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Takotsubo cardiomyopathy has been associated with the use of catecholamines; however, its development after the use of nebulised adrenaline for the management of acute airway obstruction has not previously been described.
A 66-year-old man with squamous cell carcinoma of the larynx, with tumour–node–metastasis staging of T3N2cM0, confirmed by biopsy and computed tomography, presented to the emergency department with acute airway obstruction. He was treated twice with nebulised adrenaline and intravenous dexamethasone. After a period of 24 hours, cardiac rhythm changes were noted on telemetry. A 12-lead electrocardiogram showed widespread T-wave inversion and QT prolongation suggestive of an acute coronary syndrome. Coronary angiography demonstrated no coronary artery disease, but left ventricular angiography showed marked apical ballooning and apical wall akinesia consistent with a diagnosis of takotsubo cardiomyopathy.
Takotsubo cardiomyopathy can mimic true ischaemic heart disease and the diagnosis requires a high index of suspicion in patients managed with nebulised adrenaline.
A description is given of a radar facility operating in New Zealand which measures the atmospheric trajectories and hence heliocentric orbits of earth-impacting meteoroids having radiants with declinations +5° < δ < −30° down to a limiting radar meteor magnitude of +13 (corresponding to particle sizes of ~100 μm, masses ~10−6 g). The data handling capacity of the facility permits recording, orbit reduction and efficient presentation of orbital data using graphical packages to be carried out on a routine basis. The daily yield is ~1500 individual orbits with >3×105 secured to date; this is greater than the number determined in all previous meteoroid orbit surveys combined and forms a major southern hemisphere database for dynamical studies of the solar system meteoroid population.
Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.
We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).
One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (pdiscovery = 3.82 × 10−8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (pdiscovery+replication = 1.10 × 10−6) with evidence of heterogeneity.
Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.
We examined multistate outbreaks attributed to raw tomatoes in the United States from 1990 to 2010. We summarized the demographic and epidemiological characteristics of 15 outbreaks resulting in 1959 illnesses, 384 hospitalizations, and three deaths. Most (80%) outbreaks were reported during 2000–2010; 73% occurred May–September. Outbreaks commonly affected adult (median age 34 years) women (median 58% of outbreak cases). All outbreaks were caused by Salmonella [serotypes Newport (n = 6 outbreaks), Braenderup (n = 2), Baildon, Enteritidis, Javiana, Montevideo, Thompson, Typhimurium (n = 1 each); multiple serotypes (n = 1)]. Red, round (69% of outbreaks), Roma (23%), and grape (8%) tomatoes were implicated. Most (93%) outbreaks were associated with tomatoes served predominantly in restaurants. However, traceback investigations suggested that contamination occurred on farms, at packinghouses, or at fresh-cut processing facilities. Government agencies, academia, trade associations, and the fresh tomato industry should consider further efforts to identify interventions to reduce contamination of tomatoes during production and processing.
An jet in cross-flow (JICF) of air is studied using three-dimensional direct numerical simulation with and without chemical reaction in order to investigate the role of the complex JICF turbulent flow field in the mechanism of fast fuel-oxidant mixing and of aerodynamic flame stabilization in the near field of the jet nozzle. Focus is on delineating the flow/mixing/chemistry conditions that are necessary and/or sufficient to achieve flame anchoring that ultimately enables the formulation of more reliable and precise guidelines for design of fuel injection nozzles. A mixture averaged diffusion formulation that includes the effect of thermal diffusion is used along with a detailed chemical kinetics mechanism for hydrogen–air combustion. A new parametrization technique is used to describe the jet trajectory: solution of Laplace’s equation upon, and then within, an opportune scalar surface anchored by Dirichlet boundary conditions at the jet nozzle and plume exit from the domain provides a smoothly varying field along the jet path. The surface is selected to describe the scalar mixing and reaction associated with a transverse jet. The derived field, , is used as a condition to mark the position along the natural jet trajectory when analysing the variation of relevant flow, mixing and reaction quantities in the present direct numerical simulation (DNS) datasets. Results indicate the presence of a correlation between the flame base location in parameter space and a region of low velocity magnitude, high enstrophy, high mixing rate and high equivalence ratio (flame root region). Instantaneously, a variety of vortical structures, well known from the literature as important contributors to fuel-oxidant mixing, are observed in both inert and reactive cases with a considerable span in length scales. Moreover, instantaneous plots from reactive cases illustrate that the most upstream flame tongues propagate close to the trailing edge of the fuel jet potential core near the jet shear layer vortex shedding position. Some degree of asymmetry with respect to the domain mid-plane in the spanwise direction is observed in the averaged fields, both for the inert and reactive cases.
