Three hearing aid selection procedures were compared to determine if any one was superior in producing prescribed real-ear insertion gain. For each of three subject groups, 12 in-the-ear style ...hearing aids with Class D circuitry and similar dispenser controls were ordered from one of three manufacturers. Subject groups were classified based on the type of information included on the hearing aid order form: (1) the subject's audiogram, (2) a three-part matrix specifying the desired maximum output, full-on gain, and frequency response slope of the hearing aid, or (3) the desired 2-cc coupler full-in grain of the hearing aid, based on real-ear coupler difference (RECD) measurements. Following electroacoustic adjustments aimed at approximating a commonly used target insertion gain formula, results revealed no significant differences among any of the three selection procedures with respect to obtaining acceptable insertion gain values.
In this paper, we present Q-U-I JOint Tenerife Experiment (QUIJOTE) 10–20 GHz observations (194 h in total over ≈250 deg2) in intensity and polarisation of G159.6-18.5, one of the most widely studied ...regions harbouring anomalous microwave emission (AME). By combining with other publicly available intensity data, we achieve the most precise spectrum of the AME measured to date in an individual region, with 13 independent data points between 10 and 50 GHz being dominated by this emission. The four QUIJOTE data points provide the first independent confirmation of the downturn of the AME spectrum at low frequencies, initially unveiled by the COSMOlogical Structures On Medium Angular Scales experiment in this region. Our polarisation maps, which have an angular resolution of ≈1° and a sensitivity of ≈ 25 μK beam−1, are consistent with zero polarisation. We obtain upper limits on the polarisation fraction of Π < 6.3 and <2.8 per cent (95 per cent C.L.), respectively, at 12 and 18 GHz (ΠAME < 10.1 and <3.4 per cent with respect to the residual AME intensity), a frequency range where no AME polarisation observations have been reported to date. The combination of these constraints with those from other experiments confirm that all the magnetic dust models based on single-domain grains, and most of those considering randomly oriented magnetic inclusions, predict higher polarisation levels than is observed towards regions with AME. Also, neither of the two considered models of electric dipole emission seems to be compatible with all the observations together. More stringent constraints of the AME polarisation at 10–40 GHz are necessary to disentangle between different models, to which future QUIJOTE data will contribute.
New prion-related disorders have emerged over the past 20 years, of which the most notable in the human context is variant Creutzfeldt-Jakob disease (CJD). This disorder is a challenge to medical and ...public health professionals seeking early detection and diagnosis, provision of therapy, and support for persons affected and a better understanding of transmission risks. The risk of iatrogenic transmission of the disease remains a significant threat, given the well documented cases of CJD transmission via surgery, organ transplantation, and blood transfusion. This review discusses our current understanding of the prevalence of variant CJD, the distribution of tissue infectivity, and new methods for the decontamination of surgical instruments. A comparison of emerging technologies is provided on the basis of our current perception of surgical risk to identify methods that are likely to provide sufficient safety margins and to stimulate debate about the standards needed to protect against variant CJD and CJD transmission.
Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit ...individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors.
All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service. Demographic data were supplemented from our prospectively maintained database. Follow-up was complete in 100% of patients.
Over the 12-month study period, 582 lung resections were performed. Five hundred fifty-four resections in 532 patients were performed with the thoracic surgical service as the primary service. Of these patients, 505 undergoing 521 resections consented for their data to be included in the study, and they all survived to 30 days. Mean age was 62.3 years (standard deviation SD, 13.8 years). The male to female ratio was 265:240. Fifteen pneumonectomies, 222 lesser anatomic resections in 215 patients, and 270 nonanatomic (wedge) resections in 261 patients were performed; 14 other miscellaneous resections were performed in 14 patients. Thirty-day mortality was 1% (5 of 510 patients). There were 4 in-hospital deaths and 1 additional mortality within 30 days. Unplanned readmissions occurred in 42 patients (42 of 505 patients 8.3%)-28 (67%) at our institution and 14 (33%) at other institutions. The median interval to readmission was 14 days. Readmissions occurred in 7.3% of patients discharged home, whereas 19.4% of patients discharged to a nursing home or other facility required readmission (p = 0.041). The most common reason for readmission was respiratory complications (47%). Significant factors (p < 0.05) associated with increased risk of readmission were lower percent predicted forced expiratory volume in 1 second (FEV
), longer operative time, perioperative furosemide administration, pain score of 6 or greater between 12 and 24 hours after the operation, prolonged air leakage (>5 days), blood transfusion, and discharge to a nursing home. Length of stay after lung resection was not a risk factor for unplanned readmission.
The unplanned readmission rate after lung resection for our cohort was 8.3%, with half resulting from respiratory issues. Risk factors in the preoperative, perioperative, and postoperative setting were identified that may provide opportunities for mitigating these adverse events.
