We have studied the archetypal Gigahertz Peaked Spectrum radio galaxy, PKS 1934 -- 638, using the Australian Long Baseline Array augmented with two new telescopes that greatly improve the angular ...resolution of the array. These very long baseline interferometry observations represent the first scientific results from a new antenna in New Zealand and the first antenna of the Australian SKA Pathfinder. A compact double radio source, PKS 1934 -- 638 has been monitored over a period of 40 years and the observation described here provides the latest datum, eight years after the previous observation, to aid in the study of the long-term evolution of the source structure. We take advantage of these new long baselines to probe PKS 1934 -- 638 at the relatively low frequency of 1.4 GHz in order to examine the effects of optical depth on the structure of the radio source. Optical depth effects, resulting in the observation of frequency-dependent structure, may have previously been interpreted in terms of an expansion of the source as a function of time. Expansion and frequency-dependent effects are important to disentangle in order to estimate the age of PKS 1934 -- 638. We show that frequency-dependent structure effects are likely to be important in PKS 1934 -- 638 and present a simple two-dimensional synchrotron source model in which opacity effects due to synchrotron self-absorption are taken into account. Evidence for expansion of the radio source over 40 years is therefore weak with consequences for the estimated age of the radio source.
Understanding the relative importance of larval supply vs. post-settlement mortality underlies studies of marine invertebrate recruitment, yet is often hampered by researchers' inability to identify ...species among morphologically similar larvae or early juveniles. In New Zealand, two species of co-occurring intertidal mytilid mussels have morphologically indistinguishable settlers: the blue mussel
Mytilus galloprovincialis, which is often numerically dominant in the mid-zone of the rocky intertidal, and the ribbed mussel
Aulacomya atra maoriana which is often much less abundant. In this study, we obtained samples of newly settled mussels from 6 sample dates April-May 2005 from the rocky intertidal in Wellington Harbour, New Zealand. We used PCR-RFLP of the cytochrome c oxidase subunit I (COI) mitochondrial gene region to identify settlers to species. Of a total of 224 settlers that could be identified, 64% were identified as
Mytilus galloprovincialis and 36% as
Aulocomya atra maoriana. The percentage of
A. atra maoriana in the samples was unexpectedly high and ranged from 22–50% among the sample dates. This study reinforces the need to quantify larval supply at the species level to understand the relative importance of pre- and post-settlement mortality, and also demonstrates the usefulness of the COI region as a species-specific marker for identifying mussel larvae and juveniles.
Differences in habitat use of sympatric species are influenced by variability in functional morphology and life history trade-offs and are expected to shape species resilience to environmental ...change. To determine differences in year-round habitat use and gain insight into how morphological and life history traits influence foraging of an albatross community from subantarctic Macquarie Island, Australia (54.6° S, 158.9° E), we quantified the physical features associated with high residence time for 10 black-browed Thalassarche melanophris; 10 grey-headed T. chrysostoma; 15 light-mantled Phoebetria palpebrata; and 12 wandering albatrosses Diomedea exulans tracked in 1994−2009. Overlap among the 4 species was greatest close to the island during the breeding season, extending north into the Tasman Sea. Nevertheless, black-browed albatrosses ranged more locally than the other species, perhaps because they have a shorter breeding cycle and morphological traits that result in less efficient flight and greater capacity to outcompete other species for prey. Nonbreeding albatrosses showed high variability in habitat use across wide ocean expanses, but all used productive frontal regions and mesoscale eddies. Increased residence times during the breeding and nonbreeding periods were associated with moderate wind speeds for all species (excluding breeding black-browed albatrosses), indicating that birds used areas where aerodynamic performance was enhanced. Given patterns in residence time at sea, and the functional and life history adaptations of each species, we suggest that black-browed albatrosses breeding on Macquarie Island will be more vulnerable to expected future climatedriven changes to wind patterns in the Southern Ocean, and potential latitudinal shifts in the Subantarctic Front.
Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter- and ...language-concordant clinicians may help overcome these problems but few studies have compared these approaches.
To compare self-reported communication and visit ratings for LEP Asian immigrants whose visits involve either a clinic interpreter or a clinician speaking their native language.
Cross-sectional survey-response rate 74%.
Two thousand seven hundred and fifteen LEP Chinese and Vietnamese immigrant adults who received care at 11 community-based health centers across the U.S.
