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This study investigated patient characteristics in paediatric hospitalisations for hypertrophic cardiomyopathy. We used Nationwide Inpatient Sample, which is the largest all-payer inpatient database in the United States, yielding nationally representative estimates, from 2001 to 2014. ICD-9-CM diagnostic codes identified hospitalisations for patients with hypertrophic cardiomyopathy and <18 years. Outcomes included yearly rate of hospitalisation, death, admission via emergency department, and need for surgery. Predictors of interest were age groups (<1, 1–9, and ⩾10 y/o), sex, and race/ethnicity. Logistic regression modelled associations, adjusted by patient- and hospital-level variables. With 2302 weighted hospitalisations, hospitalisation rates were 0.22 per 100,000 children/year, with higher rates for <1 y/o (0.42) and ⩾10 y/o (0.31). Male-to-female ratios were more prominent in the oldest age group; 2.7:1 in ⩾10 y/o versus less than 1.7:1 for <10 y/o. In-hospital mortality was 1.5%, with highest mortality rates among the <1 y/o (6.3%). Children ⩾10 y/o had 5.59 times higher risk of admission from the emergency department than 1–9 y/o age group. Both ⩾10 and <1 y/o age groups had lower risk of surgical intervention compared to the 1–9 y/o group with odds ratio 0.56 and 0.26, respectively. Black children had higher risk of admission from the emergency department than White children with odds ratio 2.78. A relation between age group and sex was observed, with sex-based differences in prevalence and treatment of hypertrophic cardiomyopathy becoming more pronounced with age. Further studies are needed to clarify mechanisms behind age and racial disparity in hospitalisation, especially admission source.
We have mapped the nearby (z=0.018), active galaxy NGC 1275 (3C84) at 6 different epochs from 1981 to 1986 at 1.3 cm (22.3 GHz) with a global VLBI array of seven telescopes. We find a long-lived knot of emission separating from the brightest radio component with a projected velocity = 0.4 6±0.12 h−1 c. This knot moves through diffuse emission that also moves away from the main component with a slower projected velocity of 0.33±0.12 h−1 c. We show that the knot and diffuse emission result from two separate events that occurred around 1959 and 1968.
A low temperature amorphous zinc indium oxide (ZIO) thin film transistor (TFT) backplane technology for high information content flexible organic light emitting diode (OLED) displays has been developed. We have fabricated 4.1-in. diagonal OLED backplanes on the Flexible Display Center’s six-inch wafer-scale pilot line using ZIO as the active layer. The ZIO based TFTs exhibited an effective saturation mobility of 18.6 cm2/V-s and a threshold voltage shift of 2.2 Volts or less under positive and negative gate bias DC stress for 10000 seconds. We report on the critical steps in the evolution of the backplane process: the qualification of the low temperature (200°C) ZIO process, the stability of the devices under forward and reverse bias stress, the transfer of the process to flexible plastic substrates, and the fabrication of white organic light emitting diode (OLED) displays.
Principal challenges to direct fabrication of high performance a-Si:H transistor arrays on flexible substrates include automated handling through bonding-debonding processes, substrate-compatible low temperature fabrication processes, management of dimensional instability of plastic substrates, and planarization and management of CTE mismatch for stainless steel foils. In collaboration with our industrial and academic partners, we have developed viable solutions to address these challenges, as described in this paper.
Although the great majority of antibiotics are prescribed outside hospitals, little is known about the prevalence and determinants of antibiotic resistance in the group of outpatients. Nasal swabs were taken from 627 consecutive patients aged 40 years or above attending general practitioners in Southern Germany. Staphylococcus aureus was cultured and minimal inhibitory concentrations to various antibiotics were tested. Nasal swabs of 152 patients were positive for S. aureus. Prevalence of resistance was 68·3, 8·3 and 0·7% for penicillin G, erythromycin, and oxacillin respectively. Antibiotic use within the last month was associated with erythromycin resistance [adjusted odds ratio (OR) 7·4; 95% confidence interval (CI) 1·0–53]. Besides a high prevalence of resistance to penicillinase-instable antibiotics we found only one (0·7%) methicillin-resistant S. aureus. Recent antibiotic use was associated with increased resistance to erythromycin.
