When intracranial aneurysms are deemed nonclippable, an accepted alternative neurosurgical treatment is to reinforce the aneurysm wall by wrapping or coating it with various materials, including ...muslin (cotton gauze). Granulomatous or "foreign-body" reactions, sometimes referred to as "muslinomas" or "gauzomas," and adhesive arachnoiditis are known but rare complications. Experience with MRI in these cases is limited. We describe the clinical and MRI features of a muslinoma developing after treatment of an anterior communicating artery aneurysm.
We present a spectroscopic analysis of the black hole binary Nova Muscae 1991 in quiescence using data obtained in 2009 with Magellan Echelette on the Magellan Clay telescope and in 2010 with IMACS ...on the Magellan Baade telescope at the Las Campanas Observatory. Emission from the disc is observed in Hα, Hβ and Ca ii (λ8662). A prominent hotspot is observed in the Doppler maps of all three emission lines. The existence of this spot establishes ongoing mass transfer from the donor star in 2009–2010 and, given its absence in the 1993–1995 observations, demonstrates the presence of a variable hotspot in the system. We find the radial distance to the hotspot from the black hole to be consistent with the circularization radius. Our tomograms are suggestive of stream–disc overflow in the system. We also detect possible Ca ii (λ8662) absorption from the donor star.
CONTEXT Under routine hospital conditions handwashing compliance of health care workers including nurses, physicians, and others (eg, physical therapists and radiologic technicians) is unacceptably ...low. OBJECTIVES To investigate the efficacy of an education/feedback intervention and patient awareness program (cognitive approach) on handwashing compliance of health care workers; and to compare the acceptance of a new and increasingly accessible alcohol-based waterless hand disinfectant (technical approach) with the standard sink/soap combination. DESIGN A 6-month, prospective, observational study. SETTING One medical intensive care unit (ICU), 1 cardiac surgery ICU, and 1 general medical ward located in a 728-bed, tertiary care, teaching facility. PARTICIPANTS Medical caregivers in each of the above settings. INTERVENTIONS Implementation of an education/feedback intervention program (6 in-service sessions per each ICU) and patient awareness program, followed by a new, increasingly accessible, alcohol-based, waterless hand antiseptic agent, initially available at a ratio of 1 dispenser for every 4 patients and subsequently 1 for each patient. MAIN OUTCOME MEASURE Direct observation of handwashing for 1575 potential opportunities monitored over 120 hours randomized for both time of day and bed locations. RESULTS Baseline handwashing compliance before and after defined events was 9% and 22% for health care workers in the medical ICU and 3% and 13% for health care workers in the cardiac surgery ICU, respectively. After the education/feedback intervention program, handwashing compliance changed little (medical ICU, 14% before and 25% after; cardiac surgery ICU, 6% before and 13% after). Observations after introduction of the new, increasingly accessible, alcohol-based, waterless hand antiseptic revealed significantly higher handwashing rates (P<.05), and handwashing compliance improved as accessibility was enhanced—before 19% and after 41% with 1 dispenser per 4 beds; and before 23% and after 48% with 1 dispenser for each bed. CONCLUSIONS Education/feedback intervention and patient awareness programs failed to improve handwashing compliance. However, introduction of easily accessible dispensers with an alcohol-based waterless handwashing antiseptic led to significantly higher handwashing rates among health care workers.Arch Intern Med. 2000;160:1017-1021-->
ABSTRACT
We present observations and analysis of 18 stripped-envelope supernovae observed during 2013–2018. This sample consists of five H/He-rich SNe, six H-poor/He-rich SNe, three narrow lined SNe ...Ic, and four broad lined SNe Ic. The peak luminosity and characteristic time-scales of the bolometric light curves are calculated, and the light curves modelled to derive 56Ni and ejecta masses (MNi and Mej). Additionally, the temperature evolution and spectral line velocity curves of each SN are examined. Analysis of the O i line in the nebular phase of eight SNe suggests their progenitors had initial masses <20 M⊙. The bolometric light curve properties are examined in combination with those of other SE events from the literature. The resulting data set gives the Mej distribution for 80 SE–SNe, the largest such sample in the literature to date, and shows that SNe Ib have the lowest median Mej, followed by narrow-lined SNe Ic, H/He-rich SNe, broad-lined SNe Ic, and finally gamma-ray burst SNe. SNe Ic-6/7 show the largest spread of Mej ranging from ∼1.2–11 M⊙, considerably greater than any other subtype. For all SE–SNe = 2.8 ± 1.5 M⊙ which further strengthens the evidence that SE–SNe arise from low-mass progenitors which are typically <5 M⊙ at the time of explosion, again suggesting MZAMS <25 M⊙. The low and lack of clear bimodality in the distribution implies <30 M⊙ progenitors and that envelope stripping via binary interaction is the dominant evolutionary pathway of these SNe.