Previous observations with HESS have revealed the existence of an extended very-high-energy (VHE; E>100 GeV) gamma-ray source, HESS J1834-087, coincident with the SNR W41. The origin of the gamma-ray ...emission has been further investigated with HESS and the Fermi-LAT. The gamma-ray data provided by 61h (HESS) and 4 yrs (Fermi LAT) of observations cover over 5 decades in energy (1.8GeV - 30TeV). The morphology and spectrum of the TeV and GeV sources have been studied and multi-wavelength data have been used to investigate the origin of the observed emission. The TeV source can be modeled with a sum of two components: one point-like and one significantly extended (sig_TeV = 0.17{\deg}), both centered on SNR W41 and exhibiting spectra described by a power law of index 2.6. The GeV source detected with Fermi is extended (sig_GeV =0.15{\deg}) and morphologically matches the VHE emission. Its spectrum can be described by a power-law with index 2.15 and joins smoothly the one of the whole TeV source. A break appears in the spectra around 100 GeV. Two main scenarios are proposed to explain the emission: a pulsar wind nebula (PWN) or the interaction of SNR W41 with a molecular cloud. X-ray observations suggest the presence of a point-like source (pulsar candidate) near the center of the SNR and non-thermal X-ray diffuse emission which could arise from a potential PWN. The PWN scenario is supported by the match of of the TeV and GeV positions with the putative pulsar. However, the overall spectrum is reproduced by a 1-zone leptonic model only if an excess of low-energy electrons is injected by a high spin-down power pulsar. This low-energy component is not needed if the point-like TeV source is unrelated to the extended GeV and TeV sources. The interacting SNR scenario is supported by the spatial coincidence between the gamma-ray sources, the detection of OH maser lines and the hadronic modeling.
Planck intermediate results Ade, P A R; Aghanim, N; Arnaud, M ...
Astronomy and astrophysics (Berlin),
12/2016, Letnik:
596
Journal Article
Recenzirano
Odprti dostop
The Planck mission, thanks to its large frequency range and all-sky coverage, has a unique potential for systematically detecting the brightest, and rarest, submillimetre sources on the sky, ...including distant objects in the high-redshift Universe traced by their dust emission. A novel method, based on a component-separation procedure using a combination of Planck and IRAS data, has been validated and characterized on numerous simulations, and applied to select the most luminous cold submillimetre sources with spectral energy distributions peaking between 353 and 857GHz at 5' resolution. A total of 2151 Planck high-z source candidates (the PHZ) have been detected in the cleanest 26% of the sky, with flux density at 545GHz above 500mJy. Embedded in the cosmic infrared background close to the confusion limit, these high-z candidates exhibit colder colours than their surroundings, consistent with redshifts z> 2, assuming a dust temperature of T sub(xgal)= 35K and a spectral index of beta sub(xgal)= 1.5. Exhibiting extremely high luminosities, larger than 10 super(14)L sub(middot in circle), the PHZ objects may be made of multiple galaxies or clumps at high redshift, as suggested by a first statistical analysis based on a comparison with number count models. Furthermore, first follow-up observations obtained from optical to submillimetre wavelengths, which can be found in companion papers, have confirmed that this list consists of two distinct populations. A small fraction (around 3%) of the sources have been identified as strongly gravitationally lensed star-forming galaxies at redshift 2 to 4, while the vast majority of the PHZ sources appear as overdensities of dusty star-forming galaxies, having colours consistent with being at z> 2, and may be considered as proto-cluster candidates. The PHZ provides an original sample, which is complementary to the Planck Sunyaev-Zeldovich Catalogue (PSZ2); by extending the population of virialized massive galaxy clusters detected below z< 1.5 through their SZ signal to a population of sources at z> 1.5, the PHZ may contain the progenitors of today's clusters. Hence the Planck list of high-redshift source candidates opens a new window on the study of the early stages of structure formation, particularly understanding the intensively star-forming phase at high-z.
To elucidate the molecular basis for the interaction of ligands with the human melanocortin-4 receptor (hMC4R), agonist structure−activity studies and receptor point mutagenesis were performed. ...Structure−activity studies of Nle4,d-Phe7-α-melanocyte stimulating hormone (NDP-MSH) identified d-Phe7-Arg8-Trp9 as the minimal NDP-MSH fragment that possesses full agonist efficacy at the hMC4R. In an effort to identify receptor residues that might interact with amino acids in this tripeptide sequence 24 hMC4R transmembrane (TM) residues were mutated (the rationale for choosing specific receptor residues for mutation is outlined in the Results section). Mutation of TM3 residues D122 and D126 and TM6 residues F261 and H264 decreased the binding affinity of NDP-MSH 5-fold or greater, thereby identifying these receptor residues as sites potentially involved in the sought after ligand−receptor interactions. By examination of the binding affinities and potencies of substituted NDP-MSH peptides at receptor mutants, evidence was found that core melanocortin peptide residue Arg8 interacts at a molecular level with hMC4R TM3 residue D122. TM3 mutations were also observed to decrease the binding of hMC4R antagonists. Notably, mutation of TM3 residue D126 to alanine decreased the binding affinity of AGRP (87−132), a C-terminal derivative of the endogenous melanocortin antagonist, 8-fold, and simultaneous mutations D122A/D126A completely abolished AGRP (87−132) binding. In addition, mutation of TM3 residue D122 or D126 decreased the binding affinity of hMC4R antagonist SHU 9119. These results provide further insight into the molecular determinants of hMC4R ligand binding.
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