We present a model of sedimentation in a subsiding fluvio-deltaic basin with steady sediment
supply and unsteady base level. We demonstrate that mass transfer in a fluvio-deltaic basin
is analogous to heat transfer in a generalized Stefan problem, where the basin's shoreline
represents the phase front. We obtain a numerical solution to the governing equations
for sediment transport and deposition in this system via an extension of a deforming-grid
technique from the phase-change literature. Through modification of the heat-balance
integral method, we also develop a semi-analytical solution, which agrees well with the
numerical solution. We construct a space of dimensionless groups for the basin and perform a
systematic exploration of this space to illustrate the influence of each group on the shoreline
trajectory. Our model results suggest that all subsiding fluvio-deltaic basins exhibit a standard
autoretreat shoreline trajectory in which a brief period of shoreline advance is followed by
an extended period of shoreline retreat. Base-level cycling produces a shoreline response that
varies relative to the autoretreat signal. Contrary to previous studies, we fail to observe either
a strong phase shift between shoreline and base level or a pronounced attenuation of the
amplitude of shoreline response as the frequency of base-level cycling decreases. However, the
amplitude of shoreline response to base-level cycling is a function of the basin's age.
The Bell-Boeing V-22 Osprey tiltrotor is a unique aircraft capable of landing vertically, flying at speeds in excess of 300 KTAS (knots, true air speed), with the added feature of folding the rotor and wing for deployment from ships for US Navy, Marines, and SOF operations. During the development of the V-22, including 1200 hours of flight testing, a number of significant technology and design development challenges were encountered and overcome. This paper presents an overview of many of these challenges. It also reviews the integrated approach to testing to be used in the next phase of the flight test programme, and describes the changes that have been implemented to improve flight test productivity.
The structure of porcine skin as examined by light microscopy is reviewed
and its similarities to and
differences from human skin are highlighted. Special imaging techniques and
staining procedures are
described and their use in gathering morphological information in porcine skin
is discussed. Confocal laser
scanning microscopy (CLSM) was employed to examine the structure of porcine skin
and the findings are
presented as an adjunct to the information already available in the literature.
It is concluded that CLSM
provides valuable additional morphological information to material examined
by conventional microscopy
and is useful for wound healing studies in the porcine model.
A three-generation family with Saethre-Chotzen syndrome and an isolated case are presented. The proband presented with conductive hearing loss. His mother and grandmother showed minor features of the syndrome including conductive hearing loss.
Symptoms of the craniosynostosis syndromes can include stapes ankylosis, a fixed ossicular chain in a too small epitympanum, and small or even absent mastoids. The proband was treated with a boneanchored hearing aid (BAHA) instead of reconstructive middle ear surgery. Current literature on the results of ear surgery is reviewed. In general, reconstructive middle ear surgery should only be considered if congenital anomalies of the middle ear are the only presenting symptom. In cases with additional anomalies such as atresia of the ear canal or damage due to chronic ear infections, the outcome of reconstructive surgery to correct the anomalous ossicular chain is unsatisfactory. In such cases the BAHA is probably the best solution.
A case report of a six-year-old child is presented, who had had a unilateral sensorineural hearing loss for several years. Because of impairment in the ABR as well as in the caloric testing a MRI and CT scan were performed. A 17 mm tumour in the cerebellopontine angle (CPA) was detected, which after suboccipital surgery proved to be a rhabdomyoma. This tumour has not been described before in the CPA. Unilateral sensorineural hearing loss should, at all ages, be an indication for further (radiodiagnostic) investigations.