Opinions diverge on the extent to which insurers are to blame for poor trial enrollment, but everyone seems to agree it is not the only barrier. "Many fingers have been pointed at insurance coverage ...policy as the reason there aren't more patients in clinical trials," Diana Petitti, M.D. said, but available evidence suggests the problem is more complicated.
Ascites Reynolds, T B
Clinics in liver disease
4, Številka:
1
Journal Article
Recenzirano
This article reviews the progress made during the last century in understanding and managing ascites. The list of known causes of ascites has lengthened considerably. There is improved understanding ...of the mechanism of ascites formation and the pathophysiology of the renal sodium retention that accompanies portal hypertensive ascites. Management of ascites has become substantially easier with the advent of new diuretics, and new procedures such as peritoneovenous shunting, transjugular intrahepatic portosystemic stent placement, and liver transplantation.
Cave environments are generally nutrient-poor, but can contain patches of limiting nutrients such as nitrogen in association with bats. Pseudogymnoascus destructans, the causative agent of White-nose ...Syndrome in bats, is thought to have recently emerged from cave soil saprotrophs. To determine whether changes in nitrate assimilation from a nutrient-limited to nitrate-rich environment could help explain the emergence of P. destructans as a pathogen, we analyzed the evolution of nitrate assimilation clusters in members of the genus. By screening the genomes of 21 members of the Pseudogymnoascus, we identified a very recent duplication of the high affinity nitrate transporter (NRT2) in P. destructans. Analyses of gene phylogeny, secondary structure, and evolutionary rates suggest the NRT2 paralog is functionally divergent, providing P. destructans a higher capacity for nitrate uptake. Such genomic changes may enhance the growth of P. destructans in bat-associated cave environments.
•Pseudogymnoascus destructans has a recently duplicated nitrate transporter (NRT2).•Phylogenomics supports relationship of P. destructans and Pseudogymnoascus verrucosus.•P. destructans has greater nitrate uptake capacity than close relatives.
Phosgene is classified as a chemical warfare agent, yet data on its short-duration high concentration toxicity in a nose-only exposure rat model is sparse and inconsistent. Hence, an exposure system ...for short-term/high concentration exposure was developed and characterized. Herein, we report the median lethal concentration (LC
50
) for a 10-min nasal exposure of phosgene in a 24-h rat survival model. Male Wistar rats (Envigo) weighing 180-210 g on the day of exposure, were exposed to phosgene gas via nose-only inhalation using a system specifically designed to allow the simultaneous exposure and quantification of phosgene. After 24 h, the surviving rats were euthanized, the lung/body mass ratio determined, and lung tissues analyzed for histopathology. Increased terminal airway edema in the lungs located primarily at the alveoli (resulting in an increased lung/body mass ratio) coincided with the observed mortality. An LC
50
value of 129.2 mg/m
3
for a 10-min exposure was determined. Furthermore, in agreement with other highly toxic compounds, this study reveals a LC
50
concentration value supportive of a nonlinear toxic load model, where the toxic load exponent is >1 (n
e
= 1.17). Thus, in line with other chemical warfare agents, phosgene toxicity is predicted to be more severe with short-duration, high-concentration exposures than long-duration, low-concentration exposures. This model is anticipated to be refined and developed to screen novel therapeutics against relevant short-term high concentration phosgene exposures expected from a terrorist attack, battlefield deployment, or industrial accident.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Synchrotron grazing incidence X-ray diffraction has been used to newly reveal the heating rate dependent oxidation reactions that develop on a polycrystalline nickel-based superalloy. A continuous ...layer of precursor oxide was shown to form during the heating stage. Their approximate growth rates, their effect on local surface compositions of the alloy substrate, and their degree of interface planarity are considered critical in determining subsequent oxidation reactions when held for extended thermal exposures. The precursor oxides were predominantly nickel or cobalt based (NiO/CoO and Co3O4/NiCo2O4). Following the fastest heating rates (40 °C min−1 and above), the stable Cr2O3 phase formed, inhibiting Ni or Co diffusion to the surface. At slower heating rates (10–20 °C min−1), no evidence of the stable Cr2O3 was found, even after 200 h at elevated thermal exposure, instead continued growth of the precursor oxides was observed. Heating at 5 °C min−1 gave rise to an intriguing zone where sufficient precursor and favourable kinetics enabled the formation of a spinel, NiCr2O4, surface layer. Cross sections observed with electron microscopy confirmed this to be planar and continuous. Heating at the slowest tested 2 °C min−1 contrarily gives a non-protective surface layer comprising an outwardly growing NiO/CoO precursor oxide on top of an inwardly growing mixed oxide. The quantities, interfacial morphologies of oxides of the precursor oxide grown and the possible thermodynamic reactions that lead to their formation are discussed.
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