed to a stabilization in FQ-resistant E. coli. Increased nitrofurantoin use was not associated with a change in NFT resistance.
Climate change is a growing international concern, and it is well established that the release of greenhouse gases (GHG) is a contributing factor. So far, within animal production, there is little or no concerted effort on long-term breeding strategies to mitigate against GHG from ruminants. In recent years, several consortia have been formed to collect and combine data for genetic evaluation. The discussion areas of these consortia focus on (1) What are methane-determining factors, (2) What are genetic parameters for methane emissions, (3) What proxies can be used, and what is their association with methane emission, and (4) How to move on with breeding for lower emitting animals? The methane-determining factors can be divided into four groups: (1) rumen microbial population, (2) feed intake and diet composition, (3) host physiology and (4) host genetics. The genetic parameters show that enteric methane is a heritable trait, and that it is highly genetically correlated with dry matter intake. So far, the most useful proxies relate to feed intake, milk mid IR spectral data and fatty acids in the milk. To be able to move on with a genetic evaluation and ranking of animals for methane emission, it is crucial to make measurements on commercial farms. In order to make that possible, it will be necessary to develop phenotypes that can be used by the farmer to optimise the production on farm level. Also, it is crucial to develop equipment that makes it possible to make measurements without interfering with everyday routines or identify proxies that are highly related to methane and which could easily be measured on a large scale. International collaboration is essential to make progress in this area. This is both in terms of sharing ideas, experiences and phenotypes, but also in terms of coming to a consensus regarding what phenotype to collect and to select for.
From 1966 to 1979, the University of Missouri, the University of Arizona, and the Illinois State Museum conducted extensive interdisciplinary investigations of Late Pleistocene peat deposits associated with springs, some extinct, in the Pomme de Terre River Valley of the Ozark Highland, Missouri (fig 1). Most of the sites are now beneath the waters of the Harry S Truman reservoir. Archaeologic investigations in the area produced a remarkably long sequence of cultural change and development during the Holocene but produced no evidence of human presence in the area prior to 11,000 years ago despite diligent excavation of favorable bone-bearing deposits.
Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age- and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.
Using a population-based retrospective cohort study design, data were extracted from seven provincial administrative health databases linked by a unique anonymized identification number. Individuals 45 years and older at first identification of dementia between April 1, 2005 and March 31, 2013 were included, based on case definition criteria met within any one of four administrative health databases (hospital, physician, prescription drug, and long-term care).
Between 2005/2006 and 2012/2013, the 12-month age-standardized incidence rate of dementia declined significantly by 11.07% and the 12-month age-standardized prevalence increased significantly by 30.54%. The number of incident cases decreased from 3,389 to 3,270 and the number of prevalent cases increased from 8,795 to 13,012. Incidence rate reductions were observed in every database of identification.
We observed a simultaneous trend of decreasing incidence and increasing prevalence of dementia over a relatively short 8-year time period from 2005/2006 to 2012/2013. These trends indicate that the average survival time of dementia is lengthening. Continued observation of these time trends is warranted given the short study period.
We present new far-infrared line observations of the planetary nebulae (PNs) NGC 7027, NGC 7009, NGC 6210, NGC 6543, and IC 4997 obtained with the Kuiper Airborne Observatory (KAO). The bulk of our data are for NGC 7027 and NGC 7009, including [Ne V] 24 μm, [O IV] 26 μm, [O III] (52, 88μm), and [Nm] 57 μm. Our data for [O III] (52, 88) and [N III] 57 in NGC 7027 represent the first measurements of these lines in this source. The large [O III] 52/88 flux ratio implies an electron density (cm–3) of log Ne[O III] = 4.19, the largest Ne ever inferred from these lines. We derive N++/O++ = 0.394±0.062 for NGC 7027 and 0.179±0.043 for NGC 6210. We are able to infer the O+3/O++ ionic ratio from our data. As gauged by this ionic ratio, NGC 7027 is substantially higher ionization than is NGC 7009 – consistent with our observation that the former produces copious [Ne V] emission while the latter does not. These data help characterize the stellar ionizing radiation field.