The occasion for writing this chapter is a long-overdue bill that has been proposed by the South African government to reconstitute the country’s system of traditional courts. Under the apartheid regime, the state had given these tribunals its full support, but since the new democratic Constitution of 1996, their status – and, more generally, that of traditional rulers – has been uncertain. Eventually, on April 9, 2008, the government tabled a Traditional Courts Bill, confirming, although in modified terms, the courts’ civil and criminal jurisdiction.
Field experiments were conducted on two North Carolina research stations in 1999, 2000, and 2001; on-farm in Lenoir, Wayne, and Wilson counties, NC, in 2002; and on-farm in Port Royal, VA, in 2000, 2001, and 2002 to evaluate possible gains from site-specific herbicide applications at these locations. Fields were scouted for weed populations using custom software on a handheld computer linked to a Global Positioning System. Scouts generated field-specific sampling grids and recorded weed density information for each grid cell. The decision aid HADSS™ (Herbicide Application Decision Support System) was used to estimate expected net return and yield loss remaining after treatment in each sample grid of every field under differing assumptions of weed size and soil moisture conditions, assuming the field was planted with either conventional or glyphosate-resistant (GR) soybean. The optimal whole-field treatment (that treatment with the highest expected net return summed across all grid cells within a field) resulted in average theoretical net returns of $79/ha (U.S. dollars) and $139/ha for conventional and GR soybean, respectively. When the most economical treatment for each grid cell was used in site-specific weed management, theoretical net returns increased by $13/ha (conventional) and $4.50/ha (GR), and expected yield loss after treatment was reduced by 10.5 and 4%, respectively, compared with the whole-field optimal treatment. When the most effective treatment for each grid cell was used in site-specific weed management, theoretical net returns decreased by $18/ha (conventional) and $4/ha (GR), and expected yield loss after treatment was reduced by 27 and 19%, respectively, compared with the whole-field optimal treatment. Site-specific herbicide applications could have reduced the volume of herbicides sprayed by as much as 70% in some situations but increased herbicide amounts in others. On average, the whole-field treatment was optimal in terms of net return for only 35% (conventional) and 57% (GR) of grid cells.
Background. Recent studies indicate that behavioral symptoms may play a key role in decisions to institutionalize persons with Alzheimer's disease (AD), but the specific types of behavior that contribute to this increased risk have not been reliably identified. The relationship between behavioral symptoms and time to institutionalization was evaluated in a 4-year longitudinal study.
Method. A total of 410 persons with the clinical diagnosis of AD completed annual clinical evaluations to assess cognitive impairment, functional limitations, delusions, hallucinations, depressive symptoms and physical aggression. Participation rates among survivors exceeded 90% for four follow-up evaluations with complete ascertainment of mortality and institutionalization. Time to institutionalization was evaluated using proportional hazards regression models in relation to time-varying clinical features.
Results. In multivariate models, adjusted for demographic and social variables, four clinical features emerged as the predominant predictors of institutionalization: cognitive impairment level, physical aggression, hallucinations and depressive symptoms. These associations were virtually unchanged in analyses controlling for mortality.
Conclusions. Specific behavioral symptoms are important independent risk factors for institutionalization in persons with AD. Because behavioral symptoms are susceptible to therapy, efforts to modify or prevent these symptoms deserve careful consideration as a means to delay institutionalization for persons with this disease.
