Endoscopy-related injury (ERI) is common in gastroenterologists (GI). The study aim was to assess the prevalence of self-reported ERI, patterns of injury, and endoscopist knowledge of preventative ...strategies in a nationally representative sample.
A 38-item electronic survey was sent to 15,868 American College of Gastroenterology physician members. The survey was completed by 1,698 members and was included in analyses. Descriptive, univariate, and multivariate analyses were conducted to evaluate the likelihood of ERI based on workload parameters and gender.
ERI was reported by 75% of respondents. ERI was most common in the thumb (63.3%), neck (59%), hand/finger (56.5%), lower back (52.6%), shoulder (47%), and wrist (45%). There was no significant difference in the prevalence of ERI between men and women GI. However, women GI were significantly more likely to report upper extremity ERI while men were more likely to report lower-back pain-related ERI. Significant gender differences were noted in the reported mechanisms attributed to ERI. Most respondents did not discuss ergonomic strategies in their current practice (63%). ERI was less likely to be reported in GI who took breaks during endoscopy (P = 0.002).
ERI is highly prevalent in GI physicians. Significant gender differences regarding specific sites affected by ERI and the contributing mechanisms were observed. Results strongly support institution of training in ergonomics for all GI as a strategy to prevent its impact on providers of endoscopy.
The Plasma and Suprathermal Ion Composition (PLASTIC) investigation provides the in situ solar wind and low energy heliospheric ion measurements for the NASA Solar Terrestrial Relations Observatory ...Mission, which consists of two spacecraft (STEREO-A, STEREO-B). PLASTIC-A and PLASTIC-B are identical. Each PLASTIC is a time-of-flight/energy mass spectrometer designed to determine the elemental composition, ionic charge states, and bulk flow parameters of major solar wind ions in the mass range from hydrogen to iron. PLASTIC has nearly complete angular coverage in the ecliptic plane and an energy range from ∼0.3 to 80 keV/e, from which the distribution functions of suprathermal ions, including those ions created in pick-up and local shock acceleration processes, are also provided.
We present a detailed analysis of week-long simultaneous observations of the blazar Mrk 421 at 2-60 keV X-rays (RXTE) and TeV -rays (Whipple and HEGRA) in 2001. Accompanying optical monitoring was ...performed with the Mt. Hopkins 48 inch telescope. The unprecedented quality of this data set enables us to establish the existence of the correlation between the TeV and X-ray luminosities, and also to start unveiling some of its characteristics, in particular its energy dependence and time variability. The source shows strong variations in both X-ray and -ray bands, which are highly correlated. No evidence of an X-ray/-ray interband lag tau is found on the full week data set, with tau image 3 ks. A detailed analysis of the March 19 flare, however, reveals that data are not consistent with the peak of the outburst in the 2-4 keV X-ray and TeV band being simultaneous. We estimate a image ks TeV lag. The amplitudes of the X-ray and -ray variations are also highly correlated, and the TeV luminosity increases more than linearly with respect to the X-ray one. The high degree of correlation lends further support to the standard model in which a unique electron population produces the X-rays by synchrotron radiation and the -ray component by inverse Compton scattering. However, the finding that for the individual best observed flares the -ray flux scales approximately quadratically with respect to the X-ray flux poses a serious challenge to emission models for TeV blazars, as it requires rather special conditions and/or fine tuning of the temporal evolution of the physical parameters of the emission region. We briefly discuss the astrophysical consequences of these new findings in the context of the competing models for the jet emission in blazars.
Background
The association between preoperative use of infliximab and postoperative complications in patients with inflammatory bowel disease (IBD) is a subject of continued debate. Results from ...studies examining an association between the timing of last preoperative dose of infliximab and postoperative complications remain inconsistent.
Aims
To assess whether timing of last dose of infliximab prior to surgery affects the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis.
Methods
Retrospective chart review of IBD patients who have undergone surgery while receiving therapy with infliximab was conducted. Forty-seven patients were included in the analysis.
Results
No significant association was found between timing of infliximab and the rate of postoperative complications. Age, gender, disease type, steroid use, preoperative status, surgery type, or surgeon type was not associated with increased rate of postoperative complications.
Conclusion
Timing of last dose of infliximab does not affect the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis.
Geological, geophysical, and geochemical data support a theory that Earth experienced several intervals of intense, global glaciation ("snowball Earth" conditions) during Precambrian time. This ...snowball model predicts that postglacial, greenhouse-induced warming would lead to the deposition of banded iron formations and cap carbonates. Although global glaciation would have drastically curtailed biological productivity, melting of the oceanic ice would also have induced a cyanobacterial bloom, leading to an oxygen spike in the euphotic zone and to the oxidative precipitation of iron and manganese. A Paleoproterozoic snowball Earth at 2.4 Giga-annum before present (Ga) immediately precedes the Kalahari Manganese Field in Southern Africa, suggesting that this rapid and massive change in global climate was responsible for its deposition. As large quantities of O2are needed to precipitate this Mn, photosystem II and oxygen radical protection mechanisms must have evolved before 2.4 Ga. This geochemical event may have triggered a compensatory evolutionary branching in the Fe/Mn superoxide dismutase enzyme, providing a Paleoproterozoic calibration point for studies of molecular evolution.
The Electron Drift Instrument for MMS Torbert, R. B.; Vaith, H.; Granoff, M. ...
Space Science Reviews,
03/2016, Letnik:
199, Številka:
1-4
Journal Article, Book Review
Recenzirano
Odprti dostop
The Electron Drift Instrument (EDI) on the Magnetospheric Multiscale (MMS) mission measures the in-situ electric and magnetic fields using the drift of a weak beam of test electrons that, when ...emitted in certain directions, return to the spacecraft after one or more gyrations. This drift is related to the electric field and, to a lesser extent, the gradient in the magnetic field. Although these two quantities can be determined separately by use of different electron energies, for MMS regions of interest the magnetic field gradient contribution is negligible. As a by-product of the drift determination, the magnetic field strength and constraints on its direction are also determined. The present paper describes the scientific objectives, the experimental method, and the technical realization of the various elements of the instrument on MMS.
Malignant gastroduodenal obstruction can occur in up to 20% of patients with primary pancreatic, gastric or duodenal carcinomas. Presenting symptoms include nausea, vomiting, abdominal distention, ...pain and decreased oral intake which can lead to dehydration, malnutrition, and poor quality of life. Endoscopic stent placement has become the primary therapeutic modality because it is safe, minimally invasive, and a cost-effective option for palliation. Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement, shorter time to resumption of an oral diet, and shorter hospital stays as compared with surgical options. Recurrence of the obstructive symptoms resulting from stent occlusion, due to tumor ingrowth or overgrowth, can be successfully treated with repeat endoscopic stent placement in the majority of the cases. Both endoscopic stenting and surgical bypass are considered palliative treatments and, to date, no improvement in survival with either modality has been demonstrated. A tailored therapeutic approach, taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist, surgeon, medical oncologist, radiation therapist, and interventional radiologist, should be considered in all cases.
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