During the ORFEUS-SPAS (Orbiting Retrievable Far and Extreme Ultraviolet Spectrometer on the Shuttle Pallet Satellite) mission STS-51, flown in September 1993, we observed the central star of the planetary nebula NGC 6543 in the far ultraviolet (90 nm to 115 nm) wavelength region using the University of California, Berkeley spectrometer with a spectral resolution of 0.03 nm.
The higher spatial resolution and sensitivity of ISO allowed several extragalactic surveys to be extended to greater depth than obtained with IRAS. With the extended wavelength range deep surveys were performed for the first time at wavelengths up to ~ 200 μm. They favour galaxy models with strong evolution. With ISO's new capabilities the spectral energy distributions of larger samples of ULIRGs in the local universe and those of quasars and radio galaxies were determined. These data are applicable as templates to the more distant universe. Foreground components from zodiacal light and cirrus to the intracluster dust emission were studied in connection with their separation from the extragalactic background radiation.
In August 2013, a nationwide vaccination campaign with bivalent oral polio vaccine (bOPV) was initiated after isolation of wild-type poliovirus type 1 (WPV-1) in routine sewage surveillance in Israel. The campaign started in the Southern district and later extended to the entire country. This study examined the association between socioeconomic status (SES), and compliance with bOPV vaccine during the campaign. Nationwide data relating to SES by geographical cluster were correlated with vaccine coverage rates in the same areas. All analyses were conducted separately for Jews and Arabs. Coverage with the bOPV vaccination campaign in the Arab population (92·4%) was higher than in the Jewish population (59·2%). This difference was consistently present in all SES clusters. In the Jewish population there was an inverse correlation between SES and vaccination coverage rates (R = −0·93, P < 0·001). Lower vaccination coverage with supplemental vaccine activities in higher SES groups is a challenge that needs to be addressed in future public health events and emergencies in order to achieve satisfactory protection rates for the public.
We surveyed all stars in Taurus (3h 45m < α < 4h 15m, 15° < δ < 35°) for multiplicity which are contained in the Herbig-Bell catalogue of young stars and have a 2 micron brightness of K ≤ 9.5 mag. This sample consists of 106 stellar systems (single or multiple), of which 43 are double or multiple according to the criteria of our survey, i.e. with separations of ≈0″.2 ≤ d ≤ 10″. Of these, 23 binaries are new detections found in this survey. The resulting degree of multiplicity, 43/106 = 41±6%, is higher than found for main-sequence stars. Provided that the period distribution is the same for young stars as on the main sequence, our result implies that the vast majority of stars are born in binary or multiple systems.
ORFEUS (Orbiting and Retrievable Far and Extreme Ultraviolet Spectrometer) is a 1 m normal incidence telescope for spectroscopic investigations of cosmic sources in the far and extreme ultraviolet spectral range. The instrument will be integrated into the freeflyer platform ASTRO-SPAS. ORFEUS-SPAS is scheduled with STS ENDEAVOUR in September 1992. We describe the telescope with its two spectrometers and their capabilities i.e. spectral range, resolution and overall sensitivity. The main classes of objects to be observed with the instrument are discussed and two examples of simulated spectra for the white dwarf HZ43 and an O9-star in the LMC are shown.
During the second flight of the ORFEUS-SPAS satellite (Nov./Dec. 96) high resolution (λ/∆λ = 10,000) Echelle-spectra of BD+28° 4211 in the wavelength regime 912–1400 Å have been taken. Deuterium can be clearly identified in the ORFEUSII Echelle-spectra of this star. For the first time it was possible to take spectra of faint, not redshifted objects in the far ultraviolet with a sufficient spectral resolution to study the deuterium column density in the whole spectral range of the Lyman-series down to the Lyman-limit. We obtained a value of log(ND) = 14.7 (±0.3) towards BD+28° 4211. The hydrogen column density has been determined using ORFEUS Echelle- and IUE-spectra of Ly-α (log(NH) = 19.8 (±0.2)). Thus a value of 8 × 10−6 can be obtained for the D/H-ratio on the line-of-sight towards BD+28° 4211.