The farrowing crate has been designed to prevent crushing of newborn piglets but restricts sow movement throughout lactation with the result of sow problems such as stereotypies and leg weakness. To improve the sows' and piglets' welfare and meet the requirements of commercial production, the combination of individual farrowing crates, to control the piglet mortality in the first stage, with group housed multisuckling systems to restore the social environment of the sow have been investigated (Petchy, Dodsworth and English, 1978; Bryant, Rowlinson and Steen, 1983; Andersson and Andreasson, 1992; Sinclair, 1993). The change of environment can, however, lead to problems of the sows fighting on the day of mixing and possible increase in piglet mortality by crushing (Andersson and Andreasson, 1992, Sinclair, 1993). The use of a multisuckling system with Meishan crossbreds may utilise the benefits of docile temperament, enhance pig welfare and meet the economic requirements of commercial production.
Commissural lip pits, pinna dysplasia, pre-auricular sinus and hearing loss constitute a recently described autosomal dominant branchial arch syndrome. In a large family, eight out of the 74 members were also affected by conductive hearing loss. No inner ear abnormalities could be demonstrated on the CT scans. In three patients (four ears) out of four patients (six ears), exploratory tympanotomy revealed serious ossicular chain anomalies. In one ear, round window aplasia was also present. Long-term hearing improvement could only be achieved in one ear.
On a recent (December 1990) visit to India, I had the opportunity of visiting the new excavations at Mahabalipuram (Māmallapuram) 50 km. south of Madras, carried out in 1990 by the Archaeological Department of Tamilnadu, and still in progress.
The work is in the area immediately to the north of the ‘Shore’ temple. So far uncovered is an apsidal-shaped tank, its curved end aligned south towards the middle portion of the shore temple. This middle portion consists of a mandapa enclosing a rock-cut image of reclining Visnu, Anantaśayana. From the eroded nature of this piece, and the fact that the Pallava structure over it was clearly an addition, I have long felt this Anantaśayana to antedate the shore temple. The erection of the latter would thus have ‘converted’ this area to Śaiva use, since, as extant, the shore temple consists of two cellae with liiigas, one to the East of the Visnu-figure, the other to the West.
Soil mineralization and nitrification rates were measured in (1) undisturbed and felled gaps of varying size in terra firme forest, and (2) along a forest – savanna transect, on Ilha de Maracá in northern Brazil. Both rates were similar to those found in studies of other forests with a marked seasonal rainfall pattern. However, rates were much lower than those of tropical forests where there is little seasonality in rainfall. A major finding was that the highest rates were during the transition between dry and wet seasons, implying that wetting and drying may be an important initiator of soil nitrogen flux. Felling had little effect on either process up to a gap size of 2500 m2. In the forest-savanna study, nitrogen mineralization was lower in the savanna in all seasons, but in the wet season when the savanna soils were water-logged NH4+-N was immobilized. Experimental additions of nutrients identified two important results; first that added NH4+-N was quickly immobilized rather than nitrified – this may be an important nutrient conservation mechanism, and second that soil calcium appeared to be a limiting factor, either directly or through a pH effect.
A large–scale mating disruption trial for the control of Pectinophora gossypiella (Saund.) was carried out in the Fayoum Province of Egypt during the 1981 cotton season. Two areas, each of 50 ha, were sprayed with a microencapsulated formulation of the sex pheromone (a 1:1 mixture of (Z, Z)- and (Z, E)-1, 11-hexadecadienyl acetate) as the sole means of controlling this pest. Five applications of 10 g a.i./ha were made during the season using fixed-wing aircraft. The pheromone treatments were compared with conventional insecticide spray treatments in two other 50-ha areas of cotton. From comparisons of treatments in terms of various plant damage criteria including the percentage of rosetted flowers, percentage boll infestation, gross yield of seed cotton and lint quality, it was concluded that the pheromone treatment was equal in effect to the insecticide sprays.