Five self-reported communication measures and overall rating of care.
Patients who used interpreters were more likely than language-concordant patients to report having questions about their care (30.1% vs 20.9%, P<.001) or about mental health (25.3% vs 18.2%, P=.005) they wanted to ask but did not. They did not differ significantly in their response to 3 other communication measures or their likelihood of rating the health care received as "excellent" or "very good" (51.7% vs 50.9%, P=.8). Patients who rated their interpreters highly ("excellent" or "very good") were more likely to rate the health care they received highly (adjusted odds ratio 4.8, 95% confidence interval, 2.3 to 10.1).
Assessments of communication and health care quality for outpatient visits are similar for LEP Asian immigrants who use interpreters and those whose clinicians speak their language. However, interpreter use may compromise certain aspects of communication. The perceived quality of the interpreter is strongly associated with patients' assessments of quality of care overall.
Purpose of Review
Adequate oxygen delivery is essential for life, with hypoxia resulting in dysfunction, and ultimately death, of the cells, organs and organism. Blood flow delivers the oxygen bound ...in the blood, while haemodynamics is the science of blood flow. Stroke volume (SV) is the fundamental unit of blood flow, and reflects the interdependent performance of the heart, the vessels and the autonomic nervous system. However, haemodynamic management remains generally poor and predominantly guided by simple blood pressure observations alone.
Recent Findings
Doppler ultrasound measures SV with unequalled clinical precision when operated by trained personnel. Combining SV with BP measurements allows calculation of flow-pressure based measures which better reflect cardiovascular performance and allows personalised physiologic and pathophysiologic modelling consistent with Frank’s and Starling’s observations.
Summary
Doppler SV monitoring and novel flow-pressure parameters may improve our understanding of the cardiovascular system and lead to improved diagnosis and therapy. This review examines the physics and practice of Doppler SV monitoring and its application in advanced haemodynamics.
With a rapid proliferation of clinical trials to study novel medical treatments for CRS, the objective of this study was to study the minimal clinically important difference (MCID) of the 22-item ...Sinonasal Outcome Test (SNOT-22) in medically-managed CRS patients.
A total of 183 medically-treated CRS patients were recruited. All patients completed a SNOT-22 at enrollment and subsequent follow up visit. Distribution and anchor-based methods were used for MCID calculation. These data were combined with data from a previously published study on SNOT-22 MCID in 247 medically managed CRS patients to determine a final recommended MCID value using the combined cohort of 430 patients.
In our cohort, distribution- and anchor-based methods -"using both sinus-specific and general health anchors-"provided greatest support for a 12-point SNOT-22 MCID, which had approximately 55% sensitivity but 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. In the combined cohort of 430 patients, we also found greatest support for a 12-point SNOT-22 MCID, which had approximately 57% sensitivity and 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. We also find evidence that the MCID value may be higher in CRS patients without nasal polyps compared to those with nasal polyps.
Our results - which include data from patients from two different institutions and regions - confirm a SNOT-22 MCID of 12 in medically managed CRS patients. The SNOT-22 MCID was specific but not sensitive for identifying CRS patients experiencing improvement in symptoms or general health.
A pharmacokinetic-pharmacodynamic study of a long-acting GH Nutropin Depot; somatropin (rDNA origin) for injectable suspension was performed in 25 patients with adult GH deficiency. Single doses of ...0.25 mg/kg and 0.5 mg/kg, based on ideal body weight, were administered sc. After either dose, serum GH concentrations rose rapidly in both sexes. In men, the lower dose maintained serum IGF-I levels within 1 sd of the mean for age and sex for 14–17 d; the higher dose raised IGF-I levels 2 sd above the mean. In most women, all of whom were receiving oral estrogen, the lower dose did not normalize IGF-I levels; the higher dose maintained IGF-I near the mean for approximately 14 d. Increases in IGF binding protein-3 and acid-labile subunit levels were observed in both sexes; however, a sex-related difference was not obvious. Fasting glucose and insulin concentrations were transiently elevated in men receiving the higher dose. Patients tolerated the injections well. We concluded that a single injection of Nutropin Depot at these doses in patients with adult GH deficiency increased serum IGF-I to within normal limits for 14–17 d. Estrogen-treated women required approximately twice the dose needed in men to produce comparable IGF-I concentrations.
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