A strong correlation exists between the Li isotopic compositions of CarboniferousTriassic granites from the New England Batholith, and the previously inferred involvement of sedimentary and mantle/infracrustal source components. Isotopically (Nd and Sr) juvenile, low-K, Cordilleran I-type granites of the Clarence River supersuite have δ7 Li= +2·2 to +8‰ similar to those of arc magmas, the inferred source of these granites (Bryant et al. 1997). Isotopic variability within this supersuite probably arises from heterogeneity within primary mantle-derived magmas, combined with subsequent modifications through interactions with crustal materials. Oxidised, high-K granites of the Moonbi Supersuite have more homogenous and slightly lighter Li isotopic compositions (δ7 Li= +1·9 to +4·2‰). The observed range of values lies within the range of arc magmas, and is consistent with partial melting of arc shoshonites within the crust (cf. Chappell 1978) or the involvement of high-K mantle-derived magmas (cf. Shaw & Flood 1981; Landenberger & Collins 1998). S-type granites of the Bundarra (δ7 Li= −0·1 to +2·1‰; average= +1˙3‰; n=6) and Hillgrove supersuites (δ7 Li= +0·4 to +1·7‰; average= +0·8‰) define a narrow range of isotopic compositions which are, overall, lower than those observed in NEB I-type granites or generally observed in primary arc magmas. Their isotopic compositions are equivalent to those typically observed in shales (primarily δ7 Li= −3·2 to +2·0‰; Moriguti & Nakamura 1998; Teng et al. 2004). No difference is evident in the isotopic compositions of the two S-type supersuites despite inferred differences in the degree of weathering experienced by the sedimentary protolith, or differences in mineralogy of the granites. Granites of the Uralla Supersuite, which have been have formed from mixtures of local meta-igneous and meta-sedimentary components, span a broad range of values (δ7 Li= −1·3 to +3·9‰) which overlap with both the sediment-poor New England Batholith I-type intrusions of the Clarence River and Moonbi supersuites, and the S-type granites of the Bundarra and Hillgrove supersuites. Lower δ7 Li values primarily occur in lower-K plutons from the northern portion of the Uralla Supersuite.
Overall, anatexis and magma differentiation do not appear to contribute to significant fractionation of Li isotopes relative to the inferred source components. However, subtly lower δ7 Li values, evident in the three leucogranites analysed herein, imply that subtle Li isotopic fractionation may occur in association with the exsolution of an aqueous fluid. Like most isotopic systems, the Li isotopic composition of rocks is not a definitive guide to source rock compositions, but given the results herein, the present authors suggest that it may play a very useful role in understanding crustal processes.
We present the preliminary results of a frequency analysis of 1457 fundamental mode RR Lyrae (RR0) stars in the Large Magellanic Cloud (LMC) from MACHO Project photometry. We find the same classes of pulsational behavior as were found in our earlier survey of first overtone RR Lyrae (RR1) stars. Variables whose prewhitened power spectra contain one or two peaks close to the main frequency component in the original power spectra are commonly known as Blazhko-type variables. The present analysis shows the overall frequency of Blazhko-type stars in the total RR0 population analysed to date to be ≈ 10%. This is lower than the often cited Galactic field/globular rate of 20-30% (Szeidl, 1988).
The incidence rate of Blazhko-type variability in the LMC appears to be about three times higher in RR0 stars than in RR1 stars. This puts important constraints on possible models of the Blazhko effect.
The AS/AGU rat provides an alternative to experimentally produced laboratory models of basal ganglia
disorders. This mutant is characterised by disturbances of movement including clumsy gait, whole body
tremor, rigidity and difficulty in initiating movement. From an early age, there is a profound depletion of
extracellular dopamine in the dorsal caudate-putamen as measured via in vivo microdialysis; levels are only
10–20% of those found in the parent Albino Swiss (AS) strain. Subsequently a depletion of whole tissue
dopamine levels occurs and, later still, loss of dopaminergic cells in the substantia nigra pars compacta. The
dysfunction in movement and the nigrostriatal dopaminergic system are clearly linked, since movement can
be ameliorated by L-DOPA administration. Furthermore, there are depletions in glucose utilisation in several
regions of the basal ganglia circuitry, including the substantia nigra pars compacta, the subthalamic nucleus
and the ventrolateral thalamus. The AS/AGU rat represents a unique opportunity to investigate the
intrinsic factors controlling the integrity of dopaminergic systems and the recent successful positional cloning
of the agu gene will allow the molecular mechanisms underlying this interesting phenotype to be analysed.
A review of the properties of Type II Cepheids and RV Tauri stars in the Magellanic Clouds is presented. In the behaviour of their light and colour curves, the RV Tauri stars appear to be a direct extension of the Type II Cepheids to longer periods. A single P – L – C relationship describes both the Type II Cepheids and RV Tauri stars in the LMC. The derived high intrinsic magnitudes for the RV Tauri variables supports the proposition that these objects are luminous stars evolving off the AGB. Preliminary analysis of the long time-series MACHO photometry indicates one star (MACHO*05:37:45.0–69:54:16) has an obvious ‘period-quadrupled’ periodicity, which is supporting evidence for a period-doubling bifurcation transition to chaotic pulsations.